College of Surgeons.

In terms of content, it was almost

avant-garde in the way it explored the

complex interplay between meaning and

reality.

Lurking beneath the surface narrative

was a confession of a stuff-up.

For some three-and-a-half years, the

college was admitting, it had failed to

assess specialist IMGs wanting to work

in Australia in line with the board’ s public standards.

Edith Piaf, mid-1940s.

The board introduced the standards

in 2020, clearly stating that the medical colleges were to assess specialist IMGs to the same level as one of their own newly fellowed specialists.

They were also required to make the judgement based on the specialist IMG’ s proposed scope of practice.

These rules were introduced following a public consultation that included submissions from the medical colleges themselves.

However, although the surgeons’ college was among those who took part, it apparently forgot about the standard

befallen the 200 doctors affected. Added to this was a quote from the medical board. This was also curious. It thanked the college for its“ transparency and accountability”.

I had to double-check the dictionary definition of these words.

While the college had discovered the“ variation” in its assessment back in June 2024 and immediately took steps to amend the policy, retrain assessors and implement new assessments, it did not tell the board until March this year.

assessors about the changes published on the medical board’ s website following the consultation.

Was there a concern that the new standard was a dilution of patient safety?

There is an argument, one made by a surgeon in the AusDoc comment section, that the skills and competence of newly fellowed Australian-trained surgeons are usually well known given they have been nurtured in the Australian hospital system.

not been following the national standard when it first discovered it had not followed the national standard.

The college told Australian Doctor it was unable to respond.

However, it did send another statement repeating what it had already said, along with some background information.

Of the IMGs affected, it said 146 had been previously assessed as partly comparable and were already practising under supervision in Australia.

The remaining 69 applicants judged

and continued to assess IMGs against its

non-comparable were eligible for a new

own fellows who had five years’ specialist experience, with( in many cases) no account taken of their intended scope of practice.

The result was that some 215 overseas surgeons, who probably paid the college around $ 10,000 for these assessments, may have been unfairly deemed substandard.

We live in an age where displays of contrition following a public blunder

ROYAL AUSTRALASIAN COLLEGE OF SURGEONS

‘ This is about ensuring every Australian … has access to safe, highquality surgical care.’

— Associate Professor Kerin Fielding

assessment under the revised assessment policy.

It did not say how many had gone through this second assessment or what the results were.

It is conceivable that none of the college’ s judgements about the suitability of the IMGs and their skills changed.

If so, maybe that explains the je ne regrette rien tone of the board – college media release.

have become an exercise of bloated sup-

There has been little fallout from

plication— almost performance art.

the saga. Obviously, it is not in the

But even in the more hard-headed

IMGs’ interest to make a fuss despite or

world of medicine, this media release

because careers are at stake.

was notable for the absence of any type

The rest of us only know what hap-

Knowledge of the skills of IMGs arriv-

There is a line in the media release

of apology or acknowledgement like“ we

pened to these IMGs because of the sub-

ing from overseas can be less clear-cut,

saying the Australian Medical Council

may have buggered up”.

sequent joint media release and the

hence the need for them to be judged

had imposed a condition on the college

The quote from college president

article on AusDoc.

against higher thresholds— surgeons

that it risked not being accredited unless

Associate Professor Kerin Fielding said

Given the gratitude for the college’ s

with five years’ experience.

it had“ quality assurance processes” to

only that specialist IMGs entering Aus-

embrace of transparency and account-

However, the actual submission made

ensure ongoing compliance with medical

tralia had to be“ properly trained, supported and retained in the areas where they are most needed”.

“ This is about ensuring every Australian, no matter where they live, has access to safe, high-quality surgical care.”

Curious— was it really about that? No acknowledgement of an error there. Nor any reference to what may have

ability, Australian Doctor thought it a good opportunity to ask the college some follow-up questions.

There were quite a few, but the answers were not forthcoming.

One was simply why the college had failed for so long to assess IMGs against the standards laid down by the board.

Maybe the college had not told the

by the college to the medical board’ s consultation back in 2019 did not explicitly question the board’ s suggested assessment thresholds, although it did stress the importance of robust assessments for surgeons placed in areas of need.

Another question was why the college failed to inform the board that it had

board standards. I guess that is the warning not to do it again.

But obviously, the timing of the college confession is not great since the medical colleges have been fighting accusations from state and federal health ministers that they are a block on fixing medical workforce supply.