Migrant dentists in Australia: a qualitative-quantitative study

Dentists from over 120 countries migrate to Australia. Migrants constitute a significant proportion of the Australian dental workforce, and it is estimated that one in four practising dentists is a migrant dentist (qualified from an overseas institution). The purpose of this thesis (by publication) is to provide a better understanding on the migration and settlement experiences of migrant dentists in Australia. The thesis utilises both qualitative and quantitative methods to address the purpose. The qualitative study included in-depth interviews of 49 migrant dentists (from 22 countries) conducted between July and December 2011. Semi-structured interviews elicited the narration of participants’ life stories over time. The analysis mainly supported two superordinate themes: global interconnectedness (explaining the reasons for dentist migration to Australia) and the newness-struggle-success continuum (describing the cultural adaptation process of migrant dentists in Australia). Further, participation in the qualifying examination process appeared to influence the settlement experience of migrant dentists. The quantitative study included a national survey of all migrant dentists in Australia (n=1977), conducted between January and May 2013. Migrant dentists were asked to complete a self-administered questionnaire. A broad range of data including demographic, migration and residence characteristics, practice profiles, job satisfaction and life story experience were collected. A total of 1022 participants (response rate 54.5%) were classifiable into three mutually exclusive migrant dentist groups: direct recognition (n=491); examination pathway (n=411); and alternative pathway (n=120). The direct recognition group were mainly from high-income countries and had their qualifications directly recognised for practice in Australia. The examination pathway group included migrants having successfully completed the three-stage qualifying examination process. All other migrant dentists were classified into the alternative pathway group (including students, academics, specialists and special registration candidates). Overall, 41.8% of migrants were female. More than half of the examination pathway group (54.1%) were from lower-middle income countries. A majority of the examination pathway group migrants (65.0%) were under 45 years of age, and a larger proportion (12.4%) worked in the most disadvantaged areas in Australia compared with other groups. In general, migrant dentists reported high levels of job satisfaction in Australia. However, dentists who migrated through the examination pathway had a lower probability of being satisfied with the area and type of practice (OR=0.71; 0.51 – 0.98), compared with the direct recognition group. Based on migrant dentists’ life story experience, there was a greater appreciation of the Australian way of life if migrants had lived at least ten years in Australia (OR=1.97; 1.27-3.05). Migrants through the examination pathway (OR=9.32; 3.51-24.72) and alternative pathway (OR=7.38; 2.04-26.73) also showed greater challenges associated with home country systems when compared with the direct recognition group. The work contained within the thesis provided evidence to suggest that migrant dentists from developing countries face greater challenges both in their country of origin and in Australia. This thesis offers suggestions towards targeted policies for migrants facing settlement issues in Australia. A further recommendation is to adopt a more inclusive approach and greater consensus for an international agenda to address challenges posed by dentist migration.Thesis (Ph.D.) (Research by Publication) -- University of Adelaide, School of Dentistry, 2015