To the Editor: Sondergaard is essentially correct in his criticism of the Australian and New Zealand College of Anaesthetists (ANZCA).1 And ANZCA president Leona Wilson’s obfuscatory response to the criticism provided me with little reassurance.2

We all know that our health care system is “highly complex” and involves multiple jurisdictions, but these points have no relevance in determining whether Sondergaard is adequately trained and competent to work in Australia as a specialist. To decide that someone with his history and qualifications cannot give anaesthesia unsupervised is patently nonsensical, as is the insistence that experienced overseas specialists must take the College’s final exams.

All of us who were Fellows of the ANZCA precursor, the Faculty of Anaesthetists of the Royal Australasian College of Surgeons, were granted automatic Fellowship of the ANZCA on its formation in 1992, as were some senior practitioners who had never sat the Faculty exams. The College can, it seems, arbitrarily waive the exam requirement for some, and it regularly awards Honorary Fellowships to distinguished overseas visitors.

However, these doctors are not the competent working clinicians with overseas qualifications who would, if they could, take up vacant positions in rural areas, such as Katoomba just outside Sydney. Here, in October last year, a woman in labour was turned away from a hospital for want of an anaesthetist and gave birth in an ambulance by the roadside.

I worked as a specialist anaesthetist in Sweden for nearly 2 years and can verify that Scandinavia produces competent anaesthetists. The attitude of the ANZCA to overseas-trained specialists seems elitist and denies the Australian people access to the services of competent people who happen to have learned this essential specialty elsewhere.