International medical graduates’ reflections on facilitators and barriers to undertaking the Australian Medical Council examinationPam McGrath A E , Saras Henderson B , Hamish A. Holewa C , David Henderson A and John Tamargo D
A Population and Social Health Research Program, Centre of National Research on Disability and Rehabilitation Medicine, Griffith Health Institute, Griffith University, Brisbane, QLD 4131, Australia.
B Population and Social Health Research Program, Griffith Health Institute, School of Nursing and Midwifery, Griffith University, Gold Coast, QLD 4222, Australia.
C Health Collaborative Research Networks Program Manager, CQUniversity Health CRN, CQUniversity, Brisbane, QLD 4000, Australia.
D Redland Hospital, Weippen Street, Cleveland, QLD 4163, Australia.
E Corresponding author. Email: firstname.lastname@example.org
Submitted: 31 August 2011 Accepted: 12 February 2012 Published: 27 July 2012
Objective. In Australia, 25% of international medical graduates (IMGs) make up the medical workforce. Concern is expressed in the literature about the lack of awareness and knowledge of issues that impinge on IMGs’ education. Although there is literature alluding to difficulties IMGs face with undertaking the Australian Medical Council (AMC) examination, there is little research detailing this experience. We therefore explored IMGs’ reflections on facilitators and barriers in undertaking the AMC examination.
Methods. After ethics approval, in-depth telephone interviews were conducted with 30 IMGs selected from a hospital in Queensland. Data were coded and analysed using thematic analysis principles.
Results. Two facilitating themes were identified: ability to sit for the first part of the examination in country of origin; and having access to resources such as bridging courses and study groups. Three themes represented barriers: not understanding procedural steps; financial issues; and lack of information on examination content and standards.
Conclusion. The themes provide new insights and add depth to existing literature that can be used to improve procedural processes and education for IMGs towards successful outcomes in the AMC examination.
What is known about the topic? There is concern expressed in the literature about the lack of awareness and knowledge of issues that impinge on IMGs education. The Australian work that is available only depicts educational experience of fellowships or education and training strategies after IMGs have passed their AMC examination.
What does this paper add? The findings indicate that the process of sitting for the AMC examination is perceived as one of the major difficulties associated with entering and integrating into the Australian health system. The findings indicate a range of practical, financial and resource problems faced by IMGs attempting to sit for the AMC examination.
What are the implications for practitioners? The detailed accounts from IMGs about their experience with undertaking the AMC examination will provide up-skilling program coordinators with the information they need to better assist IMGs to prepare for the examination. The provision of appropriate medical training and educational support will contribute to more effective integration of IMGs into the healthcare system.
Additional keywords: education, qualitative research.
References Pilotto L, Duncan G, Anderson-Wurf J. Issues for clinicians training international medical graduates: a systematic review. Med J Aust 2007; 187 225–8.
| 17708725PubMed |
 Rao N, Kramer M, Saunders R, Twemlow S. An annotated bibliography of professional literature on international medical graduates. Acad Psych 2007; 31 68–83.
| An annotated bibliography of professional literature on international medical graduates.CrossRef |
 McGrath P, Henderson D, Phillips E. Integration into the Australian health care system. Aust Fam Physician 2009; 38 844–8.
| 19893827PubMed |
 Holt A. Issues for clinicians training international medical graduates. Med J Aust 2008; 188 676
| 18513181PubMed |
 Heal C, Jacobs H. A peer support program for international medical graduates. Aust Fam Physician 2005; 34 277–8.
| 15861751PubMed |
 McDonnell L, Usherwood T. International medical graduates: challenges faced in the Australian training program. Aust Fam Physician 2008; 37 481–4.
| 18523706PubMed |
 Australian Medical Workforce Advisory Committee (AMWAC). Survey of doctors working in rural and remote locations under Australia’s Five-Year Overseas Trained Doctor Recruitment Scheme. Sydney: AMWAC; 2004.
 Sullivan E, Wilcock S, Ardzejewska K. A preemployment program for overseas-trained doctors entering the Australian workforce, 1997–1999. Med Educ 2002; 36 614–21.
| A preemployment program for overseas-trained doctors entering the Australian workforce, 1997–1999.CrossRef | 12109980PubMed |
 Le Q, Kilpatrick S. Vietnamese-born health professionals: negotiating work and life in rural Australia. Rural Remote Health 2008; 8 1062
| 19182858PubMed |
 Le Q, Elmer S, Kilpatrick S. Adapting to rural communities by overseas-born health professionals. In: Proceedings of the 10th National Rural Health Conference; 17–20 May 2009; Cairns, QLD, Australia. Tasmania: University of Tasmania; 2009. pp.
 Laurence C. Overseas doctors in rural and remote Australia: do they practise differently from Australian trained doctors? 2008 PhD dissertation, University of Adelaide
 Field PA, Morse JM. Nursing research: the application of qualitative approaches. London: Chapman & Hall; 1992.
 Streubert-Speziale HJ, Carpenter DR. Qualitative research in nursing: advancing the humanistic imperative. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2003.
 McGrath P, Henderson D, Tamargo J, Holewa H. ‘All these allied health professionals and you’re not really sure when you use them’: insights from Australian international medical graduates on working with allied health. Aust Health Rev 2011;
| 22126943PubMed |
 University of Queensland’s Centre for International Medical Graduates. Queensland Health. 2010. Available at http://www.health.qld.gov.au/medical/cimg.asp [verified 5 January 2012].
 Australian Medical Recognition Services (AMRS). Australian Medical Recognition Services home page. Collingwood: AMRS; 2010. Available at http://www.australianmrs.com.au/ [verified 5 January 2012].
 Monash University School of Primary Health Care. Available at http://www.med.monash.edu.au/sphc/ [verified 5 January 2012].
 Confederation of Postgraduate Medical Education Councils Reference Group. Information and resources relating to education and training available to overseas trained doctors in Australia. Canberra: Australian Government Department of Health and Ageing; 2004.
 McGrath BP, Graham IS, Crotty BJ, Jolly BC. Lack of integration of medical education in Australia: the need for change. Med J Aust 2006; 3 184–7.
 Wong A, Lohfeld L. Recertifying as a doctor in Canada: international medical graduates and the journey from entry to adaptation. Med Educ 2008; 42 53–60.
| Recertifying as a doctor in Canada: international medical graduates and the journey from entry to adaptation.CrossRef | 18086199PubMed |
 McGrath P, Wong A, Holewa H. Canadian and Australian licensing policies for international medical graduates: a web-based comparison. Educ Health; 2011; 20 452–63.
 Couser G. Twelve tips for developing training programs for international medical graduates. Med Teach 2007; 29 427–30.
| Twelve tips for developing training programs for international medical graduates.CrossRef | 17885968PubMed |