Ahead of the December 6 Health Ministers' Meeting, the Council of Presidents of Medical Colleges (CPMC) warned that the proposed fast-track registration of Specialist International Medical Graduates (SIMGs) risks exacerbating a two-tier healthcare system in which the quality of specialist care Australians receive could be determined by their postcode.  

"As Health Ministers prepare to meet on 06 December 2024, we urge them to carefully consider the long-term implications of rushing registration processes and creating different standards for different regions," said A/Prof Sanjay Jeganathan. "The current proposal effectively creates two classes of specialist registration – one for metropolitan areas and another for everyone else." 

The CPMC has repeatedly highlighted specific concerns about the proposed changes to SIMG pathways:  

• Reduced supervision requirements for newly registered international specialists  
• Abbreviated assessment processes that will not fully evaluate clinical competency  
• Limited oversight of the scope of practice in regional settings  
• Insufficient support structures for SIMGs in regional placements  
• Lack of clear continuing professional development frameworks
• No clear mechanism to ensure SIMGs go to areas of greatest need 

"International medical graduates have long been vital to Australian healthcare, but they deserve proper support and assessment pathways that ensure they can practice to their full potential," said A/Prof Jeganathan. "Creating rushed registration processes doesn't help anyone –  not the communities they serve,  and certainly not the international specialists themselves."  

The CPMC calls for Health Ministers to address:  

1. Maintaining consistent specialist registration standards nationwide while improving the efficiency of current assessment pathways  

2. Establishing adequately resourced support systems for SIMGs in regional placements  

3. Creating clear frameworks for supervision and scope of practice 

4. Developing structured transition programs for international specialists  

5. Implementing robust quality assurance measures for all registration pathways  

6. Strengthening mechanisms to direct specialists to areas of genuine workforce shortage 

"The promise to strengthen Medicare must not come at the cost of compromising our medical standards," said A/Prof Jeganathan. "We need sustainable solutions that support international specialists to meet our high standards, not shortcuts that risk patient safety and professional standards." 

The CPMC and its member Colleges are keen to work with State and Federal Governments to safely implement this program and propose alternative solutions, including:  

• Enhanced support and mentoring programs for SIMGs via Specialist Medical Colleges 
• Improved assessment efficiency without compromising standards  
• Better integration of SIMGs into existing specialist networks  
• Structured professional development programs 

"Every Australian deserves access to fully qualified specialists who meet our world-class standards," said A/Prof Jeganathan. "Creating different standards for different regions isn't the answer to our workforce challenges – and prior failed programs have shown it will exacerbate existing institutionalised inequality in healthcare delivery."  

The CPMC urges Health Ministers to consider these issues carefully at their meeting. We remain committed to working with government stakeholders to develop solutions that maintain high standards while improving access to specialist care across all regions.  

About CPMC:  

The Council of Presidents of Medical Colleges (CPMC) is Australia's peak body representing specialist medical colleges. Find us at: www.cpmc.edu.au or Twitter: @CPMC_Aust*