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Risks of complaints and adverse disciplinary findings against international medical graduates in Victoria and Western Australia

To the Editor: Elkin and colleagues acknowledged that “most [international studies] have found no association” between acquiring a medical degree overseas and being the subject of a complaint;1 however, their principal findings — which differ from these other studies — require care in interpretation.

In the study by Elkin et al, the “clinical specialty was missing” for 75% of registered doctors. Yet, certain medical specialties are associated with a higher risk of attracting complaints. In one US study, surgeons attracted significantly more lawsuits than non-surgeons.2 Therefore, a disproportionate number of complaints involving international medical graduates (IMGs) could have been owing to working in, for instance, surgical specialties.

Further, neither “race” nor ethnicity was examined. In an analysis of 14 314 doctors in the United States, non-white professionals were at significantly greater risk of being disciplined than their white counterparts.3 Similar findings for the United Kingdom have been published.4 The authors of the British study referred to “possible…