Category: IMGs

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.

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

1. You first create a registration with the AMC website.
2. 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.
3. You must then also create an EPIC account and confirm your identity with the ECFMG (located in the United States).
4. You get an EPIC id in about 3 working days, which you use to establish your AMC portfolio.
5. You upload your qualifications to EPIC. As you do so YOU MUST REQUEST that EPIC send a report to the AMC.
6. 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:

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:

1. Securing an employment offer
2. Applying to the Australian Medical Council for primary source verification
3. Applying for registration to the Medical Board of Australia
4. Completing 12 months of supervised practice
5. 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.

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