Towards more effective health workforce governance: The case of overseas-trained doctors.

Abstract

The over-reliance on overseas-trained doctors remains a pressing problem in a handful of countries. This study aimed to explore the experience of rural and remote overseas-trained doctors as regards to their migration, recruitment and ongoing support in Australia as the basis for more effective health workforce governance. Qualitative interviews were undertaken with overseas-trained doctors in rural and remote Australia. Interview questions focused on the experiences of overseas-trained doctors. Migrant doctors working in general practice in rural and remote Australia. Overseas-trained doctors who met inclusion criteria participated in interviews (n=14), which were digitally recorded and transcribed. Thematic coding and analysis were conducted with input from the study's Expert Policy Stakeholder Group. Overseas-trained doctors enjoyed the relative autonomy of working in rural or remote general practice and were grateful to be in Australia. Specialised rural and remote skills such as cultural competence in matters of Indigenous health and specialised emergency rural skills was a key finding as was the deskilling or lack of career development opportunities. Our analysis pointed to the mismatch in expectations and experiences between overseas-trained doctors, policy-makers and employers, as some doctors experienced obstacles with registration, or the location was not ideal, or there was a lack of awareness of Indigenous-related health and cultural challenges. In the context of Australia's continuing reliance on overseas-trained doctors, this study revealed the need for improved communication and coordination between overseas-trained doctors, policy-makers (education, health, employment and immigration) and employers, as a basis for more effective health workforce governance.