Migrant doctors in the bush: ‘We’re lucky to get some’

When Dr Parisa Pour Ali migrated to Australia from Iran she faced employment obstacles so great that she considered changing careers. Now she is a much-needed rural doctor working on the far-south coast of New South Wales.

Despite a sustained shortage of doctors in rural Australia, it is extremely difficult for migrant doctors to find work.

Following seven years of medical training in Iran it took a further two years of accreditations before Dr Pour Ali was allowed to practise in Australia.

However she also endured a year of frustrating rejections before she eventually found work in Merimbula, in a region that was part of a program to place migrant doctors.

Dr Pour Ali said medical clinics preferred locally trained doctors.

“It’s not about discrimination or racism,” she said.

“Even for me, if I was a practice manager of a clinic, I would prefer to get someone who already has Australian registration.

“So I am not unhappy with any of these clinics that answered no, but it was a difficult process for me.”

Peter Cumming, the practice manager of the clinic that employed Dr Pour Ali, said the problem for rural clinics was finding doctors.

“It’s very, very difficult,” he said.

“It’s very frustrating.”

He said that younger, Australian-educated, fully qualified general practitioners would not come to the town because they wanted to pursue their careers and further training in the cities.

Mr Cumming said older GPs would not come because they often had partners in other professions in which there were no employment opportunities in a rural region.

The first step for a migrant doctor is to be employed “under the supervision of a GP” until they pass their examinations to be registered as a general practitioner.

“This fellowship exam is a bit scary for doctors from other countries,” Dr Pour Ali said.

“Migrant doctors don’t have much support, so it makes it more difficult.”

It has been a long journey for Dr Pour Ali but there are more exams, and costs, ahead before she is fully registered. Meanwhile, she is facing all the challenges of practising medicine in a different culture, but also enjoying the opportunities.

“I believe Australian general practice has more opportunity to work and do different things,” she said.

“In Iran you can see any specialist without needing to see a GP, so you will not get different cases. But here the variety is much more.”

Mr Cumming said the clinic’s doctors had particularly difficult work because of the older demographic in the coastal town with its large population of retirees and four nursing homes.

He said the doctors had complex and difficult challenges with the older patients typically having at least two chronic conditions.

Dr Pour Ali said the one thing she did not like about the Australian system was the time limitation for patient consultations.

“You have to see the patient in 10 minutes, 15 minutes. Sometimes it makes me frustrated because some patients, especially in this area, are elderly and they have multiple diseases,” she said.

Dr Pour Ali and Mr Cumming both said the added challenge for migrant doctors was language.

Mr Cumming said Dr Pour Ali had excellent English but the problem for migrant doctors was always colloquialisms and slang.

“Sometimes it is a challenge,” Dr Pour Ali said.

“Especially when older people use some specific expressions or slang and then younger people use a different slang.

“I have to understand. I shouldn’t miss even one word because it could be a specific symptom they are telling me.”

However, she said she learnt a lot from her patients and from friends.

Mr Cumming said there were a number of valued migrant doctors in the region, filling a great need.

“Australian graduates don’t want to come to the bush but migrant doctors do. We’re lucky to get some.”

Dr Pour Ali said she made the right decision to stick with medicine.

“I always wanted to become a doctor. I definitely chose this career because I love it,” she said.

It’s been a difficult process for her to be accepted into the medical profession in Australia, and the journey is not over until she passes her fellowship exams.

“But I believe if you have perseverance and if you want something, definitely you will get it,” she said.