RACGP opposes lowering language barrier for IMGs

5 minute read

But removing unnecessary red tape that slows down visa applications is a go.

The RACGP opposes the Kruk report’s recommendation to lower the National Boards’ written English language requirements, proposed by AHPRA, but supports ending the Visas for GPs program. 

Following the release of the Kruk report – an interim report from the independent review commissioned by the national cabinet into regulations around IMG recruitment – at the end of April, there has been a push do away with unnecessary delays and box ticking for IMGs looking to work in Australia. 

One suite of proposed changes has involved the National Boards’ requirements for English skill levels for IMGs. 

After an initial public consultation by AHPRA and the National Boards (bar the Aboriginal and Torres Strait Islander Health Practice Board of Australia) earlier this year, which received “broad support” according to AHPRA, the group launched a new consultation last month proposing two additional changes to the English language standards for health professional. 

To meet the current National Boards’ ELS standards, IMGs must either reach a minimum score of band 7 in writing, reading, listening and speaking in a board-approved English test, or have been trained and educated in a country that the Boards recognise as having “health and education systems largely equivalent to those in Australia” and “services typically delivered in English”. 

In line with recommendations of the Kruk report, AHPRA and the boards have proposed to reduce the required test scores from band 7 to 6.5 in the writing component of the approved tests. 

In its response to the consultation, which ended on 13 September, the RACGP “strongly” opposed this initiative, noting that “the risks of adverse outcomes due to miscommunication in written records is significant”. 

“The level of English required for safe general practitioner service provision, in terms of coherent lexical accuracy, is at least International English Language Testing System Level 7 band descriptors,” the college added. 

“Below this level, the margin of error becomes too large for acceptable patient care.” 

The college also raised concerns regarding potential outcomes for the provision of care for First Nations peoples and emphasised the importance of cultural awareness and safety training for IMGs. 

“Considering remoteness is an indicator for chronic disease and multimorbidity prevalence and Aboriginal and Torres Strait Islander people represent over 30% of the total remote/very remote populations, it is critical IMGs are trained with the knowledge to deliver culturally safe best practice, along with high standards of communication – both verbal and via writing,” the college wrote. 

The college instead suggested that IMGs should be supported in providing “culturally safe primary care” which includes “maintaining high written standards”. 

The second of AHPRA’s two proposals – to expand the list of countries and jurisdiction that the National Board “can be confident that people who qualified in these countries have a level of English that is safe for practice in Australia” – had the college’s support, provided that “evidence clearly demonstrates a level of English skills equivalent to at least IELTS Level 7 band”. 

The proposal added that “objective evidence” would be needed as proof of suitable English levels in some cases, for example for countries with multiple official languages. 


Although reducing requirements for English skills might be a step too far for the RACGP, they welcomed removal of unnecessary red tape. 

The government recently confirmed the end of the Visas for GPs program which required sponsors for IMG visas to provide a certificate stating they had attempted to recruit a local healthcare worker for three months but couldn’t.  

The RACGP rural chair associate Professor Michael Clements called the certificate requirements “really ridiculous” and noted the resulting delays and barriers for recruitment in remote areas – which continue to suffer from a national GP shortage, he said. 

In a media release re-released today – after it was published “in error” last week, the Department of home Affairs told TMR – the government said the move would “reduce the time and complexity for IMGs seeking an employer sponsored visa”. 

From the middle of this month, applications will not require a Health Workforce Certificate (HWC) or Health Workforce Exemption Certificate (HWEC). But all applications submitted prior to the end of the program will still be processed in line with the program. 

“To attract international health professionals in a highly competitive global market, regulatory settings need to be fit for purpose, competitive, and not impose unnecessary barriers, while preserving patient safety standards and quality of care,” said Health Minister Mark Butler. 

“This initiative does all these things, improving the efficiency and effectiveness of the end-to-end regulatory journey for internationally qualified health practitioners.”   

Home Affairs Minister Andrew Giles added that visas relating to GP candidates remained “highest priority” for the government, “with assessment times down from approximately 30 days to one to two days for decision-ready applications”. 

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