Why Austrlaia Strict for Asian English Standards

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Why Austrlaia Strict for Asian English Standards


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Old 03-21-2010, 06:55 PM
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Exclamation Why Austrlaia Strict for Asian English Standards

I am a Pakistani Doctor(MBBS 1992) ,recently working in UAE as GP.
I am looking to move to Australia since long.But have failed due to IELTS 7+7 in all compulsion.
I have 7 overall but less in reading(6) and writing(6).This score too will expire this october 2010.I want to move to Australia on 422 Subclass visa for GP,s and start my supervised clinical practice in area of need or workforce shortage areas till I improve my IELTS(If needed) and of course do my AMC exam and track my career for General Practitioner.

I shall be thankful doctor if somebody can guide me and decrease my disappointment.


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Old 03-22-2010, 01:24 AM
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Quote:
Originally Posted by AQEEL View Post
I am a Pakistani Doctor(MBBS 1992) ,recently working in UAE as GP.
I am looking to move to Australia since long.But have failed due to IELTS 7+7 in all compulsion.
I have 7 overall but less in reading(6) and writing(6).This score too will expire this october 2010.I want to move to Australia on 422 Subclass visa for GP,s and start my supervised clinical practice in area of need or workforce shortage areas till I improve my IELTS(If needed) and of course do my AMC exam and track my career for General Practitioner.

I shall be thankful doctor if somebody can guide me and decrease my disappointment.
Australia does require good standards of english Aqeel and it is especially more so in areas like medicine and you will know better than us on how medicine can have practitioners involved in life or death situations, sometimes the rate of response being critical.

If a doctor failed to respond to an emergency in an appropriate manner because of being slower to read some information or just not having interpreted some information properly, that is just not good enough.

I've suggested on your other thread that perhaps if you wanted to make a trip to Australia, you may be able to arrange to spend some time in an observing role and be in communication with doctors here in an english speaking environment.
[ And best to do it with other than other Pakistanis for it is very easy for people from the same country to fall back on their native language ].





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Old 03-22-2010, 08:33 AM
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It's not just doctors, the NSW Nurses & Midwives Board also now requires an IELTS of 7 across all bands for registration of overseas educated nurses.

As to the reason, that should be obvious, however a reading of this case shows what can go wrong when an overseas doctor is out of their depth attempting to practice medicine in this country.

Stateline NSW

Protection of the Australian public has to come first. It is not possible to practice safely with an IELTS of less than 7....its not a guarantee of course, but it is a start.


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Old 03-22-2010, 12:59 PM
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Quote:
Originally Posted by mallory View Post
It's not just doctors, the NSW Nurses & Midwives Board also now requires an IELTS of 7 across all bands for registration of overseas educated nurses.

As to the reason, that should be obvious, however a reading of this case shows what can go wrong when an overseas doctor is out of their depth attempting to practice medicine in this country.

Stateline NSW

Protection of the Australian public has to come first. It is not possible to practice safely with an IELTS of less than 7....its not a guarantee of course, but it is a start.
Interesting report from Stateline that Mallory, as much for its lack of conclusion as anything and your own words highlighted in bold look to be the tip of the iceberg.

There's not so much any great evidence of the lack of english ability being shown in the report but quite something of the attitudes and competence of more than just two relatively junior doctors.

Doctors will make mistakes but with
Quote:
The inquest was told Dr Ismail made a decision to double the dose of endone from five to 10 milligrams at shorter intervals - three hourly instead of six. 30 milligrams of endone were subsequently administered to Vanessa between 7 pm and 2 am in addition to four Panadeine Forte tablets.
Whilst our Doctor Little even mentions the possibility of mis-reading Panadiene Forte for just Panadiene, the doseage increase of endone is just 400% !!!!!
and that is beyond the relam of competence when it comes to any sort of logic.

But the problems are more so for if with
Quote:
These drugs were administered despite the fact that earlier in the day, the neurosurgeon caring for Vanessa, Dr Nicholas Little, he was "constrained in the amount of analgesia we can give."
we are left to wonder just how well written up were instructions if his thoughts were written up at all.

And then we have
Quote:
EXCERPT OF LETTER TO GREG KNOBLANCHE: "I have spoken with Sanaa and there was a lack of insight into the first case. I think she is under pressure with her visa running out and she has enquired about going to New Zealand... Anyway, at the moment she is not safe, for whatever reason."

………………..

EXCERPT OF LETTER TO THE CORONER: "This letter generated a meeting without our Head of Department, though her position was considered non negotiable. I agreed to increase her supervision but accepted the fact that she was probably incapable of independent Specialist Practice in Australia."
Which would have me questioning the medical standards oversight, the report on the Doctor in question being some seven months prior to the patient death.

There may also be further inconsistency with information tended to the Coroner for
Quote:
Dr Barratt told the Coroner in his letter that Dr Azizi was:
EXCERPT OF LETTER TO THE CORONER: "Almost certainly not subject to any appointments or selection process as in Dr Ismail's case."
is a little different to
Quote:
EXCERPT OF LETTER TO THE CORONER: "She was paid for by the Saudi Government. Our hospital paid her on-call only. She did not undergo any selection or appointment process
The attitude of DOH would not seem to do a lot for health of the Australian health system either and it does seem that local training of doctors falls well short of Australia's population expansion and our recruiting of overseas doctors is morally questionable as well for do the countries of those doctors not have their own needs just as much as Australias?

With the current trial proceeding of Dr. Patel on manslaughter charges, english is also not being held to be an issue but certaintly the oversight of medical practices was questioned at the coronial inquest.

So Aqeel,
We have wandered away from your question Doctor on the need for good english and you would know it is not going to be just good english that will make a good doctor but more so the underlying competence of doctors and professionalism of systems and management in place.

The report posted by mallory gives a good example of a number of issues to do with the Royal North Shore Hospital, one of Sydney's major hospitals btw and you are probably aware that issues arise in many hospitals right around the globe, that being all the more reason for the best level of communication being a necessity, communication in Australia being primarily in english and certainly so for our medical staff in hospitals and medical clinics, though some multi lingual abilities are also often valuable when it comes to treating some people with an immigrant background.

Best of luck with your endeavour.





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Old 03-22-2010, 01:49 PM
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Well lets just say that adequate English communication skills are a necessary but not sufficient condition for safe practice and the avoidance of errors.

I have worked in the health care system in NSW for many years, and have been involved in the education of heath professionals for 15 years.

I can read between the lines in this report, and my assessment is that it is reasonable to draw the conclusion that the misreading of the medication chart in this case was related to language skills (or lack thereof). I also think this was very likely to be the cause of this registrar not following the neurologists recommendation (which was written in Vanessa's notes) that the prescribing of analgesia was 'constrained'. Did Dr Ismail understand the meaning of this word? Probably we will never know.

On a related issue, is not just the standard English and medical terminology that many international students and overseas educated professionals struggle with, its the Australian colloquialisms....they have to understand what the locals are saying too and that is not easy at all.


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Old 03-22-2010, 02:23 PM
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Quote:
Originally Posted by mallory View Post
Well lets just say that adequate English communication skills are a necessary but not sufficient condition for safe practice and the avoidance of errors.

I have worked in the health care system in NSW for many years, and have been involved in the education of heath professionals for 15 years.

I can read between the lines in this report, and my assessment is that it is reasonable to draw the conclusion that the misreading of the medication chart in this case was related to language skills (or lack thereof). I also think this was very likely to be the cause of this registrar not following the neurologists recommendation (which was written in Vanessa's notes) that the prescribing of analgesia was 'constrained'. Did Dr Ismail understand the meaning of this word? Probably we will never know.

On a related issue, is not just the standard English and medical terminology that many international students and overseas educated professionals struggle with, its the Australian colloquialisms....they have to understand what the locals are saying too and that is not easy at all.
I think based on the Stateline report mallory, my mind is open to poor communication or decisions for on your reading between the lines and conclusion whilst Dr Little hinself admitted that the possibility of Panadiene forte being able to be read as panadiene and whether or not that was because of english is unclear,
but with
Quote:
the cause of this registrar not following the neurologists recommendation (which was written in Vanessa's notes) that the prescribing of analgesia was 'constrained'.
have you read in some other document what was written in Vanessa's notes?
for on referring to the report, there is
Quote:
These drugs were administered despite the fact that earlier in the day, the neurosurgeon caring for Vanessa, Dr Nicholas Little, he was "constrained in the amount of analgesia we can give."
[ that actual transcript itself lacking in english expression somewhat, but certainly no mention of notes!]
Dr Little told the inquest when he learned after Vanessa's death about the dosage he was alarmed. I thought the does was too high, he said.

Counsel assisting the inquest, Gail Furness, asked Dr Little:

GAIL FURNESS (voiceover): "Would you have expected an anaesthetic registrar who was consulting a patient for the purpose of pre-operative check to prescribe medication?"

DR NICHOLAS LITTLE (voiceover): "No. Well, not for analgesia, no."
And the follow on certainly indicates something of a treatment communication gap within patient management - like, what is a registrar to do if a patient claims to be in acute pain? - tell the patient to suck it up!

If Dr Little expected it was hospital policy for a registrar or this registrar given history not to take decisions of this nature, that should have been clearly established and a management process in place [ and perhaps that should have been so ]

My reading between the lines of quite a few statements in the Stateline article is that there is more to that situation that needed addressing than just the registrar's competence.





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Old 03-22-2010, 11:32 PM
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IELTS compulsory for All........who wins dude!

Practice of Medicine skills requires competency based thorough clinical judgement.Language skill is only a part of this practice.

This by no way stands any answer to the biased IELTS criteria but allow me to let you know that may be sometimes this judgement can be wrong and unfair in the assessment of a Clinician...like in my case....
with 7 score in Listening and 8+ in speaking!! but ............

If communication is the sole criteria for the practice of medicine then so far, I see no criteria no yardstick for the language assessment of native english speakers.They may aslo have poor communication skills like all human beings.

This point needs to be worked out and categorised.

Let us end this issue with .................one solution ...................IELTS for All .
Let us make IELTS compulsory for all with no discrimination of country and colour and then see who wins the race dude!!


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Old 03-23-2010, 08:44 AM
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Quote:
Originally Posted by AQEEL View Post
Practice of Medicine skills requires competency based thorough clinical judgement.Language skill is only a part of this practice.

This by no way stands any answer to the biased IELTS criteria but allow me to let you know that may be sometimes this judgement can be wrong and unfair in the assessment of a Clinician...like in my case....
with 7 score in Listening and 8+ in speaking!! but ............

If communication is the sole criteria for the practice of medicine then so far, I see no criteria no yardstick for the language assessment of native english speakers.They may aslo have poor communication skills like all human beings.

This point needs to be worked out and categorised.

Let us end this issue with .................one solution ...................IELTS for All .
Let us make IELTS compulsory for all with no discrimination of country and colour and then see who wins the race dude!!
It would seem from that response Aqeel that you do in deed need to improve your reading skills for whilst mallory and I may want to differ a bit on interpreting ther Stateline article, there is clear indication to you that whilst communication is one issue and not just with foreign trained doctors, it has not been said it is a sole criteria and as you've agreed is a part of enhancing competent and safe medical practice in Australia.

You claim a bias and where in fact is that?
Have you bothered to read thoroughly all the information available through the Doctor Connect site?
Online Application Wizard and FAQ in particular has explanation of of why english standards are there, so why not read it and who in fact is it biased against?

You do need to do more than listen and speak in many professions, not just the medical nor the occupation of doctor.
For doctors there is:
Quote:
A national English Language Proficiency requirement for all InternationalMedical Graduates (IMGs) who require registration in Australia has been
accepted by:
Medical Board of the Australian Capital Territory
New South Wales Medical Board
Medical Board of the Northern Territory
Medical Board of Queensland
Medical Board of South Australia
Medical Council of Tasmania
Medical Practitioners Board of Victoria
Pleas take special note of :
Quote:
for all International
Medical Graduates (IMGs) who require registration in Australia
Maybe you ought to get a new set of starting blocks before you go running off at the mouth about discrimination, countries and colours.

Australia btw has people with origins of more than two hundred different countries, very much a land of immigrants you could say, but a country that has a national language of english.

So go and dude yourself and if need be get some medical help.





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Old 03-23-2010, 12:16 PM
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http://www.nswmb.org.au/resources/807
Quote:
Originally Posted by Wanderer View Post
.....what is a registrar to do if a patient claims to be in acute pain? - tell the patient to suck it up!
Not those exact words no, but effectively yes. Analgesia has to be given extremely carefully in cases of closed head injury, because of its effect on level of consciousness. LOC being a key assessment tool in the monitoring severity of the head injury itself. That was part of the reason for the 'constrained' comment by the neurologist (I don't know for sure whether he documented this, or just assumed an anaesthetics registrar would know it....its not esoteric knowledge. He would have documented his treatment plan though, and this would have included pain management).

What the registrar should have done was to explain this to Vanessa and her family, then consult with the neurologist as to whether a more effective, but non-lethal regime of pain relief was possible in this case (unlikely because of the maximum dose of PF she was already on).

Quote:
Originally Posted by Wanderer View Post
My reading between the lines of quite a few statements in the Stateline article is that there is more to that situation that needed addressing than just the registrar's competence.
It is true that most mistakes in complex systems are multifactorial, and this was no exception. For example, the nurses should have known better than to give Vanessa successive and eventually lethal doses of both medications....that should not have happened, no matter what had been charted.

However, the professional standards committee of the NMB thought Dr Ismael's deficiency was communication.

[URL="http://www.nswmb.org.au/resources/807"]

I don't know for sure what the exact nature of the communication problem was, and probably we will never know. Has the 'communication course' she was required to undertake fixed whatever the problems were? We can only hope.


Last edited by mallory; 03-23-2010 at 01:10 PM. Reason: Edited to fix link

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Old 03-23-2010, 01:00 PM
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Quote:
Originally Posted by AQEEL View Post
Let us end this issue with .................one solution ...................IELTS for All .
Let us make IELTS compulsory for all with no discrimination of country and colour and then see who wins the race dude!!
You have an attitude problem.

I could not demand to go and practice my profession in another country if I did not meet their professional standards requirements. I would have to undergo comprehensive testing if I wanted to practice in the US, for example. That is not discrimination, it is prudence.

Justice in this situation is not about imposing equality upon that which is in fact not equal. It is about providing maximum possible protection for the Australian public.


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