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Geography and Credentialism
Assessment and accreditation of overseas-trained doctors
Dimitria Groutsis
Work and Organisational Studies, School of Business, Faculty of Economics and Business, University of Sydney, Sydney, New South Wales
Abstract
The traditional stronghold of medical dominance, and thus the construction of the medical labour market, has been challenged by a number of contemporary trends. While the social, economic and cultural trends driving this shift have been explored, the significance of geography as a key determinant in the construction of the medical labour market has yet to be addressed in detail.
This paper examines how geographical arrangements have shaped the credentialist requirements for overseas-trained doctors and thus the nature and shape of the stratified medical labour market. The research traces the assessment and accreditation of overseas-trained general practitioners in NSW, focusing specifically on the registration process defining the last decade. Throughout this period the process has been significantly transformed: in the 1990s there was only one pathway to assessment, registration and subsequent entry to the labour market, there are now multiple pathways.
An examination of this historical change illustrates how credentialist requirements are negotiated and renegotiated by the various stakeholders in light of shifting spatial demands.
Keywords
sociology, overseas-trained doctors, geography, spatial arrangements, resident status, credentialism, stratification
References
Age (2002) The AMA says Many Overseas Doctors Struggling. The Age, September 30: Victoria Australia.
Australian Broadcasting Corporation (2002a) Shortages of Accredited Doctors. ABC Radio AM, September 30, Australia.
Australian Broadcasting Corporation (2002b) Fears Overseas Doctors Comprising Regional Health. ABC Radio AM, October 1 Australia.
Australian Broadcasting Corporation (2002c) Interview AMA President Phelps K and Birrell B, Monash University ABC Radio AM, September 30 Australia.
Australian Broadcasting Corporation (2004) Overseas Doctors for Rural Communities a Short Term Solution. ABC Radio PM, February 17 Australia http://www.abc.net.au/cgi-bin/common/.
Australian Bureau of Statistics (1991) Labour Market Participation for General Medicine by Ethnic Cohort 1986-1991. Unpublished Data, Canberra.
Australian Institute of Health and Welfare (2000) Overseas trained doctors reducing medical workforce shortages. Media Release, Australian Institute of Health and Welfare: Canberra.
Australian Institute of Health and Welfare (2002) Rural Health, AIHW: Canberra. http://www.aihw.gov.au/ruralhealth/.
Australian Medical Association (2003) All Doctors Practising in Australia Must have Proper Qualifications and Competencies. AMA Media Release (4/11/03) http://www.ama.com.au/web.nsf/doc/WEEN-5SY8CW.
Australian Medical Council (1990) Interim Report, Working Party to Review the AMC Examination, Australian Council: Canberra.
Australian Medical Council (1995) Australian Medical Council Information Sheet 1995, Australian Medical Council: Canberra.
Australian Medical Council (2000) Annual Report, Australian Medical Council: Canberra.
Australian Medical Council (2003) Annual Report, Australian Medical Council: Canberra.
Australian Medical Workforce Advisory Committee (2000/1) Annual Report 2000/1, AMWAC, NSW Health Department: Australia.
Australian Medical Workforce Advisory Committee (2002/3) Annual Report 2002/3, AMWAC, NSW Health Department: Australia.
Australian Medical Workforce Advisory Committee (2003/4) Annual Report 2003/4, AMWAC, NSW Health Department: Australia.
Australian Medical Workforce Advisory Committee (2004/5) Annual Report 2004/5, AMWAC, NSW Health Department: Australia.
Birrell B (1997) Hunger strikes and the accreditation of overseas trained doctors in Australia. People and Place 5(4) Accessed: http://elecpress.monash.edu.au/pnp/free/pnpv4n3/.
Birrell B and Hawthorne L (2002) Doctor Shortages And Their Impact On The Quality Of Medical Care In Australia. Monash University: Clayton Australia.
Clark GL (1983) Interregional Migration, National Policy and Social Justice. Rowman and Allanheld: Totowa New Jersey.
Commonwealth Government of Australia (1973) Health Insurance Act 1973, AGPS: Canberra, Australia.
Correspondence (1992) Correspondence from the Australian Health Ministers' Advisory Council (Amos BJ Chairman) to the President of the Overseas Trained Doctors Association (December).
Correspondence (1995) Between D Groutsis and the Australian Medical Association, National President, David Weedon, November.
Correspondence (2004a) Between Andrew Schwartz and The Hon Tony Abbott, MP, Minister for Health and Ageing, 14 February.
Correspondence (2004b) Between Andrew Schwartz and Senator The Hon. A Vanstone MP, Minister for Immigration, Multicultural and Indigenous Affairs, 24 February.
Correspondence (2004c) Between Andrew Schwartz and The Hon Tony Abbott, MP, Minister for Health and Ageing 2nd March.
Correspondence (2004d) Between Andrew Schwartz and D Fruinn, A/Director, Office of EEO in Public Employment, 5 March.
Crompton R (1990) Professions in the current context. Work, Employment and Society Special Issue: 147-166.
Dent M (1993) Professionalism, educated labour and the state: Hospital medicine and the new managerialism. Sociological Review 41:244-73.
Department of Health, Housing and Community Services (1992) The Future of General Practice, AGPS: Canberra.
Department of Immigration and Multicultural and Indigenous Affairs (2003) Skilled Labour: Gains and Losses, 30 November http://www.immi.gov.au/research /publications/skilledlab11.htm.
Doherty RL (1988) Australian Education and Workforce into the 21st Century. AGPS: Canberra.
Federal Department of Health (2004) Health Workforce Canberra. http://www.health.gov.au/workforce/general/htm.
Freidson E (1970) Professional Dominance: The Social Structure of Medical Care. Aldine: Chicago.
Freidson E (1975) Doctoring Together: A Study of Professional Control. Elsevier: New York.
Freidson E (1994) Professionalism Reborn: Theory, Prophecy and Policy. Polity Press: Cambridge.
Gardner H (ed) (1989) The Politics of Health. The Australian Experience 1st Edition, Churchill Livingston: Melbourne.
Harding J (2000) Overseas trained doctors reducing medical workforce shortages. Australian Institute of Health and Welfare, M2 Presswire. Australian Institute of Health and Welfare: Canberra.
Hawthorne L and Toth J (1996) The impact of language testing on the registration of immigrant doctors. People and Place 4(3) Melbourne, Australia.
Herod A (2001) Labour Geographies: Workers and the Landscapes of Capitalism. The Guilford Press: NY.
Human Rights and Equal Opportunity Commission (1995) Reasons for the Decision of Sir Ronald Wilson, Commissioner Elizabeth Hastings and Commissioner Jenny Morgan, 7 August HREOC: Victoria.
Independent Office for Overseas Trained Doctors (1995) Unpublished Statistical Data, Sydney NSW.
Iredale RR (1987) Wasted Skills: Barriers to Migrant Entry to Occupations in Australia, Ethnic Affairs Commission. NSW Government Printer: Sydney.
Jensen N (1991) Evidence to the Senate Select Committee on Community Affairs by the RACGP Assistant Secretary-General. Hansard 8 November, Australia.
Kenny A (2004) Medical Dominance and Power: a rural perspective. Health Sociology Review 13:158-165.
Kilkeary J (2002) Review of Complaints by Dr Balvin and Australian Doctors Trained Overseas Association Inc, Re: Non-Appointment to Areas of Need Radiologist Position in South Western Sydney Area Health Service, NSW Health Department (Released under Freedom of Information) October.
Kunz EF (1988) Displaced Persons: Calwell's New Australians. AGPS: Canberra.
Larson MS (1977) The Rise of Professionalism. University of California Press: Berkeley.
Marsh A (1999) The doctors we're not allowed to have. Sydney Morning Herald 22 Jan Australia.
Massey D (1984) Spatial Divisions of Labour: Social Structures and the Geography of Production. Macmillan: London.
Millett M (1995) Medical students numbers to be cut. Sydney Morning Herald 18 September Australia.
National Rural Health Alliance (1999) Overseas trained doctors to fill gaps in rural general practice. Media Release Australia.
New South Wales Department of Health (2003) Report on the Audit of Overseas Trained Doctors in Area of Need Positions Medical Training and Workforce Development Branch, June. NSW Health: NSW Australia.
New South Wales Department of Health (2004) Assessment and Recognition of Overseas Trained Doctors - Pathways for the Recognition of Overseas Medical Qualifications. NSW Health: Australia.
New South Wales Medical Board (2002) Areas of Need Data 2002, NSW Health: Australia.
New South Wales Medical Board (2004) Currently Registered Area of Need Doctors, 16 March NSW Health: Australia.
New South Wales Rural Doctors Network (2004a) http://nswrdn.com.au/site/index.cfm?display=1519.
New South Wales Rural Doctors Network (2004b) NSW Rural Doctors Network GP Workforce Database, 9 March NSW Australia.
Parry N and Parry J (1976) The Rise of the Medical Profession: A Study Of Collective Social Mobility. Croom Helm: London.
Peck J (1996) Workplace: The Social Regulation Of Labour Market. Guilford: NY.
Phelps K (2002a) From The President: Beware Of Misleading Statistics 18/02/02 (AusMed On-Line http://www.ama.com.au/web.nsf/doc/SHED-5EXGUD)
Phelps K (2002b) AMA President to the Country Mayor's Association of NSW (http://www.ama.com.au/web.nsf/doc/WEEN-5GHAG7).
Razaghi A (1992) A Twentieth Century Invention Quota Must Go! Paper Prepared by the President of the Overseas Trained Doctors Association, September, NSW Australia.
Razaghi A (2000) A Draft Summary of the Complaint Against NSW Health, NSW Australia.
Saks M (1995) Professions and the Public Interest: Medical Power, Altruism And Alternative Medicine. Routledge: London.
Scotton RB (1967) Medical manpower in Australia. Medical Journal of Australia 1:984-90.
Strasser R, Hays R, Kamien M and Carson D (2000) Is Australian rural practice changing? Findings from the national rural general practice study. Australian Journal of Rural Health 8(4):222-6.
Tattam A (1999) Racist wrangling for foreign trained doctors in Australia. The Lancet 8 May 353:475 1625.
Turner B (1992) Medical Power and Social Knowledge. Sage: London.
Willis E (1989) Medical Dominance: The Division of Labour in Australian Health Care. Allen and Unwin: Australia.
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