Author: Anthony Llewellyn

Area of Need Australia. What is it? Who is eligible? How to apply.
Featured image shows the distribution of population areas according to the Modified Monash Model c/- DoctorConnect site

Post Update: I continue to get regular queries about identifying Area of Need posts in Australia. Whilst the AoN system does still exist in Australia. These days it is very rare to come across an AoN designated position for any specialty. In the majority of cases, potential employers are requiring Specialists to go through the college assessment process, otherwise known as the Specialist Assessment Pathway, first before considering them for a position. You can find out more information about the Specialist Pathway here and here.

When working with specialists from countries other than Australia one of the topics we often cover is the issue of Area of Need posts. Area of Need, which is generally abbreviated to AoN is one of a number of aspects of the Australian health care system that is difficult to understand. What is also frustrating is that apart from some notable exceptions it is also difficult to find out how to apply for an Area of Need position. I am writing this post to better inform you about AoN.

Firstly let’s answer the question of what is Area of Need and how does an Area of Need post differ from the specialist assessment pathway to specialist recognition in Australia. An Area of Need is a location where there is a demonstrated shortage of suitably qualified medical practitioners. An Area of Need post is a position that is specifically established for an international doctor to work in Australia because it has been difficult to find an Australian doctor to work in that position. Whilst historically Area of Need positions have been declared for both trainee and specialist roles. They are generally now mainly declared for specialist positions. With the exception that Area of Need roles are also often declared for IMG doctors to enter into general practice in a training capacity. Area of Need positions then vary from the specialist pathway in two main ways. Firstly, they are not always related to specialist roles. But mostly are. Secondly, they still require an assessment of the specialist IMG doctor’s potential to become a specialist in Australia through the relevant college. But as part of that assessment, the college will also consider the doctor’s suitability for the actual Area of Need position.

OK. So now you know what Area of Need is and that it is essentially an add-on option to the specialist pathway. Let’s look at a few other aspects of Area of Need that are worth knowing about, including: How are AoN positions declared? How do you find an AoN position? What are the advantages of an AoN position? And how does AoN affect the Specialist Assessment process?

How is an Area of Need Position Declared?

The authority for declaring such positions lies with the state governments of Australia (not the Commonwealth government).

Medical practitioners with limited registration for area of need are working under supervision in an area of Australia where there is a shortage of medical practitioners. They are usually registered to practise in a rural or remote location.

These practitioners have been assessed as having the necessary skills, training and experience to undertake this practice safely. The state or territory Minister for Health (or their delegate) must declare that the area in which the applicant will work is an ’area of need’.

The process can vary between jurisdictions but generally, there are two main criteria that need to be filled before an Area of Need position will be approved.

Firstly, there must be some reason for the vacancy given along with a consideration on the impact upon the community and service delivery as well as access to alternate services and options explored for delivering care in an alternative manner. The impact upon particular populations, such as rural and remote and Aboriginal and Torres Strait Islanders may also be considered.

Secondly, there must be evidence of “labour market testing”. Basically, this involves demonstrating that there have been attempts to find suitable candidates from amongst the Australian trained doctor pool but this has not been fruitful. So for example, attempts at advertising and results of previous recruitment campaigns.

Certain Doctors Cannot Work Under Area of Need.

For fairly obvious reasons doctors with general registration or specialist registration cannot apply for an Area of Need position.

New applicants who are eligible for the competent authority pathway or who already hold the AMC Certificate are also not eligible to apply for limited registration and therefore cannot apply for an Area of Need position.

Finding an Area of Need Position.

You would think with the many doctor shortages in Australia. Particularly rural and remote Australia. It would be relatively easy to find out all the Area of Need positions.

Unfortunately, no central list actually exists. This is because the states and territories are both responsible for declaring Area of Need positions as well as determining how these declarations occur. And there is no requirement for these declarations to then be listed or reported anywhere. So there is no central list. And very few of the states and territories publish a list. Even when this list is published it may be out of date.

At present only NSW Health reports what purports to be an up to date Area of Need list for both General Practice as well as other Specialties. Although I have personally found that when you enquire about some of the positions on the list there is no response or the position has been filled. Western Australia’s list is “UNDER REVIEW”. And Tasmania is only currently reporting GP posts. With Specialist posts also under review.

Northern Territory, South Australia, Queensland, ACT and Victoria all have information about Area of Need on their respective health services websites. But no list that I have been able to find.

So. What other options are there for finding an AON position?

Well. Sometimes a job may be advertised as being Area of Need. Here’s an example of a Radiologist Position in Victoria advertised on Seek as Area of Need:

But some jobs may also be advertised as seeking or being open to international doctors and you only find out that it is eligible for an Area of Need candidate when you speak to the recruiting person. This can often be the case if they are also hoping to still get a more local candidate or perhaps a specialist from a competent authority country.

AoN jobs are sometimes also posted on college websites.

Area of Need Positions Come with Advantages

Ok. So thus far. It seems like identifying an Area of Need position is becoming more difficult than its actually worth. Why would an international doctor bother trying to find one in the first place?

Well. There are a couple of key reasons why it is in fact worth the bother.

The first reason is that an Area of Need position is a real job. A job which you can apply for and hopefully be appointed to prior to having to deal with issues around registration and visas.

The effect of this is that you enter the specialist assessment process with a specific position that provides the level of supervision that you will likely be required to be given should the college approve you to undergo a specialist assessment period.

A number of IMG specialists are now going through the specialist assessment process with no guarantee of a supervised position afterwards. So they are both bearing the full financial cost of this process as well as the risk that there is no suitable job at the end of it.

In fact, some colleges, like the College of Psychiatrists will not consider you if you do not have a position offer. Probably because they do not want to be in a position of granting false hope to someone.

The second reason for obtaining an Area of Need position is that generally speaking if you have secured such a position then you have an employer who will support you through the process of applying for specialist assessment and your registration (as well as visas if you need one). This generally extends to paying for the costs of the assessment, which can be substantial. And will also extend to the costs of the college supervision if you are given the go-ahead to undertake a period of assessment.

Area of Need and the Specialist Assessment Process

One key difference between Area of Need and the Specialist Assessment process is that with AoN you start off by applying for a job. This job has been declared to be suitable for an IMG specialist and so if you are able to be successful in being offered the position it is likely that you are also a strong candidate for the specialist assessment process. Otherwise, you are unlikely to be offered the position in the first place.

Before you take up the position however you must be assessed by the relevant specialty college to determine your suitability for specialist assessment. Just like any other specialist assessment process.

The process is essentially identical. It is a dual assessment process. The college reviews your general suitability or “comparability” as well as suitability for the AoN post. You may have to fill in slightly more paperwork. There may be an additional fee. The interview questions are likely to be the same.

You can, of course, apply for other suitable jobs if you are an IMG specialist and then seek specialist assessment and this is actually a smart way to do it if you are able to.

What Specialties Require Area of Need?

Wait long enough and most specialties and subspecialties will be listed for an Area of Need position. But here are some of the more common specialties, based on reviewing the past Tasmania list and current NSW and Western Australian lists:
- General Practice
- Radiology
- Psychiatry
- Physicians (Internal Medicine Specialists)
- Various Surgeons
- Ophthalmology
- Anaesthetics
- Emergency Medicine
- Dermatology
Area of Need in General Practice

Doctors applying for registration to work in general practice must provide evidence of a minimum of three years (full-time equivalent) experience working in general practice or primary care. If a doctor has had their experience formally assessed by the Royal Australian College of General Practitioners (RACGP) or by the Australian College of Rural and Remote Medicine (ACRRM) this assessment is reviewed by the Medical Board. Otherwise, the Medical Board assesses a doctors experience as part of the application for registration. There is a minimum requirement that evidence from one of these two colleges that confirms at least three years (full-time equivalent) experience working in general practice or primary care.

Unless you are also applying for specialist assessment as a general practitioner you will also need to sit a Pre-Employment Screening Clinical Interview or PESCI.

Related Questions.

Question. How Much Does it Cost to Become a Specialist in Australia?

Answer.

It is difficult to quantify this question as each specialty differs because each specialty is handled by a separate College. As I have highlighted in this post on UK doctors moving to Australia costs for specialists migrating are certainly going to be in the tens of thousands of dollars when one takes into account the following:
- costs of both the initial college assessment as well as period of supervision
- registration costs
- visa costs
- travel, accommodation and moving costs
The good news is. As I have highlighted above. If you get the right job first the employer is likely to pick up a large part of theses costs.

Question. Is the Process of Specialist Recognition Difficult?

Answer.

Again. The answer to this depends on a range of factors. The process of becoming a specialist has arguably become a little bit easier and more streamlined in the last few years since the Medical Board has become involved in monitoring the activity of the specialist colleges and setting standards for how specialists are assessed.

In 2017, 52% of doctors were assessed as substantially comparable and 27% were as deemed as partially comparable for specialist recognition. But rates vary between the country that you trained as a specialist in and between specialties.

Its probably reasonable to say that now there is more clarity in the system and for most colleges plenty of information about the specialist assessment process most IMG specialists are probably only applying for specialist assessment now with reasonable confidence that they have the evidence to be deemed comparable.

Question. How Long Does it Take to Gain a Specialist Job in Australia?

Answer.

Many IMG specialists can search for years and not find a job. Its really hard to put a clear timeframe on how long it may take. Its reasonable to assume that it will at least take a few months. Bearing in mind that the initial job you may gain might not be quite at the specialists level. Particularly if you are only deemed as being substantially comparable.

Question. What Is A PESCI?

Answer.

International medical graduates (IMGs) applying for limited registration or provisional registration may be required by the Board to undergo a pre-employment structured clinical interview (PESCI).

A PESCI takes the form of a structured interview which can only be conducted by accredited bodies. It is an objective assessment of knowledge, skills, clinical experience and attributes to determine suitability to practise in a specific position. The PESCI consists of a structured clinical interview using scenarios.

Who Needs a PESCI?

The Board has decided that IMGs who are applying for limited or provisional registration to work in general practice are required to have a PESCI. IMGs in the specialist pathway do not require a PESCI as they are assessed by the relevant specialist medical college.

You should generally only arrange a PESCI before applying for registration if you can meet all the required registration standards. There is no point doing a PESCI if you are not going to be registered for any other reason.

At the PESCI, a panel of interviewers assesses your training, knowledge, clinical experience and attributes against the requirements of the specific position for which you are seeking registration. The PESCI process takes into consideration the supports, orientation and level of supervision that can be provided.

The PESCI uses a set of structured questions and scenarios in an interview setting which are tailored to a specific position. The report of the PESCI cannot be transferred to other positions.

The interview panel consists of a minimum of three interviewers which include at least two registered medical practitioners. One member of the panel may be a layperson, other health practitioner or registered medical practitioner. The PESCI panel members will be familiar with the clinical and professional demands of the type of position for which registration is being sought.
July 25, 2019

Locum Doctors Australia. How To Become One and How to Stay Current.

A recent series of articles in the Sydney Morning Herald highlighted the rising rate of medical locum doctor usage in Australia. The articles indicated that an average of 16.5% of doctors working in the NSW Health system are locum doctors. So it seems there is a trend towards locumming as either a career or a break in one’s career in Medicine. In this article, I would like to briefly cover how you can become a locum As well as address an important issue for locum doctors which is about staying current and registered as a locum doctor.

So firstly what are the basic requirements for locumming as a doctor in Australia? The key requirements are that you either have general registration and/or specialist registration. You can either locum as a Specialist (includes General Practice) in which case you need specialist registration. Or you can locum against a vacant hospital role (usually a trainee role) in which case you need general registration. By their very nature locum positions are temporary and therefore not open to doctors on other types of registration because they require a level of independent practice. So this means as a minimum you will need to be at postgraduate year 2 and have your general registration. Beyond this basic requirement, you will need to be a citizen or permanent resident, which is most locum doctors in Australia. Or possibly be on a visa which permits you to work as a locum. You will most likely need to register with at least one medical recruitment or locum agency. You will probably need to either not be currently employed as a doctor or on a break from your role. And you will likely need to consider setting up a limited company to collect payments that you make as a locum doctor.

Beyond these basic requirements, there are a number of other considerations for doctors who work as locums, which I will now go into.

Registration Requirements

As we have noted the nature of locum jobs is that they are temporary and time-limited and notwithstanding the current reporting on their usage, they are not generally seen as a permanent workforce solution. Locums are also often seen as quick and urgent solutions to filling a gap due to an unforeseen circumstance. For these reasons, it is generally not possible to set up a locum appointment for anyone who may need one of the special types of registrations available under the Medical Board of Australia where certain supervisory requirements may need to be demonstrated to be in place. In fact, often the reason a locum is being sought is that there is a lack of supervisors available. So this generally means that International Medical Graduates can generally not obtain a locum position. Although there have been some limited circumstances where it has been possible. This has generally been around deputizing services for general practice where medical recruitment agencies themselves have set up a service and essentially employ the IMG doctor.

Locum Doctors

Provider Numbers

Locum positions (even ones for trainee doctors) are often advertised with a request for the locum to have a provider number. This may be just for referring purposes or for billing purposes as well. Performing locums in private practice, such as general practice is fairly impossible without a provider number as you will not be able to charge patients Medicare fees for the services you provide and the locum position will therefore not be viable.

Provider numbers can be quite confusing and complex. Part of the problem is that each provider number is generally linked to one medical practitioner and one location. Technically you need a provider number for each and every location that you provide services at or from. This can obviously be hard to predict if you are locumming. There are some solutions to this issue in relation to general practice but often what needs to occur is to fill in a form for another provider number. As it takes time for Medicare to approve this as a locum you need to be on to this issue promptly.

Other Skill and Experience Requirements

Services advertising for Specialist Locums are generally happy to accept anyone with the appropriate Fellowship (although there are some exceptions). For general locums, the amount of experience you have as a doctor will count towards how eligible you are for a locum as well as how much you will be paid. Having additional skills such as the various advanced life support training certificates or experience in paediatric emergencies will also open up the number of posts available to you as well as the rates you can collect. So, whilst you can technically locum as a PGY2 your prospects may be even better if you wait until PGY3 or PGY4.

Working as a Locum On a Visa

As mentioned above there are limited circumstances where a locum doctor may be able to work under a visa arrangement. Generally speaking, this would occur when you have general registration or specialist registration and the medical recruitment agency can obtain a visa on your behalf.

In most cases, you are probably better off working under a more secure form of employment until you are able to apply for permanent residency and then looking into locum work. This way you will not be obligated to one particular locum company.

Working With Medical Recruitment (Locum) Agencies

I’ve previously written in more detail about working with medical recruitment agencies. However, a key question about becoming a locum is whether you can work with a locum agency. This is because whilst it is possible to directly contract yourself for locum roles. Most doctors do find it easier and more productive to engage with a locum agency.

For the most part, most doctors find working with a locum agent to be a valued and essential part of the role. Someone who understands their requirements and negotiates on their behalf. But this is not always the experience. If you are not the sort of person who is good at negotiating conditions of employment you may find locum work difficult. Locum agents play a difficult role in attempting to keep the employer and doctor happy at the same time. Sometimes the conditions of the job are not as agreed to initially or sometimes you may feel pressured to take on a role that you don’t wish to do. So being able to stand up for yourself in this situation is an important consideration.

Can You Work As a Locum Whilst Employed?

If you have a permanent position with an employer, such as a hospital, it may still be possible to do the odd shift or week of locumming. But beyond this and even including this it can get difficult. Apart from the fact that you obviously need to have the time off work to do locum shifts. There is also the need to consider that you will probably be working in a situation of conflict of interest. Most employers have a process whereby full-time employees are obliged under the code of conduct to declare any additional work undertaken with the option for the employer to indicate to the doctor that they cannot undertake that additional employment if it conflicts with them completing their other duties.

Even if you work part-time it may be difficult to work part-time in a permanent position and locum as most locums are done in blocks of weeks rather than days.

So essentially whilst you may be able to do a small amount of locuming whilst employed. If you are planning on doing more than a little bit you cannot really do this whilst also employed.

Getting Paid As a Locum

There are essentially two options here and sometimes it comes down to the employer’s choice. Some employers will opt to pay you through payroll in which case they will also pay the ATO the requisite amount of tax on your behalf and should also pay superannuation on your behalf. Your Locum Agency then charges them an additional fee for placement. Others will pay you a set amount as part of an invoice you submit for the contract. This is often paid directly to the locum agency where the agency takes out its commission and then pays you out.

If there is a choice between PAYG and invoicing you can opt for either option.

As a locum, you are not going to be paid a regular fortnightly salary. So this means that you need to be prepared for being paid late, having to chase up on income every now and then and have some amount of cash in the bank to keep up all your regular payments (rent, mortgage, food, car, telephone bill etc…) in the interim.

You will also most likely need to set aside some of your income for tax purposes. Otherwise, you will get hit with a large bill come tax time and needing to take out a loan to pay it.

Some doctors find financial management a hassle. Good locum agencies will generally help you by chasing up on payments and providing your reports. But if you like a less complex set of financial circumstances then locumming is probably not for you.

Running a Company

Eventually, most doctors who locum set up a company in which to collect their earnings. There are several reasons for this. Part of which is that some health services like Queensland will not pay locums as what is called a sole trader. The other main reasons are to reduce tax obligations and protect your personal assets.

Running a company does not need to be overly complex. Most accountants will gladly help you to set up a simple company for a small fee. You do need to do some regular book-keeping and complete some additional tax forms quarterly and annually. It makes sense to set up a separate company bank out to make the book work easier.

Many doctors actually find the idea of being the Managing Director of their own company a little bit exciting. You get to pick your own company name and you can even get a logo, letterhead and website if you really want to. But if you have aspirations to be a Company Director you might find this aspect of locum work that leads you to question whether you want to be a locum.

Indemnity Considerations

You will probably need to revise your medical indemnity upwards if you engage in locum work. When you work as a locum for a public hospital you should probably still be state government employer indemnified. But it is important to check arrangements each and every time.

Personal Considerations

On a personal level becoming a locum generally means traveling around a lot. Spending time on the road in the car or at the airport. Living out of a suitcase in a hotel or serviced apartment. If you have regular activities like sporting, academic or social pursuits these can be severely disrupted by locum work.

If you have a family you may have some options for them to travel with you to locums. Depending on how needy the hospital or employer is they may even upgrade your accommodation to family accommodation at no extra cost. But at the minimum, you will probably have to pay for them to travel with you. Additional costs such as extra food will probably reduce the financial benefit of doing locums with your family in tow.

Maintaining Registration and Professional Development

I wanted to spend the remainder of this post discussing the issues around continuing professional development for locums.

The Medical Board of Australia has signaled that it will take an increasingly active stance in the process of revalidating doctors (confirming their ongoing suitability to practice) in order to uphold community expectations for quality and safety.

Locum doctors are often left in a vulnerable area when it comes to continuing professional development and demonstrating their ongoing fitness to practice.

And. By the way. As a locum doctor, you are going to also have to think about how you pay for your CPD. Because the hospital is not going to pay for it.

On the other hand, you are probably saving heaps in College fees.

Specialist locums can generally maintain their continuing professional development through their college’s CPD program.

However, locum doctors without fellowship who are simply relying on their general registration face a more difficult set of circumstances as there is generally no professional organization that can fully support their professional development requirements.

Under its Professional Performance Framework the Medical Board has stated that:

All doctors will:
– have a CPD home and participate in its CPD program
– do CPD that is relevant to their scope of practice
– base their CPD on a personal professional development plan
– do at least 50 hours of CPD per year, that includes a mix of:reviewing performance
measuring outcomes, and educational activities.
Medical Board of Australia

The current Medical Board requirements for medical practitioners who have general registration only (i.e. do not have specialist registration) indicate that such doctors must

complete a minimum of 50 hours of CPD per year (self-directed program), which must include
- at least one practice-based reflective element; clinical audit or peer review or performance appraisal, as well as participation in activities to enhance knowledge such as courses, conferences and online learning, or
meet the CPD requirements of a specialist medical college that is relevant to their scope of practice.

Most doctors can make a plan to engage in courses, conferences and online learning. However, the tradition of clinical audit, peer review and performance appraisal is patchy within medicine in general and it’s likely that locums with general registration may struggle to revalidate if they are unable to plan for these mandated activities each year and possibly have some support for doing them.

Let’s look at each of the mandated practice-based reflections in turn and consider how it might be implemented for a locum doctor.

Clinical Audit

A clinical audit compares actual clinical practice against established standards of practice. The audit has two main components: An evaluation of the care that the individual practitioner provides, and a quality improvement process. The evidence required by the Medical Board is a certificate confirming completion of clinical audit or a short summary of recommendations and implemented changes or a description of the process that was undertaken and a reflection on what was learnt.

Practically engaging in a clinical audit may be difficult for locum doctors because of time constraints for each placement as well as the ability to access and review clinical records at a later point in time.

Peer Review

Peer review meetings are undertaken by and with peers with the aim of updating knowledge and improving practice through the presentation of one’s own work to one’s peers with the expectation of a free and frank review. Evidence of peer review acceptable to the Medical Board includes documented account of case review or discussion with peer or team and a reflection on what was learned or evidence of log book or diary entry and a reflection on what was learned or a description of peer review activity and a reflection on what was learned.

The practical problem for locum doctors engaging in peer review is coordinating meeting times and locations so that peer group members can regularly attend. This might be overcome with the use of technology and holding peer review meetings online. Although it would be important to consider the security implications of online discussions.

An exciting aspect of a locum peer review group would be the potential to incorporate locum doctors working across a range of specialty areas into a group where one could imagine a breadth of generalist knowledge could be imparted throughout the group.

Performance Appraisal

Performance appraisal incorporates activities that allow the practitioner to review their practice /performance. The Medical Board will accept documentation to show how the practitioner reviewed or improved their practice or performance and a reflection on what was learned or a description of the process undertaken and a reflection of what was learned from the appraisal.

In my opinion, this is probably the simplest of the 3 options for mandated peer-based reflection in order to achieve compliance and could be effectively completed with a performance coach.

What the Medical Board Doesn’t Accept as Evidence of CPD

The Medical Board is becoming quite circumspect in relation to CPD evidence. Here is a list of things that the Board will not accept as evidence of 50 hours of CPD per annum.

Receipts of Courses

Course Itineraries

Course Agendas

Course Programs

Conference Itineraries

Conference Agendas

Non planned and non measured reading online

Web-surfing

Statutory declarations stating 50 hours of journal reading was undertaken

Agendas of journal clubs

Generally speaking, the Medical Board requires more definitive evidence of the 50 hours of CPD, examples of which would include certificates of attendance, certificates of completion, evidence of questions being attempted and log books of readings.

How Much Do Specialty Trainee Doctors Earn? Registrar Pay Rates

On this blog, we want to give you the best information possible about Medical Careers. That obviously includes information about pay rates and related conditions We have already given you the low down on Interns and Residents, as well as Specialists. So its high time we discussed Specialty Trainees or registrar pay rates. Right?

In this post we are going to talk about Specialty Trainees, also referred to as Registrars and how much they earn. Specialty Trainee Registrars working full-time in the hospital system will earn between $89,649 as a first-year Registrar in Tasmania up to $161,766 per annum working at the most senior Registrar level in Western Australia. General Practice Trainee Registrars working full-time are guaranteed $75,328 per annum in their first year of training. Going up to a guaranteed $96,724 per annum in their 3rd and final year of training.

Once again it’s important to emphasize that these salaries are base salaries for full-time employees. Specialty Registrars are often required to work considerable amounts of overtime and on-call which will increase their pay rate significantly. And General Practice Registrars are able to negotiate with their employers above the guaranteed rate of pay. Often this will be on the basis of a proportion of the Medicare revenue that they generate for the practice. So, again they can possibly earn significantly more.

Specialty Trainees Can and Often Do Earn Much, Much More.

We can see evidence of the fact that Registrars do earn much more than their base rate of pay. “Other Medical Practitioners”, which is where most Registrars classify themselves for tax purposes with the Australian Tax Office earned on average $204,387 of taxable income in 2016/17 according to the ATO.

Whilst these figures are likely to be conflated by General Practitioners and other Specialists indicating this category as their profession as well they do back up the contention that most trainee doctors earn significantly more than their base registrar pay rates due to working excessive hours with specialty trainees at most risk of working excessive hours and amongst these Intensive Care and Surgical trainees being at the highest risk of fatigue.

Its certainly been my observation over the years that surgical trainees in particular work long hours. This is generally a combination of rostered and unrostered overtime as well as being “on-call”. I was literally at a meeting last week where an administrator reported that the surgical trainees at her hospital were the best paid doctors last year due to their workload. Meaning that they were paid even more than the specialists.

Its easy to see why and how this would be the case. Lets take a typical situation of a medium hospital which employs 3 General Surgical trainees. Each is on the roster approximately 1 in 3 on top of their normal 40 hours per week. This means being on call around 2 weeknights per week and 1 weekend in 3.

Let’s assume one of these surgical trainees does slightly more than their share of weeknights in a month (4 weeks). 8 in total. But only one weekend. Let’s say that they get called on average 2 times per weeknight and 15 times over the course of that weekend.

In New South Wales each of these call-backs would amount to a period of 4 hours of overtime. This is initially paid at time and a half for the first two hours and thereafter double time.

So we have:

160 hours of normal time
2 callbacks X 8 = 64 hours of overtime for the weeknights
15 callbacks for the weekend = 60 hours

This gives us a total of 284 hours for that 4 week period. Which is close to double the base hours! But wait. Because those overtime hours get paid initially as time and a half and then very quickly as double time. The total amount of hours paid becomes about 400 hours!

So you see it’s not all just about the base registrar pay rate.

Now, this example is obviously not typical for every specialty and there are some specialties that may not have to do as much overtime and not get called in as much. But it is also not the most extreme example either as the case of Dr. Yumiko Kadota has demonstrated to us.

Breakdown of Registrar Pay Rates and Other Rates By State and Territory.

We have compiled below a table that demonstrates the current base rates of pay for Intern, Resident, Senior Resident, Registrar and Senior Registrar for each State and Territory in Australia.

Please bear in mind a number of things. Once again we are talking Full-Time Annual Salary. Also, as I have pointed out above the actual take-home pay can vary considerably. Also, the Awards and agreements for each State and Territory are set independently and at different times from each other. So over time, the tendency is for there to be movement both up and down through the table.

What is apparent, however, as we have pointed out on our other blog posts about Interns and Residents is that Western Australia is clearly the best place to work if your sole interest is registrar pay rates. Victoria is next best and rates a special mention as its Enterprise Agreement contains a lot of additional friendly provisions that others do not.

$31,000 in difference between the highest rate of pay between Western Australia and Tasmania is a bit hard to fathom and justify. It’s almost a 20% difference.

State / Territory	Intern	Resident	Senior Resident*	Registrar	Senior Registrar**
Western Australia	$78,479	$86,328	$94,960	$109,678	$161,766
Victoria	$74,563	$79,391	$86,060	$116,460	$155,477
New South Wales	$67,950	$79,648	$87,603	$99,218	$139,900
Australian Capital Territory***	$68,094	$79,682	$87,410	$98,704	$138,667
Queensland	$73,306	$79,413	$85,521	$105,377	$134,389
Northern Territory	$71,350	$82,731	$88,629	$98,413	$134,113
South Australia	$73,370	$80,041	$86,710	$100,717	$133,400
Tasmania	$68,936	$72,837	$89,649	$89,649	$126,854

*Being appointed to a specialty trainee position does not automatically mean appointment to a Registrar role in all States and Territories. For some, for example NSW, the entry point is the Senior Resident Medical Officer position.

**Not all States and Territories have a Senior Registrar role. We have used the maximum Registrar pay grade where there is no Senior Registrar role.

***The Australian Capital Territory Enterprise Agreement expired in July 2017. Therefore we expect that the salaries quoted here will increase significantly when there is a finalization of the new agreement.

What About General Practice?

Ok. So far I have ignored General Practice. But this has not been deliberate. It’s because General Practice is a different set of circumstances to the other specialty training cases. This is because General Practice works more on a national basis. Because there is an Australia-wide minimum set of pay standards.

So, according to the General Practice Registrar Association website the current base rate of pay for a first-year General Practice Registrar is $75,328.23 per year and for a Registrar in their final year (which is either 3rd or 4th year) $96,724.43 per year. Again, this is for full-time work.

Now, whilst these rates appear to be somewhat lower than for Specialty Trainees paid as Registrars you should bear in mind four things about General Practice training.

The first is that General Practice training is a minimum of 4 years, whereas most other specialties are 5 years and possibly longer. So there is no need for higher Registrar levels in general practice.

The second is that is actually possible to enter General Practice training in your PGY2 hospital year. So when you enter your first actual GP training post you are actually in your second year of training.

The third is that the pay agreements are a minimum standard as part of an employment contract below which your employer may not go. But it is quite common for GP trainees to negotiate a better agreement with their employer, by agreeing to collect a share of their Medicare billings. So it is possible to do far better than these minimum amounts. Although, clearly this partly has to do with your own productivity as a GP trainee. And I don’t have any meaningful information to tell you how much this can increase salaries.

The fourth and final thing is that clearly, GP trainees become specialists earlier. So whilst other specialists can and do eventually earn more than GPs. You get there first as a GP and so you get a head start on the rest of the field. Also, GPs are generally working less time than other specialists. So in theory more able to enjoy their very reasonable salary.

Time To Complete Training and Other Costs.

It has been suggested to me by my readers and viewers that in order to tell the complete picture I should talk about the time it takes one to complete training as well as some of the other costs involved in getting there.

Whilst I agree that this probably does make the picture a little bit more complex for Specialty groups such as Surgeons. As I have also pointed out. Whilst one is working as a Surgical Trainee, either accredited or unaccredited you are in a group of doctors who are going to be earning quite a bit due to the amount of time worked. Now. This observation in itself is not really an attractive reason to enter Surgical training in my opinion.

But it does mean that if you are successful in getting your way through Surgical training to your FRACS you are probably going to end up earning one of the highest incomes of doctors across your medical career.

This is all pretty relative when we consider that most medical professions are in or close to the top ten occupations in terms of average income in Australia.

Some key things to observe here are:

Some specialties are somewhat easier to get into at an earlier stage of training, examples being Emergency Medicine, Psychiatry, Physician Training and Emergency Medicine.
Other specialties have long waiting lists where you might end up becoming a very, very senior Resident before you get onto the program. Examples here are Surgery, Ophthalmology and Dermatology
Costs of training fees and exam fees can also vary significantly. Annual College fees usually start at over a thousand dollars for most Colleges. Examination fees can be a few thousand dollars to over ten thousand dollars. These costs are all tax deductible.
You may also need to or find it desirable to enter a formal training course. Some Colleges make this mandatory. This will also cost you a few thousand dollars. Again. This is also tax deductible.
Depending on your specialty there may be some equipment that you need to buy. For example, some of the surgical specialties utilise special equipment (think Ear, Nose and Throat).

Salary of Australian Doctors | Doctors Pay Scale

Not surprisingly, one of the more popular topics on this blog is the subject of income or salary of Australian doctors. We have recently written about how much an Intern is paid and how much a Resident is paid. Of particular interest to many is how much a doctor earns when they have completed all their training and achieves the status of a Surgeon or a Physician or a General Practitioner or one of the many other specialties in Australia. A recent report from the Australian Tax Office has confirmed that doctors in Australia are amongst the best paid in the country.

If we take our entry point as internship and our peak point an Australian surgeon. Then a good guide as to how much one can earn as a doctor in Australia is somewhere between $68,000 AUD and $395,000 AUD per annum.

Of course not every doctor will earn $395,000 per annum and there are many factors that affect the earnings of a doctor. And a number of doctors also earn even more than $395,000. Let’s dive into the earnings in a bit more detail and also look at some of the cost factors for doctors.

Surgeons, Anaesthetists, Physicians, Psychiatrists and ‘Other Medical Practitioners’ Amongst the Top Ten Earners in Australia.

What is impressive is that 5 of the ten top occupations by earnings come from the medical profession, with Surgeons leading with an average taxable income of $394,866, followed by Anaesthetists in second with $367,343 and Internal Medicine Specialists in third with $299,378. Psychiatrists are in fifth with $216,075 and ‘Other Medical Practitioners’ in sixth with $204,387.

Occupation	Average Taxable Income
Surgeons	$398,866
Anaesthetists	$367,343
Internal Medicine Specialists	$299,378
Financial Dealer	$261,008
Psychiatrist	$216,075
Other Medical Practitioner	$204,387
Judicial / Legal Professionals	$195,703
Mining Engineer	$167,345
CEO or Managing Director	$157,643
Engineering Manager	$147,451

This is even more impressive when one considers that the ATO lists around 1,100 occupations to select from when one compiles their tax return.

You have probably already spotted one potential problem with these figures, which is that they rely on the person completing the tax return to select the appropriate occupation.

The other possible occupations for doctors to choose under the ATO categories are: General Medical Practitioner and Doctor specialist – type not identified. Both of which earned about $140,000 AUD per annum in 2016/17.

Presumably most surgeons select surgeon for an occupation and anaesthetists select anaesthetics etcetera. However, its not clear what occupations trainee doctors select. Most will likely select “Other Medical Practitioner”. Some may select the specialty that they are training in and this will reduce the overall average as trainee doctors earn less than specialists.

There were 28,307 doctors who selected “Other Medical Practitioners” in 2016/17, versus for e.g. 3,951 for Surgeons, so this number would incorporate most of the trainee doctors in Australia. But it might also be joined by for e.g. Emergency Physicians and Obstetricians and Gynaecologists, who don’t have another obvious occupation to select. Not many doctors selected Doctor specialist -type not identified (only 37).

In any regard its fairly plausible to say that trainee doctors are also in the top ten earners in Australia. And this certainly stacks up when one considers the publicly available information about trainee doctor salaries in Australia and one factors in overtime.

The average of these salaries will also be influenced by doctors working part-time and doctors working in the public sector (although as we show below by not too much).

Some interesting information is discerned when one digs into the detail provided by the ATO.

The ATO provides more detailed breakdowns on a State or Territory level so let’s look at Surgeons, Anaesthetists, Physicians and Psychiatrists in NSW:

Occupation	Average taxable income	Average salary or wage income	Average total income
Surgeons	$324,965	$65,881	$340,511
Anaesthetists	$335,301	$68,794	$348,323
Physicians	$283,577	$63,489	$296,034
Psychiatrists	$213,160	$58,305	$224,159

So what we notice here is that there is a very low level of average salary or wage income compared to the actual salary. This likely reflects the fact that many specialists do not earn the majority of their income as a paid wage but rather through contractual work and Medicare and private billings.

Is There a Difference Between Public and Private Earnings in the Salary of Australian Doctors?

In short. Yes. But what we see when we compare the above average taxable income with some of the rates that Specialists are paid in Australia for working in the public hospital system is something quite comparable.

Let’s take NSW again.

Salaried Staff Specialists.

First, let us look at Staff Specialists. These are Consultants who are employed on a salary basis in NSW hospitals. Generally, they work full time in the hospital system and don’t work in the private sector.

They may, however, see some private patients within the hospital system for which there is sometimes the capacity to share in part of the revenue.

A first-year Staff Specialist working full time will earn a minimum of $234,556 if they do not see private patients. So we are already above the average taxable income of a Psychiatrist.

This income can go up to $342,060 if the doctors sees a large number of private patients and splits this revenue with the hospital. Going past the average taxable income of Physicians.

The staff specialist rates increment every year until year 5. Once you have worked as a Staff Specialist for 7 years you are eligible to apply for Senior Staff Specialist status.

At this point, you will earn a minimum salary of $316,891 and a maximum salary of $462,133.

At this point, the Specialist is on par with the average taxable income of a Surgeon.

Add to this a generous professional development allowance of up to $35,000 and the possibility of a managerial allowance of an extra $9,000 to $23,000 for being the head of department or such. Being publicly employed is a well-remunerated experience for specialist doctors.

Visiting Medical Officers.

Visiting Medical Officer is the term given to a Specialist that contracts their services to a hospital. There are various ways that this occurs but lets stick with the most common one which is a sessional rate which is paid on an hourly basis.

Again sticking with NSW, a senior surgeon on a sessional VMO contract will earn $234.75 per hour plus $46.55 for background practice costs. That’s $281.30 per hour.

Were that surgeon to work 40 hours per week, just for the hospital for 48 weeks a year. That amounts to $540,096 AUD per annum. So about $80,000 more than what one could possibly earn as a Staff Specialist.

Of course, VMOs don’t generally just work for the public hospital system. They often consult from rooms and work in private hospital settings where they can generate greater revenue.

But to bring it back to reality a little bit. Working as a contractor means that you are not paid for your leave. You do not receive a professional development fund. And you have to carry your own Indemnity Insurance.

How Much Do Specialists Make Working in the Private Sector?

This question is a little bit more difficult to answer. Because there are no real reliable sources of information other than the broad information provided by the Australian Tax Office.

In addition, different specialists do different things. Some solely or primarily work in rooms, for example many Psychiatrists, General Practitioners and Physicians. Others work between rooms and hospitals, including most Surgeons and Anaesthetists.

Even the costs of running rooms can be considerable. Psychiatrists tend to have the lowest costs as they generally just need a comfortable office, reception and waiting room and a small amount of equipment. Versus, for example, Obstetricians and Gynaecologists who need a large amount of equipment to perform their job in rooms.

As we have also mentioned once you are in the private sector you are not just earning you are paying out expenses, which includes your own wage as well as the staff you employ, rent, various insurances, your own costs of professional development.

Also, when you go on leave you don’t get paid. But your staff generally do.

That being put aside we can do some rough estimations.

I’m going to use my own background specialty of Psychiatry for a simple example.

Lets say I work as a Psychiatrist solely in private rooms and charge patients for either half hour or 1 hour sessions. If I apply Australian Medical Association rates (which most specialists in private do). And I saw 4 patients for an hour and 8 patients for a half hour every day for 5 days a week for 47 weeks of the year (4 weeks leave and some adjustment for public holidays).

I would generate around $3,100 AUD in fees per day OR about $730,000 AUD per annum. This could go up somewhat if I charged for different items OR engaged in writing medico-legal reports.

This seems a lot and its and it is. And it doesn’t take into account all the costs I mentioned above.

For Specialists who are able to charge for procedures. Earnings scale up even more significantly. It is certainly not inconceivable therefore to see how some Surgeons in particular are making more than $1million per annum

Question: How long does it take to become a Specialist in Australia?

Answer. A long time.

First, you need to go to medical school which is generally a minimum of 5 years for an undergraduate program. After graduating you then complete one or two provisional years which are called intern and resident years. You then apply for specialty training which in some cases is quite competitive (for example surgery) and therefore may take several years to get in. Most specialty training is a minimum of 5 years. Although General Practice training can take as little as 3 years.

So from entering into medical school to becoming a specialist may take you a minimum of 9 years but is more likely to take you about 12 or more.

For part of this time you are at medical school, incurring debt and with limited scope to work. But as we have pointed out above once you enter the hospital system you start to earn a decent wage helping you to pay off those debts. As a trainee you are probably already in the top ten of earners in the country. But you will have significant costs in terms of paying for your training. Exam fees and College fees tend to be in the several thousands of dollars. And you will be making this money partly due to working long hours.

Question: How much tax do Specialists pay?

Answer. This obviously depends on the Specialist and how much they earn. In Australia there are quite a few deductible expenses. So doctors are generally able to deduct things like equipment, insurance, college and exam fees, medical board fees even sometimes travel and accomodation. This will reduce the taxable income somewhat. Also many doctors who work privately will establish companies or trusts through which they collect some of their earnings. They may leave some of this money in these entities paying a lower corporate tax on the profits than if they were to pay themselves.

If we create an example of a full time Senior Staff Specialist in NSW who is not earning additional from their private billings. And has $20,000 in deductible expenses. They will have a taxable income of $296,891. Assuming that they have already cleared their university debts and have private health insurance, so don’t need to pay a medicare levy. Such a doctor would pay $106,860 in tax.

Question: How many doctors pay tax?

Answer. A fun fact is that if you count up all the doctors who filed a tax return according to the ATO figures there were 80,482 tax returns filed by doctors in 2016/17.

This post was compiled with acknowledgement to the Australian Taxation Office for some of the information in this post.

April 1, 2019

Career Coach Melbourne. How to Find a Good One & 4 More Tips
Career coaching is something I write about often. And there is a reason. Career coaching is something many professionals don’t give enough importance to. The truth is that a lot of people, especially medical professionals, can use career coaches to kick start or even keep their professional lives moving forward. This even includes medical students who are just entering the job market, as well as seasoned medical professionals looking to manage or make changes to their careers.

A good career coach can come from a range of backgrounds so long as they can help you fulfill your potential. They should also be able to understand your career needs, have achieved good outcomes for past clients and be someone you are comfortable with challenging you. If you are looking for a career coach in Melbourne there are plenty of good options. Some good general career and executive coaches include: Katie Roberts, Tenfold Coaching, Michelle Pizer and Noted Careers Coaching. For doctors specifically there is Jocelyn Lowinger of Coach GP. But you should also consider that there may be other good coaches that are a good fit for you elsewhere.

Limiting your search just to Melbourne may not necessarily be the smartest thing to do these days especially with online video technology. I will explain why later in this post.

But first in order to determine who might make a good career coach we need to know what one does.

Tip 1. Know What Makes a Career Coach

When we think about coaches we often think about sports coaches. And it’s a reasonable metaphor to start with. One way of looking at is that a coach simply takes you from one point to another, just like a bus. But at the end of the day, you have to determine what your destination will be. This is where the parallel with sporting coaches and career coaches tends to differ. Often in sports, the destination is reasonably clear, for e.g. make the finals, improve my time for the hundred metres. For careers, it may be clear, for e.g. get into surgical training, or not so clear, for e.g. do I want to take on a managerial position? That is why career coaches are so important. We spend a lot of our time working, and the truth is that a few major adjustments to our career lives can make huge differences to our professional and personal futures.

For instance, imagine the impact of completing your specialty training earlier could have on your annual salary and lifestyle. or how a different career leaves you with more time to spend on personal matters which could do to help you build a closer family?

Paying a career coach to help you fast track your career or make career changes and adjustments can be a very smart investment when it results in a significant boost to your income or helps you to meet other important goals.

Generally speaking, a career coach should help you find greater fulfillment in your profession and help you have the dream life you want to make out of your career. Let’s face it, for most people, the lives we dream of living depend substantially on the careers we have. Coaches can also help those looking for jobs, and ensure that those using their services do the best they can to fulfill their most cherished career goals.

Tip 2. How to Find A Career Coach.

Now that you have made the decision to invest in a career coach. Getting the right fit is very important for you. A coach who has achieved wonderful results with one person might not necessarily help you attain a similar level of success as your coach. Therefore, here are some tips for finding a good career coach.

1. Don’t consider their field, but their potential to help you achieve your goals

As you look for a career coach, it is important to remember that he/she does not have to be an expert at your specific field. So, if you are a surgeon, you do not have to focus on finding a career coach with a background in surgery. Similarly, for any doctor nderstand that there are lots of coach without a medical background who can help you.

The most important thing as you look for a career coach is to find someone who will inspire you and help you achieve your potential. A career coach should help you ask yourself thought-provoking and actionable questions that help you attain a particular career goal. A good career coach should also offer guidance and empower you to take appropriate action so that your career keeps moving forward.

2. Find someone who understands your career guidance needs

As you look for a career coach, you have to understand what your expectations are as far as these services go. You should try to work out beforehand what outcomes you expect out of the assistance the coach offers. So, whether you want a better paying job, or a more fulfilling career, or a different career path, you have to understand what kind of assistance you need.

That being said. If we knew exactly what we wanted. We might already know how to get there and not need a career coach. So a good career coach will also spend time with you to truly clarify your goals. Sometimes clients enter into career coaching with goals in mind that are really not their own goals but other peoples goals. Career coaches can help to clear up goal confusion.

Otherwise, if there is no clear focus on what your career goals are, a coach can also help you out with this. From there, find out what the career coach you are evaluating promises to help you achieve and see if it matches the specific career goals you have in mind.

3. Look into what they have achieved in the past

You can also have a look at their coaching bios and find out what former clients have to say of their skills. For instance, have the coaching skills helped someone in your specific field get what they wanted? Also consider their experience, because someone who is just entering the field might not be in a position to help you navigate an important career obstacle.

4. Choose someone you are comfortable with

How you feel about your career coach should also matter. You should trust your intuition based on the conversation you have with the coach. If for some reason you have doubts about their abilities to help you with your career, then it’s worth looking at what other career coaches have to offer.

At the end of the day, you should have a great rapport with your career coach. This is important because however successful the coach has been in the past with former clients, he/she might not be the best fit for you if your strained relationship gets in the way of their offering you sound career guidance.

You should not just go and book sessions with the first coach you find with the expectation that your career will be changed for the better. Consider making a quick call with them first. Most good coaches will offer a quick free call service because they are confident in their abilities and they know this helps clients to make a decision about their services.

Tip 3. Investigate How a Career Coach in Melbourne Costs.

There is no particular standard by which career coaches in Melbourne or other parts of Australia fix their rates. Career coaching is essentially a free market. You will generally be getting what you pay for. If a career coach sets a high rate it is generally because their clients see the sort of results from their coaching to pay that rate.

Bear in mind that when you are paying for an hour of coaching you are probably not just paying for the coaches direct time. They will have administrative costs to factor in and possibly support staff, insurances, rent, website etc… They will also likely be doing some work for you outside of the session, such as researching issues, setting up for the next session and responding to emails from you.

In Australia, most basic level career coaches will charge at least $150 for a one-hour session. Some may provide discounted rates depending on your ability to pay. These coaches tend to be more targeted to younger people just entering the job market and might not have the experience and expertise to work with the majority of medical practitioners who already have a developed career.

Mid-range career coaches will charge somewhere between $300-600 AUD per session. These are the types of coaches who tend to work with most doctors.

An elite level career coach in Melbourne may charge $1,000 or more a session. If you are working as a medical Executive or CEO you might be able to afford the services of such a coach.

As I mentioned most coaches will provide a discount based upon your ability to pay. They may also pay a discount if you purchase a package of coaching. Sometimes you need to ask about this. It never hurts to do so.

Several factors come into play as far as career coaching goes. including, how long you will work with the professional, as well as the complexity of the goal you are trying to attain. Obviously, if you want help getting starting a career in a specialty with high barriers to entry, you might expect to need more sessions and pay a bit more than someone who just needs once off help preparing for an upcoming job interview.

It is important to remember that each career coach will charge you different fees for the same types of services. So, even as you try to find a bargain, it is important to remember that you will generally get what you pay for.

If you want cheap services, then you might end up getting poor quality services as well. Generally, coaches who have been in the business for much longer can and do charge more, and that because they are usually more successful at helping their clients achieve their career goals. This assurance obviously comes at a premium. But you will probably also find that because you are paying more they are actually seeing fewer clients and will give you extra support outside of the formal coaching sessions.

That said, you can always negotiate with your career coach so that you get a price that you can handle. However, what your career coach has to offer also matters. For instance, if they have a vast professional network that can provide you with other forms of career assistance, then you can expect to pay more. As opposed to coaches who will only stop at helping you polish up your interview performance.

Tip 4. Understand What a Career Coach Does.

Career coaches can do plenty to assist you to accomplish your career goals. Some of the things they can help you out with include the following.
- Showing you how to deal with office politics
- Help you understand yourself, your career strengths, and what value you can offer
- Guide you on resolving feelings like frustration, anger, and resentment with regard to your current job
- Help you meet with more success at work
- Help you to manage difficult conversations and difficult team dynamics at work
- Help you to get better feedback on your performance at work
- Help you to manage your relationship with your boss
- Help you to manage your relationship with your co-workers
- Help you be a better manager, if your role involves managing
- Show you how to land your dream job or career
- Guide you towards your most appropriate career based on your skills and interests
- Assist you in planning, developing and managing your career path
- Help you recognize things that are stressing you at work and helping you deal with them
- Help you identify problems that affect your career and satisfaction as a professional
- Helping you find more passion in what you do when you are stuck in a rut
- Helping you to make a difficult decision about exiting your current career
It is important to realize that a career coach is there to assist you, which means you have to play your part as well. At the end of the day, you have to work towards becoming what you want as far as your professional life goes and resolving any career issues you might be facing. Essentially, they use their training, experience, expertise and skills to help you overcome hurdle that keep most people from becoming all they would like to be. Otherwise, these professionals are also restricted by other factors, including your qualifications, your attitude, and how well you are willing to work with them.

Conclusion.

At the end of the day, you can think of a career coach as an experienced friend who can help you achieve your dreams more easily or with greater chances of success. Once you know what changes you need to be making in your career, you should hire this professional to help you along. While at it, consider what the professional you have in mind can offer, how much it will cost you, and what assurances you have as far as delivering on their promises goes.

Related Questions.

Question: Who trains career coaches?

Answer.

The career coaching industry is not regulated. But some take courses, and others do it because they have enough experience in the corporate world to offer the much-needed guidance to people in search of the services require to resolve the career issues they are facing. There are some international organisations which some coaches belong to.

Question: How does career coaching work?

Answer.

Basically, the service involves talking through issues and ideas in order to get the services you desire as the client. If you want to land a dream job, you can get confidence building sessions to help you do better at things like interviews in addition to technical skills, such as how to write a killer CV. Sometimes there may be other activities performed by the coach for you, for example administering surveys on your behalf to get feedback on your impact at work.

Question: Does it matter if my career coach is in Melbourne or not?

Answer.

Some people think that where the career coach comes from matters a big deal. However, this is not always necessary, even if the desire is to have a face-to-face interaction with the career coach. In fact with technology these days it is incredibly easy to connect with a coach via video on your computer or even smart device. This actually offers up a few advantages.

Firstly, it potentially expands the range of coaches you may be able to engage with.

Secondly, it often makes scheduling appointments easier as the coach is not pinned down to meeting you in a certain office or location at a certain time.

Thirdly, it means you are not having to travel somewhere to see the coach.

Fourthly, the sessions can often be recorded and provided back to you to review.
March 30, 2019
Career Coach. When Do You Need One? Costs & How to Find a Good One.
Being a success at what you do is a great feeling. This is why you need all the help you can to get to this point. On our blog, you will find a lot of tips and information on how to make the best of your medical career. Put together by an experienced team of doctors, this blog contains the critical information you need to manage your medical career and achieve your greatest career goals as a doctor in Australia. And is also helpful for other parts of the world.

Career coaching is something I write about often. And there is a reason. Career coaching is something many professionals don’t give enough importance to. The truth is that a lot of people, especially medical professionals, can use career coaches to kickstart or even keep their professional lives moving forward. This even includes medical students who are just entering the job market, as well as seasoned medical professionals looking to manage or make changes to their careers.

What is a Career Coach?

When we think about coaches we often think about sports coaches. And it’s a reasonable metaphor to start with. One way of looking at is that a coach simply takes you from one point to another, just like a bus. But at the end of the day, you have to determine what your destination will be. This is where the parallel with sporting coaches and career coaches tends to differ. Often in sports, the destination is reasonably clear, for e.g. make the finals, improve my time for the hundred metres. For careers, it may be clear, for e.g. get into surgical training, or not so clear, for e.g. do I want to take on a managerial position? That is why career coaches are so important. We spend a lot of our time working, and the truth is that a few major adjustments to our career lives can make huge differences to our professional and personal futures.

For instance, imagine the impact of completing your specialty training earlier could have on your annual salary and lifestyle. or how a different career leaves you with more time to spend on personal matters which could do to help you build a closer family?

Paying a career coach to help you fast track your career or make career changes and adjustments can be a very smart investment when it results in a significant boost to your income or helps you to meet other important goals.

Generally speaking, a career coach should help you find greater fulfillment in your profession and help you have the dream life you want to make out of your career. Let’s face it, for most people, the lives we dream of living depend substantially on the careers we have. Coaches can also help those looking for jobs, and ensure that those using their services do the best they can to fulfill their most cherished career goals.

How to Find A Career Coach.

Now that you have made the decision to invest in a career coach. Getting the right fit is very important for you. A coach who has achieved wonderful results with one person might not necessarily help you attain a similar level of success as your coach. Therefore, here are some tips for finding a good career coach.

1. Don’t consider their field, but their potential to help you achieve your goals

As you look for a career coach, it is important to remember that he/she does not have to be an expert in your specific field. So, if you are a surgeon, you do not have to focus on finding a career coach with a background in surgery. Similarly, for any doctor understand that there are lots of coaches without a medical background who can help you.

The most important thing as you look for a career coach is to find someone who will inspire you and help you achieve your potential. A career coach should help you ask yourself thought-provoking and actionable questions that help you attain a particular career goal. A good career coach should also offer guidance and empower you to take appropriate action so that your career keeps moving forward.

2. Find someone who understands your career guidance needs

As you look for a career coach, you have to understand what your expectations are as far as these services go. You should try to work out beforehand what outcomes you expect out of the assistance the coach offers. So, whether you want a better paying job, or a more fulfilling career, or a different career path, you have to understand what kind of assistance you need.

That being said. If we knew exactly what we wanted. We might already know how to get there and not need a career coach. So a good career coach will also spend time with you to truly clarify your goals. Sometimes clients enter into career coaching with goals in mind that are really not their own goals but other peoples goals. Career coaches can help to clear up goal confusion.

Otherwise, if there is no clear focus on what your career goals are, a coach can also help you out with this. From there, find out what the career coach you are evaluating promises to help you achieve and see if it matches the specific career goals you have in mind.

3. Look into what they have achieved in the past

You can also have a look at their coaching bios and find out what former clients have to say of their skills. For instance, have the coaching skills helped someone in your specific field get what they wanted? Also consider their experience, because someone who is just entering the field might not be in a position to help you navigate an important career obstacle.

4. Choose someone you are comfortable with

How you feel about your career coach should also matter. You should trust your intuition based on the conversation you have with the coach. If for some reason you have doubts about their abilities to help you with your career, then it’s worth looking at what other career coaches have to offer.

At the end of the day, you should have a great rapport with your career coach. This is important because however successful the coach has been in the past with former clients, he/she might not be the best fit for you if your strained relationship gets in the way of their offering you sound career guidance.

You should not just go and book sessions with the first coach you find with the expectation that your career will be changed for the better. Consider making a quick call with them first. Most good coaches will offer a quick free call service because they are confident in their abilities and they know this helps clients to make a decision about their services.

How Much Does a Career Coach Cost?

There is no particular standard by which career coaches fix their rates. Career coaching is essentially a free market. You will generally be getting what you pay for. If a career coach sets a high rate it is generally because their clients see the sort of results from their coaching to pay that rate.

Bear in mind that when you are paying for an hour of coaching you are probably not just paying for the coaches direct time. They will have administrative costs to factor in and possibly support staff, insurances, rent, website etc… They will also likely be doing some work for you outside of the session, such as researching issues, setting up for the next session and responding to emails from you.

In Australia, most basic level career coaches will charge at least $150 for a one-hour session. Some may provide discounted rates depending on your ability to pay. These coaches tend to be more targeted to younger people just entering the job market and might not have the experience and expertise to work with the majority of medical practitioners who already have a developed career.

Mid-range career coaches will charge somewhere between $300-600 AUD per session. These are the types of coaches who tend to work with most doctors.

An elite level career coach may charge $1,000 or more a session. If you are working as a medical Executive or CEO you might be able to afford the services of such a coach.

As I mentioned most coaches will provide a discount based upon your ability to pay. They may also pay a discount if you purchase a package of coaching. Sometimes you need to ask about this. It never hurts to do so.

Several factors come into play as far as career coaching goes. including, how long you will work with the professional, as well as the complexity of the goal you are trying to attain. Obviously, if you want help getting starting a career in a specialty with high barriers to entry, you might expect to need more sessions and pay a bit more than someone who just needs once off help to prepare for an upcoming job interview.

It is important to remember that each career coach will charge you different fees for the same types of services. So, even as you try to find a bargain, it is important to remember that you will generally get what you pay for.

If you want cheap services, then you might end up getting poor quality services as well. Generally, coaches who have been in the business for much longer can and do charge more, and that because they are usually more successful at helping their clients achieve their career goals. This assurance obviously comes at a premium. But you will probably also find that because you are paying more they are actually seeing fewer clients and will give you extra support outside of the formal coaching sessions.

That said you can always negotiate with your career coach so that you get a price that you can handle. However, what your career coach has to offer also matters. For instance, if they have a vast professional network that can provide you with other forms of career assistance, then you can expect to pay more. As opposed to coaches who will only stop at helping you polish up your interview performance.

What Does a Career Coach Do?

Career coaches can do plenty to assist you to accomplish your career goals. Some of the things they can help you out with include the following.
- Showing you how to deal with office politics
- Help you understand yourself, your career strengths, and what value you can offer
- Guide you on resolving feelings like frustration, anger, and resentment with regard to your current job
- Help you meet with more success at work
- Help you to manage difficult conversations and difficult team dynamics at work
- Help you to get better feedback on your performance at work
- Help you to manage your relationship with your boss
- Help you to manage your relationship with your co-workers
- Help you be a better manager, if your role involves managing
- Show you how to land your dream job or career
- Guide you towards your most appropriate career based on your skills and interests
- Assist you in planning, developing and managing your career path
- Help you recognize things that are stressing you at work and helping you deal with them
- Help you identify problems that affect your career and satisfaction as a professional
- Helping you find more passion in what you do when you are stuck in a rut
- Helping you to make a difficult decision about exiting your current career
It is important to realize that a career coach is there to assist you, which means you have to play your part as well. At the end of the day, you have to work towards becoming what you want as far as your professional life goes and resolving any career issues you might be facing. Essentially, they use their training, experience, expertise, and skills to help you overcome hurdles that keep most people from becoming all they would like to be. Otherwise, these professionals are also restricted by other factors, including your qualifications, your attitude, and how well you are willing to work with them.

Conclusion.

At the end of the day, you can think of a career coach as an experienced friend who can help you achieve your dreams more easily or with greater chances of success. Once you know what changes you need to be making in your career, you should hire this professional to help you along. While at it, consider what the professional you have in mind can offer, how much it will cost you, and what assurances you have as far as delivering on their promises goes.

Related Questions.

Question: Who trains career coaches?

Answer.

The career coaching industry is not regulated. But some take courses, and others do it because they have enough experience in the corporate world to offer the much-needed guidance to people in search of the services required to resolve the career issues they are facing. There are some international organizations which some coaches belong to.

Question: How does career coaching work?

Answer.

Basically, the service involves talking through issues and ideas in order to get the services you desire as the client. If you want to land a dream job, you can get confidence building sessions to help you do better at things like interviews in addition to technical skills, such as how to write a killer CV. Sometimes there may be other activities performed by the coach for you, for example, administering surveys on your behalf to get feedback on your impact at work.

Question: Does the location of the career coach matter?

Answer.

Some people think that where the career coach comes from matters a big deal. However, this is not always necessary, even if the desire is to have a face-to-face interaction with the career coach. In fact with technology these days it is incredibly easy to connect with a coach via video on your computer or even a smart device. This actually offers up a few advantages.

Firstly, it potentially expands the range of coaches you may be able to engage with.

Secondly, it often makes scheduling appointments easier as the coach is not pinned down to meeting you in a certain office or location at a certain time.

Thirdly, it means you are not having to travel somewhere to see the coach.

Fourthly, the sessions can often be recorded and provided back to you to review.
March 18, 2019
Salary of Australian Doctor: From Intern to Surgeon

If you are thinking of working in Medicine in Australia you may naturally want to know exactly how much you will earn. Having worked in the Medical HR field for over two decades I thought I would challenge myself to write you a comprehensive post to cover as many possibilities as could be thought of.

But first let’s get the question of the range of doctor salaries dealt with. As of March 2019, A doctor salary will range from a low of $68,000AUD per annum as an Intern in the State of NSW to a possible high rate of $393,467AUD on average per annum for a Surgeon (according to Nine Finance).

Now let’s dive deeper. Because most doctors, can often earn a lot more than average, particularly by working additional hours and working in the private sector. Let’s also look at what various types of training doctors make in pay before looking at the various specialties and some other categories of doctors.

Trainee Doctors.

Specialists.

This is where it starts to get a bit more difficult

Career Doctors.

Additional Benefits.

Related Questions:

Question. What Costs Are Involved in Becoming a Doctor in Australia?

Answer.

Question: Do All Doctors Get Superannuation?

Answer.

Question: Do Doctors in Australia Get Health Insurance?

Answer.

Question

March 12, 2019

Resident Doctors Salary Australia: Pay Rates & Titles Explained.

Image by jennycepeda on Pixabay

Resident Medical Officer. Or just plain “Resident”. Is the job title that is most commonly applied to Australian doctors working in their 2nd year of Medicine in Australia. This title can also be given to a doctor working in their 3rd year or later. However, Resident is not the only title used and the situation can be confusing. Add to this, that being a resident doctor in Australia is not the same as being a resident doctor in a country like the United States. What trainee doctors get called and what doctors salary they get paid after their internship can become terribly confusing. Both for Australian doctors as well as doctors from other countries. So I pulled together this post to help clear it up.

Firstly, let’s address the key question. What does a Resident Doctor get paid in Australia? As of 2019, a Resident Medical Offcier (RMO) in Australia will make anywhere between $72,837, in Tasmania, which is the lowest rate and $86,328 AUD in Western Australia, which is the highest rate. Bear in mind that this is base annual Full-Time salary. Most Resident doctors are employed Full-Time but work additional overtime hours as well as shiftwork. So take home salaries can increase rapidly and it would not be unreasonable to see about 25-50% more salary on top of this.

To further clarify, these are the rates paid to doctors in their second year of work in the hospital system. Or what is commonly referred to as a Postgraduate Year 2 (PGY2) doctor. The rates do increase if you are more experienced.

So let’s dive in a bit deeper to the situation. To see how pays compare across the various States and Territories in Australia. As well as what sort of title you might have if you are working at a PGY2 level in one of those particular States and Territories.

Resident Doctors Salary By State and Territory

State or Territory	Common Title	Base Full Time Annual Pay (AUD)
Western Australia	Resident Medical Officer	$86,328
Northern Territory	Resident Medical Officer	$82,731
South Australia	Resident Medical Officer	$80,041
Australian Capital Territory	Resident Medical Officer	$79,682
New South Wales	Resident Medical Officer	$79,648
Queensland	Junior House Officer* OR Resident Medical Officer	$79,413
Victoria	Hospital Medical Officer*	$79,391
Tasmania	Resident	$72,837

Information accurate as of February 2019. Rates of pay are regularly altered on an annual basis at different times depending on the State or Territory industrial framework.

*Interns (PGY1 doctors) are also employed as Junior House Officers and Hospital Medical Officers in Queensland and Victoria respectively. So the titles are interchangeable and you should check if the position is for a PGY1 or greater.

An Explanation of Titles

As I have noted the most common position title you will probably see in most States and Territories is some version of “Resident Medical Officer”. So you might also see just plain “Resident” or the abbreviated version of “RMO”.

If you see “Senior Resident Medical Officer” this means the position suits someone slightly more senior. Usually someone in their PGY3 or third year of medicine.

However, employers generally have a choice or even free reign to call these positions whatever they like. Some will stick to the title under the Award or Enterprise Agreement (see below). Some will go for the more generally understood Resident Medical Officer.

But you may also see titles like “Medical Practitioner” or “Trainee” or “Unaccredited Trainee.”

Addressing the Confusion.

If you are confused as to what level the position is there are a few things that you can do:

Firstly, you can look at the details of the job description:

It will often tell you the level under the Award or EBA.
There may be a description of how many years of experience you need.
You might be able to infer that it is a resident level job because you will report to Registrars or specialty trainees. If you are reporting directly to Consultants then it is a much more senior position.
Finally, you might be able to work it out from the salary range.

If none of that works you can try contacting the person who advertised the position. They will normally have an email contact and often a phone number listed.

Western Australia Leads Again.

There are some interesting observations about this list when one compares it to the Intern pay table. Firstly, Western Australia remains the clear leader in trainee doctor pay rates. And in fact, Western Australia continues to stay ahead as one enters into the specialty trainee doctor pay scales. On at least an annual base salary basis it has to be said that Western Australia pays its trainee doctors the best.

The strong improver on the list is NSW. Which leaps over Tasmania and just squeezes past Victoria and Queensland to no longer be last. Tasmania is in fact well and truly last being almost $7,000 in the rear of Victoria which is second last.

The two largest States in Australia (by population), being Queensland, Victoria and NSW are actually extremely close in what they pay Resident doctors. There is really not that much difference between them.

Not All Are Equal.

But this is oversimplifying the situation.

Whilst Victoria and NSW pay their Resident doctors approximately the same rate of pay. The Enterprise Agreement for doctors in Victoria (see below for what one of these is) is arguably the most modern in the country. And includes a suite of additional benefits which are not given to doctors in NSW. NSW arguably has the most out of date Award of all the trainee doctors Awards or EBAs in the country.

There are some things you get when you work as a Resident in Victoria. Which you don’t get when you work as a Resident in NSW. These include a provision of up to $3,000 for continuing professional development, as well as specific provision examination leave as well as conference leave.

How Are Doctor Pay Rates Determined in Australia?

You may be wondering why there is such a difference in pay rates for trainee doctors in Australia? And also why I am quoting you pay rates by State and Territory with confidence? And not digging into individual rates of pays at certain hospitals or health networks.

To understand all of this one has to briefly explain what is called the industrial relations system in Australia. Before Australia became a sovereign country it was actually already a collection of individual States. With their own parliamentary and judicial systems based on the UK system. These systems continued with the Federation of Australia, with a division of authorities and responsibilities between the Commonwealth and State parliaments. One responsibility that was maintained by the State’s was the ability to determine labour laws. Or the laws that regulate who can work, how and when and for how much.

On top of this federal system, Australia has always had a strong trade union movement that has worked collectively for its members to secure improvements to work conditions. Over time a system developed in Australia to determine disputes between workers (represented by trade unions) and employers on both a State and later Federal level.

The Arbitration System.

This system was and is called “arbitration” and basically involves a court hearing both sides arguments and making a determination.

So basically whenever there is a dispute over conditions it is determined on an industry basis and either for the whole State or the whole country. Disputes are generally not heard on an employer or workplace basis. Although this has changed a bit of recent times.

The arbitration courts developed and updated legal documents called Awards. These Awards contained all the rules about what certain workers were required to do, how they got paid and what other “entitlements” (such as leave) they would have.

Awards are determined based on industrial classifications. So for example, in NSW there is an Award which is called the Public Medical Hospital Officers Award which covers all trainee doctors employed in NSW hospitals.

More recently in certain States the Award system has altered slightly to a process of what is called enterprise bargaining. Essentially, the employer and the union representing the workers agree to put aside the Award and develop a contract that both parties agree to.

Awards and EBAs Outline the Conditions of Employment for Everyone.

Whether it is an Award or Enterprise Bargaining Agreement (EBAs) both documents outline the conditions of employment for all employees of that classification.

Awards and EBAs normally outline rates of pay based upon years of experience with some progression steps. So for example in Tasmania, you will start out as a Medical Practitioner Level 1 (Intern). And after one year automatically progress to a Medical Practitioner Level 2 (Resident year 1). And the next year move up to a Medical Practitioner Level 3 (Resident year 2). But you have to be appointed to a Medical Practitioner Level 5 (as either a Senior Resident year 1 or Registrar year 1) before you can progress up to this particular salary point.

So there are names attached to the classification or grading levels under the Awards and EBAs. And these are often also used for the actual position title when you see a job advertised.

Additional Benefits.

As I have mentioned most trainee doctors work full time and on top of this are expected to do a certain amount of overtime. As well as what are called penalty rates on top of their normal work hours. Normal work hours in Australia are generally Monday to Friday 8.30am to 5.00pm but can also sometimes vary to be something like 7.30am to 4.00pm.

You generally work 40 hours per week if your are full time. So if you work 8.30am to 5.00pm you get paid 8 hours for that day’s work. The additional 30 minutes is meant to be an unpaid lunch break.

Penalty Rates.

Penalty rates are extra amounts of pay you accumulate per hour for working your normal hours in a less favourable time period. So, for example, working evening shifts or night shifts or working on the weekends. You might get paid anywhere between an additional 25% to 75% for a penalty rate shift depending on how undesirable it might be.

Overtime.

Overtime is different from penalty rates in that whilst you are also working outside the normal working hours you are doing so on top of your normal 40 hours per week. Overtime rates usually start at time-and-a-half, i.e. you get paid 150% of your normal hourly rate and in most circumstances quickly escalate to double-time (200%).

The system for penalty rates and overtime does vary a little bit amongst the different State and Territories a little bit. So you need to check out the individual Awards and EBAs to know exactly what you get paid and for what.

Some Other Benefits.

There are a range of other benefits that you get when working as an employed doctor in Australia.

On top of your salary, your employer is required to pay an additional 9.5% into a superannuation fund to assist with your retirement.
As an employee, you are covered by workers compensation for any injury or accident that might occur at work. Although payouts are often fairly poor and below what most professionals earn. So you may wish to consider taking out additional income protection insurance.
If you are asked to be on-call you will get a small allowance for this and be paid if you are called back into work.
You may get an allowance or even a mobile phone provided to you if you are required to be on call.
You might get some meal allowances for shifts.
If you have been seconded a reasonable distance from your normal place of appointment you will generally be provided with free temporary accommodation (you may need to pay a bond) and a travel allowance, for example, a free air ticket back home every 13 weeks or so.
You will get at least 4 weeks of annual leave per year.
Most doctors will also get one extra day off per month. Called a Rostered Day Off or RDO.
You will get a certain amount of sick leave every year which you can accumulate if you don’t use.
You also get access to other types of leave, such as leave to take your child to the doctor.

What About Health Insurance?

Unlike in the United States and some other countries Australian employers do not provide health insurance. If you are a citizen or permanent resident you will be well covered for basic care under the Federal Government’s universal health care scheme. If you are on a temporary visa you will likely need to take out some form of insurance. Unless your country has a reciprocal agreement in place (for e.g. between the United Kingdom and Australia).

Indian Doctors Australia: Jobs, Chances, Salary, Registration.

Many doctors from India have successfully migrated to work in Australia. Doctors from India were the fourth-highest country to be granted a visa to work as a doctor in Australia in 2017. After the United Kingdom, the Republic of Ireland and Malaysia. As someone who has worked in Medical HR for more than two decades, I have found Indian doctors on the whole to be a really good group of doctors to work with.

Can Indian doctors work in Australia? The answer is, of course, yes. India provides one of the largest sources of overseas doctors or International Medical Graduates (IMGs) working in Australia at both a trainee doctor as well as specialist level. Of course, no doctor coming from another country is absolutely guaranteed to be able to work in Australia.

Just like doctors from other countries. Doctors from India are limited in regards to what doctor jobs they can initially apply for in Australia. Once employed you receive the same rates of salary and pay as other doctors, with some possible restrictions on where you can work. Salary packages vary from about $70,000 AUD for a very junior level job to $300,000 AUD and much more for consultant-type positions. There are two main ways that Indian doctors need to either apply for initial registration. Both are quite hard.

The Standard Pathway is the process if you are not a specialist. It requires sitting for the Australian Medical Council exams, which have an overall pass rate of about 60% for the MCQ component and 25% for the clinical component.
The Specialist Pathway is the process if you are a specialist. Between the years 2015 and 2021, 729 specialist Indian doctors applied to a specialist medical college for assessment. 244 were deemed to not be comparable. 401 were deemed to be partially comparable and only 84 were deemed to be substantially comparable (a 66% rate of being found comparable.

So the prospects for working in Australia as an Indian doctor are good for many but challenging for some. So it’s important to give you a little bit more detail. There are also other options for getting registered which I will outline.

So let’s dig into a bit more of the details of the top of Indian Doctors Australia.

Get a Guide

A bundle of resources written by a local Australian expert covering how Indian doctors can work in Australia.

Only $5.70 AUD

The Standard Pathway. The Option for Trainee Indian Doctors Australia.

If you are a trainee doctor from India and do not have specialty status then the Standard Pathway is the main option for you.

The major hurdle in this process is pursuing the Australian Medical Council examinations, which we have written about in more depth here.

In order to be able to sit for the AMC, you must first establish what is called a portfolio

You first create a registration with the AMC website.
You should also check that your medical degree is awarded by an institution recognized by the AMC. The AMC recognizes most but not all medical schools which are listed with the World Directory of Medical Schools. There is a handy search on the AMC site.
You must then also create an EPIC account and confirm your identity with the ECFMG (located in the United States).
You get an EPIC id in about 3 working days, which you use to establish your AMC portfolio.
You upload your qualifications to EPIC. As you do so YOU MUST REQUEST that EPIC send a report to the AMC.
EPIC notifies you and the AMC when they have completed their check.

This whole process will cost you $500 AUD to register with the AMC and about $205 USD for EPIC (more if you are wanting more than one qualification verified).

Once EPIC reports back in the affirmative to the AMC you will be allowed to request to sit for the AMC Part 1 Examinations.

There is no actual work experience requirement to sit the AMC Part 1 Examination and you can, in fact, start preparing for this whenever you like. But of course, you will not be able to sit the exam without a verified medical degree. So you can start studying for it in medical school but won’t be able to sit it till after you graduate.

The Part 1 MCQ Examination

The AMC Computer Adaptive Test (CAT) MCQ Examination is a computer-administered fully integrated multi-choice question examination delivered in one sitting that lasts 3 and a half hours.

There are regular invigilated examinations in Australia as well as a number of sessions available in the examination across the world.

The examination itself consists of 150 “A-type MCQs”. You must select the one correct response from amongst the five options. 120 of the questions are “live” questions, which means they count towards your score. The remaining 30 questions are being piloted and don’t count towards your final score. You do not know which questions are being piloted so you have to give your best for all 150.

You are expected to complete all 150 items and must complete the 120 scored items. Failure to complete all 120 scored items in the examination may lead to insufficient information for a reliable determination of your ability and therefore a result on the AMC adaptive scale.

You should practice as many MCQs as you can. There is also an official online practice exam through the AMC website.

Because the MCQ exam is computerized you will receive your result fairly quickly in about 4 weeks. You get a printout that indicates where you performed overall, as well as the range for all candidates appearing for that particular exam. You also get a breakdown of your performance in the question domains. This is useful if you don’t pass to know where to put your efforts next time.

You need to score 250 or more to pass. Less than 60% of candidates pass. Although this score is probably depressed somewhat by those candidates sitting more than once.

It currently costs $2,920 AUD to sit for the MCQ.

The AMC Clinical Examination Part 2

Once you pass the AMC MCQ exam, you are then able to appear for the AMC Clinical exam. These are all held in Melbourne at the AMC’s purpose-built examination National Testing Centre or online.

Clinical Exam Format

The Clinical exam format is a 20-station multidisciplinary structured clinical exam that assesses your skills in Medicine, Surgery, Gynecology and Obstetrics, Pediatrics, and Psychiatry. There are 14 scored stations, 2 pilot (non-scored) stations and 4 rest (non-scored) stations.

As of 2019, the result is graded as either a clear pass or a clear fail. Prior to this borderline candidates were offered a retest. However, the AMC found that the time between examination and retest was becoming so long that the results were not meaningful.

You must pass 10 or more of the stations to pass the exam. The pass rate is incredibly low. About 28%

It is recommended that you should study the Handbook of Clinical Assessment and practice roleplays as much as you can. You may want to attend a course. Candidates also study different notes such as Karen notes, and the VMPF notes. John Murtagh’s General Practice is also worth revising.

It is extremely wise to form a study group and there are many groups around where you can practice what is called “recalls”, which is when a candidate who has previously sat the exam attempts to reconstruct the station.

The cost of sitting the Clinical Examination is currently $3,730 AUD ($400 extra for the online version).

When and What types of jobs can I apply for as an Indian Trainee?

You can apply for a range of trainee jobs. The main limitation is whether the employer will accept an IMG. Which for the majority of cases they will not.

You can actually start applying for jobs after you have passed your AMC Part 1 Examination. But you will need a valid English language test if you do.

There are often a number of postgraduate year 2 or 3 general jobs on offer. They are generally termed Resident Medical Officers in most States and Territories, but may also be called House Officers or Hospital Medical Officers in some places.

Above these sorts of posts, come the specialty training positions. In Australia, you tend to enter specialty training around postgraduate year 3. These positions are generally referred to as Registrar positions. But you might also see advertised as Senior House Officer or Trainee or Advanced Trainee.

One key thing to look out for is that most of these jobs will not accept an overseas applicant.

A key thing to look for is the phrase “eligible for registration” in the selection criteria.

It is very important to try and secure an employment offer. Whilst you can apply to the Australian Medical Council to check your primary medical degree at any stage. You won’t be able to gain registration until you have an offer of employment. This is because the Medical Board needs to see a supervision plan from your employer.

Outside of general practice, the majority of employment opportunities for trainee doctors occur within public hospitals. So your best places for finding suitable job postings are on the State and Territory health department recruitment sites. We have a listing of these on our international doctors’ resource page.

What Type of Supervision Do I Need Or Get?

The Medical Board of Australia is very vigilant about supervision standards for IMG doctors. What sort of supervision you receive will depend on a number of factors, including:

your qualifications
your previous experience, especially in the type of position for which you have applied
whether you have practised recently and the scope of your recent practice
the requirements of the position including the type of skills required for the position
the position itself, including the level of risk, the location of the hospital or practice and the availability of supports (supervisors)
the seniority of the position, for a hospital position

In general, you will either be approved for Level 1 or Level 2 Supervision. There are 4 Levels and the higher up you go the less direct oversight you require.

Level 1 Supervision.

Level 1 Supervision requires your supervisor (or alternative supervisor) to be present in the hospital or practice with you at all times and you must consult with them about all patients. This is the level of supervision that most Indian doctors will receive Remote supervision (e.g. by telephone) is not permitted. This type of supervision is generally recommended when you are very junior yourself or entering a junior role which you are not very familiar with. In Australian major public hospitals, there are many layers of other doctors who you can get supervision from. So Level 1 is not too much of an issue in these circumstances.

Level 2 Supervision.

Level 2 Supervision, is what most other Indian trainees approved to work in Australia will be approved for. It is a step up from Level 1 Supervision. Supervision must primarily be in person but your supervisor can leave you to do work on your own and you can discuss it by phone. You should discuss with them on a regular (daily) basis what you have been doing with patients. But do not need to discuss every case.

Level 3 Supervision.

Level 3 Supervision, is what you might receive if you are working in an Advanced Trainee role in India and transferring to something similar in Australia. In this case, you have much more primary responsibility for the patient. Your supervisor needs to make regular contact with you but can be working elsewhere and available by phone or video.

What happens after I commence my position?

Once you are approved for registration and you have your visa issues sorted you will be able to commence work. Your employer should help you out with all these things. You will be working under what is called “provisional registration” by the Medical Board of Australia. Generally, all you need to do for these 12 months is to show that you can learn and grow and get regular feedback from your supervisors. Your supervisors will need to complete regular reports for the Medical Board of Australia and it is your responsibility, not theirs to see that they are completed and returned on time. If all the reports go well you will be able to be recommended at the end of the 12 months for general registration.

The other thing that you need to watch out for is that your employer is ensuring that you gain exposure to the types of experiences that the Medical Board requires for this year. Generally, these shadow the experience that Australian interns go through.

Depending on whether you have completed AMC Part 2 or not. You will need to try and sit and pass this in these 12 months. Although you may be able to get an extension.

If you are lucky enough you may be employed in one of the 20 or so health services which offer Workplace-based assessment as an alternative to the AMC Clinical exam. Candidates find this process far easier to complete.

You will probably be starting to look for another job or negotiating an extension around the end of your 12 months. With general registration, you may be able to apply for a skilled visa, as well as be looking at applying for permanent residency.

Permanent residency is crucial for applying for most specialty training programs. See below.

The Specialist Pathway. The Option For Specialist Indian Doctors Australia.

For Indian specialists, your option for working in Australia is what is called the Specialist Pathway.

Once again this starts with becoming verified as a doctor with the Australian Medical Council and should again coincide with an active search for a position.

You may be lucky enough to be in a targeted specialty area where you might successfully be approved for what is called an Area of Need position, in which case the employer or recruitment agent will provide you with a lot of support and will likely pick up the costs of being assessed.

For most International Doctor specialists however these days you will be approaching the college directly to be assessed for specialist recognition. This is not something to be trifled with. The paperwork requirements and the cost (generally around $10,000 AUD or more) is considerable.

On the plus side, the colleges all have reasonably helpful information on their websites, including the application forms and a little bit about their criteria for assessment.

Finding Out What You Need To Do.

We have saved you the trouble of finding those pages by putting them on our International Doctors resource page here.

The majority of Indian specialties (but not all) map to a similar college or specialty in Australia. So working out which specialty goes into which Australian college is generally not too confusing. We have put together a summary of the Australian specialist medical colleges here.

After you go through your specialist assessment you are given an outcome.

As I have noted the majority of cases for Indian specialists are either deemed not comparable or substantially comparable.

If you are deemed not to be comparable by the college. This means you cannot directly become a specialist in Australia. You will probably have to go through the standard pathway to work as a doctor in Australia.

If you are deemed to be partially comparable (a situation where this commonly may occur is if you have just recently finished specialty training but have not worked as a specialist for very long). In this situation you will need to work under supervision for longer and may well also face some formal examinations.

Substantially comparable is the best result. This essentially means that you will need to work under some form of peer review for up to 12 months and so long as your reports are satisfactory you will be recommended for specialist registration at the end.

How to Maximize Your Chances of Getting a Substantially Comparable Outcome.

To ensure that you are seen as substantially comparable by the relevant college I would recommend the following:

You should have your Certificate of Completion of Training and relevant college Fellowship
You should ideally have worked substantively at a Consultant level in your field for 3 years or more
You should be able to demonstrate good standing with your Medical Board and your employers
You should be able to demonstrate ongoing continuing professional development
You should prepare for your interview with the college as if it were an important job interview

Can you enter training in Australia if you are an Indian doctor?

To undertake formal specialty training in Australia you need to be accepted into a college training program. In all circumstances, you will need general registration and in some cases permanent residency or citizenship.

After receiving your general registration you can apply for specialty training in the same way that Australian-trained doctors do. And if accepted will go through the exact training program and experience. Some colleges may offer recognition of prior learning for any training you have done already. But this is often quite limited and may at best normally shave one year off of your training.

An Alternative But Limited Option.

There is an alternative but time-limited pathway for Indian doctors who are just seeking a short-term experience in Australia to add to their training in India. This is called the Short-Term Training in a Medical Specialty Pathway. To do this you must be offered a training position first and you must have either completed your training in India or be less than two years from completion. So this is a program mainly for early career specialists or advanced trainees.

In this pathway you go through the same steps with the AMC as per the competent authority pathway to gain registration. You will not, however, be able to apply for specialist assessment as part of this pathway. But if you gain general registration you may then be able to apply for another position and then apply for specialist assessment.

Can you do your internship in Australia as an Indian doctor?

Basically no. Internship in Australia is a provisional year that only applies to medical graduates from medical schools in Australia and New Zealand. There is a “loophole” which only applies to doctors who have not been able to complete an internship or equivalent in their own country. But the Medical Board warns that this is not a great option and is only granted in limited cases. You are far better off completing the requirements for general registration in India.

How many Indian doctors are working in Australia?

There is no one public data source to tell us how many Indian doctors are currently working in Australia.

From data collected by the Australian Government, we know that:

171 working visas were granted to Indian doctors to work in Australia in the year 2017.
729 applications were made for specialist assessment, of which 244 were deemed not comparable, 401 partially comparable and only 84 substantially comparable (2015-2021).

How hard is it to become a specialist in Australia if you are from India?

As we have noted. Many Indian doctors struggle to gain recognition as a specialist. This normally occurs in the first step. The initial specialist college assessment. Once Indian doctors are granted comparability. Most go on to complete the process.

Are there any particular specialties that are easier to apply for?

The majority of specialties have some vacancies and will provide opportunities for Indian and other IMG doctors from time to time. This is particularly the case if you are prepared to go outside of the major cities. Some areas of medicine are more popular and so finding jobs in areas such as most surgical fields, as well as other fields such as cardiology can be quite difficult.

On the other end of the spectrum general practice, psychiatry and most parts of critical care medicine are often always looking for doctors.

Costs of Moving To Australia and Working As a Doctor.

There are lots of costs to consider when thinking about moving to Australia to work as a doctor.

There are some direct costs to consider. Most of which relate to the bureaucratic process of being assessed and gaining registration.

Some of the costs you may be up for, include:

	AUD (unless otherwise noted)
Establish a Portfolio with the Australian Medical Council	$600
Registering with EPIC and having one primary degree checked	$125 USD + $80 USD
Medical Board Application Fee for Provisional Registration	$430
Medical Board Application Fee for Specialist or General Registration	$860
College Specialist Assessment Fees	$6,000-$11,000
College Placement Fees (for the period of supervision)	$8,000-$24,000

Further, if you are required to undertake further exams there will be a cost for this as well. As an example, RACS charges exam fee is $8,495.

The Cost of Your Time and Effort.

Adding to all of this financial cost, you will need to factor in the cost of your own time. It takes a lot of effort and persistence to deal with the paperwork and track down the records you need.

In addition, you are probably going to have to pay costs in your own country for things like records of schooling and certificates of good standing.

There are also visa costs.

And then there is the cost of airfares and transporting your belongings halfway across the world.

Depending on where you work in Australia you may find that the cost of living is higher or lower than you are used to. House prices and therefore house rental rates have gone through the roof in Australia in the last decade or so but are starting to come down.

You will probably have to factor in some initial extra hotel or short-term rental charges whilst settling in and you may find if you have children that you have to pay to enrol them in school as public schooling is only generally free if you are a citizen or permanent resident.

If you are lucky and in one of the specialty areas of demand your employer may offer to pay for some of these costs. It’s certainly worth asking about it.

The Competent Authority Pathway. An Option For Some Indian Doctors.

If you have already worked in the United Kingdom, Canada or the United States then you may be able to apply to work in Australia under what is called the competent authority pathway.

The competent authority pathway assigns a preferential status to any doctor who has completed their primary medical training in one of the following countries: the United Kingdom, Canada, the United States and the Republic of Ireland.

There is largely an historical rationale for this situation. It is based on the premise that all these jurisdictions have similar approaches to medical school training and similar standards.

New Zealand is not included in the list above as its medical schools are accredited by the same body as Australian medical schools, the Australian Medical Council. So doctors from New Zealand in Australia are generally treated identically to those from Australia.

If you are an international medical graduate and you have achieved general registration in the United States, Canada or the United Kingdom (but not the Republic of Ireland) you are also eligible for the competent authority pathway.

What are the steps involved for the competent authority pathway?

You can find out more about the competent authority pathway on the Medical Board of Australia website.

The key steps are as follows:

Securing an employment offer
Applying to the Australian Medical Council for primary source verification
Applying for registration to the Medical Board of Australia
Completing 12 months of supervised practice
Applying again to the Medical Board of Australia for general registration.

Eligibility for Competent Authority

You can do a “self-assessment of your eligibility for the competent authority pathway on the Medical Board of Australia website here.

The essential requirements for Indian doctors applying via the competent authority pathway are:

You need to have completed the appropriate process in Canada, the United States or the United Kingdom to become fully registered in that country. This involves an assessment of your English language skills, examinations and a period of supervised training.

So for example, if you have worked in the United Kingdom, you need to successfully complete the Professional and Linguistic Assessments Board (PLAB) test

AND

Successfully complete the Foundation Year 1, or 12 months supervised training (internship equivalent) in the United Kingdom, or 12 months supervised training (internship equivalent) completed in another Medical Board Australia approved competent authority country, approved by the GMC.

Conclusion.

We hope that you found this summary about how Indian doctors can work in Australia useful. If you have any questions or queries or just want to relate your experience. Please feel free to leave a comment below. We would love to hear from Indian doctors who have made the journey to Australia.

UK Doctors Australia: Job Prospects, Registration & Costs.

Any doctor who has worked for more than a few months in Australia will likely have worked alongside a UK doctor who has decided to work in Australia. Whether this is for a short-term working holiday or a permanent move. As someone who has worked in Medical HR for more than two decades, I have found that UK doctors on the whole to be a really good group to work with. So let’s talk about UK Doctors Australia.

Can UK doctors work in Australia? The answer is, of course, yes. The United Kingdom provides the largest source of overseas doctors or International Medical Graduates (IMGs) working in Australia. Of course, no doctor coming from another country is absolutely guaranteed to be able to work in Australia.

But because the UK medical training system is recognized by the Medical Board of Australia as being on par, UK doctors have good success with either becoming generally registered through what is called the competent authority pathway or being recognized as a specialist through the specialist pathway. In 2017 (the latest year we have figures for) 430 UK doctors were recommended for specialist registration, with many more achieving general registration.

So the prospects for working in Australia as a UK doctor are extremely good. But it’s important to give you a little bit more detail. As I have highlighted there are two main options for getting registered. So we will talk about these first and then go into some other common questions.

The Competent Authority Pathway. The Option For Trainee UK Doctors Australia.

If you are a trainee doctor in the UK. Then you are looking at the competent authority pathway for working in Australia.

There is largely a historical rationale for this situation. It is based on the premise that all these jurisdictions have similar approaches to medical school training and similar standards.

If you are an international medical graduate and you have achieved general registration in the United States, Canada, or the United Kingdom (but not the Republic of Ireland) you are also eligible for the competent authority pathway.

What are the steps involved for the competent authority pathway.

You can find out more about the competent authority pathway on the Medical Board of Australia website.

The key steps are as follows:

Securing an employment offer
Applying to the Australian Medical Council for primary source verification
Applying for registration to the Medical Board of Australia
Completing 12 months supervised practice
Applying again to the Medical Board of Australia for general registration.

Eligibility for Competent Authority

You can do a “self-assessment of your eligibility for the competent authority pathway on the Medical Board of Australia website here.

The essential requirements are:

You need to be a graduate of a medical course conducted by a medical school in the United Kingdom which is accredited by the General Medical Council

AND

Successfully complete Foundation Year 1, or complete 12 months supervised training (internship equivalent) in the United Kingdom, or complete 12 months supervised training (internship equivalent) another Medical Board of Australia approved competent authority country, which is also approved by the GMC.

OR if you are an IMG who has been working in the United Kingdom you need to

Successfully complete the Professional and Linguistic Assessments Board (PLAB) test

AND

For this reason, doctors who have completed medical school in another European Union country are often unable to get registered in Australia via working in the United Kingdom as they are often not required to complete the PLAB.

What types of jobs can I apply for as a UK Trainee?

You can pretty much apply for any sort of trainee job. There are often a number of postgraduate year 2 or 3 general jobs on offer. They are generally termed Resident Medical Officer in most States and Territories, but may also be called House Officer or Hospital Medical Officer in some places.

Above these sorts of posts, come the specialty training positions. Australia’s specialty training system is fairly much in parallel with the United Kingdom. So you tend to enter specialty training around postgraduate year 3. These positions are generally referred to as Registrar positions. But you might also see advertised as Senior House Officer or Trainee or Advanced Trainee.

One key thing to look out for is that most of these jobs will not accept an overseas applicant.

A key thing to look for is the phrase “eligible for registration” in the selection criteria.

What Type of Supervision Will I Need Or Get?

The Medical Board of Australia is very vigilant around supervision standards for IMG doctors. What sort of supervision you receive will depend on a number of factors, including:

your qualifications
your previous experience, especially in the type of position for which you have applied
whether you have practiced recently and the scope of your recent practice
the requirements of the position including the type of skills required for the position
the position itself, including the level of risk, the location of the hospital or practice and the availability of supports (supervisors)
the seniority of the position, for hospital position

In general, you will either be approved for Level 1 or Level 2 Supervision. There are 4 Levels and the higher up you go the less direct oversight you require.

Level 1 Supervision.

Level 1 Supervision requires your supervisor (or alternative supervisor) to be present in the hospital or practice with you at all times and you must consult with them about all patients. Remote supervision (for e.g. by telephone) is not permitted. This type of supervision is generally recommended when you are very junior yourself or entering a junior role with which you are not very familiar with. In Australian major public hospitals, there are many layers of other doctors from who you can get supervision from. So Level 1 is not too much of an issue in these circumstances.

Level 2 Supervision.

Level 2 Supervision, which is what most UK trainees approved to work in Australia will normally be approved for is a step up from Level 1 Supervision. Supervision must primarily be in person but your supervisor can leave you to do work on your own and you can discuss by phone. You should discuss with them on a regular (daily) basis what you have been doing with patients. But do not need to discuss every case.

Level 3 Supervision.

Level 3 Supervision, is what you might receive if you are working in an Advanced Trainee role in the UK and transferring to something similar in Australia. In this case, you have much more primary responsibility for the patient. Your supervisor needs to make regular contact with you but can be working elsewhere and available by phone or video.

What happens after I commence my position?

Once you are approved for registration and you have your visa issues sorted you will be able to commence work. Generally, your employer helps you out with all these things. You will be working under what is called “provisional registration” by the Medical Board of Australia.

Generally, all you need to do for these 12 months is to pay attention, show that you can learn and grow and get regular feedback from your supervisors. Your supervisors will need to complete regular reports for the Medical Board of Australia and it is your responsibility, not theirs to see that they are completed and returned on time. If all the reports go well you will be able to be recommended at the end of the 12 months for general registration.

You will probably be starting to look for another job or negotiating an extension around this time. With general registration, you may be able to apply for a skilled visa, as well as be looking at applying for permanent residency.

Permanent residency is crucial for applying for most specialty training programs. See below.

The Specialist Pathway. The Option For UK Specialists

For UK specialists your option for working in Australia is what is called the Specialist Pathway.

Once again this starts with becoming verified as a doctor with the Australian Medical Council and should again coincide with an active search for a position.

You may be lucky enough to be in a targeted specialty area where you might successfully be approved for what is called an Area of Need position, in which case the employer or recruitment agent will provide you a lot of support and will likely pick up the costs of being assessed.

On the plus side, the colleges all have reasonably helpful information on their websites, including the application forms and a little bit about their criteria for assessment.

Finding Out What You Need To Do.

We have saved you the trouble of finding those pages by putting them on our International Doctors resource page here.

The majority of UK specialties (but not all) map to a similar college or specialty in Australia. So working out which specialty goes into which Australian college is generally not too confusing. We have put together a summary of the Australian specialist medical colleges here.

After you go through your specialist assessment you are given an outcome.

In the majority of cases for UK specialists, you will be deemed substantially comparable. This essentially means that you will need to work under some form of peer review for up to 12 months and so long as your reports are satisfactory you will be recommended for specialist registration at the end.

Occasionally UK specialists are deemed to be partially comparable (a situation where this may occur is if you have just recently finished specialty training but have not worked as a specialist for very long). In this situation, you will need to work under supervision for longer and may well also face some formal examinations.

Rarely are UK specialists deemed not to be comparable by the college. This only happened to 6 out of 409 UK doctors in 2017 (less than 1%). If you are deemed to be not comparable, this means you cannot directly become a specialist in Australia. You will probably have to go through the competent authority route and re-enter training in Australia.

How to Maximize Your Chances of Getting a Substantially Comparable Outcome.

To ensure that you are seen as substantially comparable by the relevant college I would recommend the following:

You should have your Certificate of Completion of Training and relevant college Fellowship
You should ideally have worked substantively at a Consultant level in your field for 3 years or more
You should be able to demonstrate good standing with the GMC and your employers
You should be able to demonstrate ongoing continuing professional development
You should prepare for your interview with the college as if it were an important job interview

Can you enter training in Australia if you are a UK doctor?

To undertake formal specialty training in Australia you need to be accepted into a college training program. In all circumstances, you will need general registration and in many cases permanent residency or citizenship.

After receiving your general registration UK doctors can apply for specialty training in the same way that Australian trained doctors do. And if accepted will go through the exact training program and experience. Some colleges may offer recognition of prior learning for any UK training you have done already. But this is often quite limited and may at best normally shave one year off of your training.

An Alternative But Limited Option.

There is an alternative but time-limited pathway for UK doctors who are just seeking a short-term experience in Australia to add to their training in the UK. This is called the Short Term Training in a Medical Specialty Pathway. To do this you must be offered a training position first and you must have either completed your training in the UK or be less than two years from completion. So this is a program mainly for early-career specialists or advanced trainees.

In this pathway, you go through the same steps with the AMC as per the competent authority pathway to gain registration. You will not, however, be able to apply for specialist assessment as part of this pathway. But if you gain general registration you may then be able to apply for another position and then apply for specialist assessment.

Can you do your internship in Australia as a UK doctor?

Basically no. Internship in Australia is a provisional year that only applies to medical graduates from medical schools in Australia and New Zealand. There is a “loophole” that only applies to doctors who have not been able to complete an internship or equivalent in their own country. But the Medical Board warns that this is not a great option and is only granted in limited cases. You are far better off applying for the Foundation Program in the UK and completing at least Foundation Year 1.

How many UK doctors are working in Australia?

There is no one public data source to tell us how many UK doctors are currently working in Australia.

From data collected by the Australian Government, we know that for 2017 (latest available year):

718 applications were made for provisional registration via the competent authority pathway by UK doctors with 701 granted provisional registration
An additional 43 applications were made for provisional registration via the competent authority pathway by doctors who had completed the PLAB in the UK, with 31 being granted provisional registration
409 applications were made for specialist assessment, only 6 of which were deemed not comparable, 36 partially comparable and 367 substantially comparable.
430 UK doctors were recommended for specialist recognition with 12 not being recommended

How hard is it to become a specialist in Australia if you are from the UK?

Specialist doctors from the United Kingdom are not automatically granted specialist recognition. However, most are. As you can see from above in 2017 there were 409 applications made for specialist assessment to the Australian colleges by UK doctors and of these, the majority were deemed substantially comparable.

UK doctors tend to get a very favourable outcome in comparison to doctors from most other countries. The UK has generally the highest rate for doctors being seen as substantially comparable. Even when comparing to the other competent authority countries of the United States, Canada and the Republic of Ireland.

We hope that you found this summary about how UK doctors can work in Australia useful. If you have any questions or queries or just want to relate your experience. Please feel free to leave a comment below. We would love to hear from UK doctors who have made the journey to Australia.

Are there any particular specialties that are easier to apply for?

The majority of specialties have some vacancies and will provide opportunities for the UK and other IMG doctors from time to time. This is particularly the case if you are prepared to go outside of the major cities. Some areas of medicine are more popular and so finding jobs in areas such as most surgical fields, as well as other fields such as cardiology can be quite difficult.

On the other end of the spectrum general practice, psychiatry and most parts of critical care medicine are often always looking for doctors.

Costs of Moving To Australia and Working As a Doctor.

There are lots of costs to consider when thinking about moving to Australia to work as a doctor.

There are some direct costs to consider. Most of which relate to the bureaucratic process of being assessed and gaining registration.

Some of the costs you may be up for, include:

	AUD (unless otherwise noted)
Establish Portfolio with Australian Medical Council	$500
Registering with EPIC and having one primary degree checked	$125 USD + $80 USD
Medical Board Application Fee for Provisional Registration	$382
Medical Board Application Fee for Specialist or General Registration	$764
Medical Board Provisional Registration Fee	$382
Medical Board General or Specialist Registration Fee	$764
College Specialist Assessment Fees	$6,000-$11,000
College Placement Fees (for a period of supervision)	$8,000-$24,000

Further, if you are required to undertake further exams there will be a cost for this as well. As an example, RACS charges an exam fee is $8,495.

The Cost of Your Time and Effort.

To all of this cost, you will need to factor in the cost of your own time. It takes a lot of effort and persistence to deal with the paperwork and track down the records you need.

In addition, you are probably going to have to pay costs in your own country for things like records of schooling and certificates of good standing.

There are also visa costs.

And then there is the cost of airfares and transporting your belongings halfway across the world.

You will probably have to factor in some initial extra hotel or short-term rental charges whilst settling in and you may find if you have children that you have to pay to enroll them in school as public schooling is only generally free if you are a citizen or permanent resident.

If you are lucky and in one of the specialty areas of demand your employer may offer to pay for some of these costs. It’s certainly worth asking about it.

English Requirements for Doctors. Why You Need Better Than a Minimum IELTS

featured image c/- CC wikimedia

As somebody who has reviewed 1000s of applications from international medical graduates for oftentimes scarce roles in Australia, I have had the opportunity to correlate English testing score performances with job candidate performance as well as real-world performance in the job. I’ve also spoken with many other doctors who do job selection. I’d like to share some insights with you about the English proficiency standards and English Requirements for doctors working in Australia. What I intend to share with you is the knowledge you ought to have but which is actually not normally shared with candidates.

But first of all. It is not surprising that the focus of many international doctors in seeking employment in Australia is working out what the required medical board standard for English proficiency is and how to meet this. On this blog, I often write that answers to questions in medical recruitment are sometimes complex.

But actually the answer to the question of what English Test score do I need to satisfy the Medical Board of Australia requirements for registration is reasonably straightforward. The Medical Board of Australia will accept the following language tests and results for international medical graduates (IMGs):

IELTS Academic module. The IELTS score for doctors in Australia is a minimum overall score of 7 and a minimum score of 7 in each of the four components (listening, reading, writing and speaking).
OET with a minimum score of B in each of the four components (listening, reading, writing and speaking
PTE Academic with a minimum overall score of 65 and a minimum score of 65 in each of the four communicative skills (listening, reading, writing and speaking)
TOEFL iBT with a minimum total score of 94 and the following minimum score in each section of the test: 24 for listening, 24 for reading, 27 for writing, and 23 for speaking.

Perhaps It Is a Little Bit More Complicated Than That.

OK, it is actually a little bit more complicated than this because the Medical Board will also accept successful completion of the following tests as evidence of English language competency:

the New Zealand Registration Examination (NZREX) administered by the New Zealand Medical Council
the PLAB test administered by the Professional and Linguistic Assessments Board of the General Medical Council.

Aggregation of Results

And in addition, for each of the above-mentioned tests, the International English Language Test (IELTS), The Occupational English Test (OET), The Pearson Test of English Academic (PTE Academic) and The Test Of English as a Foreign Language Internet-Based Test (TOEFL iBT), the Medical Board of Australia will now accept an aggregation of results across two separate tests.

So for example, for the IELTS score for doctors in Australia, you can aggregate your scores across two tests such that you can count scores from either test to come up with 7 or more across the 4 domains. As long as you do not score less than 6.5 on any domain in either test. So if you get a 6.5 in listening on one sitting you can fix this by getting a 7 on a future test.

The Minimum Standard Is Not Going To Get You Very Far

Whilst the focus on achieving the minimum standard is understandable its actually a distraction from what international doctors ought to be focusing on, which is being able to demonstrate effective communication skills.

You see in order to be registered as a health practitioner in Australia, the Medical Board and the Australian Health Practitioner Regulatory Authority say that you “must be able to demonstrate that your English language skills will enable you to safely practice your profession.”

Safe To Practice Or Good Practice?

But this only part of the point. There is also the issue of being able to effectively practice your profession or even practice your profession at a high standard.

So why is it that the minimum score may not be sufficient for you. Well actually there are a couple of main reasons and I will take you through each of them in turn.

Your English Proficiency Score Is An Indicator Of Your Ability to Communicate

At the end of the day, you always want to pass the test. But if you are studying to pass an English language test you really should be asking yourself the question. “How good is my English and how good do I need it to be?”

If you are studying to pass an English language test you really should be asking yourself the question. “How good is my English and how good do I need it to be?”
Dr Anthony Llewellyn

To illustrate my point lets look at the most common test that International Doctors take the IELTS score for doctors in Australia. Let’s consider what IELTS itself says about the scores that you may receive on their test.

The IELTS test delivers a result of 0 to 9 in each band, as well as overall. Regardless of which testing component you score the meaning assigned to each band is as follows:

Meaning of IELTS score for doctors in Australia

Band	Meaning
0	The test taker did not answer the questions.
1	Non-user. The test taker has no ability to use the language except a few isolated words.
2	Intermittent User. The test taker has great difficulty understanding spoken and written English.
3	Extremely Limited User. The test taker conveys and understands only general meaning in very familiar situations. There are frequent breakdowns in communication.
4	Limited User. The test taker’s basic competence is limited to familiar situations. They frequently show problems in understanding and expression. They are not able to use complex language.
5	Modest User. The test taker has a partial command of the language and copes with overall meaning in most situations, although they are likely to make many mistakes. They should be able to handle basic communication in their own field.
6	Competent User. The test taker has an effective command of the language despite some inaccuracies, inappropriate usage and misunderstandings. They can use and understand fairly complex language, particularly in familiar situations.
7	Good User. The test taker has operational command of the language, though with occasional inaccuracies, inappropriate usage and misunderstandings in some situations. They generally handle complex language well and understand detailed reasoning.
8	Very Good User. The test taker has fully operational command of the language with only occasional unsystematic inaccuracies and inappropriate usage. They may misunderstand some things in unfamiliar situations. They handle complex and detailed argumentation well.
9	Expert User. The test taker has fully operational command of the language. Their use of English is appropriate, accurate and fluent, and shows complete understanding.

Do You Just Want To Be a Good User?

Let’s think about the implication of being deemed to be at Band 7. A “Good User”. Being a “good user” means that you occasionally deliver inaccurate information. Or occasionally use the wrong word. Or occasionally misunderstand in some situations. You will generally (but not always) handle complex language and detailed reasoning.

Working effectively in medicine in Australia is all about communication. You really cannot afford to be occasionally misunderstanding a patient as this might lead to a serious outcome, such as an error or a conflict. Given the amount of communication that goes on in a hospital and the level of complexity of communication and language your “occasional” problems are likely going to translate into being at least once a day if not more often.

Employers Evaluate Your English Proficiency Score Differently to AHPRA

Employers know that there is a big difference between a straight-set of 7s on an IELTS or a set of Bs on an OET versus having at least one 8 or an A. The higher your overall score the better. Selection panels definitely do take this into consideration.

Selection panels do it when they review the initial applications in what is called the “culling phase”. So a classic example might be a situation where for example there are 20 IMG applicants for one job and only 6 interview slots. If the candidates are equal in all other ways then those with just the minimum scores for English language requirement may well be placed in the “non-interview” pile.

Even when interviewing candidates selection panels will be more keen to see the candidate who has a good result on their test. And will more intensely scrutinize candidates with lower scores to see if there are any significant communication concerns.

So my best advice for any doctor who does, unfortunately, need to prove their English proficiency is to study and work on your English with the end aim being that your English communication should not get in the way of you being a good doctor in Australia.

Author: Anthony Llewellyn

How is an Area of Need Position Declared?

Certain Doctors Cannot Work Under Area of Need.

Finding an Area of Need Position.

Area of Need Positions Come with Advantages

Area of Need and the Specialist Assessment Process

What Specialties Require Area of Need?

Area of Need in General Practice

Related Questions.

Question. How Much Does it Cost to Become a Specialist in Australia?

Question. Is the Process of Specialist Recognition Difficult?

Question. How Long Does it Take to Gain a Specialist Job in Australia?

Question. What Is A PESCI?

Who Needs a PESCI?

Registration Requirements

Provider Numbers

Other Skill and Experience Requirements

Working as a Locum On a Visa

Working With Medical Recruitment (Locum) Agencies

Can You Work As a Locum Whilst Employed?

Getting Paid As a Locum

Running a Company

Indemnity Considerations

Personal Considerations

Maintaining Registration and Professional Development

Clinical Audit

Peer Review

Performance Appraisal

What the Medical Board Doesn’t Accept as Evidence of CPD

Related Questions.

What Areas of Medicine Can I Locum In?

How Do I Choose a Locum Company?

How Long Should I Locum For?

Is it Possible to Make a Career As a Locum?

1. Practicing

2. Understand what the panel is looking for

3. Review your CV for examples.

4. Record yourself and watch yourself.

5. Engage an Expert

Related Questions.

Question. What if there are no obvious selection criteria?

Question. How do I find an interview coach?

Question. I get really nervous in interviews. Are there some specific things I can do about this?

Don’t Write a Cover Letter if They Ask You Not To.

Write a Brief Cover Letter. So They Read Your Resume.

First Sentence

Second Sentence

Third Sentence

Fourth Sentence

Fifth and Final Sentence

Related Questions.

Tip #1. Your Medical Intern Placement Number.

Tip #2. Other Things You Will Likely Need.

Why All This Information?

Tip #3. Research and Apply Early.

Tip #4. Know Where You Sit In The Priority List.

Priorities Within Priorities.

South Australia

Northern Territory

New South Wales

Victoria

Commonwealth Program

Western Australia

Queensland

Canberra

Tasmania

Western Australia.

Northern Territory.

South Australia.

Queensland.

New South Wales.

Australian Capital Territory.

Victoria.

Tasmania.

Tip #5. Commonwealth Program.

How To Decide?

Related Questions

Specialty Trainees Can and Often Do Earn Much, Much More.

Breakdown of Registrar Pay Rates and Other Rates By State and Territory.

What About General Practice?