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The struggle of being an international medical student in Australia

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(Image by Piotr Bodzek, MD via Wikimedia Commons)

International medical students just want to be treated fairly by Australian universities and the medical field.

I WOULD NEVER have thought my tutor from our medical school, Dr Wang, a friendly Chinese doctor, would end up in our Professionalism and Leadership (PAL) class discussion.

But he did.

In one of the PAL lectures on the internship crisis, we learned about his story. He left his job as a consultant in China and came to Australia in 2001. He has satisfied all the requirements to be registered as a doctor in Australia. The last thing he needed was a one-year internship. But he couldn’t find one.

Eventually, he lost the opportunity to domestic medical students, who were given higher internship priority, despite lacking his decades of medical experience. 

The story is sad and disappointing. Unfortunately, there are countless stories like this one.

At around the same time, Dr Haddad, an experienced Argentinian-trained orthopaedic surgeon, who moved to rural Australia to practice medicine decades ago, had his registration removed by the Medical Board of Australia (MBA). For a very long time, he had been the only doctor in a remote area in Victoria. He had done 40 years of general practice in Australia and won an award in 2011 for his outstanding service to his rural community.

Nevertheless, he was disposed of from the field of medicine after he failed a standardised exam that tests him against "Australian standards". According to local residents, the whole town suffered after he was gone.

The list goes on. Foreign doctors are routinely discriminated against in job-seeking — or worse, are being actively removed from practice. It appears that Australia is no longer short of doctors and is now actively expelling the international medical students and medical graduates.

In the case against Dr Wang, Professor Bowden – chief medical administrator in the ACT – argued that Australia-trained doctors understand the Australian medical system better. In addition, since most of the domestic medical students are Commonwealth-funded, employing the domestic medical graduates provides a good return on investment.

But is his argument compelling?

I applied to Australian medical schools last year and was accepted by more than one medical school here. I chose the Australian National University (ANU), under the impression that all ANU medical graduates (both domestic and international) are in category one on the priority list when it comes to internships. This has been the case for years. In our offer letter, there was no warning of potential internship problems, unlike other medical schools.

However, this year our priority was lowered to category four, coming after six NSW trained medical graduates (category two) and ACT high school graduates who trained interstate for their medical degrees (category three).

The argument that locally-trained doctors understand the local system better breaks down in this case — we are receiving training in Canberra and would’ve stayed in a Canberra hospital for two years after we graduated.

Wouldn’t we be the ones who are more familiar with the local system than those who were trained outside of the ACT?

As full-fee students, we pay more than $310,000 for our degrees. I highly doubt that the Australian Government will have negative net revenue, even if they provide us with a one-year internship. 

Funding international medical students for future internships is valuable, since providing job security for us will attract more overseas applicants to Australian medical schools. If they wanted to control the number of medical professionals, they should restrict the number of admitted medical students, rather than at the internship level.

However unfortunate it might be, there are even more barriers for us. This is even before we graduate. After a week of rural medicine in Goulburn, I became interested in going into a year of rural placement in my third year in medical school. There, I could gain some first-hand experience in rural medicine.

I enthusiastically emailed our coordinator while I was still in Goulburn, only to learn that international students are precluded from such opportunities. I understand why there are no scholarships for international students — tuition fees from the international students provides significant income for all Australian universities. They do not like to take some of that and give it back to us.

However, I was deeply perplexed when we were denied the rural opportunity. A significant portion of the rural doctors graduated from medical schools as international students. Australia needs rural doctors and thus it is counterproductive to limit international students from taking rural placements.

Similar confusion and disappointment were also expressed by numerous international medical students in a survey conducted by the NSW Medical Student Council (NSWMSC), where international medical students expressed very strong concerns about their future prospects.

Compared to domestic students, our path to becoming a fully registered doctor is difficult. Whatever the actual reason might be, the reality is that the international medical students – who are paying several times more than domestic Commonwealth-supported (CSP) students – have a much harder time finding an internship after graduation and obtaining full registration. This puts us at risk of having a semi-useless medical degree if we cannot secure an internship.

It would be better for everyone – both the international students and the Australian medical system – if international and domestic medical students were treated equally. We study hard, we understand the local medical system, we pay high tuition fees.

Most importantly, we will be just as competent as any domestic medical graduate after we graduate from medical school.

Changhan Xu has been an international student since he was 18, when he first moved to the U.S. to study biochemistry. He is currently a medical student at Australian National University.

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