More than three quarters of GPs think experiences of racial and ethnic discrimination will discourage IMGs from working in Australia to at least some extent – potentially contributing to the workforce shortage, a national survey of close to 1500 GPs has found.

Almost one in five GPs (19%) reported experiencing racial/ethnic discrimination from patients in the past six months—and nearly one in six (16%) from the public. Seven percent said they’d experienced it from medical colleagues.

While there are likely many factors at play, over half say the current political environment is playing a part, to varying degrees.

Among respondents with non-Australian qualifications, 18% thought experiences of racial or ethnic discrimination would discourage IMGs from working in Australia to a great extent, compared with just 7% of those who received their qualifications in Australia.

Likewise, while around three-quarters of GPs felt this would contribute to the GP workforce shortage to some extent, GPs with non-Australian qualifications were more likely to say it contributed to a moderate or great extent (49%), compared with their colleagues who have Australian qualifications (32%).

There were no statistically significant differences between responses from GPs in metro vs rural or regional areas.

“As news gets back to various countries, it is likely to put some people off coming here,” one GP commented.

The rise of right-wing politics

Last month in the NSW town of Kurri Kurri, a post on a community Facebook page received several racist comments when it welcomed two new GPs, and anti-immigration leaflets were dropped into letterboxes in the region the following week, the Medical Republic reported.

Support for Pauline Hanson’s One Nation partyhas been rising in rural and regional areas – with campaigning against immigration at the core of the party’s message. Late last month the One Nation leader lost an appeal to overturn a court ruling that had found she had breached the Racial Discrimination Act in a tweet to Greens senator Mehreen Faruqi in 2022.

While Healthed’s survey did not specifically ask about right-wing or extremist politics, 57% of GPs felt “the current political climate” deserved at least some of the blame for experiences of discrimination – with one third of GPs attributing it to “a great or moderate extent.”

Some respondents said the issue should be viewed alongside broader challenges such as administrative burden and declining interest in general practice among Australian graduates.

Others felt economic opportunities and quality of life are still powerful incentives drawing overseas-trained doctors to Australia.

RACGP Victoria chair Dr Anita Muñoz agrees workforce shortages are multifactorial, but discrimination cannot be separated from retention.

“If we invite people to our country to work, then we should be doing what we can to help them thrive,” Dr Muñoz says.

She argues more investment and support are needed for IMGs, noting many face additional challenges around culture, geography, language nuances and professional regulation.

“We need to think, what can we do to help rather than leave people to their own devices and hope for the best?”

A particular challenge for rural Australia

Several survey respondents highlighted the intense pressures faced by IMGs working outside metropolitan areas, where reliance on overseas-trained doctors is often the greatest. Some pointed to social isolation, separation from family and perceived discrimination within small communities.

One said they knew doctors who had declined positions in certain locations because of concerns about discrimination and their families’ safety.

GP Dr Jennifer Schafer, the Medical Director of Doctors’ Health in Queensland says many IMGs experience challenging circumstances before discrimination even enters the picture.

“Often they’re working in places where there is a workforce shortage. They’re going above and beyond to do what they can for the community. And then you are met with this sort of behaviour.”

“We need them, is the short version. And many members of the public support international medical graduates because they’re providing services where there are none, or they’re limited.”

Dr Muñoz agrees.

“The entire Australian healthcare system would have collapsed decades ago were it not for our IMGs.”

“Yet when it comes to the perpetration of racist behaviour, I’m seeing limited action being taken.”

How well are policies working?

The RACGP, AMA and Ahpra all have anti-racism policies, and the right to a safe workplace is enshrined in Australian laws. But there’s a gap between theory and the day-to-day experiences of some IMGs.

“Working in the country previously, I was aware of a lot of patients who treated IMG colleagues differently from how I was treated,” one survey respondent commented.

“Some patients are not willing to see ethnic doctors,” wrote another.

AMA President Dr Danielle McMullen says we need “a commitment from everyone, including those in executive and senior leadership roles, to create systems and processes” that hold individuals and groups responsible for their decisions and actions, and ensure people who experience racism have access to trusted and safe reporting systems.

Dr Muñoz says we need to “go beyond just saying that we have a zero tolerance for poor behaviour. We need to determine what can be done to change that behaviour.”