Vision at risk

October 2009


Integration into the Australian health care system

Insights from international medical graduates

Volume 38, No.10, October 2009 Pages 844-848

Pam McGrath

David Henderson

Emma Phillips


International medical graduates (IMGs) now comprise a significant part of the Australian workforce. However, their perspective on strategies to facilitate their effective integration into the Australian health care system have not been adequately explored. This article presents the findings from qualitative research that explored IMGs experience before, during, and after their involvement in the observer program, a hospital based pre-employment program for IMGs conducted in the Department of Medicine at the Redland Hospital, Queensland.


An iterative, qualitative research methodology was utilised, using open ended interviews with IMGs about their experience and involvement with the observer program. The interviews were transcribed verbatim and thematically analysed.


The participants asserted that, due to the Australian need for IMGs, it is in Australia’s interests to ensure an effective and efficient process for the integration of IMGs. Strategies they believed would improve this process included providing information to IMGs before departure from their country of origin, improving website information, providing more support for bridging courses, funding more observer programs, providing an IMG liaison officer at hospitals, reducing the difficulties associated with passing the Australian Medical Council examination, providing support for IMGs’ families, and relaxing the rules about when and where IMGs can practise medicine.


The participants’ perspectives on desirable changes to the Australian system that would facilitate IMGs’ integration are presented. It is stressed that these findings represent the perspectives of IMGs only, and that any and all changes to the process of integration of IMGs must have as a primary benchmark the aim of ensuring that the highest quality of medical care is provided to the Australian population.

In recent decades there has been an increase in the mobility of populations that has resulted in considerable numbers of physicians choosing to work in countries other than those in which they trained.1 In Australia, the term ‘international medical graduate’ (IM G) is used to refer to physicians who have obtained their primary medical qualification elsewhere.2,3 In the Australian health care system the majority of IM Gs are employed in general practice.2

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