Global Medics Survey – Insight 2

Registration Processes a Significant Barrier to Physician Migration

Over the last 15 years we have noted a significant increase in the number of physicians who have shown interest to travel internationally for job or career opportunities. What started initially as an interest in short term locum work has evolved to a more structured and deliberate attempt by many physicians to gain international experience – often then returning to their home countries at the end of the assignments.

We, and others, have done a considerable amount of work to understand the factors that motivate and detract internationally mobile physicians to seek work in a country other than their own. As one would expect, there are many considerations that influence this decision: lifestyle, remuneration, training opportunities, logistics, language and culture, family commitments and more. Interestingly, in our most recent survey, the administrative processes in obtaining medical registration in a destination country ranked as the single most significant factor detracting doctors from moving overseas. Almost 7 out of every 10 doctors who said they would be willing to consider international opportunities, listed medical registration processes as the single most important factor preventing them from doing so.

This is a staggering statistic. Although I always knew it played a role in decision making, I was surprised to see the rating that high. On further questioning, the rationale becomes more evident. There is no meaningful reciprocity between the specialist Colleges – even though the assessment processes, curricula and training programs are substantially similar – at least between the traditional Western curricula countries such as New Zealand, Australia, the United Kingdom, Ireland, Canada and South Africa. The process and requirements are complicated, cumbersome and not designed to be user friendly. I know of several instances where different people at the same regulator have provided conflicting advice to the same enquiry based on their own understanding of what is required. Often the costs associated with a new application is considerable, the timelines vague and the needs or expectations of potential employers disconnect from the (lack of) urgency with which new applications are assessed and an outcome provided.

In defense, regulators will often argue that their processes are necessary to protect the public from clinicians who are not suitable (or not comparable) to the standard of medicine practiced in that country. This position is often linked to extreme, and often isolated examples of malpractice by International Medical Graduates – and so the need for existing processes is legitimized.

Whilst nobody will argue with the notion of ensuring that physicians are competent to practice safe and high quality medicine, it seems the pendulum has swung too far. Given the very significant need in most public health systems for experienced, capable and competent clinicians the opportunity for regulators to design their processes so it meets both the needs of the user and the reasonable safety demand of the public seems obvious.

Global Medics has almost 15 years’ experience in moving doctors between countries – working to ensure the employee, employer and regulator processes remain connected. If you are thinking about a career overseas, talk to one of our specialist Recruitment Consultants located in one of our local offices In the United Kingdom, Ireland, Australia or New Zealand or visit our international job board at