Do you Need Supervision?

If you are an International Medical Graduate (IMG) who has obtained Limited or Provisional Registration, you must work under supervision. Supervision remains a requirement of registration for the duration of the IMG’s limited or provisional registration.

However, supervision is not required if you are an Australian or New Zealand Medical Graduate with provisional registration (interns) who undertake a period of supervised practice in an accredited intern position.

Purpose of Supervision

IMGs are required to go through Supervision so that they become familiar with the Australian health system and the expected standard of medical practice. Supervision assures the Medical Board of Australia and the community that the medical practitioner with limited or provisional registration is practising safely and is not putting the public at risk.

Good supervision enables the International Medical Graduate to review and improve their practice in a constructive and supportive environment and to develop and enhance their knowledge, skills and professionalism in the field.

IMG candidates who have completed their supervised year are almost in an equal position with Australian medical graduates.

Who can be Supervisors?

According to RACGP guidelines, a supervisor taking responsibility of medical students at all stages of their term should display the following attributes:

ü  be known, approachable and easily accessible to the medical student and have established a rapport with them early in their placement

ü  be a good communicator

ü  be an advocate for the medical student

ü  understand the medical student’s role in terms of ‘experience’ of general practice

ü  be supportive of the medical student

ü  be able to adopt a counselling role with the medical student in relation to career or vocational planning and dealing with work pressures

ü  be interested in education, enjoy and be enthusiastic about teaching

ü  be able to deal effectively and assertively with other staff and specialists that the medical student will need to deal with

Supervision Requirements

According to the AHPRA guidelines, supervisors, including principal supervisors, co-supervisors, term co-supervisors and temporary co-supervisors should meet the following requirements:

ü  must not have conditions imposed on their registration or undertakings accepted by the Board as a result of health, performance or conduct issues

ü  must not be a relative or domestic partner of the IMG, and

ü  must not be an employee of the IMG.

The Medical Board will approve supervisors based on the past notification history of proposed supervisors.

Can you work anywhere under supervision?

As per the latest guidelines, IMGs with limited or provisional registration work at medical practices accredited by the RACGP for its General Practice standards. If not, the supervisor is required to assure the board that they have structures in place to support safe practice by the IMG.

What factors will decide your Supervision Level?

When deciding the level of supervision that is necessary, the Medical Board will consider a range of factors including:

·       The IMG’s qualifications

·       The IMG’s previous experience, especially in the type of position for which the IMG has applied

·       Whether the IMG has practised recently and the scope of their recent practice

·       The requirements of the position including the type of skills required for the position

·       The position itself, including the level of risk, the location of practice and the availability of supports (other practitioners, local hospital)

·       The seniority of the position for hospital positions

·       Recommendations from a pre-employment structured clinical interview (PESCI) (noting that the Board may require a different level of supervision than recommended in the PESCI), and

·       Recommendations from a specialist medical college that has assessed the IMG (noting that the Board may require a different level of supervision than recommended by the college).

Supervision Levels in GP positions

The Medical Board will decide the supervision level for IMGs working in General Practice. Under each supervision level, there are specific requirements.

Level 1 Supervision

The Supervisor takes direct and principal responsibility of each patient. IMGs who gain registration for the first time are likely to get level 1 supervision.

a)       The supervisor must ensure that there are mechanisms in place for monitoring whether the IMG is practising safely.

b)       The IMG is permitted to work alone provided that the supervisor is contactable by telephone or video link.

Level 2 Supervision

Here both the Supervisor and the IMG are responsible for each patient. Therefore, the supervisor should ensure the IMG’s patient management responsibility is allowed according to the supervisor’s assessment of the IMG’s competence.

a)       Supervision must be primarily in person - the supervisor must be physically present at the workplace a minimum of 80% of the time that the IMG is practising. Where the supervisor is not physically present, they must always be accessible by telephone or video link.

b)       The IMG must inform their supervisor daily about the management of individual patients.

Level 3 Supervision

Under level 3 supervision the IMG takes primary responsibility of the patient.

a)       The supervisor must ensure that there are mechanisms in place for monitoring whether the IMG is practising safely.

b)       The IMG is permitted to work alone provided that the supervisor is contactable by telephone or video link.

Level 4 Supervision

The IMG is directly and fully responsible for each patient.

a)       A supervisor must oversee the supervised GP’s practice.

b)       A supervisor must be available for consultation if the IMG requires support.

c)        A supervisor must periodically conduct reviews of the supervised GP’s practice.

However, according to the board, it may be more appropriate to use the existing hospital supervision structures and protocols for hospital-based positions. If the four supervision levels do not correspond to the proposed level of supervision for a hospital-based position, the Board will consider other supervision structures.

Are you an IMG seeking to work in Australia under supervision? Check out our comprehensive job board that offers multiple vacancies for medical professionals. For more details and guidance on supervision, drop a line at feed@medfuture.com.au.

Sources:

Guidelines for supervised practice for limited registration

https://www.medicalboard.gov.au/Registration/International-Medical-Graduates/Supervision.aspx

https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Supervised-practice-guidelines.aspx