The Medical Board’s self-assessment has called the SIMG expedited pathway a success, but whether it moves the needle on rural workforce shortages remains too early to tell.
The Medical Board of Australia’s fast-tracked pathway might be bringing more overseas specialists, but experts say it is failing to ease rural workforce shortages.
The board’s annual report on the expedited specialist pathway, released yesterday, included data from the first 18 months of the pathway’s operation, from 21 October 2024 to 30 April 2026.
A total of 656 applications were received, of which 476 successfully led to conditional specialist registration. Only 46 SIMGs received unconditional registration during the period.
General practice accounted for 85% of expedited specialist registrations and almost half of all total specialist registration applications.
The MBA reported that at least 82% of SIMGs practiced in a Distribution Priority Area (DPA), yet 88% of these practitioners were based in metropolitan regions.
While Western Australia reported the highest proportion of SIMGs – at 26% – the Northern Territory recorded less than 1%.
General practice was the only specialty where SIMGs practised across all Modified Monash locations (MM1-7), with 11% based in rural and remote areas.
RACGP rural chair, Associate Professor Michael Clements, told The Medical Republic the outcome was “disappointing”.
“Only one in ten of the doctors that come in under this pathway have been going outside of the cities,” he said.
“It’s clear that this is not relieving the workforce pressures and stressors from the communities that need them outside the major metropolitan areas.”
Professor Clements attributed this partly to the failures of the current DPA system, which allows outer suburban areas to attract internationally qualified doctors.
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The report said the expedited pathway was “performing strongly” against its assessment-time benchmarks, with 80% of applications finalised within six weeks and 45% within four weeks – timeframes the evaluation described as substantially shorter than those of the specialist pathway.
However, Professor Clements said this was only one segment of the many steps in the pathway and that the report’s claim of an increase in SIMG applicants had to be set in the broader context of increased volume across all traditional pathways.
Applications across all SIMG specialist pathways increased by 25% overall between 2024 and 2025, with 82% of pathway entrants having never previously held registration in Australia.
Most applicants were from the United Kingdom, followed by New Zealand and Ireland.
ACCRM president Dr Rod Martin said the pathway’s results in delivering SIMGs to rural and remote areas were lacklustre.
“It hasn’t done terribly much in terms of delivering people into rural and remote Australia that are providing broadscale rural generalist service,” he said.
However, because there currently was no clear pathway to rural generalist recognition for doctors who fellowed overseas, he told TMR this wasn’t at all surprising.
“The challenge is the government’s gone a long way down the track to be able to build it out now,” he said.
Instead, Dr Martin said it wasn’t unreasonable to support the colleges in the transfer pathways they already had in place to provide better services.
“From a rural perspective, many of these doctors may well be able to provide a service, but there’s a strong preference for end-to-end homegrown rural generalists, for example. Many of the doctors coming in on the expedited pathway won’t be able to supervise unless they complete a full fellowship,” he said.
Among the report’s nine recommendations were clearer guidance materials, transparency of pathway fees, and improved system automation to minimise administrative burden.
“Future evaluations, drawing on a more mature dataset, will be better positioned to assess longer-term outcomes and provide more definitive conclusions,” the report said.
Read the report here.
