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

To the Editor: While using medical board data for research purposes is very welcome, I have some reservations about ethical aspects of the study by Elkin and colleagues.1 Prospective ethics review of human research is intended to protect participants from foreseeable and avoidable harm. I suggest that, in this instance, avoidable harm has resulted, through generalised adverse and possibly unfair publicity about particular groups of international medical graduates.

Although identifying “complainant factors” as one source of potential bias, the authors interpreted the data as if this potential bias could be ignored. The surprising difference in complaint frequency between Victoria and Western Australia might say something about these complainant factors, but this is left unremarked. In addition, they failed to identify another potential source of bias in the outcome data, namely the potential for medical board adjudicators to assess complaints in a prejudiced way. Without knowledge of the nature of the complaints, the investigative findings and the outcomes that resulted, readers cannot assess the possible existence and impact of such biases.

A claim is made that complaints represent a form of sentinel-event surveillance system that flags…