AMA President Dr Rosanna Capolingua discusses overseas trained doctors and reported links to terrorism suspects

DR CAPOLINGUA: There is a natural feeling for people to feel disturbed about what's happened and I'm sure that many Australians, particularly ones who are just encountering an overseas trained doctor and don't have a relationship with them that they will feel a little anxious.

QUESTION: How would you reassure them?

DR CAPOLINGUA: I guess I need to tell you that overseas trained doctors have been an essential part of our workforce for many years. Many people will have encountered them on a day-to-day basis in rural areas and in our metropolitan teaching hospitals and they have provided Australians with good service and that we need them. They have been well screened.

QUESTION: Who provides a background check on these doctors and are they done all the time?

DR CAPOLINGUA: The doctors have to undergo two lots of scrutiny. One is immigration scrutiny and above and beyond that the doctors have to undergo medical registration so that all doctors are scrutinised by the medical boards. The overseas doctors have their primary degree, are checked and verified from a reputable university. They have their secondary degrees checked and verified. They have their previous employment record examined. They have reference checks done. There's a whole barrage of review and scrutiny before we register a doctor in this country.

QUESTION: In light of the current events are you confident that those security checks are good enough?

DR CAPOLINGUA: You know I think that when you're talking about people involved in terrorist activities, maybe there aren't any security checks that are good enough. They're able to get through some loopholes. Medical boards aren't scrutinising people to see whether or not they're members of terrorist packs. They're looking at doctors to make sure that they are reputable, credible and provide good clinical service to Australian patients.

QUESTION: What is the level of service provided by overseas doctors within the Australian context?

DR CAPOLINGUA: Something like 50 per cent of rural doctors in Queensland are actually international medical graduates. And certainly, there would be three to 5,000 international medical graduates working on temporary visas across Australia right now.

QUESTION: Why is it necessary for Australia to rely so heavily on overseas...

DR CAPOLINGUA: There's a long history of insufficient numbers of medical graduates and restriction on doctors in this country which has left us with a depletion in workforce in light of increasing need. We've turned to international medical graduates. They have wanted to come here; it's great experience for them and they have been a very important part of our workforce.

QUESTION: Should the Australian Government be providing more support for local doctors rather than relying on overseas...

DR CAPOLINGUA: We are very keen that the Australian Government provides the support. Now, for the increased medical graduates they have committed to - in 2009 onwards - we'll have a doubling of our number of medical graduates and we need government support and funding to make sure that they are trained adequately and properly so that they can fill this gap in our workforce shortage.

QUESTION: Is there any evidence to suggest that because of this gap and because we need IMGs here that the checks might not be as stringent as perhaps they should be?

DR CAPOLINGUA: The bottom line around the checks is that these doctors are coming in to look after the patients of Australia. That's our benchmark. So despite a workforce shortage, it is that benchmark that we check off the doctors by. They have to be able to be good enough to look after our patients.

Sometimes, when they get out into the workforce, sometimes in the public sector where the government is employing them, they may be elevated into positions where their registration and experience perhaps doesn't fulfil all the criteria and they may be put under pressure. Those things also need to be stopped.

QUESTION: If medical boards are doing the medical checks and taking care of that side, who's doing the immigration checks? Are they stringent enough?

DR CAPOLINGUA: The immigration authorities do the immigration checks and that is something that is in their department and Australian security, obviously, is very high on the government's agenda.

QUESTION: Are the AMA are looking at investigating this incident themselves or any other like it?

DR CAPOLINGUA: There's really no reason for the AMA to be involved in investigating a particular incident such as this. There are plenty of principal registration bodies in the government itself in place to take those very actions.

QUESTION: Are you aware of any discrepancies in this Queensland doctor's medical background that should be

QUESTION: Just in relation to the overseas trained doctor scenario, I mean obviously what's happening at the moment is quite dire. What are the AMA's concerns in regard to that in relation to...?

DR CAPOLINGUA: Our concerns are, firstly, that the Australian public don't become disillusioned and frightened and lose trust in their doctors that they're seeing. They're actually overseas trained doctors. International medical graduates have been providing service in Australia for a very long time. They are a large part of our workforce and a very important part of our workforce and provide good care. And I don't want patients frightened to go and see their doctor.

QUESTION: But are the checks that have been put on these doctors, are they stringent enough?

DR CAPOLINGUA: The medical boards across the country do scrutinise doctors for registration very carefully and closely. So, if you were not a doctor and you were coming into the country, you would have to go through immigration checks. If you're a doctor you have to actually go through those and medical board registration checks.

They are a series of verifications looking at the clinical qualifications of that particular doctor from undergraduate degrees to post graduate training, their experience and where they've worked in various hospitals and reference checks. So reputation and credibility checks as well.

QUESTION: So are these people still going to slip through the net though?

DR CAPOLINGUA: I think that people involved in terrorists acts are probably fairly astute and can probably slip through many nets as we've seen globally over the last few years.

QUESTION: So is there really anything we can do about it?

DR CAPOLINGUA: If there's an increased level of scrutiny through immigration and a review again of medical board processes; though I don't know how much more they can do really. Then there is never any harm to increase the security of this country.

QUESTION: And just lastly, there's also a Sydney GP who apparently has been giving vitamin and mineral injections. Do you know about the case?

DR CAPOLINGUA: No, but you can tell me now.

QUESTION: Apparently it has led to five cases of Hep C and then they've had to notify another 2000 patients in regards to this sort of alternative therapy. How popular are these sort of injections? Are you aware of GPs giving out more of these?

DR CAPOLINGUA: The Australian market actually puts quite a high demand for alternative and complementary therapies. There's actually a big industry and, as you well know, it's provided not necessarily just by doctors but by a whole range of people who are in the market.

Intravenous injections I guess these are - of vitamin C - is something that's been around for a little while. Not terribly popular but has its rise and falls in popularity and this must be an example of that occurring.

QUESTION: And the demand is growing? Do you know that?

DR CAPOLINGUA: For intravenous supplementation of alternative therapy? No, I don't think there's a demand growing for that particular area. There is a general consumer market for alternative therapies in this country.

QUESTION: How widespread is it? What's the actual demand for these intravenous vitamins?

DR CAPOLINGUA: I think the intravenous vitamin injection demand is not a very high demand. Having intravenous processes put in place are really quite threatening to the patient anyway and it's something that a doctor would very seriously consider before they would even offer a patient.

QUESTION: Are alarm bells ringing considering that we've had people - obviously there's not enough measures out there to ensure that they can't get infected and they've got infected with Hep C?

DR CAPOLINGUA: The infection issue is actually a separate issue to the provision of an alternative therapy. Infection control is a paramount standard in the medical professions and certainly I'm sure there'll be good investigation around this particular case where potentially Hepatitis C has been - a patient's been exposed to Hepatitis C.

QUESTION: Would you warn patients, I guess, to be careful if they seek this sort of therapy?

DR CAPOLINGUA: Patients who have gone to see a doctor should feel confident that a registered medical practitioner upholds and maintains the highest level of sterilisation technique and infection control. So, indeed, there should be that sense of security and if doctor's breach that, then they are rapidly investigated then appropriately suspended. So, if you're going to anything other than a registered medical practitioner then, indeed, you should be asking the questions about sterilisation.

QUESTION: Sorry I just had one more question about overseas doctors. Given the extent of the shortage of locally trained doctors and the latest incident, would you say that the need for overseas doctors is putting - as has happened here - is putting potentially security at risk?

DR CAPOLINGUA: No I wouldn't say that. We have overseas migrants in the workforce - in all sorts of the workforces, not just doctors. So you would say the immigration overall is putting security at risk. I don't think you'd target the doctors in particular.

QUESTION: So you're confident with the screening procedures?

DRAPOLINGUA: As I said, the doctors actually undergo more screening that many of the other migrants that come into the country because of the registration process, but I guess, if they want to they will get through. I don't know how they do that. It's up to the government departments to sort that out.

QUESTION: We don't know how many, like the percentages, or all people that are into alternative therapies?

DR CAPOLINGUA: I know that alternative therapies - and we're talking about things that you buy over the counter in the health food shop either, okay?

QUESTION: Oh, just intravenous.

DR CAPOLINGUA: No intravenous - sorry, we don't know the number of people that would be into intravenous alternative therapy. It's not a big issue on the radar. A fairly small percentage. Okay? Is that enough; Can I get away now?

QUESTION: Yeah, I think so.

DR CAPOLINGUA: Thank you.

Ends