A guide to understanding and managing performance concerns in international medical graduates


Last revised: 19 May 2020

Presently in Australia, many international medical graduates (IMGs) working in general practice are non–vocationally registered (non-VR), are ineligible to join an Australian General Practice Training (AGPT) Program and are relatively unsupported on their path towards Fellowship of The Royal Australian College of General Practitioners (FRACGP), although the Practice Experience Program (PEP) introduced by the RACGP in 2019 now offers some support.

Many IMGs struggle with Australian general practice and have difficulty passing the Fellowship exam. This can also be the case for IMGs who do manage to join a general practice training program.

This guide provides an understanding of the issues that IMGs contend with and the clinical performance problems that occur. It also provides a framework for managing those performance concerns, including exam support.

This guide is complementary to the RACGP’s A guide to managing performance concerns in general practice registrars. While the two contexts are different, the principles of performance management and support (remediation) are the same. The performance management that is discussed in both guides is with respect to the attainment of the requisite level of clinical skills for the doctor to be able to practise independently in Australian general practice and attain FRACGP.

IMGs who are underperforming may sometimes come to the attention of the Medical Board of Australia (Medical Board). For information regarding performance management in that context, refer to the RACGP’s A guide to performance management and support for general practitioners.

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