The Medical Board of Australia and the Australian Health Practitioner Regulation Agency (Ahpra) have released the evaluation, which examines the first 18 months of the Expedited Specialist Pathway’s operation.
RACS supports the pathway’s objective of reducing unnecessary duplication, cost and delay for appropriately qualified specialist international medical graduates (SIMGs).
The evaluation provides useful early evidence that the pathway is faster, more predictable and attractive to eligible SIMGs.
But RACS says speed cannot be the only measure of success.
“The Expedited Specialist Pathway should ultimately be assessed by whether it contributes to a safe, appropriately distributed and sustainable specialist workforce that meets Australia’s long-term community needs,” RACS President Dr Philip Morreau said.
“That means looking not only at how many specialists enter the Australian workforce, but whether they practise in the specialties, locations and scopes of practice where they are needed.”
The evaluation found that 89 per cent of SIMGs on the pathway were practising in metropolitan areas, while just 11 per cent were practising in regional, rural or remote locations.
RACS says this highlights a key limitation of registration reform: it can increase the overall supply of specialists, but cannot by itself determine where they practise or whether they meet specific community needs.
“Registration reform is not, in itself, workforce planning,” Dr Morreau said.
“Expedited pathways need to be part of a broader approach to workforce planning and distribution.”
He said the same principle applies to locally trained doctors.
“Australia has a strong pipeline of junior doctors. The challenge is ensuring they transition into the specialist workforce Australia needs, in the specialties and locations where they are needed.
“The issue is not simply how many doctors we have.
“What is required is targeted, evidence-based workforce planning and distribution alongside changes to specialist registration pathways, whether these are for overseas-trained or homegrown doctors.”
RACS is also cautioning against drawing firm conclusions about the pathway’s longer-term quality and safety from its first 18 months.
While the evaluation found no systemic quality or safety concerns and reported a positive experience among most participating SIMGs, it acknowledges that the evidence is still early and that longer-term safe and competent practice requires ongoing monitoring.
This will be particularly important as the pathway expands into procedural specialties. General Surgery and Otolaryngology Head and Neck Surgery were not represented in the evaluated cohort and are among the specialties identified for the next phase of the pathway’s rollout.
RACS is calling for specific quality and safety evaluation as the pathway is implemented in these specialties.
RACS has written to Ahpra, the Health Workforce Taskforce and Australian health ministers outlining its response to the evaluation report, including the need for stronger quality and safety monitoring and clearer national workforce planning.
