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.