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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXIII | Pages 114 - 114
1 May 2012
Pitchford D
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Orthopaedic International Medical Graduates (IMGs) have provided an invaluable service and source of workforce relief mainly in rural and outback Australia. Queensland has relied more heavily than any other state on overseas trained doctors to provide general practitioners and specialists around the state, particularly in areas deemed ‘an area of need’ (AON). The AON designation was seen to be a way of easy recruitment but is a two-edged sword for both the state government and for the IMG.

While overseas trained doctors may be more compliant with administrators' wishes than what locally trained doctors might be, they have not necessarily passed a local medical examination or even sat a medical examination in English before coming to Australia.

Meticulous and drawn out medical qualification checks, health and security checks are carried out which can take a long time to perform and could frustrate the end user who is often dependent on that doctor arriving by a certain date to cover a call roster and maintain a continuum of care for a specific district. The many and varied steps have been changing over the past few years and so this presentation is meant to clear up some of the misunderstandings that exist for the various parties involved. This would include some guidelines to the IMG and to the recipient hospital or practice recruiting that IMG, outlining some of the traps and pitfalls for all to consider.

State government administrators also need to show leadership when advertising, interviewing and employing IMGs, as this may have implications for all of us into the next decade. A frank look at our present and future workforce needs by the whole Orthopaedic community is necessary. The challenges and solutions of how Orthopaedic Surgery will be provided both publically and privately into the future is resting with us now.


Orthopaedic Proceedings
Vol. 84-B, Issue SUPP_III | Pages 272 - 272
1 Nov 2002
Pitchford D Mcphee IB Swanson CE
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Aim: To review the effect of school screening on the referral pattern and management at a provincial scoliosis clinic.

Methods: Records of all females aged 10 to 17 years with scoliosis seen in Mackay (North Queensland) were reviewed. The age, date of presentation, magnitude of the curve, Risser sign, menarche and previous treatments were noted. Patients wearing scoliosis braces were reviewed to determine compliance. School Health, Mackay, provided data on number of females who were in grade seven at school and these were screened. The number having a possible deformity, and the number of confirmed cases per year were recorded.

Results: Notification rates for potential scoliosis cases ranged from 29.5% in 1993 to1.8% in 1998. The annual prevalence of confirmed scoliosis ranged from 3.3% in 1992 to 1% in 1997. Twenty-four of 57 cases seen in the clinic were initially detected by school screening. Those in the group detected by screening were significantly younger than other referrals, but no significant differences were noted in curve size, Risser sign or the menarche. The proportion treated with a brace was significantly greater in the screened group (p=.03), but the proportion coming to surgery was not significantly different (p=.07) between groups.

Conclusions: Although school screening for scoliosis resulted in referral at an earlier age, it did not translate to detection of smaller curves at an earlier stage of development, nor to a trend to brace treatment. The efficacy of bracing depended on compliance.