Longitudinal Outcome of Programmatic Assessment of International Medical Graduates

Australia depends on international medical graduates (IMGs) to meet workforce shortages. The current standard assessment for IMGs is by clinical examination in observed structured clinical encounter (OSCE) format lasting 200 minutes. There are concerns about adequateness of this assessment as it does not test the qualities required to practice in a new country. We introduced a programmatic performance-based assessment for IMGs to prepare them to meet these challenges. The workplace-based assessment (WBA) program involves six-month longitudinal programmatic assessments comprising of 12 mini-clinical evaluation exercises (Mini-CEX), five case-based discussions (CBD), two in-training assessments (ITAs) and two sets of multisource feedback (MSF) assessments. We assessed 254 IMGs since 2010. We conducted a survey to evaluate the satisfaction with the program and the outcomes of these doctors.

We surveyed 254 candidates from 2010 to 2020. The survey used "SelectSurvey" tool with 12 questions and free-text comments. All candidates were sent the survey link to their last registered mobile phone using "Telstra Instant Messaging Service". We analysed the data using Microsoft "Excel".

We received 153 (60%) responses. Amongst them, 141 (92%) candidates did not require further supervised practice for general registration and 129 (84%) candidates hold general/specialist registration. The candidates found the program useful and felt well supported. They appreciated real patient encounters. The feedback with positive critiquing was helpful in improving their clinical practice. The negative themes were program costs and frustration with the length of the program.

Upon completion of the WBA program and obtaining the AMC certificate, most of the doctors were able to gain general registration. Seventy-eight (50%) candidates chose to continue their careers within the local area with 124 (80%) of them within the state. Our survey shows a comprehensive assessment program with immediate constructive feedback produces competent doctors to fill the medical workforce shortages.