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The potential of workplace-based assessment of international medical graduates

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The concept is attractive — but capacity may limit its practicality

For many years, Australia has relied on supplementing its medical workforce with doctors who have qualified outside Australia. Each year, about 2500 of these medical practitioners, known as international medical graduates (IMGs), seek general registration with the Medical Board of Australia. For many IMGs, this has included sitting the clinical examinations conducted by the Australian Medical Council (AMC) as part of the Standard Pathway for IMGs. The eligibility standard for registration is set at the expected level of an Australian medical graduate at the time they complete their internship.1 Concerns have been expressed about the accessibility of these examinations and the ability of IMG candidates to pass them. Some of these problems were highlighted during an inquiry in 2011–2012 by the House of Representatives’ Standing Committee on Health and Ageing, Lost in the labyrinth.2

Workplace-based assessments (WBAs) have been developed as alternatives to the Objective Structured Clinical Examination (OSCE) and other approaches for assessing clinical competence.3 They have the perceived advantage of allowing a single set of high stakes (summative) assessments in an examination environment to be replaced by multiple low stakes (formative)…