An IMG's road to GP training and fellowship

Doctors trained in countries other than Australia, whether they are Australian citizens or not, are referred to as an OTD (overseas trained doctor) or an IMG (international medical graduate).

I am an IMG in Australia.

I have a basic medical degree from the National University of Ireland and I’m a citizen of Sri Lanka, my country of birth. My road to fellowship has been a long and arduous one; but at the same time, it has given me the opportunity to become a better doctor.

Foreign-trained doctors make up a large part of the Australian medical workforce. I believe it’s important for all medical practitioners to have a basic understanding of the processes involved in achieving specialist qualifications for IMGs. Some IMGs pursue the path to general registration with Ahpra before commencing specialty training. Others can enter a training program regardless of their residency or Ahpra registration status.

It took me a long time to figure out which specialty I wanted to pursue. When I was at PGY4 as an obstetrics and gynaecology RMO in New Zealand, a patient died during a night shift. Although it was no fault of mine, I still lost sleep over it. It was then that I decided to leave the hospital system. I felt general practice would keep me out of the hospital shift-work roster and give me the routine I needed, with more regular work hours.

I hope to finish up specialist general practice training next year and then pursue further training in palliative care. I do love general practice and the chance to practise all my skills including minor surgery, gynaecology, general medicine, mental health, obstetrics and paediatrics.

GP training and fellowship providers

Focusing on general practice in Australia, there are two providers of GP training:

• Australian General Practice Training (AGPT) – who recruit and fund the program, while the actual training is provided by Regional Training Organisations [RTOs]
• Remote Vocational Training Scheme (RVTS) – who recruit and provide their own training.

There are two colleges who award fellowship, which recognises the holder as a specialist general practitioner. Both colleges also offer an independent pathway to fellowship for experienced GP IMGs:

• The Royal Australian College of General Practitioners (RACGP)
• Australian College of Rural and Remote Medicine (ACRRM)

I was lucky enough to secure a training position with RVTS for the 2018 cohort. There were 22 funded spots and 91 applicants – a very popular program. RVTS aims to encourage GPs to work in a rural setting as they train towards achieving fellowship. Webinars, clinical teaching visits, and workshops twice a year are a regular occurrence.

I’ve had two lots of maternity leave in the last two years and RVTS have been very supportive of my family. I was able to get through the first part of the RACGP exams in February 2020 and I aim to complete the rest of the assessments by 2021.

Some things to consider when starting work as an IMG GP in Australia

• Fulfilling the conditions of the visa – work hours, pay rate, employer sponsorship, income tax
• Fulfilling the conditions imposed by Ahpra – supervision requirements, CPD requirements, evidence of progress towards fellowship
• Fulfilling conditions imposed by the specialist college – supervision, logbooks, face-to-face training, annual leave allowances, assessments. Keep in mind that regional training organisations that facilitate training for AGPT have their own set of rules – e.g. the requirement for the RTO in Tasmania is different to other states
• Considering the requirements for permanent residency and citizenship if you want to stay in Australia long-term – and what this means for the current citizenship held, dual citizenship, etc

I hope I’ve been able to shed some light for IMGs heading towards fellowship in general practice in Australia.

Here are some useful website links:

• Remote Vocational Training Scheme (RVTS): rvts.org.au
• The Royal Australian College of General Practitioners (RACGP): racgp.org.au
• Australian College of Rural and Remote Medicine (ACRRM): acrrm.org.au

Dr Vasuki Annamalai is an MDA National Member and GP Registrar at RVTS