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In 2004, an experienced Argentinian Nephrologist emigrated to Australia and sought work as a Nephrologist. The direct pathway via full professional recognition was precluded, and the option of retraining was prohibitive. A pragmatic pathway to a return to clinical practice was found through nursing qualification, concluding with meaningful employment as a Nurse Practitioner.
In Australia, a Nurse Practitioner is a Registered Nurse with a Master' degree with the expertise and authority to diagnose and treat people with any health condition under their scope of practice. Hence, the Nurse Practitioner role creates an opportunity for International Medical Graduates to provide and promote the increasing demands of complex care, enabling high-quality healthcare delivery.
This paper describes the Argentinian medical graduate journey to a Nephrology Nurse Practitioner in Australia as an alternative pathway to continue practising in the renal field.
The presenter emigrated in 2004, and although the Australian Medical Council verified her medical qualifications, her Nephrologist experience in a public hospital and in private companies of dialysis, was not recognised as equivalent nephrology training by the College of Physicians. She began work as a renal dialysis technician and decided to apply for a Bachelor of Nursing. The local universities provided no specific credit for being a physician, and she then had to complete the years required to become a nurse. She graduated as a Registered Nurse in 2014 and then completed a Master of Clinical Nursing in 2016, enabling her to then take up her current position as an accredited Nephrology Nurse Practitioner. In 2021, she commenced a PhD, focusing on self-management in chronic kidney disease.
Not all specialist physicians achieve professional recognition when they migrate, and many face the option of either fully retraining or abandoning their clinical careers. In many developed countries, such migrants find work in low-skilled and low-paid work outside the health system of their adopted country. The case presented highlights the culmination of her expertise with eventual emergence as a valued and respected clinical expert working independently in a Nurse Practitioner role.
Nursing programs to facilitate international medical graduates to become Nurse Practitioners are not yet supported by Australian Universities. Based on economic analysis and published literature, international medical graduates as Nurse Practitioners can enhance access to high-quality and cost-effective healthcare for the growing number of chronic kidney disease population with significant mortality, morbidity and economic burden. Hence, international medical graduates becoming nurse practitioners provide a balanced blend of clinical medical and nursing knowledge to manage the high demand of multicultural Australian renal population.
Although the career transition pathway in this case study was complicated and fraught, it presents a pragmatic solution for some individuals. It helps fill critical gaps in the health workforce structure. A key enabler that sets this pathway on a more rational footing would be establishing specific graduate nursing programs to facilitate Nurse Practitioner training for International Medical Graduates in Australian Universities, as currently happens in the US.