Medical Training Review Panel 19th Report

Assessment of Overseas Trained Specialists

Prior to 1990, all overseas trained specialists seeking registration in Australia who did not hold a recognised primary medical qualification were obliged to pass the AMC examination and obtain general registration before they could be registered to practice as a specialist. In addition, before 1990 only two states (Queensland and South Australia) had separate specialist registers.

In 1991, the Australian Health Ministers’ Conference (AHMC), in anticipation of the implementation of the mutual recognition scheme, approved a process for overseas trained specialists to be assessed by the relevant specialist medical college in Australia against the standards for an Australian-trained specialist in the same field of specialist practise. If the qualifications and relevant experience of the applicant were assessed as substantially comparable to an Australian-trained specialist, they could apply for registration limited to the field of specialty.

In consultation with the former state and territory medical boards and colleges, it was subsequently agreed that the specialist assessment process should not be seen as a backdoor to specialist training in Australia. For this reason, it was resolved that any overseas-trained specialist who required more than two years of further supervised training to meet the required standard for substantial comparability (equivalence to an
Australian-trained specialist) would be assessed as ‘not comparable’ and would be required to sit the AMC examination and obtain general registration.

A national assessment process for Area of Need specialists was not resolved until 2002, when agreement was reached on a separate pathway for the assessment and registration of overseas-trained specialists in Area of Need positions. This involves an assessment against a position description that defines the levels of clinical responsibility, supervision and specific clinical skills required for a particular position. The relevant specialist college assesses the individual against the position description, rather than against the standards required by the medical college for a (fully-recognised) specialist.

A number of colleges have agreed to combine their Area of Need and full comparability assessments, so that the applicant (and the Medical Board of Australia) can be advised of the additional steps required to achieve substantial comparability at the same time as they are being assessed for the Area of Need position. To date, nine colleges (RANZCOG, RACP, RCPA, ACD, RACS, RANZCO, RANZCP, ACRRM and RANZCR) have agreed to undertake the combined assessments of overseas trained specialists.

As with the Competent Authority pathway, in order to streamline processing since

1 July 2014 applications for specialist assessment have been dealt with directly by the relevant specialist colleges and report to the AHPRA in line with the recommendations of the House of Representatives Lost in the Labyrinth report. Applicants who do not meet the requirements for specialist assessment are required to undergo assessment through one of the non-specialist pathways.