Aussie rules may not suffice, says Medical Council

The Medical Council says there is a potentially tricky issue over how it regards doctors allowed into Australia specifically to work in "areas of special need" if they later seek work in this country.

"There are people coming in there with qualifications that wouldn't gain recognition in New Zealand and may not have been under the sort of supervision that we would require here," said Medical Council chairman John Campbell.

Australia had "imported" doctors into areas of special need where there were shortages of skilled workers, mostly in rural and remote areas.

"We haven't gone down that line," said Dr Campbell, a former dean of the Otago medical school. "We don't feel that we can be assured of the standards of those doctors.

"We could end up with a two-tier health system and people without adequate training."

The Medical Council is set to axe the fast-track route many South African doctors have been using to qualify to practise here: it will no longer deem South Africa to have a "health environment" similar to New Zealand's.

"We have looked at South Africa against all the criteria on which we assess comparable health systems, and they could not be regarded as a comparable health system," Dr Campbell said.

But he said that the council had not recognised Australian "areas of special need" as being compromised, even though many of those were in places that were remote or impoverished.

After a council briefing for journalists in Wellington on the council's work, Dr Campbell said allowing easier entry for doctors who had been working in a comparable health system had helped graduates from a lot of European countries.

"We've actually freed up access for a lot of people coming from overseas, but unfortunately South Africa didn't meet the criteria.

"There are things like life expectancy, infant mortality, and the nature of the illnesses that practitioners are seeing," he said. Other public health indicators were the mortality rate for children under five years and survival rates to 65.

Dr Campbell emphasised the council was not stopping entry for South African doctors, but simply requiring them to follow a longer pathway to practising here.

Until now, South Africans have been able to register to practise in this country if they have good English language skills and have spent 36 of the previous 48 months practising in a comparable health environment in 18 countries in North America, Australia, Hong Kong, and most of northern Europe.

The route for someone who does not come from a comparable health system is to sit two United States medical licensing exams and then to sit the New Zealand registration examination.

But Dr Campbell said the council now believed a new Australian screening examination for immigrant doctors would be better than the American one because it was based on clinical practice rather than biomedical science.

"It's pretty difficult for someone who's been in practice for 15 years to go back to those basic biomedical sciences," he said. "The Australian exam will be more valid, and fairer."

Discussions were still under way on the availability of the Australian exam and it was expected to be an option from the start of next year.

In the meantime, provision for South Africans to continue to enter on the basis of working in a comparable health environment had been extended at least to the end of the year.

The council is also considering changing its requirement for people who sit the New Zealand registration examination to then work for a year as an intern in a local hospital.

"We will need to re-examine that as well," he said. It was difficult for people who had been practising in their own right to turn around and work as an intern.

It was possible to make sure a person had a breadth of experience and was supervised for their first year of practice in New Zealand, without insisting they completed an internship.


Foreign doctors

New Zealand has the Western world's highest reliance on overseas-trained doctors - about 40 per cent are foreign-born - and they have become the backbone of rural general practice.

The Medical Council said in its July newsletter that 41.5 per cent of the nation's registered doctors graduated overseas, including 36 per cent of its specialists.

- NZPA