Expedited SIMG registration pathway continues

18 September 2024

The proposed expedited registration pathway for anaesthesia specialist international medical graduates (SIMGs) for agreed qualifications (United Kingdom and Irish specialists), is due to be implemented by the Medical Board of Australia (MBA) by the end of 2024. ANZCA is considering impacts to existing processes, including a potential pathway to ANZCA fellowship, regulation changes and associated risk factors.

In June the college provided information relating to the Australian government’s proposed implementation of an expedited registration pathway for SIMGs. You can read the news item here.

The proposed expedited pathway bypasses existing medical college assessment processes for agreed qualifications that MBA deems substantially comparable or based on similar competencies to an approved Australian specialist qualification. Initial implementation is for four priority specialties - general practice first by October 2024 followed by anaesthesia, obstetrics and gynaecology, and psychiatry by December 2024. Other medical specialties will be included progressively.

As a result, an expedited pathway in anaesthesia will be available to those anaesthesia SIMGs from the United Kingdom and Ireland who have completed full specialist training and qualifications.

This expedited SIMG pathway issue is something that the college is actively engaged in and continuing to have discussions with MBA and Ahpra, particularly to gain further information on the proposed design and development of associated processes.

To date ANZCA has provided a range of considered documentation to ensure relevant decision makers are aware of our successful existing process (noting that our SIMG assessment process conforms to the MBA’s good practice guidelines and is regularly reviewed for consistency with regulatory changes), our recommendations for consideration and any potential risks that the Australian government should be aware of. Patient safety continues to be our central priority.

Unfortunately, we have been provided with minimal information to date.

We do have college representation on various associated Australian government groups in the coming weeks on this matter - Ahpra’s SIMG Pathway Advisory Working Group, manager’s meeting focusing on expedited pathway update and an AMA/MBA discussion – we envisage we will gain further insights from these forums.

The college is also working together with all other medical colleges, as a critical part of the health system, to ensure there is a unified position on oversight, standards maintenance and legal responsibilities under the proposed settings.

What we know is that the expedited pathway offered by MBA will not lead to an ANZCA fellowship. We are unsure of the associated placement and distribution of these expedited SIMGs, we assume it will depend on states and territories’ (who are the employers of public hospital clinician positions) intended process of recruitment and vetting, including indicating if a FANZCA title is required.

In parallel, ANZCA is developing a pathway to ANZCA fellowship to be offered to this cohort, to run concurrently to their expedited pathway, and if successful will lead to ANZCA fellowship. For the college there are some likely non-negotiables, consistent with our current approach. To proceed to FANZCA we are likely to insist that those on the Ahpra fast-track must have done an Effective Management of Anaesthetic Crises (EMAC) course, undergone formal ANZCA review of their supporting application and an external workplace-based assessment (the SIMG Performance Appraisal). The college is also considering other associated items that require ANZCA involvement or impacts to existing processes, including regulation changes and risk factors.

ANZCA would like to reiterate that internationally qualified health practitioners play a vital role in our health system and are needed to supplement critical vacancies in the short term. However, we recognise that any changes have potential adverse implications for anaesthesia training, legal responsibility of clinicians, required cultural safety and community awareness, and training site accreditation into the future. It will also significantly impact a key area of business and operation for the college.

We would also like to continue to work with state and territory governments to increase local trainee numbers as a longer-term or large-scale strategy for specialist staffing recruitment.

The college will pass on relevant information once further information is received from MBA/Ahpra, including updates to the ANZCA SIMG website pages. MBA have also advised as information is approved it will be updated on their website.

For any queries contact the ANZCA Policy Team.