Hurdles and hardships of overseas doctors
A PhD thesis that revealed the hurdles and hardships encountered by overseas doctors trying to register to practise in Australia has won the Faculty of Medicine’s prestigious 2011 Dean’s Award for Excellence in a PhD thesis, in the Faculty of Medicine, at the University of Melbourne.
Dr Anna Harris’s thesis moved her examiners to tears and was assessed as “in the top 5 per cent of all PhDs they have read or examined”. Dr Harris has applied its findings to address the issues facing overseas doctors, many of whom moonlight as taxi drivers navigating city streets while they negotiate the maze of registration bureaucracy.
The findings from her thesis, ‘Overseas doctors’ adjustments in Australian hospitals: an ethnographic study of how degrees of difference are negotiated in medical practice’, have been disseminated nationally and internationally. This pioneering research had its genesis at Tasmania’s Launceston General Hospital, where Dr Harris was a medical intern.
“I knew very little then about my overseas colleagues other than they had many stories to tell and vast clinical experience which was underutilised in their junior hospital positions,” she said. After completing a Masters in Medical Anthropology at the Melbourne School of Population and Global Health’s Centre for Health and Society (CHS), she later did her PhD at CHS, researching the experiences of overseas doctors in Melbourne. She graduated in 2010.
“The thesis was situated in the fields of medical anthropology and sociology, and I used a research method called ethnography. This entailed becoming integrated into three outer-metropolitan Melbourne hospitals and being involved in my research participants’ lives while they worked and studied in the hospital,” she said.
“For 12 months I shadowed more than 30 overseas doctors working and studying for their exams in these hospitals,” she said. “My thesis attempted to capture their perseverance, creativity and determination, while putting their situation in a larger context of Australian workforce issues and medical registration.
”Dr Harris’s thesis told of the bewildering maze of interconnected but separate bureaucracies that overseas doctors must negotiate as they meet the various registration requirements. These include passing English language tests, written medical exams, clinical exams, workplace assessments and interviews. She said the requirements differed according to where doctors had studied medicine, their visa, their medical specialty, where they would work within Australia and their job position. “And these rules and regulations change frequently,” she said.
Her research conclusions focused on practical recommendations that were relevant to the training and support of overseas doctors in Australia. Since finishing the thesis Dr Harris has liaised with policy makers, obtained funding to undertake several support programs for overseas doctors, published a booklet that was distributed freely to hundreds of doctors in Melbourne and has published in international peer-reviewed journals and presented at international conferences.
Dr Harris has since undertaken postdoctoral research at Maastricht University in the Netherlands, and is currently working at the University of Exeter in the United Kingdom.
She has called on Australia’s medical colleges, boards and associations to take the lead and some responsibility for simplifying the complex registration system. “The critical shortage of doctors in Australia, especially in rural and outer-metropolitan areas, means there is an urgent need to address these difficulties,” she said. “The relevant authorities first need to answer a fundamental question: do we consider our overseas-trained doctors as skilled migrants or gap-fillers?”
Caption: Dr Anna Harris, winner of the 2011 Dean’s Award for Excellence in a PhD thesis, in the Faculty of Medicine. Photo, Moniek Wegdam