Australia needs doctors – so why are hundreds of qualified international physicians unable to work?

Australia is facing a critical doctor shortage. By 2026, we'll need an additional 13,000 doctors to meet demand, yet hundreds of qualified international physicians already living here but cannot practice due to bureaucratic barriers. This isn't a minor administrative issue – it's a healthcare emergency unfolding in slow motion.

International Medical Graduates (IMGs) aren't supplementary to Australia's healthcare system; they're essential. They comprise 32 per cent of our medical workforce and over half of all rural doctors. Without them, many regional communities would have no medical care at all.

Despite their importance, these doctors face a frustrating maze of repetitive assessments, unclear registration pathways, and huge costs. The process is so demoralising that many qualified physicians end up in casual jobs just to survive while waiting for approval, sometimes for years.

In 2012, the House of Representatives Standing Committee on Health and Ageing released the Lost in the Labyrinth report, identifying these problems and offering 45 recommendations for reform. While some improvements have emerged – particularly in workplace assessments and training programs – they remain scattered and inconsistent. A doctor in big city might access some support, while another in rural Queensland faces isolation and discrimination.

The COVID-19 pandemic starkly revealed our dependence on international doctors to keep hospitals running. Yet even as we rely on them, we continue to treat them as temporary solutions rather than valued colleagues.

Fixing Australia’s international medical graduate (IMG) bottleneck isn’t about more reports — it’s about putting proven solutions into action. My research with fellow University of Queensland experts points to six clear steps that would make an immediate difference.

1. A unified national approach

We need stronger national coordination. Right now, each state operates different registration systems, creating confusion and delays. A unified approach would get skilled doctors working faster where they're needed most.

2. Practical workplace assessments

Let doctors demonstrate their abilities in real clinical settings through expanded workplace-based assessments. Instead of endless paperwork, they can prove their competence while actually helping patients—far more practical than theoretical exams alone.

These proposals do not involve lowering clinical standards or allowing unsupervised practice before exams are completed. All clinical exposure would occur under supervision, ensuring patient safety remains paramount.

3. Earn while learn

Create paid transition programs where international doctors earn while learning Australian medical practices. These structured positions provide essential income stability while giving our hospitals extra support during their training period. There needs to be investment in targeted language and communication training, while including international doctors in decision-making. Specialised workshops that focus on clinical terminology, patient communication, and cultural nuances would help doctors navigate Australia's healthcare environment more confidently.

Doctors may eventually earn good incomes once fully registered, but without passing their exams – and without supervised clinical exposure to prepare for them – international medical graduates cannot access those opportunities. Offering targeted support or government-backed loans simply ensures that financial hardship does not prevent qualified doctors from progressing.

4. Fix the visa and registration maze

Streamline the visa and registration maze. The current process takes years and costs thousands, creating enormous stress. Simplifying these administrative hurdles benefits everyone—doctors get certainty, patients get care faster.

5. Mental health support

Provide robust mental health support. Years of uncertainty take a serious psychological toll. Counselling services, peer support networks, and clear guidance throughout the accreditation journey are essential for wellbeing. Expert navigators who understand both the bureaucratic requirements and emotional challenges could help guide IMGs through the complex accreditation maze.

6. Listen to international doctors

Finally, include international doctors in decision-making. They understand the system's flaws better than anyone. Their voices must shape policy reforms, ensuring solutions actually work in practice. With proper investment in these areas, we can transform wasted talent into healthcare solutions.

Behind every statistic is a skilled professional unable to use their training – and patients who could have benefited from their care. Every qualified doctor who gives up and leaves represents one less clinician for struggling emergency departments, understaffed rural clinics, and overwhelmed aged-care facilities. This isn't about being nice to international doctors – it's about building a healthcare system that serves all Australians effectively.

The solutions aren't mysterious or unaffordable. They require coordination and genuine commitment to treating international doctors as partners.

When we leave skilled doctors waiting in the wings, everyone loses. Patients wait longer for care. Rural communities go without doctors. Hospital staff face burnout from understaffing.

And talented professionals feel their expertise is unwanted.

Australia can transform this labyrinth into a welcoming pathway. The question isn't whether we can afford to fix this system – it's whether we can afford not to.