Cultural Diversity In Health

1. Dr. Rakesh Mohindra M.B.,B.S., D.C.H., FACPsychMed Provost Royal Australian College of GP's Past Chair RACGP – SA & NT Faculty Principal Surveyor - AGPAL General Practitioner - Ladywood Clinic Modbury Heights S.A. Cultural Diversity In Health

2. Informed Consent & Cultural Issues Facing IMG’s • Who is an IMG • Synonymous with OTD's / Foreign Doctors / Imported MG’s • Fortunately not called “The desperately needed Doctors”. (DND’s) • Any Medical Graduate with basic degree from a country other than Australia • Includes Both General Practitioners & Specialists • Australian Medical Graduates become IMG’s when they work overseas

3. I am • Not a person with legal back ground or a Lawyer (thankfully) • Not an authority on “Informed Consent” • An IMG – as defined above • Worked in Public and Private Sector of Health delivery both here in Australia and Overseas

4. My Talk Is Based On • My experience of working in three continents • My Observations over the years • Experience as Principal Surveyor for AGPAL • Experience as an Assessor and National Chair for Vocational Training & Accreditation Committee (VTASC) of The Royal Australian College of GP's • Understanding of the health care delivery in Australia (including its limitations).

5. I believe • The human body and the associated pathology and the Disease processes are generally the same all over the world – incidence of disease / pathology can vary • It is the social and cultural aspects of Medicine which are different at various places. • The issue of informed consent can be influenced by poor communication and interpersonal skills. • There are “many ways to skin a cat” and the acceptable ways can be different

6. Cultural Issues faced by IMG's • What is Culture ? • How do we define culture in context of IMG’s • We, as humans, are a product of the people, institutions and Cultures we have grown up and trained in. • Our experiences do influence our behaviours.

7. Social Culture • We are a Multicultural nation • Our patients are a diverse mix of various Ethnic backgrounds and different religious beliefs • To cater for the needs of such diverse patient base can cause a multitude of difficulties for the health providers – both IMG’s and local graduates. • As a Nation we are still a long way from “Closing the Gap”

8. Culture Can be • Medical Culture (practitioner's) can be influenced by • Attitudes • Ego & self esteem • Prior experiences both professional & Personal

9. Cultural Issues (contd) • Medical Culture (practitioner's) • Provider’s Attitudes vary based on their country of Origin, quality of training etc. • Work load related attitudes • Interaction with colleagues • Working relationship with other health professionals

10. Cultural Issues (contd) • Community's Expectations • Competence, Skills and acceptable behavior • Sensitivity to Local Community needs • Social and cultural integration (Country areas) and assimilation. • Reliability and long term commitment

11. Cultural Issues (contd) • Provider’s Expectations • Being accepted • Being Understood • Being respected & valued

12. Cultural Issues (contd) • Community's Perception of Provider's Culture can be influenced by • Looks & Colour • Accent / Language • Religion - based on International Events / happenings • Ill informed fear re competency (mostly) • Insecurity of long term commitment of the Provider to the local Community

13. Its not all Doom & Gloom • Future / Systems in Place • Very Robust Systems in place (GP’s & Specialists) • Very Proactive Medical Board • Impending National Medical Registration

14. Any Questions