A shortage of doctors in the north-west of Queensland has highlighted the ongoing problem of recruiting doctors in regional Australia.
- Patients in Mount Isa cannot see their local GP within seven days, resulting in long wait times in the emergency room and home-remedies
- Mount Isa Medical Centre believes restrictions on hiring international medical graduates is creating doctor shortage
- Doctors groups say tightness on international doctor safety checks shouild not loosened because of the regional workforce shortage
Mount Isa patients are waiting up to a week to see their local general practitioner (GP), with most resorting to the hospital emergency room and home remedies.
To add to the complexity of the issue, a new barrier to solving the regional doctor shortage is emerging in Mount Isa as overseas-trained doctors apply for positions at local medical practices.
Throughout 2019, seven GP applicants were denied permission to practice in Mount Isa due to failing the pre-employment structured clinical interview or PESCI system.
A PESCI is mandatory for international medical graduates seeking limited or provisional registration in Australia to practise as GPs.
The interview is designed to be an objective assessment of a GP’s knowledge, skills, clinical experience, and attributes to determine whether they are suitable to practise in a specific position.
The Australian College of Rural and Remote Medicine (ACRRM) has warned finding doctors for regional areas was a major issue that was being felt statewide.
“Even bigger towns such as Rockhampton, Gladstone, right up and down the [east] coast are suffering,” ACRRM president Dr Ewen McPhee said.
Common colds headed straight to the hospital
Tamara McHenry could not see a GP within a week in Mount Isa after her nine-week-old daughter developed conjunctivitis.
“I asked three medical centres about the emergency spots they keep, but was told they wanted to leave them open,” Ms McHenry said.
The mother of two resorted to washing her daughter’s eye with salt water to clear the conjunctivitis.
“I asked the nurse what I could do, as chemists couldn’t give me anything without a ‘script as she was under two [years old],” she said.
“Considering her age, I felt let down by the medical clinics.”
Hospital feeling the pressure
It is a situation that has left most local patients waiting in the Mount Isa Hospital’s emergency department.
Director of the emergency department Dr Ulrich Orda said numbers of GPs this year were smaller than usual and locals had experienced the brunt.
“What’s definitely increasing within our service is the number of admitted patients, and that’s also a trend that we can see right across the state,” Dr Orda said.
He said patients presenting to the hospital with a cold or for repeat prescriptions should ideally be seen by their local GPs.
“A lot of times during the past year we’ve had an increase in waiting times due to lack of space in the emergency department to see patients,” he said.
The GP shortage has been blamed on multiple factors including the lack of financial incentives and the impact on social life, education, and available facilities in regional towns.
It is a situation that has left Mount Isa Medical Centre recruiting international doctors, still a challenge according to the centre’s lead doctor, Michael Mbaogu.
Is PESCI to blame?
Mount Isa Medical Centre has blamed the PESCI on its doctor shortage with Dr Mbaogu questioning the rigid structure of the interview.
“It’s not because we’re not trying; we did try,” he said.
“These applicants were more than qualified for regional work and were 10 years post-graduate.”
The Medical Board of Australia regulates the PESCI and last reviewed the interview structure in November 2019 with no plans to review it again in 2020.
A spokesperson for the Board said patients in rural, regional, and remote areas deserved doctors who could provide safe care.
Regional work can be daunting
The Australian College of Rural and Remote Medicine (ACRRM) provides the PESCI in all states and territories of Australia.
Dr McPhee said he was not aware of the seven doctors refused to work in Mount Isa and said the PESCI was highly regulated and a safety check for patients.
On top of the cultural differences, moving international medical graduates to regional areas with fewer resources could be daunting.
“It’s not necessarily easy when you come from another country, [with a] completely different healthcare system and often another language,” Dr McPhee said.
“This is a major issue, but it’s not just an issue of the PESCI, it’s also the changes by Federal Government to international doctors.”
Impact of changes questioned
Under Federal Government requirements introduced in March 2019, overseas-trained doctors must obtain a Health Workforce Certificate from a rural workforce agency to get a visa.
It is these changes that Mount Isa Medical Centre has been struggling to comprehend, given the workforce shortage and increasing waiting time to see a GP.
“Why is it almost impossible to get GPs approved to work in Mount Isa? Is it a charade, or what?” Dr Mbaogu said.
However, Dr McPhee said he was not prepared to suggest the standards should be lowered in regional areas and for doctors to “slip through” the system.
“Australian doctors don’t want to go to the country, but it’s not up to international doctors to fix Australia’s healthcare,” he said