When United States nurse Joshua Gregory went back to university in 2018, his only goal was to work in Australia.
Australia is experiencing a shortage of healthcare workers and he says he has the skill and experience to help.
"I've worked in cardiothoracic care, I've worked in emergency medicine, I've worked in an ICU, I've worked in psychiatry, and I feel that I have a level of flexibility that would really benefit Australia," he said.
Despite his enthusiasm for moving here, Mr Gregory almost gave up at one point because the process was so hard.
He said registering as a nurse and getting a work visa was slow and complicated, with different regulatory bodies not communicating with each other.
Leading medical groups say red tape is preventing qualified workers like Mr Gregory from moving to Australia.
Victorian Healthcare Association chief executive Tom Symondson said Australia needed to prioritise healthcare work immigration.
"We've got an incredibly serious shortage of healthcare workers across the country," he said.
"There's no reason why we should be taking so long to process immigration applications for people who are so critical to our healthcare sector."
A long process and lots of paperwork
Mr Gregory had to register as a nurse twice with two different bodies before applying for a visa.
That was on top of having to jump through other bureaucratic hoops to meet paperwork requirements.
"I found myself driving eight hours one way to another state in order to be able to have my documents notarised, and I had to do that on three different occasions," he said.
Registering as a healthcare practitioner in Australia is a lengthy process with many steps that can only be completed one after the other, not simultaneously.
The process differs depending on the profession, but each step can take months to finish, delaying the next stage in the process.
For example, the first step for GPs is a compatibility assessment by the Royal Australian College of General Practitioners (RACGP), which can take more than 10 weeks.
Only when that is complete can they start their medical registration, which takes another 10 to 12 weeks to get approved by the Australian Health Practitioner Regulation Agency (AHPRA).
On top of that they need to secure a job offer and apply for a visa through Border Control.
Once the doctor arrives in Australia, they need to apply for their registration number and then their Medicare provider number — another 13 weeks.
All up, it can take 12 months or more to complete the process.
Simon Spalding, who co-owns a medical practice on the Mornington Peninsula in Victoria, recently spent more than $25,000 on fees recruiting a new GP from the UK.
"It took over a year and some of the delays caused great distress to our doctor," he said.
"She took her kids out of school and resigned from her job thinking that the immigration part of it wouldn't take as long as it did and ended up home-schooling and doing locums over Christmas waiting for her visa."
He said he felt the process could be faster, easier and possibly cheaper.
"I think there would be things that you could do at the same time rather than subsequently," he said.
"All those steps you have to do one, then the next. And I, in some cases, I don't see any reason for that."
Thorough checks important for safety
Regulatory bodies contacted by the ABC said they try to make the approval process as smooth as possible, and that it was important to thoroughly check that health professionals were suitable and safe to work in Australia.
An AHPRA spokesperson said it actively engaged with health departments, colleges and accreditation providers to streamline applications and avoid duplication.
The Nursing and Midwifery Board of Australia (NMBA) and The Australian Nursing and Midwifery Accreditation Council (ANMAC) said skilled migration assessments took on average fewer than four weeks unless there were issues with documentation from other countries.
Both agencies also said they worked closely together and with other bodies to enable skilled nurses and midwives to move to Australia.
"We are always willing to work to improve systems and open to efficiency improvements. However, this must not jeopardise public safety," an NMBA spokesperson said.
The RACGP said it recognised some of the bureaucratic processes involved with recruiting overseas-trained doctors were expensive, cumbersome, and time-consuming.
"The RACGP has made a number of recommendations to fast-track the recruitment of overseas-trained doctors, including deploying a team in the Department of Health to fast-track processing requests through immigration, AHPRA, Medicare and the medical colleges," RACGP president Karen Price said.
The federal government did not answer questions about whether any work was underway to make the process faster but said the number of skilled visa places would increase next year.
Professionals looking to other countries for work
Australia was already dealing with a healthcare worker shortage before COVID-19 hit, then workers quitting due to burnout and shutting off immigration made it worse, Mr Symondson said.
He said Australia needed a national, multi-pronged approach to deal with the shortage, and that recruiting workers from overseas was part of it.
"If we're too difficult as a country to move into … people who want to work overseas will choose somewhere else," he said.
"We need to do everything that we possibly can to make Australia the destination that people choose first and are not put off by our red tape and our long waiting times."
Mr Gregory considered giving up on Australia and moving to Canada instead, simply because it would be easier.
"I feel like many nurses are in that same position," he said.
The South Australian government has now offered Mr Gregory a sponsored visa.
He has not been guaranteed work, but Mr Gregory is hopeful.
"This entire time I've actually used that little colloquialism from Australia, that 'She'll be right', and that I'm going to get there eventually," he said
