Blacket R B
University of New South Wales.
Med J Aust. 1990 Aug 6;153(3):125-32. doi: 10.5694/j.1326-5377.1990.tb136827.x.
From July 1978 to March 1989, 1703 foreign medical graduates who entered Australia as immigrants took the examinations of the Australian Medical Examining Council (AMEC) and its successor since 1986, the Australian Medical Council (AMC). Of these, 821 (48.2%) passed the multiple choice question examinations and, of these, 627 (76.3%) passed the clinical examinations. The overall pass rate was 36.8%. The majority of those who passed required more than one attempt to do so. Graduates of medical schools from South Africa, Canada and the United States were, in general, more successful than those from other countries by a large margin. Most candidates were graduates of medical schools in third-world countries and Eastern Europe, and although substantial numbers ultimately passed, few of them had reached the same level of competence as graduates from South Africa and North America. There are many probable reasons for their generally poor performance, the most likely being the quality of their medical education in preclinical and clinical sciences and their lack of substantial postgraduate experience. A second factor for some is their inadequate command of English. A third factor is age. Of 547 candidates who presented for the first time in 1988 and 1989, 258 (47%) were 35 or more years old. Since 1984 medical immigration has trebled and is still rising. At the present rate of growth, foreign graduates sitting the AMC examinations for the first time in 1994 will number approximately 482, which (assuming all pass) will be equivalent to 40% of doctors expected to graduate from the 10 Australian medical schools in that year. In spite of a more than adequate supply of locally qualified doctors, Australia, through easy immigration, has become a target country for foreign medical graduates. The high failure rate in the AMC examinations has led to immigrant-activated political pressure for bridging courses and other concessions. If, as a result, the majority of the immigrants were to pass the AMC examinations and so enter general practice, medical immigration will increase at an even faster rate than it has since 1984, with significant changes in the medical workforce. Some reforms which might avert this are suggested.
1978年7月至1989年3月，1703名以移民身份进入澳大利亚的外国医学毕业生参加了澳大利亚医学考试委员会（AMEC）及其自1986年起的继任机构澳大利亚医学委员会（AMC）的考试。其中，821人（48.2%）通过了多项选择题考试，在这些人中，627人（76.3%）通过了临床考试。总体通过率为36.8%。大多数通过考试的人需要不止一次尝试才能通过。南非、加拿大和美国医学院的毕业生总体上比其他国家的毕业生成功得多。大多数考生是第三世界国家和东欧医学院的毕业生，尽管最终有相当数量的人通过了考试，但他们中很少有人达到了与南非和北美毕业生相同的能力水平。他们总体表现不佳可能有很多原因，最有可能的是他们在基础医学和临床科学方面的医学教育质量以及他们缺乏丰富的研究生经历。对一些人来说，第二个因素是他们英语掌握得不够好。第三个因素是年龄。在1988年和1989年首次参考的547名考生中，258人（47%）年龄在35岁及以上。自1984年以来，医学移民增加了两倍，并且仍在上升。以目前的增长速度，1994年首次参加AMC考试的外国毕业生人数将约为482人，这（假设所有人都通过）将相当于当年预计从澳大利亚10所医学院毕业的医生人数的40%。尽管当地有足够数量的合格医生，但澳大利亚通过宽松的移民政策，已成为外国医学毕业生的目标国家。AMC考试的高失败率导致了移民引发的政治压力，要求开设衔接课程和给予其他优惠。如果结果是大多数移民都能通过AMC考试从而进入全科医疗领域，那么医学移民的增长速度将比1984年以来更快，医学劳动力将发生重大变化。文中提出了一些可能避免这种情况的改革建议。
