The Kruk Report - a review into specialist international medical graduate pathways

Posted 21/7/2023 by Alasdair Spinner


This blog is about the Kruk report’s interim recommendations. The Kruk report is an Independent review of Australia's overseas health practitioner regulatory setting whose interim findings were published in April 2023. 



Navigating the Australian regulatory system for senior medical specialists is slower, more complex and expensive in many instances than other comparative countries. 


So much so, in 2012, a parliamentary report was even titled “Lost in the Labyrinth” . Sadly its recommendation to clarify pathways and assessment criteria for specialist international medical graduates (SIMGs) didn’t result in any improvements. In fact, I work closely with one medical college who three years after this report's publication actually made it harder for overseas trained specialists to work as consultants in Australia. 



In 2023, 11 years late, with little improvement, stakeholders are crying out for change. The health sector remains impacted by Covid-19 - delayed staff leave, deferred access to specialist care (elective surgery etc.) and so on. Many clinicians are planning to retire. Demand for specialists is rising. Australia’s population continues to grow and as it does it gets older with increased chronic diseases. 


The State and Territory governments who are tasked with running their respective health systems demanded urgent action to improve the system for SIMGs. In response, a review was commissioned and Robyn Kruk OA was tasked with its delivery. Kruk is a retired senior Australian public servant and senior policy maker with the experience appropriate enough for a complex subject matter with many stakeholders.



Kruk worked with state and territory health ministers, AHPRA (Australian Health Practitioner Regulation Agency- the GMC equivalent), National Boards, consulted with SIMGs and other stakeholders. The aim was to discover ways to reduce complexity, reduce duplication and inefficiency in the current process without sacrificing patient and public safety.



The interim report was published in late April with the final report due later in 2023. The key recommendations so far:


  • Enable a single portal for SIMG applicants to provide their documentation once. 


  • Expedite SIMG applicants coming from comparable health systems.


  • Have a method to better recognise skills and experience to recruit more experienced clinicians. 


  • Align English language standards with NZ and UK. 


  • Gather and publish more effective workforce data.


  • Help employers recruit faster in the areas of greatest need. 


  • Help SIMGs obtain permanent residency.



The system in Australia is demanding change. It's reassuring therefore to see this interim report. I look forward to the final version in a few months. Let's hope Kruk’s review doesn’t go the way of previous reports and get kicked into the long grass. Cynics might say the Medical Colleges have too many vested interests to make it easier for SIMGs to get assessed and accredited to work alongside their existing members. 


In fact WA Health satisfyingly gives the medical colleges a swipe in Kruk’s report, for actively controlling the number of specialists practising in Australia for their own nefarious (my word, only implied) ends.


I have cherry picked the SIMG information from the Kruk report but it also covers junior doctors, nurses and midwives. 


Hopefully, it will lead to meaningful reforms in the future to help today’s young medical professionals move to Australia easily and quickly.



I welcome your comments and to hear about your own experiences as an SIMG trying to work in Australia.

Independent review of overseas health practitioner regulatory settings - Robyn Kruk AO

Health Workforce Australia, Australia’s future Health Workforce – Doctor, Department of Health and Aged Care, Australian Government, 2014
House of Representatives Standing Committee on Health Care and Ageing, Lost in the Labyrinth, House of Representatives Standing Committee on Health Care and Ageing, Australian Government, 2012.

Photo by Bruno Rodrigues on Unsplash


How long does it need to implement these recommendations? What does it mean Align English language standards with NZ and UK??
Posted on July 22, 2023 by Ahmad
Hi, Thanks for this post. Some positive changes. However looks like no changes made to the 3 years experience requirement post-cct? Thanks
Posted on July 22, 2023 by Dr Syed Abdullah

Post Comment

Ready to find your next big challenge? Let's Go!
Cookies on this website
Spinner Medical Recruitment uses cookies just to track visits to our website. We don't store any personal details. You can restrict or block cookies by changing browser settings. If you continue without changing settings, we'll assume you're happy to receive all cookies on this website.