What is the PESCI? A Complete Guide for IMG Doctors Entering Australian General Practice

For International Medical Graduates (IMGs) aiming to work as a GP in Australia, one important requirement along the pathway to registration is the Pre-Employment Structured Clinical Interview (PESCI). The PESCI is an assessment designed to evaluate whether an IMG has the clinical skills, knowledge, and professional attributes required to work safely in Australian general practice, especially in practices located in areas of workforce shortage.

This guide will explain what the PESCI is, why it is required, what to expect during the process, and how IMGs can prepare effectively.

 

 

What Is the PESCI?

The Pre-Employment Structured Clinical Interview (PESCI) is a structured interview conducted by accredited providers on behalf of the Medical Board of Australia. It assesses whether an IMG is suitable for a specific general practice position.

Unlike standard exams such as the RACGP Fellowship assessments (AKT, KFP, and CCE), the PESCI is tailored to the role and practice where the IMG is seeking employment. It evaluates whether the doctor can safely manage the clinical and professional demands of that particular job.

 

Who Needs to Sit the PESCI?

Not all IMGs are required to complete a PESCI. It is generally needed if:

• You are applying for limited or provisional registration with the Medical Board of Australia.
• Your job offer is in a general practice position where independent practice requires further assessment of your readiness.
• The practice is located in a Distribution Priority Area (DPA) or an area of workforce shortage.

Essentially, if you are an IMG applying for your first GP role in Australia, there is a strong chance you will be asked to undergo the PESCI.

 

 

What Does the PESCI Assess?

The PESCI is designed to evaluate whether an IMG is competent to work safely in the proposed position. The assessment focuses on:

• Clinical Knowledge and Reasoning: Ability to assess patients, diagnose, and create management plans.
• Communication Skills: Effectiveness in interacting with patients, families, and the healthcare team.
• Professionalism and Ethics: Understanding of Australian standards of care, confidentiality, and ethical practice.
• Awareness of the Australian Healthcare System: Familiarity with referral pathways, Medicare, and practice guidelines.
• Cultural Competence: Ability to work with patients from diverse cultural backgrounds, including Aboriginal and Torres Strait Islander communities.

 

What to Expect in the PESCI?

The PESCI is usually a panel interview that lasts around 1.5 to 2 hours. It includes:

• Clinical Scenarios: You will be presented with case-based questions similar to real-life GP encounters.
• Practice-Specific Questions: Assessors may ask how you would handle situations in the context of the practice where you will be employed.
• Professional Judgement Questions: Designed to test your decision-making, risk management, and ethical reasoning.

At the end of the assessment, the panel makes a recommendation to the Medical Board about whether you are suitable for the position.

 

How to Prepare for the PESCI

Preparation is key to success. Here are some strategies:

1.    Review Clinical Guidelines: Familiarize yourself with Australian guidelines such as the RACGP’s Guidelines for Preventive Activities in General Practice and Therapeutic Guidelines.

2.    Practice Case-Based Scenarios: Focus on common presentations in general practice like chronic disease, mental health, and women’s health.

3.    Understand the Healthcare System: Learn how Medicare, referral systems, and care coordination work in Australia.

4.    Work on Communication Skills: Clear, patient-centered communication is essential. Practice structured consultations, including ICE (Ideas, Concerns, Expectations).

5.    Know the Practice Context: If your job is in a rural or regional clinic, be prepared to discuss how you would manage limited resources and referrals.

 

 

Why Is the PESCI Important?

The PESCI is not just a hurdle, it is a safeguard. It ensures that IMGs can provide safe, competent, and culturally appropriate care in the Australian primary care setting. For doctors, passing the PESCI is often the first major step toward gaining experience, building trust with patients, and eventually working toward FRACGP Fellowship and full specialist recognition.

The PESCI (Pre-Employment Structured Clinical Interview) is an essential gateway for many international doctors entering general practice in Australia. By assessing clinical competence, communication, and readiness for a specific role, it helps ensure both patient safety and professional success. For IMGs committed to building a career in Australian general practice, understanding and preparing for the PESCI is the first step toward a rewarding future.