An Expat’s Journey of Working in Clinical Neurophysiology in Australia
In 2009, I made a more than 9000km move to Tasmania…you could say I am a local now but not quite!
I had been working in South Africa prior to this; this is where I was born, raised, and had trained for 4 years in Clinical Neurophysiology and worked with professional private practice accreditation afforded by the Health Professions Council of South Africa (HPCSA).
I was lucky enough to be given the opportunity to visit Hobart prior to accepting my position and meet members of the department and be given a visitor’s tour. It took another 9 months before I could start work officially though, as the visa process was not as timely due to various factors like: lost paperwork or immigration case managers going on extended leave. For those unaware the visa process also includes taking an International English exam (IELTS) and significant medical testing like chest X-rays and blood work (dependent on your country of origin).
When I arrived in Hobart as a young unassuming 27-year-old, I became part of a much smaller Neurology unit. This has grown exponentially by way of consultants and registrars over the last 10 years; and I have grown as an individual both personally and professionally within the department.
As far as neurophysiological testing goes, the protocols of testing were not much different to the ones I was used to- so this transition was quick, and independent work was almost immediate.
The challenges for me, were facing the many misconceptions about who I am, where I am from, why I look a certain way, from both patients and colleagues. Fast forward 14 years and society has come a long way, as the assumptions and questions that were posed to me early on happens much less now. In the first few years of my move, I found these cultural misconceptions and judgements discomforting- but more about cultural intelligence (CQ) later.
Education and Training around the World and the International Guidelines
A survey conducted last year by the International Federation of Clinical Neurophysiology (IFCN) looked at education and training methods in their Europe, Middle East and Africa, Latin America and Asia Oceania chapters, within respective professional societies.
It largely surveys the training of medical practitioners in Clinical Neurophysiology but also touched on Neurophysiology Scientist /Technologist training and reported that this training lasted <2 years in 15 of the 27 professional societies (15/27) within the Europe, Middle East and Africa group; 2-4 years in 12/27; with exit through a university exam in 8/27.
The Asia Oceania group’s 12 professional societies showed durations of training were less than 2 years in 5/12 and 2 to 4 years in 4/12. They had exit exams in 6/12, of which three were run locally and three by the national society.
In Latin America however, there is no formal training program for technicians or technologists, instead they are trained informally for a short period (weeks or months) by the physician they work with.
Some professional societies across all 3 groups additionally trained nurses in clinical neurophysiology.
This exposes that the training programs vary across the globe, and it is suggestive that the practical and theoretical training methods be recognised and fully appreciated for training adhering to international guidelines of Clinical Neurophysiology practice.
Cultural Intelligence (CQ)- Listening without Judgement
We know about IQ and EQ but what about CQ? Cultural intelligence is, to put it very simply, the ability to relate to people from other cultures. This is an incredibly broad topic, but I can’t not draw attention to it, if I am to describe my journey. Regardless of my birth country or nationality, people see my ethnicity first- and that’s ok because I’m proud of that too. I have at times been met with inappropriate comments like “but your English, how is it so good?”. The judgement is already posed in the question.
I grew up in an old apartheid South Africa where overt racism was legal, but I had never experienced blatant workplace (or any place) racism until I moved here. More than once (very early on), patients have hurled racial slurs at me. Nothing and no one can prepare you for this the first time it happens, but remaining calm and professional got me through those days! Could workplaces be better equipped and transparent to manage such incidents? Definitely!
On a positive note, I have experienced a change in behaviour as the years roll on and cultural diversity and exposure is becoming more prevalent in Tasmania.
Over time, I learned how to subtly talk about my background and achievements but learnt that I needed to first add value; and that the exchange is only beneficial if the listener listens without judgement.
The future of Clinical Neurophysiology in Australia
With accreditation available for our profession, as well as inclusive and active societies like the NSSA, I am excited about the future developments and advancements that we may make as Neurophysiology Scientists.
References and Further Reading:
1. Jonathan Cole , Anita Kamondi , Paulo Teixeira Kimaid d , Nortina Shahrizaila Training and education practice in the Europe, Middle East and Africa, Latin America and Asia Oceania chapters, IFCN; an international survey March 2022 Clinical Neurophysiology Practice 7(43)
2. Negin et al. Human Resources for Health 2013, Foreign-born health workers in Australia: an analysis of census data
3. Jonathan P. McNulty, Yurgos Politis Empathy, emotional intelligence and interprofessional skills in healthcare education Source Information: June 2023, Volume54(Issue2)Pages, p.238To - 246 - Journal of Medical Imaging and Radiation Sciences
4. Neville D Yeomans, Demographics and distribution of Australia’s medical immigrant workforce. Journal of Migration and Health Volume 5, 2022, 100109
5. Maria E. Peltola et al Clinical Neurophysiology Volume 147, March 2023, Pages 108-120 Routine and sleep EEG: Minimum recording standards of the International Federation of Clinical Neurophysiology and the International League Against Epilepsy
6. Laura A. Brooks, Elizabeth Manias, Melissa J. Bloomer. Culturally sensitive communication in healthcare: A concept analysis Collegian Volume 26, Issue 3, June 2019, Pages 383-391
7. P. Christopher Earley and Elaine Mosakowski Harvard Business Review Cultural Intelligence (online access) https://hbr.org/2004/10/cultural-intelligence
8. https://immi.homeaffairs.gov.au/visas/working-in-australia
Ranitha Nandkumar
Neurophysiology Scientist
Royal Hobart Hospital