KEY POINTS:
New Zealand is failing to capitalise on the skills of hundreds of overseas-trained doctors who are commonly languishing in depression and low-paid jobs, their representative says.
Qualified and experienced doctors from countries including Pakistan, Iran and China, they cannot practise in New Zealand because they must pass a difficult English test and licensing exam.
Overseas Doctors Association co-ordinator Dr Jamal Ahmed said he knew of 200 foreign-trained doctors who, like him, could help to reduce New Zealand's shortage of doctors if the Medical Council lowered its English requirement to Australia's level and the Government reactivated its medical bridging programme to help applicants prepare for the exam.
Many were shifting to Australia, where the IELTS (International English Language Testing System) requirement was level 7, compared with 7.5 in New Zealand; where authorities provided programmes to integrate overseas-trained doctors; and where they could register provisionally, in areas of particular doctor shortages, before completing the licensing exams.
The issue of the pool of immigrant doctors barred from practising faded from public view in New Zealand after the bridging programme began in 2002. It has been thrust back into prominence by the shortage of doctors - Auckland is about 20 per cent short of hospital house officers - and was this week discussed at an AUT University forum in a bid to find solutions.
Although closed to the media, the meeting involved representatives of the Ministry of Health, the Department of Labour, district health boards, health-worker registration authorities and international speakers. Its recommendations will go to Health Minister David Cunliffe.
But while the Government is at least listening, the Medical Council is adamant that its English-language standard is set at the level needed to protect patient safety and it will not be changed. Opponents of lowering the English requirement, like Dr Stephen Child, director of clinical training at Auckland District Health Board, point out "85 per cent of doctoring is communication".
From 2002 to 2004, the Government provided the bridging programme for 328 doctors, at a cost of around $60,000 each excluding GST.
They had been encouraged to come to New Zealand in the 1990s without being adequately informed they must pass the licensing exam in order to practise medicine.
The ministry says the programme was of limited value. Only a quarter of those who applied to do it were qualified to take part and their pass rate of the licensing exam, 64 per cent, was little different from immigrant doctors outside the programme.
Nearly 40 per cent of New Zealand's working doctors are overseas-trained, but the ministry does not know how many immigrant doctors are not practising. It is now gathering information for on their number and qualifications for Mr Cunliffe to decide if assisting them is warranted.
A Government-appointed medical workforce committee recommended New Zealand aim for self-sufficiency in doctors. The ministry says it is preferable to spend state money on training New Zealand doctors rather than re-training immigrants.
But AUT University's pro vice-chancellor, Professor Max Abbott, said that if overseas-trained health workers unable to practise in New Zealand had comprehensive support schemes like those running in Canada and Australia, they could help fill shortages.
"Immigrant and refugee doctors are a reservoir that could feed into this."
For several years the Auckland health board has run a 26-week, programme to prepare international graduates for work once they have registered.
But Dr Child said applications had dropped off from potential applicants, possibly because of the shortage of junior doctors creating more demand for them to start working in hospitals even without going through the course.
"Last month, for the first time, we've had not enough interest, so it won't go ahead for this next six months."
Dr Ahmed, aged 53, would like to be on such a course. After commuting between Bangladesh and New Zealand for a decade, Dr Ahmed joined his wife, Madheury Khadun, at their Auckland home last year. Mrs Khadun, had migrated with their son in 1997 and gave birth to their daughter in New Zealand.
With a Master of Science in physics, Mrs Khadun works as a check-out operator. Dr Ahmed, a GP in Bangladesh for 17 years, is now a rehabilitation support worker for accident victims who have lost limbs; he is paid $15 an hour.
Dr Ahmed said the doctors who could not register were consigned to low-paid work. They had become taxi drivers, pizza deliverers, fruit-pickers.
"Almost all are suffering from different levels of chronic depression and a multitude of other physical illnesses due to this unfair situation."
Dr Ahmed's IELTS test score was 7. If he gets 7.5 on his next attempt he aims to sit the council's exam set for foreign doctors - other than those who come from health systems comparable to New Zealand's.
The exam is at a similar level to the final year of a medical degree.
If he does not reach 7.5, he will aim for the Australian licensing exam and consider moving to Australia, where his son, now an adult, lives. Dr Ahmed can list numerous Bangladeshi doctor friends who are now in Australia earning A$100,000 to A$220,000 ($122,000 to $269,000).
One, Dr Salahuddin Chowdhury, said he spent five years struggling to resume his career in New Zealand.
The Medical Council did not recognise his Occupational English Test result, but Australian authorities did and he has since got a job as a GP in the Northern Territory.
The council won't budge from IELTS 7.5. It says it has considered the issue many times and 7.5 is the "appropriate level", adding that communication problems are at the heart of many complaints about overseas-trained doctors.
And chief executive Philip Pigou said that as the council had to protect public safety, it would not follow Australia in allowing doctors to work in areas of special need before passing licensing exams.
"We believe that the standard of competence should be the same in Wanganui as it is in Wellington."
