Beat Medical Blog

Living tropical - an alternative lifestyle as a GP

Posted by Beat Medical

There are so many options for where to live and work as a doctor in Australia that it can be a bit of an overwhelming choice.

As an overseas trained general practitioner, you are generally restricted to working in a regional or rural area of Australia. Although this might mean being some distance from a capital city like Sydney or Melbourne, it opens the door to a much higher quality of living.

In this article, I am going to focus on Townsville - which is in Queensland. Although there are some similar cities around Australia, Townsville has the enviable quality of having over 300 days of sunshine in the year, and is directly across from Magnetic Island, one of the most spectacular natural retreats in Australia.

Being in a regional area doesn't mean that you have to sacrifice education and lifestyle- with the best in public and private schools, a large international university (which has an excellent medical school and world-class school of tropical medicine), amazing sporting facilities, and easy childcare it is truly the best of both worlds. If you do need a fix of the 'big city', there are regular flights to Brisbane and Sydney, as well as flights north to Cairns which go onward to Bali and beyond.

In comparison to the larger cities, drive time to work is a maximum of 30 minutes (the more common average being 5-15 minutes), crime rates are relatively low, and you get a sense of being part of a community. The best part is you can enjoy your time away from work with proximity to the coastline (within sailing distance of the Great Barrier Reef), and myriad sporting and recreational facilities.

If you don't enjoy warm weather, and a relaxed lifestyle, Townsville is most likely not for you. Otherwise, consider going tropical!


At the moment, we have a number of GP positions available in a rapidly growing area of Townsville.

Nearly national medical registration?

Posted by Beat Medical

A bane of most locum doctors' existence is the lack of a national medical registration system. Thankfully, there is light at the end of the tunnel, with the formation of the new Medical Board of Australia, and national registration on 1st July 2010.

Many doctors will have already received a letter outlining the new system, and what you need to do next. There are some changes, with greater responsibility placed on the individual doctor to keep up their CME, undertake criminal history checks, and more. The actual registration fee remains unknown.

So, why is it nearly national registration? At the moment, there are three dissenting states - Western Australia, South Australia, and Tasmania - who have not passed the required legislation to make the national registration happen. Until this is completed, the national system will be rolled out to some states, but not the dissenting ones. If you are not registered in one of those rogue states, and you wish to be, you will still need to apply for mutual recognition.

When will true national registration happen? Your guess is as good as ours. We hope it happens sooner rather than later - with nationally mobile doctors in locum work across Australia, it is almost ridiculous that they need to go through a complex, paperwork laden process just to work in another Australian state.

What do you think about it? Let us know your thoughts...

Doctors responsible for Emergency Department return rates?

Posted by Beat Medical

In this SMH article published last weekend, there is an interesting commentary on emergency department return rates.

Whilst the health service responded highlighting the aging population as a major factor, the State opposition highlighted that there are many parts of the Garling report which have not been addressed - thus causing major issues in the health services.

Many of our 'inside sources' tell us that the truth is somewhere halfway between the two responses.

As a locum agency placing doctors in emergency departments, we consistently receive feedback that emergency departments are not rostered with an appropriate mix of medical staff. That is, not only are junior staff rostered on at night - on their own, there is often little backup for them to call on when the worst happens. In some cases, there is a huge imbalance between senior doctors and junior doctors. At other times, there is no doctor at all.

I imagine at this time that there are a number of health service managers being pushed to provide a response to the adverse media publicity - what do you think the likely explanation will be? Will the doctors be to blame?

Let us know your thoughts.

Down the rabbit hole - the curiousness of health services

Posted by Beat Medical

If you have experience in healthcare at any level - a clinician, manager, cleaner, administrator, window washer - you were most likely nodding in agreement with this fantastically written piece in today's Age.

As a medical recruiter, and (I am a little embarrassed to admit it) former health service manager, I can see some palpable parallels between working with the health system, and the absurd (but all to familiar?)  characters in Alice in Wonderland.

It must have taken a Mad Hatter to design the current system for working as a locum in one Australian state (....to remain nameless). Not only are locum doctors expected to read over 450 pages of policies, and complete hours worth of online learning - they are encumbered by their current employer's consent to work as locums in areas of critical medical workforce shortage. It's also not a walk in the park for the the front line rostering people, who are restricted in terms of how much they can pay locum doctors in accordance with arbitrary geographical zones (which seem as though they were decided upon at a health department tea party). Here is the crux - the people making these decisions, however well meaning, are often at a critically dangerous distance from the reality of health care 'in the trenches'.

What is the point of these polices? To provide better health care, of course.  I've noticed how well it has worked - have you? Well, maybe not.

The aim is, of course, cost reduction. There is a Queen of Hearts in every health service, exacting sharp fiscal control on areas she may or may not have any understanding of, and proclaiming "Off with their heads" at the slightest hint of dissent or creative thought. New health service managers are often given no training, no expectations, no targets to meet, except "reduce the budget".  When I started in a hospital, I felt like Alice, tumbling down a hole to who-only-knows-where, as there is only one way to reduce the budget - to reduce medical staffing. Trying to explain to a high level administrator that it is less expensive to pay our own staff slightly more to work unpopular shifts, than it is to bring in hundreds of expensive outside locums of questionable quality and skills was almost like putting my head through a wall.

More dangerous than the Queen of course, is the Cheshire Cat, the duplicitous sycophant whose sharp teeth are covered by a flurry of nonsensical and vexing arguments. These people are the worst enemy of medical recruitment - swiping away any attempt to boost staffing numbers, citing an endless array of policies, precedents, and alluding to the opinions of a distant CEO who is always at arms length. Here is a common scenario - we need a new emergency specialist. Can we advertise? "No, too expensive". Can we attend a conference to attract potential candidates "No, too expensive. Perhaps try a sandwich board in front of the train station". In their heart of hearts, they know it is less expensive to keep a position vacant than it is to fill it.

I can't help but think that we are compelled to reject the reality presented to us by the looking glass - now is the time to agitate, question the system, and find your way out of the rabbit hole. What do you think we can do to change the system? Is it too late to turn it around?

Alice: But I don't want to go among mad people.
The Cat: Oh, you can't help that. We're all mad here. I'm mad. You're mad.
Alice: How do you know I'm mad?
The Cat: You must be. Or you wouldn't have come here.
Alice: And how do you know that you're mad?
The Cat: To begin with, a dog's not mad. You grant that?
Alice: I suppose so,
The Cat: Well, then, you see, a dog growls when it's angry, and wags its tail when it's pleased. Now I growl when I'm pleased, and wag my tail when I'm angry. Therefore I'm mad.

The Art and Zen of fudging emergency waiting times

Posted by Beat Medical

As a health consumer, I welcome the Federal Government’s $500 million plan to halve waiting times in emergency departments. It is admirable, and in honesty there are few things that would break your heart more than seeing a member of your own family waiting on an ambulance trolley in a hallway for a day in an overstretched emergency department.

As a medical recruiter, and a former health service manager, I know that halving waiting times is most likely too good to be true.

In many hospitals, particularly in regional areas, management exacts severe pressure on emergency doctors to ensure that waiting times are reduced. This sometimes involves pushing them beyond reasonable hours of work, and most frightening – insisting that junior trainees work in supervisory positions, after hours with little or no support from senior staff.

Lost in translation – Say goodbye to DWS and AoN

Posted by Beat Medical

Mary is a UK trained GP, and wishes to migrate to Australia to get away from that chilling London drizzle. Apparently, it’s easy to find GP jobs in Australia because there is such a shortage here. She speaks to the college of GPs, and they give her some very clear instructions, as follows:

“The first thing you need to do is apply to the AMC for assessment towards the SPP. They will deal the EICS, and make sure that you meet language requirements, else you might need to sit IELTS. You shouldn’t have to do that AMC I or II because you are a MRCP, and will be recognised for fellowship to the RACGP. Once that is done, you can apply to the MBA for the SPP, who will also assess the DWS status to make sure you are registered in an appropriate location. If you can’t get SPP, you will need to consider AoN – but any location without DWS can’t have AoN, so remember that. The next step is to talk to DIAC get your 457 Long Stay (SBS) visa – but you can’t do that without having your SPP finished first. It’s smooth sailing after that to the HIC for the section 3J application – unless PR is involved (no, not that type of PR), in which case it will be a 19AB application. Now, that’s clear isn’t it?”

This bewildering tale is an all-too-common symptom of the broken medical recruitment system in Australia. There are so many fantastic people out there working in the government, medical boards, immigration, the colleges, and the AMC to try to help overseas trained GPs work in Australia. Some would say that with such a multilayered, complex system it is amazing we have anyone to see patients on a Monday morning. In fact, in many places of Australia, we are failing to recruit doctors because of an outdated, thorny labyrinth of forms, bureaucracy, and stone walls.

The recruitment agencies of Australia play a de-facto role as the coordinating body, acting as the translators, and conduits for GPs to start work in Australia. We do what the private sector does best – be effective.

The more I think about it, I can’t help but think that a free market will result in more effective recruitment. What would happen if we abolished elements of the Health Insurance Act, District of Workforce Shortage, and Area of Need? Some would say absolute anarchy, others would say that DWS and AoN have created a misguided sense of security, and a false economy of recruitment. The argument against a free recruitment market is that doctors will flood to city and sub-city regional areas. This could be the case, but given that there are a finite amount of doctors jobs in those areas, there will inevitably be pressure to move out further and further from cities.

The protectionist approach afforded by these policies simply means that those who know, and understand the system best can work it to their advantage – and the rest are left by the wayside. For doctors like Mary, having to deal with the language of the system is enough of a reason to stay home – what is wrong with a bit of drizzle, anyway?

Specialist recognition for GPs – thanks to the AMC and RACGP

Posted by Beat Medical

From February this year, the Australian Medical Council will be accepting applications from international medical graduates to be assessed as GPs under the specialist category, possibly negating the need for complex area of need registration, and the like. This is a fantastic move which will hopefully make it a more transparent process for GPs to make the transition to working in Australia. Candidates from the UK, Ireland, Canada, United States, and South Africa will particularly benefit from the level of recognition provided for their qualifications and experience.

Well done AMC and RACGP – a positive move in what is already a complex and difficult system. Next stop…. national medical registration!

Working in Australia as a UK trained GP

Posted by Beat Medical

Working in Australia as a UK trained general practitioner is even easier now with the new RACGP specialist pathway into general practice. In short, as a MRCGP, you can apply for ad eundem fellowship of the Australian college. In most cases, after a twelve month mentoring period, you will be a full fellow of the college.

The Australian Medical Council is responsible for the initial assessment and documentation process to get started as a GP in Australia. There are a number of documents which will need to be provided, as well as a verification process for your academic qualifications. When you start, your head will most likely be swimming with forms and regulations, so it is a good idea to get in contact with a medical recruitment agency to discuss your options. A good recruitment agent can manage the entire application process on your behalf, so you can concentrate on the where and when of starting your new job.

About working conditions in Australia