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New CoAG IMG national assessment process

The RACGP welcomes the soon to be launched new preregistration assessment processes for International Medical Graduates (IMGs). The College is very pleased that General Practice is recognised within the Specialist Pathway. There are three main pathways that on successful completion will lead to the appropriate level of medical registration for IMG doctors. The pathways are: The Specialist Pathway which on successful completion leads to Specialist registration in the relevant speciality in Australia; The Competent Authority and The Standard Pathways which on successful completion both lead to general registration. Each pathway has a set of prerequisite requirements and required learning and assessment activities. In September 2007, following a meeting of Council of Australian Governments’ (CoAG), all State and Federal ministers signed off that these new assessment processes would be in place in 2008. The Australian Medical Council (AMC) was tasked to oversee consistent assessment processes. The general practice pathways enable IMGs with appropriate assessment to be practising in Australian General Practice. The workforce agencies and medical boards will also have roles in preemployment interviews and the orientation of IMGs to practice formally, post July 1 2008.

National CoAG registration pathways

The RACGP has developed a Specialist Pathway that will enable doctors with appropriate assessment to be practising in Australian General Practice. The table below presents the prerequisite requirements for each pathway.

Note – all doctors in all pathways require primary source documentation of degrees and must meet English language requirements

The RACGP Specialist Pathway

This pathway is part of the CoAG National Registration Process and applies to those doctors wishing to work in Australian general practice.

Note: These doctors continue to require English language certification (levels set by medical boards and implemented by the AMC) and primary source verification of their qualifications.

The Specialist Pathway – General Description

Each specialist medical college can make one of three determinations within this pathway:

1. Fully equivalent / comparable – the doctor is at the same level as an Australian trained specialist of that college.
2. Partial equivalent / comparable – the doctor is at the level of an Australian trained advanced trainee and requires further training / supervised practice and assessment to be regarded as fully equivalent. From the RACGP's viewpoint, this equates a doctor to a GP registrar in their third year of training (GPT 3 and 4 year equivalent).
3. Not equivalent / comparable – these doctors will need to progress through the standard or competent authority pathways to general registration then progress to specialist training in whatever discipline they wish to undertake.

The RACGP provides the specialist pathway in Australian general practice for this CoAG initiative.

Doctors within this pathway must undertake the RACGP assessment requirements. They are not required to undertake AMC written or clinical assessments within this pathway.

The RACGP Fully Equivalent Pathway

The RACGP already has this pathway well documented and in place. This is our Fellowship ad eundum gradum (Faeg) candidates. The requirements of programs to be granted this status are well documented and are well recognised. Listings of Faeg recognised qualifications can be found in the Fellowship guide at www.racgp.org.au/fellowship.

These doctors are recognised as Category 1 doctors. The definition of the categories is provided in Appendix 1.

Application checklists and application forms can be found at www.racgp.org.au/fellowship (Fellowship ad eundum gradum application form)

Once commenced in practice Faeg doctors must comply with RACGP Quality Assurance and Continuing Professional Development requirements which can be found at: www.racgp.org.au/qacpd.

The Partial Equivalent Pathway

In this part of the pathway the RACGP recognises partial equivalent / comparable doctors with recognised qualifications who may immediately enter our assessments with no further time requirements – these are our Category 2 doctors, eg MRCGP without CSCT (accepted qualifications are listed in the College Examination Handbook 2008-Section 3: Membership Type) - www.racgp.org.au/exam.

Note: The list of Category 2 recognised qualifications is currently under review and further qualifications may be added over the next six months.

Also within the partial equivalent / comparable pathway, Category 3 and 4 doctors may undertake the RACGP Applied Knowledge Test (AKT) being provided overseas and in Australia at secure sites multiple times per year.

On successful completion of this knowledge test these doctors may enter this pathway and progress to Fellowship while working in supervised general practice in Australia.

All Category 2, 3 and 4 doctors will be required to:

1. Undertake a formal learning needs analysis and review any educational requirements they may have.
2. Undertake a formal orientation to the Australian health care system and an educational program concerning the systems and processes required of the Australian GP.
3. Undertake a structured preemployment interview related to the practice location requirements where they will be placed.
4. Undertake a local orientation program meeting RACGP standards.
5. Undertake an educational program to assist progressing the doctor to Fellowship.
6. Enrol for components of Fellowship assessment within the first year of Australian practice.
7. Undertake a DISQ patient satisfaction survey activity each year whilst moving to Fellowship.
8. Undertake quarterly supervisor review and reports (submitted to the RACGP).

Candidate doctors in this pathway have three years to complete all assessment requirements for achievement of Fellowship. A diagramatic view of the pathway is provided in Appendix 2.

Appendix 1: Definition of Categories

1. General practice training, postgraduate qualifications and experience equivalent to the FRACGP. Currently these are
   • FRNZCGP
   • Holders of both the MRCGP and the Certificate of the Joint Committee on Postgraduate Training for General Practice, UK
   • Holders of the Certificate in Family Practice from the College of Family Physicians who have successfully completed both parts of the Medical Council of Canada qualifying examination
   Others are being investigated.
   
   
2. GP training, postgraduate qualifications and experience, which is recognised, but not considered equivalent to FRACGP. This includes
   • Holders of either the MRCGP or the Certificate of the Joint Committee on Postgraduate Training for General Practice, UK
   • Membership of the Irish College of General Practitioners
   • Certificate of the American Board of Family Practice
   • Master of Family Medicine, South Africa
   • Master of Prax Medicine, South Africa
   • Membership of the College of Family Practitioners (MFGP/MCFP), South Africa
   • Holders of registration as a Family Physician with the Health Professions Council of South Africa
   • Master of Medicine (Family Medicine) from the National University of Singapore.
   Others are being investigated. These OTDs would be eligible for the FRACGP immediately on successful completion of the RACGP examination, without further requirements.
   
   
3. GP training and postgraduate qualifications not recognised, but have more than five years of full-time GP experience in another country.
4. No GP training or postgraduate qualifications, but have more than five years of full-time GP experience in another country.
5. No GP training or postgraduate qualifications and less than five years of equivalent full-time GP experience in another country.

Appendix 2 Diagramatic representation RACGP Specialist Pathway

Publication Date: 2 July 2008
Authorised By: Education and Assessment