Neville Yeomans

Neville Yeomans (PhD in History, 2023) ‘A History of Australia’s Immigrant Doctors, 1838–2021: Colonial Beginnings, Contemporary Challenges’

Since colonisation in 1788, Australia has been populated by immigrants. Among them, for all this period, there have been practitioners of Western medicine who qualified overseas. This thesis is about them, now termed International Medical Graduates (IMGs). Starting in 1838, when the first colonial medical Acts were promulgated, it explores who those graduates were, from where they came, why they migrated at specific times in response to geopolitical and other events, how were they received and what were their experiences. Their history is integral to the history of medical practice and medical politics in Australia. It has not previously been examined across the longue durée researched here; the purpose has been to better understand the evolving and continuous process of medical immigration, rather than the fragments that constitute the current historiography.

The methodology is quantitative and qualitative. First, a prosopography was constructed comprising all IMGs registered in each colony, state, and territory from 1838 to 1984, supplemented by data from a random sample of contemporary IMGs to bridge to the present. From this, the time course, profile of donor countries, and characteristics of successive waves of IMGs has been documented, then linked to causal historical events, including the changing and frequently obstructive medical legislation. Throughout the colonial period and the first half of the twentieth century, nearly all immigrant doctors had trained in Great Britain and Ireland, often motivated by difficulties establishing practice at home and attracted by opportunities in a new land, but with source countries restricted by the Medical Acts. Then, as Australia opened to migrants from the rest of the world in the second half of the twentieth century, so the spectrum of IMGs expanded immensely – approximately, but not completely matching that of the immigrant populations overall.

Currently, about 30 per cent of the Australian medical workforce was born and trained overseas. A second aim was to understand and learn from the experiences of living IMGs. For this, 89 oral histories were recorded – using criterion-referenced, random, and snowball sampling. Many were negotiating the pathways to medical registration, under the now national regulator, the Australian Health Practitioner Regulation Agency (AHPRA). The thesis gives them a voice, and illustrates their difficulties and crises – sometimes at the hands of what seems to have been a Kafkaesque bureaucracy. The other pathway for some has been to persuade a specialist college that their overseas qualification is comparable to that of the Australian college. Interviews with college and AHPRA representatives confirm the author’s impression that much has been done recently to improve the fairness of those processes; but the thesis also provides evidence in the oral histories of what appear to be historical and recent injustices. Australia owes much to its IMGs. The thesis allows us to learn from their history during almost two centuries. It concludes with recommendations for how we can still assure the paramount need to protect Australian patients, yet also improve the effectiveness and fairness of our current processes for registering and supporting those who received their medical training overseas.

Supervisors: late Laureate Professor Emeritus Stuart Macintyre AO, Professor Sean Scalmer, Redmond Barry Distinguished Professor Emerita Janet McCalman AC, and Dr James Bradley