Tag: AMC

  • The Competent Authority Pathway Explained.

    The Competent Authority Pathway Explained.

    One of the most common requests I receive from International Medical Graduates (IMGs) on this blog or my YouTube channel is to explain the competent authority pathway process and/or answer who is eligible for the AHPRA competent authority pathway. There is a big reason for this. You see, the competent authority pathway is the most straightforward pathway for a doctor outside of Australia to gain work in Australia. Let me explain.

    Competent Authority Pathway TL;DR

    Any doctor who graduates from medical school in any of the four competent authority pathway countries and has completed the required one or two years of supervised experience is generally eligible to work as a doctor in Australia under a year of provisional registration. After which, if their performance is deemed suitable, they will be invited to apply for general registration. The four competent authority pathway countries are the United Kingdom, the United States, Republic of Ireland and Canada. The pathway is the best option for any trainee or prevocational trainee from these countries. IMG doctors from other countries can become eligible for the competent authority pathway by completing the USMLE, PLAB or LMCC process and obtaining the necessary experience. The PRES (Ireland) is not recognised by the Medical Board of Australia.

    Doctors from the United Kingdom, Ireland, Canada and the United States have a strong track record of success in coming to Australia. These 4 countries comprise what is known as the competent authority pathway countries in Australia.

    For example, for the years 2016 to 2021, 2077 UK Specialists were approved to work in Australia the next biggest group was specialists from India at 485.

    And in the same time period many more UK, US, Irish and Canadian trainee doctors made the move to Australia during that time via what is called the competent authority pathway Australia.

    So the prospects for working in Australia as a doctor from Ireland, the United States, the United Kingdom and Canada are excellent.

    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.

    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 (almost) as those from Australia. There is no need for a competent authority pathway New Zealand style, except for IMG doctors who qualify in New Zealand (see FAQs).

    Historically UK medical qualifications have been recognized by the Australian Medical Council and the Medical Boards in Australia as being of high quality. The reason for this is quite simple. Australia inherited its medical training system from the United Kingdom, and to this day, both its undergraduate and postgraduate training systems remain pretty similar to those in the UK.

    For this reason, again, Australia has recognized doctors from Ireland as having a higher quality. Because, once again, our training and regulatory systems are pretty similar.

    The reasons why doctors from the United States and Canada are also recognised as being of higher quality are less clear. It is undoubtedly the case that these systems whilst somewhat different in their approaches to training are on par in terms of outcomes and the quality of health care in these countries.

    An IMG doctor may, at this point, question why it is that these 4 countries are given priority status above other countries for the purpose of registering IMG doctors in Australia. This is, in my opinion a reasonable question. Unfortunately, there is no clear information about this on the Medical Board of Australia website. Nor does there appear to be a process for a new country to apply for competent authority status.

    In any case, the main point of this post is to outline how an individual doctor can achieve eligibility and utilise this pathway.

    Step 1 For Any UK Doctor Wanting to Work in Australia. Work Out Your Pathway.

    The first step that any IMG doctor wishing to work in Australia needs to consider is which pathway they will be utilising. Often times you will be eligible for more than one pathway.

    So, for example, a Specialist Anaesthetist, from the United States would in fact be eligible for all 4 pathways. Let me explain:

    • They would be eligible to attempt the Standard Pathway (as this is open to all IMG doctors);
    • They would be eligible to register via Competent Authority (as they achieved their medical degree in the United States and trained in the United States);
    • They would be eligible for the Short Term Training in a Medical Specialty Pathway (as they are a qualified specialist); and finally
    • They would be eligible for the Specialist Pathway (as they are a Specialist IMG), and this is, of course the pathway they would most likely be opting for.

    As a side note, even if you are a Specialist from a Competent Authority Pathway country, you end up being registered via your Competent Authority status and are given provisional (as opposed to limited) registration as your first registration.

    In summary, if you are a trainee doctor from any of the Competent Authority countries, you should choose the Competent Authority pathway. There are no advantages to the other 2 pathways.

    And, if you are a Specialist IMG doctor from any of the Competent Authority countries, you should choose the Specialist pathway. Unless you are certain you only want to come to Australia to train for a limited period of time. In this case, choose the Competent Authority pathway as it will allow you to stay longer than the maximum period of 2 years under the Short Term Training pathway.

    competent authority

    Competent Authority Pathway Course

    A Free Course For Trainee Doctors

    This course covers all the required steps for working as a doctor in Australia if you are a trainee doctor from Ireland, the UK, US or Canada.

    The Competent Authority Pathway. The Option For Trainee Doctors from the UK, Ireland, Canada and USA

    If you are a trainee doctor (or Prevocational Trainee) in the UK, Ireland, Canada or the USA. Then you are looking at the competent authority pathway for working in Australia.

    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.

    The Competent Authority Pathway. A Possible Option for IMG Doctors from the UK, Canada and USA

    In addition, 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 may also be eligible for the competent authority pathway.

    What are the steps involved in the competent authority pathway?

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

    The key steps for the competent authority pathway 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 Competent Authority pathway requirements for graduates of UK, USA, Canada, Ireland are.

    You need to be a graduate of a medical course conducted by a medical school in one of the Competent Authority countries

    AND

    Successfully complete the experiential component required in that country. It is a requirement that this experience is in a supervised position. For the UK, Canada and Ireland you need a minimum 12months supervised experience. For the United States, you need a minimum of 2 years.

    The essential Competent Authority pathway requirements for IMGs who have qualified in UK, USA and Canada are.

    You need to have completed the AMC Certificate equivalent in the UK, USA or Canada. So the PLAB or the USMLE or the LMCC. You must complete all steps of this qualification.

    Plus

    Successfully complete the experiential component required in that country. It is a requirement that this experience is in a supervised position. For the UK, Canada and Ireland, you need a minimum of 12 months of supervised experience. For the United States, you need a minimum of 2 years.

    No, the MRC… Does Not Count. Nor does just getting registered.

    For this reason, doctors who have completed medical school in another European Union country are often unable to register in Australia via working in the United Kingdom as they are usually not required to complete the PLAB. Similarly, many doctors for Gulf State and Asian countries meet one of the multitudes of Royal College exams in the UK and are able to gain registration in the UK without needing to complete the PLAB. Unfortunately, skipping the PLAB means that you are not eligible for the Competent Authority Pathway.

    What about the UKMLA?

    There is no word yet from the Medical Board of Australia about the United Kingdom Medical Licensing Examination. But I would expect that this would be recognised.

    What types of jobs can I apply for as a Competent Authority Pathway Trainee?

    You can pretty much apply for any sort of trainee job. There are often a number of postgraduate years 2 or 3 general jobs on offer. They have 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 specialty training positions. Australia’s specialty training system is pretty much 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 them 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 around supervision standards for IMG doctors. What sort of supervision you receive will depend on several 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 support (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. 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. In Australian major public hospitals, there are many layers of other doctors from who you can get supervision. So Level 1 is not too much of an issue in these circumstances.

    Level 2 Supervision.

    Level 2 Supervision, which most competent authority trainees approved to work in Australia will usually be approved for. Level 2 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 consult with them on a regular (daily) basis about 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 “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 can be recommended at the end of the 12 months for general registration.

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

    Permanent residency is crucial for applying for some specialist training programs. See below.

    Specialist Pathway Course

    Specialist Pathway Course

    Free Course

    You can enrol now in this free course that will step you through all the requirements for working as a specialist doctor in Australia

    The Specialist Pathway. The Option For UK, USA, Irish and Canadian Specialists

    For Competent Authority Pathway country specialists, your option for working in Australia 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.

    However, Area of Need is becoming extremely rare these days, and I don’t advise actively looking for such a post as you will likely waste lots of time.

    For most International Doctor specialists, you will approach 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) are 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.

    The Key Steps for the Specialist Pathway Are As Follows:

    1. Apply to the Australian Medical Council for primary degree and postgraduate degree source verification
    2. Apply to the relevant college for a comparability assessment.
    3. Apply for a suitable job offer.
    4. Apply for registration with the Medical Board of Australia.
    5. Complete 12 to 24 months of supervised practice +/- examinations.
    6. Applying again to the Medical Board of Australia for specialist registration.

    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. This is similar for Ireland and Canada. The United States has a more complex arrangement of specialties and subspecialties. But generally 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 most cases for Competent Authority 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 Competent Authority Pathway 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 face some formal examinations.

    Rarely are Competent Authority country 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 for the UK or equivalent for other countries e.g. Board Certificate for the US.
    • 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 a Competent Authority Pathway 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 Competent Authority pathway 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 some recognition of prior learning that you have done already. But this is often quite limited and may at best normally shave one year from your training.

    Can you do your internship in Australia as a UK, US, Irish or Canadian 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, completing the Internship program in Ireland, completing 1 year of residency in Canada or 2 years in the United States.

    How many Competent Authority doctors are working in Australia?

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

    From data collected by the Australian Government, we know that for trainee doctors for 2018:

    • 639 applications were made for provisional registration via the competent authority pathway by UK doctors with 623 granted provisional registration.
    • An additional 36 applications were made for provisional registration via the competent authority pathway by doctors who had completed the PLAB in the UK, with most of these also being granted provisional registration.
    • 263 applications were made for provisional registration via the competent authority pathway by doctors from Ireland with 257 granted provisional registration.
    • 40 applications were made for the competent authority pathway by US doctors with 30 granted provisional registration through that pathway.
    • 21 applications were made for registration under the Competent Authority Pathway by Canadian doctors with 20 being granted.

    How hard is it to become a specialist in Australia if you are from a Competent Authority country?

    Specialist doctors from the competent authority countries are not automatically granted specialist recognition. However, most are. For example, in 2019 there were 430 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.

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

    The majority of specialties have some vacancies and will provide opportunities for Competent Authority 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 pretty 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 many costs to consider when considering moving to Australia to work as a doctor.

    There are some direct costs to consider. Most 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 $130 USD + $100 USD
    Medical Board Application Fee for Provisional Registration$430
    Medical Board Application Fee for Specialist or General Registration $860
    Medical Board Provisional Registration Fee$430
    Medical Board General or Specialist Registration Fee$860
    College Specialist Assessment Fees*$7,000-$15,000
    College Placement Fees (for a period of supervision)*$8,000-$30,000
    as of 2023

    *Only applicable to Specialist Pathway

    Compared to the regulatory costs for other pathways, the Competent Authority Pathway is quite cheap.

    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 some time effort and persistence to deal with the paperwork and track down the records you need, particularly for the specialist pathway.

    In addition, you will probably 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.

    Why do UK doctors move to Australia?

    ‍Compared to the United Kingdom, Australia generally offers improved quality of life, work-life balance, finances, and weather. For these reasons, Australia is a popular destination for doctors worldwide. In addition, the UK medical degree and specialty qualifications are well recognised by the Australian Medical Council, Medical Board of Australia and Australian specialty colleges, which makes the transfer easier than for most other countries.

    Are there other options for working as a UK doctor in Australia?

    Answer. The Competent Authority Pathway and the Specialist Pathway are the best two pathways for UK doctors to work in Australia. The other pathways do not offer any more advantages and actually have many disadvantages.

    Should I use a medical recruitment company if considering working in Australia?

    Answer. It is possible to deal directly with employers in Australia as a UK doctor. In general, however, when moving from one country to another most doctors find it useful to engage with a medical recruitment company as they can tend to take some of the stress out of the planning for you and help with all the paperwork and negotiating with prospective employers. Some medical recruitment companies also provide migration services and relocation services as well. We have written more on this subject here

    How much do doctors earn in Australia?

    For many, this is the most important question. And the reason that UK doctors seek to work in Australia. Generally, doctors are paid better in Australia compared to the UK but finances are more complicated than just salaries because you obviously need to consider other factors such as taxes, housing, insurance, schooling, and transportation (Australia is a big place) which can vary.

    The cost of living in Australia is generally on a par with that of living in the other competent authority countries.

    Salaries also differ in Australia depending on the state or territory. But generally, an intern (PGY1 or FY1) earns between $70,000 and $80,000 AUD baseline salary in Australia. After completing the internship your salary will vary somewhere between $80,000 to $160,000 AUD as you progress through your training.

    Consultant salaries in Australia can be quite considerable.

    GPs earn the least but still generally manage to earn over $200,000 AUD if they work full time and some specialties can earn as much as $600,000 AUD on average.

    What is the Australian equivalent of the GMC (General Medical Council)?

    This is a little complicated as the General Medical Council in the UK has both registration and performance and safety functions as well as verification functions.
    You would think that by virtue of its name the Australian Medical Council is the same as the GMC. But it is not. The AMC accredits medical training insitutions such as medical schools and specialty colleges as well as some aspects of the verification of IMG doctors.
    The Medical Board of Australia is responsible for the registration process as well as reviewing maintenance and upholding of standards, dealing with complaints against doctors and reviewing their performance if needed.
    The competent authority pathway really belongs to the Medical Board. It is not really an AMC competent authority pathway.

    How do I become an IMG in Australia?

    Assuming that you mean as an IMG doctor how can I work in Australia. You do this by attempting and completing one of the 4 pathways eligible to IMG doctors.

    Can I work in Australia with GMC registration?

    Most doctors who have registration in the United Kingdom with the General Medical Council can gain registration in Australia under either the Competent Authority Pathway or Specialist Pathway. However, it is essential to note that it is not a direct transfer between registering authorities. There is always a provisional registration period.

    I qualified in New Zealand under the NZREX. Am I eligible for the Competent Authority pathway?

    Yes. If you have completed all the requirements for the NZREX, including the supervised experience requirement you qualify for the Competent Authority Pathway via New Zealand. Well done! You are in a very niche part of the pathway.

    I completed an Osteopathic Medicine program in the United States. Am I eligible for the Competent Authority pathway?

    Yes. The Medical Board of Australia recognises medical graduates of Osteopathic Medicine programs in the United States. The requirements are similar to other US doctors and IMG doctors who qualify in the United States.
    You are required to complete all phases of the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) as well as a minimum of 2 years of graduate medical education in a residency program accredited by either the ACGMR or American Osteopathic Association.

  • Can a UK Doctor Work in Australia? Yes. Step By Step Guide.

    Can a UK Doctor Work in Australia? Yes. Step By Step Guide.

    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. Although you may graduate with a medical degree from the United Kingdom, you may not want to work there for your entire career (or ever!). For UK doctors it is certainly worth considering what your options are in Australia.

    Can a UK doctor work in Australia?

    The short answer is, yes. The United Kingdom provides the largest source of overseas doctors or International Medical Graduates (IMGs) working in Australia. This is because the undergraduate and postgraduate training systems between the UK and Australia are quite similar which makes transferring between the two a relatively simple process. At least on the Australia end of the transfer.

    UK doctors have good success coming to Australia. For the years 2016-2021, 1261 UK specialists were approved to work in Australia under what is called the specialist pathway (which includes 2 years heavily affected by COVID-19). And many more UK trainee doctors made the move to Australia during that time via what is called the competent authority pathway.

    So the prospects for working in Australia as a UK doctor are extremely good. UK medical qualifications are recognised by the Australian Medical Council and Medical Board in Australia as being of high quality. However, there are a number of processes and requirements that need to be met in order for registration to be granted.

    In order to give you the detail you need. I have highlighted that there are two main options for getting registered. So we will talk about these first and then go into some other common questions.

    Step 1 For Any UK Doctor Wanting to Work in Australia. Work Out Your Pathway.

    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.

    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 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.

    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 as 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 in the competent authority pathway?

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

    The key steps for the competent authority pathway 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 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 of supervised training (internship equivalent) in the United Kingdom, or complete 12 months of supervised training (internship equivalent) in 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

    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.

    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.

    How Do I Prove My Supervised Training? What Evidence is Required?

    From the Medical Board of Australia, current at the time of posting – please do your own checks.

    As per above the requirement to prove 12 months of supervised training is fairly liberal and essentially requires you to demonstrate that you have practised at an FY1 level or superior for the minimum of 12 months.

    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 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. 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.

    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 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 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. 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 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) are 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.

    The Key Steps for the Specialist Pathway Are As Follows:

    1. Apply to the Australian Medical Council for primary degree and postgraduate degree source verification
    2. Apply to the relevant college for a comparability assessment.
    3. Apply for a suitable job offer.
    4. Apply for registration with the Medical Board of Australia.
    5. Complete 12 to 24 months of supervised practice +/- examinations.
    6. Applying again to the Medical Board of Australia for specialist registration.

    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.

    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 UK trainee doctors for 2018 (latest available year):

    • 639 applications were made for provisional registration via the competent authority pathway by UK doctors with 623 granted provisional registration
    • An additional 36 applications were made for provisional registration via the competent authority pathway by doctors who had completed the PLAB in the UK, with most of these also being granted provisional registration

    We also now know that for the year 2021 40 UK-trained specialists applied to work in Australia with all being deemed comparable.

    2021 was not a very indicative year however as it was strongly affected by COVID-19

    In 2019, 249 UK specialists applied for comparability in Australia with 240 being granted approval.

    In 2017, 430 UK specialists applied for comparability in Australia with 418 being granted approval.

    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 2019 there were 430 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 a Portfolio with the 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.

    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.

    UK doctor work in Australia
    UK Doctors in Australia

    Question: Why do UK doctors move to Australia?

    ‍Compared to the United Kingdom, Australia generally offers improved quality of life, work-life balance, finances, and weather. For these reasons, Australia is a popular destination for doctors around the world. In addition, the UK medical degree and specialty qualifications are well recognised by the Australian Medical Council, Medical Board of Australia and Australian specialty colleges, which makes the transfer easier than for most other countries.

    Question: Are there any other options for working as a UK doctor in Australia?

    Answer. The Competent Authority Pathway and the Specialist Pathway are the only two pathways for UK doctors to work in Australia.

    Question: Should I use a medical recruitment company if I am considering working in Australia?

    Answer. It is possible to deal directly with employers in Australia as a UK doctor. In general, however, when moving from one country to another most doctors find it useful to engage with a medical recruitment company as they can tend to take some of the stress out of the planning for you and help with all the paperwork and negotiating with prospective employers. Some medical recruitment companies also provide migration services and relocation services as well. We have written more on this subject here. And a list of medical recruitment companies is available here.

    Question: How much do doctors earn in Australia?

    For many, this is the most important question. And the reason that UK doctors seek to work in Australia. Generally, doctors are paid better in Australia compared to the UK but finances are more complicated than just salaries because you obviously need to consider other factors such as taxes, housing, insurance, schooling, and transportation (Australia is a big place) which can vary.

    The cost of living in Australia is generally on a par with that of living in the United Kingdom.

    Salaries also differ in Australia depending on the state or territory. But generally, an intern (PGY1 or FY1) earns between $70,000 and $80,000 AUD baseline salary in Australia. After completing the internship your salary will vary somewhere between $80,000 to $160,000 AUD as you progress through your training.

    Consultant salaries in Australia can be quite considerable. GPs earn the least but still generally manage to earn over $200,000 AUD if they work full time and some specialties can earn as much as $600,000 AUD on average.

    A key difference between the UK and Australia is the opportunity to earn considerably as a private practitioner.

  • Medical Internship Australia. Application Guide For 2023 Posts.

    Medical Internship Australia. Application Guide For 2023 Posts.

    *We will be regularly updating this post as the various States and Territories update their processes. Where information is not currently available for the 2023 year we have used information from the previous year, i.e. 2022. If you notice anything incorrect please let us know in the comments below.

    It’s that time of the year again when the whole medical internship Australia system kicks into gear. The time when each of the States and Territories in Australia opens up their process to allow applications for medical internships for the following year. For four years I was responsible for running the largest Intern application system in Australia for 4 years. The NSW Intern application system. So I’d like to share with this year’s medical graduates some of the wisdom I gained from that experience.

    (Disclaimer: All information here has been sourced in good faith but things do change so you should always do your own due diligence in such matters, we are providing this information to aid you in your application but take no responsibility for any outcomes)

    As has been the case in past years the main Intern application and allocation dates are aligned across Australia so that every State and Territory opens and closes their systems at the same time and makes offers at the same times. There are some variations to this in relation to special priority categories in some States and Territories. The key things that all medical graduates should consider in preparing their medical internship application for 2023 year are as follows:

    • Applications open on 9th May 2022.
    • Applications close on 6th June 2022.
    • Make sure that you have an Intern Placement Number otherwise you won’t be able to apply.
    • You should research the application requirements now as there may be some “surprises”. As soon as the application system opens, register or log in and ensure that you have everything you need to complete your application.
    • Understand where you sit on the priority list for any State or Territory you are applying to.
    • If you are required to attend an interview. Make sure that you have obtained leave from your medical school requirements to attend.
    • Also, consider that the interview is likely to be either via phone or video this year.
    • Give yourself time to request referees, put together a Resume, if required, and find other documents that you may need.
    • Offers for Rural and other Special Pathways will come out on 18th July. The first offers for all other main pathways will come out on Wednesday, 20th July. So make sure that you have regular access to your email as your time for accepting offers can be quite short.
    • The National Close Date for 2023 Intern Recruitment is Friday 18th November 2022. After which all remaining vacant intern positions move into the Late Vacancy Management Process.
    • Stay in touch with your medical school. you may be worried about completing your degree on time but they are all working very hard with the other institutions to give you the best chance of completion.

    Tip #1. Your Medical Intern Placement Number.

    The IPN is a unique nine-digit number that has been generated by AHPRA and has been provided to medical schools for distribution to all 2022 final-year medical students. The number is used as part of the national audit process (which ensures that intern positions across the country are made available to as many applicants as possible) as well as to streamline registration.

    This number is not the same number as your AHPRA registration number or student number. If you have not received your IPN you should check with your school.

    If you are not an Australian medical student you won’t be issued an IPN. If you are applying as a non-Australian medical student you do not require an IPN. However, please note that unless you are a New Zealand medical student your chances of gaining an internship are very slim.

    Tip #2. Other Things You Will Likely Need. 

    The majority of States and Territories require you to upload an academic transcript as proof that you are indeed a medical student. 

    They will also request evidence that you satisfactorily meet the AHPRA English Language requirements. This may seem a bit ridiculous given that you have been attending medical school in English for the last 4 or 5 years. But it is the law. So check whether you may need to submit an up-to-date English test result or some other form of documentary evidence such as a high school certificate.

    Most States and Territories will also request a CV or Resume. For tips on your CV or Resume see our ultimate guide to CVs or watch a video series about this.

    Some States and Territories have a CV template that they suggest that you use to fill in your information. In the case of Victoria, you are no longer required to use the suggested template (change from last year). It’s probably fairly harmless to use the template for the other States and Territories. But if you are thinking about your future career, then now is a good time to be designing your own CV. The risk of using the template is that you don’t stand out from other candidates.

    You will need to also provide proof of your identity, citizenship, residency, or visa. And if you have had a name change along the way you will probably also need to provide some documentation in relation to this.

    Why All This Information?

    The State and Territory bodies who administer the Intern application process have a responsibility to ensure that you are eligible to apply for provisional registration at the end of the year in order to work as an Intern.  They collect this information to check that everything is in order so that you are indeed eligible to apply. Employers can get rightly annoyed when told that someone who has been allocated to work with them as an Intern will have a several-month delay whilst they resit an English language test.

    However, it’s your responsibility to ensure that you are eligible for registration. So you should also be checking these things yourself. 

    It’s hard to fathom given the amount of communication from health departments, medical schools and student colleagues. But every year there are a handful of medical students who forget to apply for their internship. This means having to wait another year. Don’t let that be you.

    Dr Anthony Llewellyn | Career Doctor

    Tip #3. Research and Apply Early.

    It’s hard to fathom given the amount of communication from health departments, medical schools, and student colleagues. But every year there are a handful of medical students who forget to apply for their internship. This means having to wait another year. Don’t let that be you.

    There are even more students who leave their applications to the last minute. Only to find that they are missing a vital document. For example, this could be evidence you need to substantiate that English is your first language, such as a high school certificate. Or perhaps your last name has changed whilst you have been in medical school? Or maybe you need to submit a CV with your application?

    As soon as the application page opens for each State and Territory you are going to apply to make sure you register. And then go as far through the process of applying as possible so you can see if there is some sort of document you need to obtain.

    Tip #4. Practice Your Video Interview Technique.

    If you are one of the many students who may need to undertake an interview for your internship choices as occurs in certain situations, such as rural preferential recruitment and certain States such as Victoria. The COVID pandemic resulted in a shift to a preference for video interviewing job applicants in Medicine in Australia. Many employers now see an inherent advantage to this. So you should still be prepared for the fact that this year your interview may be conducted on video.

    There’s a lot more than you think to video interviewing. For a rundown on this check out this recent post.

    Tip #5. Know Where You Sit In The Priority List.

    ts important to know where you sit on the priority list. Each State and Territory has a slightly different order but in essence, it goes something like this:

    1. If you are an Australian Citizen or Permanent Resident and went to Medical School in that State or Territory you are top of the list.
    2. If you are an Australian Citizen or Permanent Resident and went to Medical School in another State or Territory or New Zealand you are probably second.
    3. If you are an international student who studied Medicine in Australia you are probably next.

    Tip #6. Know the Key Dates, including Offer Dates.

    As noted above it’s crucial that you know the key dates. If you miss your application submission date (and it does happen) there is no allowance for a last-minute submission. You also need to make sure you are available to accept your offer. Generally, the window for offer acceptances is quite narrow (often 48 hours).

    For this year the day on which the first round of offers can be made nationally is 18th July for the rural and other special pathways. The first date that offers can be made to the main group of applicants is 20th July and most offers will come out on that day. Thereafter there is a series of offer windows for 2nd and 3rd and 4th rounds etc… in between which there is a mandated pause, which allows the National Intern Audit process to run. This is a system that works to ensure that vacancies are being freed up as soon as possible by highlighting medical students who may have an offer in more than one jurisdiction and ensuring that they accept one offer and decline others.

    The nationally coordinated offer system concludes on 18th November 2022. Technically this is the last date that the Medical Board can guarantee that they will be able to process your registration application in order for you to commence your internship on time the following year in 2023.

    However, there are generally still vacancies after this point and so the National Intern Audit Office switches over to an ad hoc coordinated late vacancy management process from December 2023. This runs up until 24th March 2023, which is around the 1st term to 2nd term change over for most interns. So it is still possible to commence your internship in 2023 but you might have to finish one or two terms in the following year.

    Priorities Within Priorities.

    Some States and Territories also have priority pathways to ensure that groups such as Aboriginal and Torres Strait Islanders and doctors who wish to work rurally or regionally can obtain their preferred placement early.

    So if you are an International student and like the idea of working rurally it’s probably a good idea to consider a rural pathway as it will likely boost your chances of gaining an Intern position earlier in the process.

    More Information on Each Jurisdiction

    New South Wales

    Medical Internship Australia NSW 2023
    Sydney Harbour Bridge, New South Wales.

    Intern Positions = 1,100 (including 202 rural preferential) across 15 Networks
    Annual Salary = $71,283
    Length of Contract = normally 2 years
    Professional Development Allowance = nil
    Orientation = 23rd January 2023
    Term 1 Start – 30th January 2023

    The 4 Pathways in NSW


    You have the option of applying through one of 4 pathways:
    – Aboriginal Recruitment Pathway
    – Rural Preferential Pathway
    – Regional Allocation Pathway
    – Optimised (or Main) Pathway

    Only applicants who go through the Rural Preferential Pathway need to submit a CV and attend an interview.  All other pathways are based on applications only. A key advantage of the Aboriginal, Rural, and Regional Allocation Pathways is that you are far more likely to be given your preferred hospital network.

    c/- HETI https://www.heti.nsw.gov.au/education-and-training/courses-and-programs/medical-graduate-recruitment

    Intern Placement Priorities in NSW:


     Priority 1 – Medical graduates of NSW universities who are Australian/New Zealand citizens or Australian permanent residents (Commonwealth Supported Place and Domestic Full Fee paying). This priority category is guaranteed an intern position in NSW. 

    Priority 2 – Medical graduates of interstate or New Zealand universities who completed Year 12 studies in NSW who are Australian/New Zealand citizens or Australian permanent residents (Commonwealth Supported Place, Domestic Full Fee paying or NZ equivalent). 

    Priority 3 – Medical graduates of interstate or New Zealand universities who completed Year 12 studies outside of NSW who are Australian/New Zealand citizens or Australian permanent residents (Commonwealth Supported Place, Domestic Full Fee paying or NZ equivalent). 

    Priority 4 – Medical graduates of NSW universities who are not Australian/New Zealand citizens or Australian permanent residents and who hold a visa that allows them to work or are able to obtain a visa to work.

    Priority 5 – Medical graduates of interstate or New Zealand universities who are not Australian/New Zealand citizens or Australian permanent residents and who hold a visa that allows them to work or are able to obtain a visa to work in Australia. 

    Priority 6 – Medical graduates of Australian Medical Council accredited universities with campuses that are located outside of Australia or New Zealand who are not Australian/New Zealand citizens or Australian permanent residents and who hold a visa that allows them to work or are able to obtain a visa to work in Australia.

    Victoria

    Trains leaving the Melbourne CBD passing the Melbourne Cricket Ground

    Intern Numbers = 891
    Annual Salary = $79,138
    Length of Contract = 1 year
    Professional Development Allowance = $65 per week for FT Intern = $3,380
    Term 1 Start Date = 16th January 2023
    Orientation varies but is usually the week before
     
    Internship in Victoria works around a computer matching system which is administered by the Postgraduate Medical Council of Victoria. The system had a significant overhaul in the previous year.

    The Allocation & Placement Service is a mathematical process that matches the preferences of both candidates and Health Services and is designed to be “impartial and transparent”. 

    Candidates create an account and then register with the Intern match. The second step is to preference your preferred services. At the same time, the health services also place preferences. The matching process successful candidates to positions according to rankings.

    For Victoria, you will need to submit referees as well as a CV. In past years this had to be on the quite unattractive PMCV standardised CV Template. The status of this template has now been downgraded to a “guide”. You don’t have to put a photo on your CV. I would recommend using your own CV template and now included a photo.

    In 2020 Victorian Health services began the use of video-recorded interviews. This continues for 2022 for certain candidates. The system appears to be being used as an efficient way for certain services or hospitals to review applications without having to arrange formal interview panel days and for candidates to appear in person.

    The way these interviews work is you are usually allocated a specific time to log into the system. Once you have gone through a couple of orientation steps you are usually given a series of questions and asked to record your answers. Generally, you don’t get a second go if you are not happy and the time is limited. It is vital therefore that you practice before you do your interview and ensure you have optimised your video environment.

    All health services can use these recordings to rate you along with your CV and referee reports.

    Metro hospitals may conduct live interviews with shortlisted candidates at any time before 3 July. Although I understand many do not and just rely on the candidates’ CV, referees and video interviews.

    Interns can be allocated to one of 22 hospitals and networks. This includes a small number of community-based internships where the focus is more on community-based models of care, including working in primary care and smaller hospitals.

    You can elect to be prioritised for an internship by entering the Victorian Rural Preferential Allocation (VRPA) match. Where you can be allocated to one of 5 rurally based networks. This pathway involves a live interview. First-round offers for VRPA come out on 18th July on the national rural allocation date.

    Intern Placement Priorities in Victoria:

    VRPA Priority Group 1 – Australian citizens or permanent residents and New Zealand citizens graduating from Victorian medical schools including CSP and domestic full fee-paying students (i.e. graduates of University of Melbourne, Monash University, Deakin University and University of Notre Dame: Melbourne & Ballarat Clinical Schools).

    VRPA Priority Group 2 – Australian permanent resident graduates of interstate universities who meet the following criteria:

    • Completed their Year 12 schooling in Victoria; OR
    • Previously lived in rural Victoria (Modified Monash Model (MMM)1 – MM2 classification or higher) and worked in a rural healthcare setting; OR
    • Graduates of the University of New South Wales who have undertaken their last two years of clinical placement at Albury Wodonga Health clinical school.

    As well as Australian temporary residents graduating from Victorian medical schools (i.e. graduates of the University of Melbourne, Monash University, Deakin University and the University of Notre Dame: Melbourne & Ballarat Clinical Schools).

    Priority Group 1 – Australian citizens or permanent residents and New Zealand citizens graduating from Victorian medical schools including CSP and domestic full fee-paying students (i.e. graduates of University of Melbourne, Monash University, Deakin University and University of Notre Dame: Melbourne & Ballarat Clinical Schools).

    Priority Group 2 – Australian temporary resident graduates of Victorian medical schools. As well as Interstate Special Considerations*.

    Priority Group 3 – Australian citizens or permanent residents and New Zealand citizens graduating from interstate or New Zealand medical schools; Australian temporary resident graduates of interstate universities; New Zealand temporary resident graduates of New Zealand universities; Graduates from an overseas campus of an Australian/New Zealand University accredited by the Australian Medical Council (i.e. Monash University, Malaysia or Ochsner).

    *There are a number of special consideration categories available including for significant medical, disability and carer responsibilities. Check with the PMCV directly for this.

    Queensland

    Story Bridge Brisbane

    Estimated Numbers = 805 (including 61 rural generalist intern positions)
    Annual Salary = $78,941
    Length of Contract = 1 year
    Professional Development Allowance = nil for Interns but $2,311 for RMOs
    Term 1 Start Date = 23rd January 2023
    Orientation varies but is usually the week before
     
    Queensland has possibly the most complex internal allocation system of all jurisdictions. With a number of pathways and a combination of allocating certain priority groups and merit selection for others.

    Queensland Health conducts the annual intern allocation process in Queensland. To apply you will need to use the online portal and upload a range of documents, including a curriculum vitae and referee details. Note: Queensland Health has also produced an unattractive CV template for you to use. But this also has the status of “guide only”, therefore I recommend you use your own.

    Interns can be allocated to one of 20 Employment Hospitals.

    There are 4 Intern priority groups in Queensland:

    Group A – Medical graduates of Queensland universities who are Australian/New Zealand citizens or Australian permanent residents; and:- are seeking an internship commencing in the year immediately following graduation; OR – received Review Committee approval from a previous campaign to defer commencement of their internship.

    Group B – Medical graduates of Australian (interstate) or New Zealand universities who are Australian/New Zealand citizens or Australian permanent residents; OR Medical graduates of Queensland universities who are Australian/New Zealand citizens or Australian permanent residents who do not meet the criteria outlined in Group A.

    Group C – Medical graduates of Australian (Queensland or interstate) or New Zealand universities who are NOT Australian / New Zealand citizens or Australian permanent residents who: – – currently hold a visa that allows them to work in Australia; OR- will need to obtain a visa to work in Australia.

    Group D – Medical graduates of Australian University campuses outside of Australia accredited by the Australian Medical Council (AMC); OR Medical graduates of international universities who have not completed an internship in Australia or another country and have either: – obtained the AMC Certificate – successfully completed the AMC MCQ (multiple choice questionnaire).

    Note: Queensland is one of the few jurisdictions that offer an opportunity for IMG doctors to complete an internship in Australia. The number of doctors who are successful in doing so each year is rarely more than a handful.

    There are 3 pathways for Intern Allocation in Queensland.

    1. The Rural Generalist Program offers an opportunity to select a rural hospital centre as part of a program that is a pathway to working as a Rural GP. Applications open (8th March) and close extremely early (22nd March) for this pathway.
    2. Aboriginal and Torres Strait Islander Intern Allocation Initiative. The purpose of the initiative is “to promote the success of Aboriginal and Torres Strait Islander medical graduates in the Queensland Health workforce”. Eligible applicants can apply to the Aboriginal and Torres Strait Islander Intern Allocation Initiative to be allocated to their first preferenced hospital. Applications are reviewed by a panel that includes Aboriginal and Torres Strait Islander representation.
    3. The General Intern Campaign.

    The General Intern Campaign Allocation Process.

    An interesting aspect of the previous Queensland application portal is that you could see a live indication of where other applicants have preferenced other hospitals. This was presumably designed to encourage medical students to consider other hospitals and get the student group itself to work out the allocation. Queensland Health has instead now put in place an interesting “rollback” system.

    For the General Intern Allocation process. Group A applicants are allocated via a ballot process. The first consideration is whether a hospital is undersubscribed or oversubscribed with Group A (top priority applicants)

    If the hospital is undersubscribed all Group A applicants are offered their posts at this hospital.

    If the hospital is oversubscribed with Group A applicants. All Group A applicant candidates for oversubscribed hospitals are placed in a pool and assigned a number. Oversubscribed hospitals are drawn randomly and applicants with first preference for this hospital are also drawn randomly. The process continues until all applicants are offered their next available preference for hospitals and are placed.

    After this, a “roll-back” process may occur. The roll-back process only applies to Applicant Group A candidates who tentatively accepted their first-round offer (because they did not receive their first preference). The roll-back occurs after the ballot and first-round offers have been finalised and aims to match Applicant Group A candidates to a higher preference hospital should a vacancy become available due to another Applicant Group A candidate declining their offer.

    The whole roll-back process happens in 1 day.

    If an applicant is unavailable on the day of rollback they can nominate a proxy to be available via phone.

    Merit Selection for Groups B-D.

    Following the completion of first-round offers, the Position Status Report (PSR) is updated.

    This is an updated list of available positions remaining.

    Applicant group B-D candidates have 48 hours to change their preferences if they wish to.

    Queensland Health hospitals then assess applications and conduct their own meritorious selection processes. You should contact each Hospital and Health Service directly to find out what they look for in an intern.

    If vacancies become available after the First and Second Round offers, individual hospitals will meritoriously select from the remaining applicants for available vacancies. Recruitment to fill available vacancies will continue until the national closing date for intern recruitment. After the closing date, any further vacancies that arise will be filled via the Late Vacancy Management Process (LVMP).

    Western Australia

    Perth CityScape

    **2022 Information not currently available**

    Estimated Numbers ≅ 330 (based on 2021)
    Annual Salary = $79,479
    Length of Contract = 3 years in most cases (IMGs may have shorter contracts tied to their visa status)
    Professional Development Allowance = nil
    Term 1 Start Date = Not Available
    Orientation varies but is usually the week before

    WA Intern Eligibility and Priorities

    WA does not have a formal priority list. However, in order to apply for an internship in WA you must:

    • complete an application
    • be a graduate from a university accredited by the Australian Medical Council
    • possess a valid Intern Placement Number
    • have not previously worked as an intern either in Australia or overseas
    • meet the Medical Board’s English language skills registration standard
    • be eligible to work in Australia

    In WA all interns are employed by a Primary Employing Health Service (PEHS). 

    Each PEHS is a major tertiary hospital in WA that has been accredited to directly employ interns and provide an intern training program.

    The six PEHSs in WA are:

    • Fiona Stanley Fremantle Hospitals Group (Fiona Stanley Hospital)
    • Joondalup Health Campus
    • Royal Perth Bentley Group (Royal Perth Hospital)
    • Sir Charles Gairdner Osborne Park Health Care Group (Sir Charles Gairdner Hospital)
    • St John of God Health Care (St John of God Midland Public Hospital)
    • WA Country Health Service

    Each PEHS normally holds an information night. You can also choose to work as a rural intern by applying to work through Western Australia Country Health Service.

    Intern Applications in WA open on 9th May. Information nights are as follows:

    • Sir Charles Gardiner 9 May
    • St John of God Midland 11 May
    • WA Country Health Service 12 May
    • Royal Perth 13 May
    • Joondalup Health Campus 17 May
    • Fiona Stanley 18 May

    The process is coordinated by the Postgraduate Medical Council of Western Australia but you apply through the WA Jobs site and selection occurs through panels representing each of the PEHSs. As part of your application, you need to provide a cover letter and address the intern selection criteria, a CV and will require a range of other documents as well as to nominate 3 referees. If successful you will receive a contract for 3 years.

    South Australia

    The River Torrens in the city of Adelaide

    Estimated Number = 301 (including 18 rural intern posts)
    Annual Salary = $77,084
    Length of Contract = 3 years in most cases (IMGs may have shorter contracts tied to their visa status)
    Professional Development Allowance = nil
    Term 1 Start Date = 6th February 2023
    Orientation varies but is usually the week before

    SA Health Careers conducts the annual Intern application process in South Australia. There are 3 Adelaide-based Local Health Networks and 3 smaller country-based networks to which you can apply for the priority Rural Intern pathway. It should be noted that whatever network you are allocated to you may request or be required to undertake one or more rotations in other networks.

    The Rural Intern Pathway is a strength-based recruitment process for applicants who are interested in undertaking their internship (and potentially subsequent years) in rural hospitals within Country Health SA (CHSA). Rural intern positions provide broad opportunities in unique settings and are best suited for medical graduates with a history of living or working in rural areas or a desire to commence a career in the country. 

    Those applying for the rural intern pathway undertake an interview from 27 June to 1 July and offers come out on the national rural allocation date of 18th July.

    SA Intern Priorities:

    International Medical Graduates from non-Australian medical schools can apply for the rural intern pathway so long as they have only graduated in the last 2 years and have completed the AMC Part 1, and can meet the other requirements which are extensive and include meeting the Medical Board English language requirements, completing electronic medical record training and have residency status or a visa that allows you to work unrestricted.

    South Australia’s main round intern allocation priorities are the most complex of all jurisdictions.

    Aboriginal and Torres Strait Islander applicants are given priority preference by being placed in the first subcategory for categories 1 and 2.

    From 2022 Guide C/- SAMET

    Within the respective South Australian category groups, applicants are randomly allocated to their highest possible Local Health Network preference.
    If an offer is made, applicants must respond via the electronic application system within the specified timeframe. Where an applicant has been made an offer and no response received, the offer will be automatically declined. Applicants are only eligible to receive one offer for an internship in South Australia.

    South Australia is one of few States that specifically permits medical graduates from other countries to apply for internship positions. But they are at the very bottom of the priority list. Please see the above information about the rural internship.

    In addition to a CV and referees, in order to apply for an internship in South Australia, you will need to provide a certificate confirming that you have completed the SA Health online electronic medical record (Sunrise EMR & PAS) training.

    Tasmania

    Hobart in Australia

    **2022 Information not currently available**

    Estimated Number  = 92 (Based upon last year).
    Annual Salary = $73,586
    Length of Contract = 1 year
    Professional Development Allowance = nil for Interns but RMOs get an allowance of $2040 per annum
    Term 1 Start Date = 9th January 2023
    Orientation = 4rd January 2023

    Internships are coordinated in Tasmania via the Department of Health and Human Services.
     
    All applicants are required to apply online. As part of your application you are asked to preference all of the 3 available sites:
    – Hobart
    – Launceston
    – North West Region

    You can also preferentially apply for the Tasmanian Rural Generalist Program. You will be allocated to one of the above sites based on your preference but also undertake a 13 week rural GP placement as part of your internship.

    Candidates need to attach a CV/Resume and any other relevant information to their application and must arrange the completion of two electronic referee reports:

    – One (1) referee that is employed in a clinical role (Clinical Academic) with the University where you are studying/or studied medicine and is aware of your studies in the past 12-24 months; AND

    – One (1) that is – a senior clinician (>4 years’ experience post general registration) who has observed you (you have worked with) during your clinical placements in the past 12-24 months, and can comment on your suitability for hospital-based practice.

    Intern Placement Priorities:

    In the past, The Tasmanian Health Service currently has given priority order to:
    1. Australian permanent resident Tasmanian-trained Australian Government supported and full-fee paying medical graduates.
    2. Australian temporary resident Tasmanian-trained full-fee paying medical graduates.-
    3. Australian permanent resident interstate-trained Australian Government supported and full-fee paying medical graduates.
    4. Australian temporary resident interstate-trained full-fee paying medical graduates.
    5. Medical graduates of an Australian Medical Council accredited overseas University.

    At this point, it is not clear how selection will work for 2022. In past years there has been an interview process. However, the information to date indicates that priority 1 candidates will be placed on a ballot and allocated according to preferences. This seems to indicate there will be no interview or merit-based selection at least for this group.

    Northern Territory

    ocean coast in Darwin, Northern Territory Australia

    **2022 Information not currently available**

    Estimated Number = 50 (24 for Central Australia Health Service, unknown for Top End Health Service)
    Annual Salary = $78,750
    Length of Contract = 1 year
    Professional Development Allowance = $3,295 per annum with option to apply for additional $3,000 or $3,000 for HELP relief.
    Term 1 Start Date = Not Available
    Orientation varies but is usually the week before

    The NT Prevocational Medical Assurance Services (PMAS) conducts a central review of eligible applicants and all intern positions are allocated within the two NT Health Services:
    Top End Health Service (TEHS) – based upon Royal Darwin Hospital (RDH)
    Central Australia Health Service (CAHS) – based upon Alice Springs Hospital (ASH)

    Each Health Service has a primary employing health service as well as additional placement hospitals as per below:

    C/- NTPMAS Guide

    Eligible applicants are allocated intern positions in line with the Northern Territory category groups. Within the relevant category groups, applicants are allocated to their highest possible Health Service preference, pending availability of a position.

    Intern Priority Categories:

    The applicant eligibility categories in order of selection for Internship in the Northern Territory are:

    CategoryCriteria
    ANT Medical Program Bonded Scheme / Return of Service Obligation (RoSO) applicants (guaranteed placement)
    BNT Indigenous applicants who have completed medical degrees at accredited Australian and New Zealand medical schools who are:
    NT Indigenous scholarship holders;
    Identified as an NT Indigenous resident.
    CNon-NT Indigenous applicants.
    DNT applicants (non-Indigenous) who have completed medical degrees at accredited Australian and New Zealand medical schools who are: NT scholarship holders;
    Identified as NT residents (may include non-bonded JCU/Flinders NTMP students).
    EAustralian applicants (non-Indigenous / non-NT residents):
    Previous experience working/studying in NT (JCU/Flinders/Other university student placements);
    Previous experience in a rural, remote and Indigenous health location/s (eg. Aboriginal Medical Services, Rural Clinical Schools, involvement in Rural Student Clubs and those applicants who come from rural, and remote locations).
    FInternational applicants on a student visa, now an Australian medical graduate who has:
    Previous experience working/studying in NT (JCU/Flinders/Other university student placements);
    Previous experience in a rural, remote and Indigenous health location/s (e.g. Aboriginal Medical Services, Rural Clinical Schools, involvement in Rural Student Clubs and those applicants who come from rural, and remote locations).
    GInternational medical degree applicants who have:
    Previous experience in NT student placements/clinical observers;
    Experience in rural, remote and Indigenous health locations.


    As part of your application, you are required to submit a curriculum vitae of no more than 2 A4 pages and address the selection criteria. Applications are submitted to the NT Government employment portal.

    Overall the intern allocation process is based on an applicant’s category group, Health Service preference, and the number of positions available in each health service.

    The two NT Health Services are responsible for selecting applicants and making their offers of employment, applicants are advised via email.  The Health Service responsible for making the offer of employment will after receiving an acceptance from an applicant arrange an employment contract for an Internship position within their health service to be provided prior to commencing their internship.

    *NT is one of a few jurisdictions which will consider IMG applicants. Generally, you will have to have had previous experience in the NT.

    Australian Capital Territory

    The Australian War Memorial in Canberra


    **No current information for 2022**

    Below is the information for last year.

    Estimated Numbers = 95
    (6 of these positions are normally guaranteed to NSW medical students)
    Annual Salary = $74,826
    Length of Contract = 1 year
    Professional Development Allowance = $1,040 per annum
    Term 1 Start Date = Not Available
    Orientation varies but is usually the week before
     
    If you want to apply for an internship position in the Australian Capital Territory you do so via the ACT Health Recruitment page.

    Most of your time is spent at the Canberra Hospital. But ACT is interesting as it is one of the few chances you may have as an Intern to work in 2 separate States and Territories. Rotations may include secondments to Calvary Public Hospital, Goulburn Base Hospital, and South East Regional Hospital (SERH) at Bega. Because the ACT utilises some positions in NSW for intern posts there is a reciprocal arrangement whereby a number of NSW graduates are guaranteed an intern post in the ACT.

    Priority is given to:
    – Australian Graduates of ANU
    – A maximum of 6 graduates of NSW Universities
    – Graduates of other Universities who completed Year 12 in ACT

    ACT Intern Priority List:

    Category 1a (Guaranteed First Round Offer) – Domestic Graduates of the Australian National University Medical School

    Category 1b Guaranteed First Round Offer (capped at SIX) – Domestic Graduates of NSW Universities.

    Category 1c Guaranteed First Round Offer – Aboriginal and Torres Strait Islander Graduates of other Australian Universities (who provide a statutory declaration regarding Aboriginality)

    Category 2 First Round Offer Not Guaranteed – Graduates of other Australian Universities who completed Year 12 studies in the ACT.

    Category 3 First Round Offer Not Guaranteed – International Student Graduates of the Australian National University Medical School.

    Category 4 First Round Offer Not Guaranteed – Graduates of other Australian Universities.

    Category 5 First Round Offer Not Guaranteed – Graduates of Australian University campuses outside of Australia accredited by the Australian Medical Council.

    The Commonwealth – Private Hospital Stream

    **2022 Information not yet available**

    The Private Hospital Stream (PHS) funds private hospitals to deliver medical internships and support junior doctors to work in expanded settings. It focuses on supporting training for junior doctors in rural, regional and remote areas in Modified Monash (MM) 2 to 7 locations.

    This includes fostering partnerships between private hospital providers, rural public hospitals and other training settings (such as Aboriginal Medical Services) working as part of expanded training networks.

    Annual Salary and conditions = should reflect the annual salary for an intern in the State or Territory you are working in.

    Internships and places

    The PHS supported up to 115 internships and up to 80 PGY 2 and 3 eligible junior doctor places in the 2020, 2021 and 2022 training years.

    Expression of Interest (EOI) internships

    An annual EOI internship process is run for junior doctors to express interest in a PHS-funded medical internship place.

    This process is only for PGY 1 funded places. It opens each year after state and territory governments have offered and filled their internship positions.

    Eligibility

    The program divides applicants into 2 categories – Priority One and Priority Two.

    Priority One eligibility criteria

    The Priority One category is for final year medical students who meet all eligibility criteria for an internship under the PHS.

    You are Priority One if you:

    • are a full-fee-paying international student completing your medical degree during the current calendar year from a medical school in Australia, having completed all of your medical degree in Australia (university-approved, short-term elective rotations completed overseas are allowed)
    • have met the Medical Board of Australia (MBA) English language proficiency requirements for registration purposes
    • are not an Australian Citizen
    • commit to getting a visa to work in Australia during your internship year.

    Priority Two eligibility criteria

    You are Priority Two if you:

    • have MBA provisional registration as a medical practitioner
    • have met the MBA English language proficiency requirements for registration purposes
    • commit to getting a visa to work in Australia during your internship year.

    Who is not eligible

    You are not eligible to apply for the PHS if you:

    • do not meet the Priority One or Priority Two eligibility criteria
    • have accepted an internship position from a state or territory government.

    Recruitment process

    The recruitment process aligns with the state and territory government recruitment processes and the national audit process.

    Suitable applications are forwarded to the PHS participating private hospitals by the due dates each year.

    The PHS participating private hospitals do eligibility checks. They will contact eligible applicants they want to interview.

    You should not make direct contact with the hospitals.

    Category prioritisation

    PHS participating private hospitals must fill PGY 1 places with Priority One applicants first.

    If there are still places available after the Priority One list is finished, the hospitals can then recruit Priority Two applicants.

    PGY 2 and 3 funded places

    PHS participating private hospitals make their own recruitment and employment arrangements for PGY 2 and 3 junior doctors. This allows them to meet their own service needs.

    PHS-funded hospitals

    The Commonwealth funded the following private hospitals to deliver the PHS from 2020 to 2022:

    • Mater Health Services North Queensland (PGY 1 places)
    • Mercy Health and Aged Care Central Queensland – Friendly Society Hospital, Bundaberg; Mater Private Hospital, Bundaberg; Bundaberg Base Hospital, Bundaberg; Mackay Base Hospital, Mackay; Mater Misericordiae Hospital, Mackay (PGY 1, 2 and 2 places)
    • MQ Health, New South Wales (Macquarie University Hospital) (PGY 1 places)
    • St John of God Ballarat Hospital, Victoria – Grampians Intern Training Program (PGY 1 places)
    • Mater Hospital Sydney (PGY 1 places)
    • St Vincent’s Private Hospital Sydney (PGY 1 places)
    • Ramsay Health Care, Western Australia (Joondalup) (PGY 1, 2 and 3 places)
    • Greenslopes Private Hospital, Queensland (PGY 1, 2 and 3 places)
    • Calvary Health Care Riverina, New South Wales (PGY 2 places)

    How To Decide Where to Apply for Your Internship?

    There are lots of considerations when it comes to putting in your Intern application. Everyone is a bit different. Some graduates feel like they would like to be close to home and family whilst going through their transition to Intern. Others see it as a chance to get away and explore a new place and location. And then others focus on the long-term career prospects of certain locations.

    I think this last consideration is a little overrated for most. You can generally experience a wide range of medicine in your first couple of years of medicine after graduation and there is scant evidence that this affects your prospects of applying for specialty training posts.

    That being said if you have an interest in anything other than Medicine, Surgery or Emergency Medicine as a future career you should probably investigate whether this particular specialty is offered at the hospitals or networks to which you apply.

    Unfortunately, the internship model in Australia is quite antiquated and we have continued to use the experience as a proxy for competency when a large portion of the medical education world has moved on. The result has been the mandating of the 3 core terms for internship of Medicine, Surgery, and Emergency Medicine. There is really no solid educational basis for this approach and one of the unfortunate outcomes is that all the other specialties get squeezed out and few interns get to experience psychiatry, general practice, obstetrics, paediatrics, pathology etc… which ultimately does have an effect on recruitment to these specialties.

    So the basic message is this. If you are really dead set keen on doing radiology as a career you should try to track down the very few locations that might offer this rotation to either interns or residents.

    Each year the Australian Medical Students’ Association produces a very useful Intern Guide with lots of information about the composition of intern training networks across the country. The 2022 version is not available but here’s a link to the 2021 version.

    Related Questions

    Is There Any Restriction On Where I Can Complete My Internship?

    To meet the Medical Board of Australia’s requirements for general registration, an internship can be completed in any state or territory of Australia.

    Can I Apply to More Than One State or Territory for an Intern Position?

    Yes, you will need to apply separately to each state and territory where you would like to work. You will need to complete a separate application for each position, submit the documents, provide the information required and meet the selection requirements. As part of the application process, each state and territory requires you to include your intern Placement Number (IPN).

    What is an Intern Placement Number?

    The Intern Placement Number is a unique nine-digit number that has been generated by the Australian Health Practitioner Regulation Agency (AHPRA) and has been provided to medical schools for distribution to all 2022final year medical students. If you do not have an Intern Placement Number issued or you have misplaced it, you must contact your medical school to have the number issued or reissued. Do not contact AHPRA.
    Note: The Intern Placement Number is not your University Student Identification Number.

    I Am Not an Australian Medical Student. How Do I Obtain an Intern Placement Number?

    In this situation, you do not require an IPN and will not be issued with one. You can still apply for internships. But unless you are a New Zealand medical student your chances of gaining a place are very very limited.

    What If I Have Special Circumstances Which Make It Hard For Me To Work In Certain Places?

    All States and Territories Have processes for considering special circumstances. Some of the types of circumstances that are generally approved are: where you may have certain health conditions that mean you need to be close to certain hospitals or specialists; where you have dependents, such as young children, and are unable to relocate due to care arrangements; and where you and your partner want to work as doctors in the same location. Generally, requests to stay in certain locations, for reasons such as work commitments of partners or needs of school-aged children are not granted.

    I Have Received My Intern Offer. But I Would Like to Defer It. Is This Possible?

    This will partly depend on how long you wish to defer. If you just wish to defer for a few months. Once you have your offer and are in discussions with your new employer make enquiries. It may be possible to negotiate a later start with your employer. Most employers will generally prefer that you start on time so that you are not out of sync with your colleagues. But there might be some advantage for the employer in you attending orientation but then starting a bit later as it will probably help them to fill out roster gaps. On the other hand. If you wish to defer for a complete year. Then you will need to check the policy of the State or Territory that has provided you with an Intern offer. In some cases (for example Victoria) you will be permitted to defer and your place will be held for you the following year. In most other cases you will need to reapply the following year and check whether your priority status has altered. In most cases, you have the same priority status. Also bear in mind that it is unclear how long you can defer commencing your internship. However, the Medical Board of Australia expects that once you have commenced your internship you will have completed this process within 3 years.

    I am a Doctor With a Medical Degree From Outside Of Australia. Can I Apply For an Internship?

    Unless you obtained your medical degree from a New Zealand Medical School. Then the brief answer to this question is no. I would love to stop there. And I really think you should as well. But there are rare circumstances where you may be able to obtain an internship with a medical degree from outside of Australia. But the Medical Board of Australia strongly advises against this option and so do I. For good reasons. Firstly the whole Australian medical internship system is designed to ensure that Australian medical graduates are able to undertake an internship. Not for overseas graduates. Secondly (and as a result of the first point) it is very rare to be offered the chance. Some States and Territories will not even consider an application from an IMG for an internship. Others will only do so in limited circumstances, for example, the Northern Territory will accept applications from IMGs who may have done a medical student elective or clinical observership in the Northern Territory and who have experience in rural, remote and indigenous health locations. But even then these applicants are at the bottom of the priority list for obtaining an internship. South Australia will accept applications. But again you are bottom of the list. Queensland will also accept applicants, but only if you have never worked as a doctor. And again you are bottom of the list. A final note on this question is that the majority of IMGs who do obtain a medical internship position each year in Australia generally have Australian citizenship or permanent residency.

    I Have Heard That Some Graduates Miss Out On Internship. Is This True?

    Whilst it is theoretically a possibility that some medical graduates miss out on Internships according to information provided by HETI for the most recent year of intern applications no one was actually left at the end of the process without an offer. Only Australian citizens and permanent residents are guaranteed an intern position under the COAG agreement. However, there are generally enough intern positions available for those students who have come to Australia to study medicine and the Commonwealth Private Hospital program offers additional spaces for those that may miss out. That being said. It is also clear that many graduates choose to drop out of the application process themselves. So not everyone who applies gets an offer. The assumption is that some graduates take up similar intern opportunities in other countries upon graduation.

    Can I Submit a Late Application?

    Acceptance of late applications is at the discretion of each state and territory.

    When Will Offers Be Made in 2022?

    All states and territories will commence making offers for Rural Pathways on Monday 18 July 2022 and will commence making offers for all other pathways on Wednesday 20 July 2022. The National Close Date for 2023 Intern Recruitment is Friday 18 November 2022.

    What if I Receive More Than One Offer?

    You need to decide where you would like to undertake your internship and accept this position and decline all other positions. You should not hold onto more than one offer as this negatively impacts both the hospital that will have a vacancy if you fail to start work because you have started in another position in another state, and other applicants who would like to work at that hospital who do cannot receive an offer for that vacant position.

    What is the National Audit?

    States and territories share intern applicant information at pre-agreed dates. This data is then used to identify applicants who have applied for and/or accepted intern positions in more than one state/territory. Applicants who have accepted more than one intern position will be contacted by the National Audit Data Manager by phone or email and given 48 hours to withdraw from all intern positions, except the one where they intend to undertake their intern year.

    What if I Don’t Respond to the National Audit Data Manager?

    If you don’t respond to the National Audit Data Manager and/or do not withdraw from all positions except one, the relevant states/territories where you have accepted an offer will be advised and all offers, except for the first offer you received may be withdrawn.

    What is the Late Vacancy Management Process?

    The Late Vacancy Management (LVM) Process runs from Monday 5 December 2022 to Friday 24 March 2023.
    The process ensures any late vacancies are offered to eligible intern applicants who have not yet accepted an internship position. The Late Vacancy Management Process will be coordinated by the National Audit Data Manager on behalf of states and territories. Please ensure you have updated your contact details if you are going overseas during the Late Vacancy Management Process period.
    The National Audit Data Manager will send out emails on Friday 25 November 2022 to participants who will need to opt into the Late Vacancy Management Process if they still wish to receive an internship position offer in Australia.
    Note: if an applicant does not respond to this email, they will no longer be eligible to receive an internship offer and their application will no longer be considered in any Australian jurisdictions.

    Who can participate in the Late Vacancy Management Process?

    The process is open to medical graduates of AMC accredited medical schools who have applied for and are not holding a 2023 intern position through the Commonwealth or states and territories at the National Close Date for Intern Recruitment (18 November 2022). Participation in the LVM is an opt-in process -you must confirm that you want to participate in the LVM by responding to the National Audit Data Manager by e-mail.

    (Disclaimer: All information here has been sourced in good faith but things do change so you should always do your own due diligence in such matters, we are providing this information to aid you in your application but take no responsibility for any outcomes)We’d welcome feedback from any Intern programs in relation to the accuracy of the above information.

  • Do Doctors Get Paid to Train in Australia? Yes, They Do.

    Do Doctors Get Paid to Train in Australia? Yes, They Do.

    This blog is open to comments, I also run a YouTube Channel and a Facebook group and frankly way too many other ways for people to contact me. So no surprise. I do get a lot of questions and queries on a daily basis. One of the surprisingly common and interesting questions that I do get a lot from doctors from other countries is “do doctors get paid to train in Australia?”. Being paid for work is part of our culture in Australia. But I am aware that in other systems you may not necessarily be paid when you train in medicine or even have to pay for your training.

    So let’s try to clear up this question in this blog post. Along with answering some related questions that come up around this topic.

    From the time after you graduate from medical school in Australia, you will be entitled to and will receive payment for your services as a doctor. This includes any further career stage which might be referred to under the label of training. So you get paid to be an Intern, you get paid to be a Resident and you get paid to be a Registrar (which is what most doctors who are undertaking specialty training in Australia are referred to).

    Therefore, you also get paid when you are doing surgical training, physician training, psychiatry training, emergency training, general practice training etcetera. You also get paid when you become a specialist doctor or consultant, although in some cases you may be working for yourself, in which case, you are paying yourself out of the revenue you collect.

    What does all of the above means for international medical graduates (IMGs)?

    Do IMG Doctors Get Paid to Train in Australia?

    The answer is again yes. If you are an IMG doctor and you get appointed to any training position, whether this is a resident position for the purposes of completing the standard pathway process or a specialty training (Registrar) post as part of any of the competent authority, the specialist, or the short term training in a medical specialty pathways. You will get paid.

    Whilst wage theft and the exploitation of overseas workers in Australia have become a real concern in Australia over the past decade or so. I am not aware of any such situations that have involved international medical graduates. If you do know of such a circumstance I would be interested to hear from you.

    Do IMG Doctors Get Paid Differently to Australian Doctors?

    This is a more complicated question to answer.

    As a general rule if you are an IMG doctor and you are recruited to a position you will be paid under the same classification as any Australian doctor also doing the same job. So if, for example you are appointed to a Resident position you will be paid as a Resident.

    However, for most classifications, there are steps or levels that increase based on your years’ of experience. Sometimes the employer may try to start you out at the bottom of this classification scale, even though you may actually have more experience, citing that you don’t have any experience in Australia. So in this case you may end up being paid slightly less. In my experience, most employers in Australia will try to recognise your experience and pay you at a higher rate if you are eligible. This is a grey area in terms of what is correct. So it’s definitely worth querying things if you feel you are on the wrong end of the stick.

    Why Do Doctors Get Paid to Train in Australia?

    The answer to the question of why doctors get paid whilst training is that they are performing real and substantial services in these roles. The training is on top of this work or embedded into this work. They are generally not taking large amounts of time away from the workplace to attend things like lectures and seminars or workshops. Much of the training occurs within the workplace and a lot of the additional studying occurs in the doctor’s own time after work.

    Many Doctors Do Have to Pay to Train

    Hang on. What’s that? You just said that doctors get paid to train. But now you are saying they also have to pay?

    Doctors do get paid to train in Australia. But there are some costs associated with being a trainee doctor in Australia.

    There are the normal regular costs like paying your medical registration every year and having a car so you can get to work.

    But there are also some specific costs associated with being a trainee doctor.

    As an intern, you generally won’t have any particular costs associated with your training as it will normally be provided for you by the hospital.

    As a resident doctor, you will probably be thinking about paying for some courses that might help you get into a particular training program. So things like emergency courses and anatomy courses and radiology courses and the like.

    As a specialty trainee doctor, you will have to pay college membership fees, you may also have to pay for a formal education course and you will have to pay to sit examinations.

    Personal costs for training as a trainee doctor in Australia can rack up to several thousand dollars and even pass into the tens of thousands of dollars range. But this is generally over a significant period of around 5 to 10 years.

  • Canadian Doctors In Australia. Great Prospects. Here’s Why.

    Canadian Doctors In Australia. Great Prospects. Here’s Why.

    Given that doctors from Canada have the same preferred status in Australia as doctors from the United Kingdom, Ireland and the US. It’s really surprising that there are not more Canadian doctors in Australia. The same rules apply for Canadian doctors as per doctors from the above mentioned other countries. And employers are generally very open to an application from a doctor from Canada. Whether this is for a short-term working holiday or a permanent move.

    So how can Canadian doctors work in Australia? The short answer is that if they are a trainee doctor they should apply for a vacant post under the competent authority pathway and if they are a recognised specialist in Canada they should first apply to the relevant college for recognition. Of course, no doctor coming from another country is absolutely guaranteed to be able to work in Australia. But if you are from Canada you have a very good chance.

    Because the Canadian medical training system is recognized by the Medical Board of Australia as being on par or what is termed “competent”, Canadian doctors have good success with either becoming generally registered through the competent authority pathway or being recognized as a specialist through the specialist pathway. In the year 2019 (the latest year we have figures for) 33 trainee doctors from Canada applied for registration in Australia with 31 of those applications granted. In addition, from the years 2015 to 2021, 94 Specialist doctors from Canada have applied for assessment in Australia with 82 being granted comparability.

    So the prospects for Canadian doctors working in Australia are generally positive. But it’s important to have a 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 Canadian Doctors in Australia.

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

    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 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.

    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. Or are more competent!

    If you are an international medical graduate (IMGs) 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.

    So for doctors from Canada who did their primary medical degree elsewhere, this involves completing all steps of the Licentiate of the Medical Council of Canada and completing 12 months of postgraduate education or residency training in Canada, either as part of the LMCC or otherwise.

    In essence, this is identical to the requirements that you would need to demonstrate if you had just graduated from a medical school in Canada.

    What are the steps involved in 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 are:

    You need to have completed the LMCC

    AND

    be able to demonstrate 12 months of postgraduate education or residency training in Canada.*

    (*it is also possible to undertake supervised training in another competent authority country to meet this requirement).

    competent authority

    Competent Authority Pathway Course

    A Free Course For Trainee Doctors

    This course covers all the required steps for working as a doctor in Australia if you are a trainee doctor from Ireland, the UK, US or Canada.

    What Types of Jobs Can I Apply for as a Canadian Trainee Doctor in Australia?

    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 normally 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. These are usually referred to as Registrar posts. Australia’s specialty training system is a little different to Canada’s in that Australian doctors do not immediately enter specialty training. You tend to enter specialty training around postgraduate year 3. You might also see advertised as Senior House Officer or Trainee or Advanced Trainee.

    One key thing to look out for is that most jobs you come across 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. The 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. If you are quite a senior trainee doctor in your own right you might be granted Level 3. 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 (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. In Australian major public hospitals, there are many layers of other doctors from who you can get supervision. So Level 1 is not too much of an issue in these circumstances.

    Level 2 Supervision.

    Level 2 Supervision, which is what most competent authority trainees receive 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 Canada 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 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 some specialty training programs. See below.

    The Specialist Pathway. The Option For Canadian Specialists

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

    Actually, it’s a combination of the Specialist Pathway and the Competent Authority Pathway. More on that in a bit.

    Once again your process 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.

    Specialist Pathway Course

    Specialist Pathway Course

    Free Course

    You can enrol now in this free course that will step you through all the requirements for working as a specialist doctor in Australia

    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 Canadian 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 Canadian 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 specialists from Canada 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 specialists from Canada deemed not to be comparable by the college. This has only happened to 12 out of 94 specialist doctors from Canada from 2015 to 2021. 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.

    Alternatively, if you are just looking for a short period of time in Australia you may want to consider the Short Term Training in a Medical Specialty Pathway.

    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 be recognised as a specialist in Canada and be a Fellow of the RCPSC or CFPC
    • You should ideally have worked substantively at a Consultant level in your field for 2 years or more
    • You should be able to demonstrate good standing with the Medical Council of Canada, your College 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 doctor from Canada?

    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 their general registration doctors from Canada 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 training you have done already. But this varies and may at best normally shave one or two years off from your training.

    An Alternative But Limited Option.

    There is an alternative but time-limited pathway for Canadian doctors who are just seeking a short-term experience in Australia to add to their training in Ireland. This is called 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 Canada 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.

    Generally Canadian doctors do not opt for this pathway as they have the option to get registered for these posts under the Competent Authority Pathway.

    How many doctors from Canada are working in Australia?

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

    From data collected by the Australian Government, we know that for 2018 and 2019 (the latest available years):

    • In 2018, 21 applications were made for registration under the Competent Authority Pathway with 20 being granted.
    • In 2019, 33 applications were made for registration under the Competent Authority Pathway with 31 being granted.

    So the best estimate is that there are probably a few hundred Canadian doctors working in Australia.

    It should also be noted that quite a few students come from Canada to Australia to study medicine.

    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
    Costs for Working as a Doctor in Australia

    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 of $8,495.

    The Cost of Your Time and Effort.

    For all of this financial cost, you will also 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 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. Its certainly worth asking about it.

    We hope that you found this summary about how Canadian 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 Canadian doctors who have made the journey to Australia.

    Get a Clarity Call

    If you are wanting to gain further guidance about your personal situation or just get some answers to questions then you can book a RISK-FREE Clarity Call. Held over Zoom

    Related Questions.

    Do I Need to Sit An English Test?

    Answer.
    Doctors from Canada are amongst a select group of countries for which the Medical Board does not expect an English proficiency test. However, there may still be some circumstances where you do need this. If, for example, some of your schooling was in another country. You should always check the requirements.

    Are there any other options for working as a Canadian doctor in Australia?

    Answer.
    Some doctors just want to come to Australia for a limited period of time as an opportunity to train in another country.
    As we have highlighted above there is an alternative but time-limited pathway for Canadian doctors who are just seeking a short-term experience in Australia to add to their training in Canada. 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 Canada or be less than two years from completion. So this is a program mainly for early-career specialists or advanced trainees.
    Most Canadian doctors do not use this pathway as the Competent Authority Pathway is more accessible and able to be used for the same purpose.

    Should I use a medical recruitment company if I am considering working in Australia?

    Answer.
    It is possible to deal directly with employers in Australia. In general, however, when moving from one country to another most doctors find it useful to engage with a medical recruitment company as they can tend to take some of the stress out of the planning for you and help with all the paperwork and negotiating with prospective employers. Some medical recruitment companies also provide migration services and relocation services as well. We have written more on this subject here. And a list of medical recruitment companies is available here. Feel free to contact us first for recommendations.

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

    Answer.
    Specialist doctors from Canada are not automatically granted specialist recognition. However, most are. Canada has generally one of the highest rates for doctors being seen as substantially comparable.

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

    Answer.
    The majority of specialties have some vacancies and will provide opportunities for Irish 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.

  • What are the Entry Requirements for Specialty Training in Australia?

    What are the Entry Requirements for Specialty Training in Australia?

    Are you a current medical student or an international medical graduate thinking about doing specialty training in Australia? The entry requirements for specialty training and how to go about applying to specialty colleges can be extremely confusing. This guide summarises the key entry requirements for specialty training and pathways for training with all 15 specialty training colleges in Australia.

    At the time of writing this post, I am a final year medical student in Newcastle and until looking into specialty training in Australia for this post, I didn’t realise that some of the specialty colleges below even existed. The requirements needed for each college can vary greatly. So if you are nearing the end of medical school, as I am, you will need to really plan the next two years of your career to make sure you are able to apply effectively.

    There are 15 medical specialty colleges you can apply to after finishing your medical degree in Australia, with a 16th, the college of dental surgeons, available to medical practitioners that have also completed a Dental degree. Whilst the entry requirements for specialty training for each college vary there are some common requirements, which include the fact that in most cases you will require general registration, and some level of postgraduate experience in Australia, usually at least 2 years (although this can vary). In addition, a number of the specialty colleges also require that you have permanent residency or citizenship, including surgical training, sports medicine training, obstetrics and gynaecology, dermatology, ophthalmology and oral-maxillofacial surgery.

    An Overview of the Specialty Colleges.

    Let’s start by listing the 16 specialty colleges. These are the bodies that have been recognised by the Medical Board of Australia for providing postgraduate medical training.  They determine the entry requirements for specialist training in Australia.  You can also find out more information about these colleges in a related post on this blog.

    The 16 specialist colleges in Australia are:

    1. Australasian College of Sport and Exercise Physicians (ACSEP)
    2. Australasian College for Emergency Medicine (ACEM)
    3. Australian College of Rural and Remote Medicine (ACRRM)
    4. Australasian College of Dermatologists (ACD)
    5. Australian and New Zealand College of Anaesthetists (ANZCA)
    6. College of Intensive Care Medicine of Australia and New Zealand (CICM)
    7. Royal Australian College of General Practitioners (RACGP)
    8. Royal Australasian College of Medical Administrators (RACMA)
    9. Royal Australasian College of Physicians (RACP)
    10. Royal Australasian College of Surgeons (RACS)
    11. Royal Australian and New Zealand College of Ophthalmologists (RANZCO)
    12. Royal Australian College of Obstetricians and Gynaecologists (RANZCOG)
    13. Royal Australian and New Zealand College of Psychiatrists (RANZCP)
    14. Royal Australian and New Zealand College of Radiologists (RANZCR)
    15. Royal College of Pathologists of Australasia (RCPA)
    16. Royal Australasian College of Dental Surgeons (RACDS)

    But how do I know what college to apply for? Below I have provided for you a brief description of what types of specialties each college trains for. Along with the entry requirements for specialty training for each college.

    You can also read more about how the specialty training system in Australia works in general on this related post.

    sports medicine

    The Australasian College of Sport and Exercise Physicians (ACSEP)

    The ACSEP website describes the role of a Sports and Exercise Medicine practitioner as follows:

    A Sports Physician “provides for safe and effective sporting performance at all levels. Alongside this is the increasing recognition of the importance of exercise in the prevention and treatment of common and often serious medical conditions, such as arthritis, heart disease, diabetes and many cancers.”

    Entry Requirements for Specialty Training as a Sports Physician

    Entrance to the training program is open to Australian citizens or permanent residents with general registration completing PGY 3 or more. The first step is passing the ACSEP entrance examination held twice a year in March and July which costs $2100. Then paying the application fee of $896.50 to submit your CV and referees for scoring. Your application must contain 3 referees, one of which being an ACSEP fellow.

    emergency physician

    The Australasian College for Emergency Medicine (ACEM)

    ACEM Fellows deal with all people requiring urgent medical care. They manage conditions from every area of medicine. The majority of your work as an emergency physician will be in an emergency department. But FACEM’s can also be asked to work in other areas of critical care medicine such as retrieval services, or providing urgent ward cover or even coverage to intensive care units.

    Entry Requirements for Specialty Training in Emergency Medicine.

    Entrance to the ACEM training program is available to Australian and New Zealand citizens, permanent residents, or people with relevant visas (you need a visa for the length of your training). You must have general registration and be completing PGY 3 or more.

    The experiential requirements are quite complex.

    You must have completed the following as a minimum:

    • One 6-month (FTE) ED placement that must have been completed:
      • in a single Emergency Department where the applicant assesses and manages all types of patients in that Emergency Department (i.e. not only fast-track patients) in Australia or New Zealand
      • entirely within the date range relevant to the round in which you are applying
      • during or after PGY2
      • at a minimum of 0.5 FTE
    • Your ED placement must NOT IN ANY PART be completed:
      • at an Australian Urgent Care Centre
      • of your six months FTE ED placement, no more than five weeks can be leave
    • Three placements in three different disciplines other than emergency medicine, each of which must have been completed:
      • as a minimum of eight weeks full-time equivalent (FTE) of clinical work at a single site, exclusive of any leave
      • at a minimum of 0.5 FTE
    • At least one of your non-ED placements must have been completed during or after PGY2. Non-ED placements may have been completed in PGY1 and/or overseas.

    To enrol with ACEM you also need to have had relevant experience prior to application involving 6 months FTE in a single Emergency Department in Australia or New Zealand after PGY 2 and in the year prior to application. You will also need 3 placements in 3 different disciplines other than Emergency Medicine, for a minimum of 8 weeks each, with at least 1 placement completed during or after PGY 2.

    As of 2022 ACEM has developed a new training program and application process. The application no longer includes an interview. It comprises a structured CV, nominated references and an institutional reference.

    You can nominate 4 referees

    Your selection of referees must comprise the following roles:

    • The Director of Emergency Medicine Training (DEMT), or the Director of EM (DEM) in departments not accredited for the FACEM Training Program;
    • The Term Supervisor if this is not also the DEMT;
    • One other senior EM consultant (FACEM), defined as at least three years since commencing employment as an EM consultant;
    • One other senior clinician (medical or EM nurse) who has worked with you during your ED term. This may include non-EM consultants who have worked with you in the ED but must not be someone with whom you have worked exclusively in a non-ED term.
    rural gp

    Australian College of Rural and Remote Medicine (ACRRM)

    As described by the ACRRM website, the role of the Rural Generalist is, “a General Practitioner who has specific expertise in providing medical care for rural and remote or isolated communities. A Rural Generalist medical practitioner understands and responds to the diverse needs of rural communities: this includes applying a population approach, providing safe primary, secondary and emergency care, culturally engaged Aboriginal and Torres Strait Islander peoples’ health care as required, and providing specialised medical care in at least one additional discipline.”

    Fellowship of ACRRM is one of two ways of becoming recognised as a specialist general practitioner in Australia. The other being via the Royal Australian College of General Practice.

    Entry Requirements for Specialty Training in Rural General Practice with ACRRM

    There are a number of different pathways that you can choose from in order to obtain your Fellowship with the ACRRM (FACRRM). Therefore the entry requirements for specialty training with ACRRM vary a little bit.

    There are four training pathways that lead to fellowship with the ACCRM. The Independent Pathway, the Rural Generalist Training Scheme, Australian General Practice Training, and the Remote Vocational training.

    The Australian General Practice Training Program.

    The Australian General Practice Training is a, “fully funded Commonwealth pathway providing vocational training through accredited Regional Training Organisations” according to the ACRRM website. This is the most common pathway in which doctors achieve the FACRRM.

    Eligibility for this pathway has no citizenship requirements, however evidence of citizenship, residency or relevant visa is required for application. Applicants must have general registration and pay the $700 application fee to meet eligibility requirements.

    The Rural Generalist Training Scheme

    The Rural Generalist Training Scheme is, “a four-year, fully funded stream of the College-led Independent Pathway that leads to Fellowship of ACRRM” according to the ACRRM website. It is available to Australian citizens or permanent residents.

    Doctors born overseas and who obtained their primary medical degree in Australia or New Zealand may be eligible to apply with Australian temporary residency. Applicants are required to have general registration. 2 referees who were direct supervisors for at least 4 weeks within the past 3 years are required for application. A $700 application fee must be paid with the submission of your application.

    Becoming a rural generalist is similar to the AGPT pathway but also involves an additional one or two years in an Advanced Specialty Training post (AST). Undertaking an AST is a great idea if you are considering working as a rural GP where you both provide primary care services but also hospital services in a smaller rural centre. Some of the advanced specialties that rural generalists can choose to work in include: anaesthetics, obstetrics and gynaecology, mental health and surgery.

    The Independent Pathway

    The Independent Pathway is “A flexible, self-directed, self-funded Fellowship training pathway delivered and supported directly by ACRRM” according to the ACRRM website. It is available to Australian citizens, permanent residents, and people with skilled migration visas.

    The level of registration needed can be general registration, Specialist registration, Provisional registration, or Limited registration for an area of need. So this is also a potential pathway for IMG doctors.

    To apply you will require 2 referees who were direct supervisors for at least 4 weeks within the past 3 years are required for application. The application fee for this pathway is $700, and a $495 enrolment fee is due on acceptance to the college, as well as a $24,950 Education Program Gee to cover the first year of education.

    The Remote Vocational Training Scheme

    The Remote Vocational Training Scheme is a, “Fully funded Commonwealth pathway providing vocational training for medical practitioners in remote and isolated communities and Aboriginal and Torres Strait Islander communities throughout Australia” according to the ACRRM website. Australian citizens, permanent and temporary residents are eligible to apply if they currently work in a remote community of MMM 4-7, or an Aboriginal community of MMM2-7, and will stay there throughout their training.

    Applicants can have General, Provisional, or Limited Registration for Area of Need if they have completed the AMC part 1 examination. So this is a training pathway that is open to IMG doctors as well.

    dermatologist

    Australasian College of Dermatologists (ACD)

    The ACD training program teaches about all conditions of the skin, hair and nails. It is a 4 year course only undertaken in accredited training positions in hospitals and come private dermatology practices.

    The program involves onsite clinical training, workshops for procedural skills and professional development, and online learning modules ($3250). The assessments for the program involves summative in-training assessments, workplace-based assessments, a fellowship examination ($4000) undertaken in the final year, and the completion of a research project. The training fee for the program is $5602.

    Entry Requirements for Specialty Training in Dermatology

    Entrance to the training program is available to Australian citizens and permanent residents with general registration in Australia. You must have successfully completed a primary medical degree and can apply while completing PGY 2 or more, with no specific specialty rotations being taking into consideration for application. There is an application fee of $1600 which is required to be paid before your application can be submitted.

    Your application requires 6 referees who have worked directly with you in the last 2 years. Two referees need to be medical practitioners of the same level, 2 others being medical practitioners who have supervised you, and 2 paramedical or nursing staff.

    There is also a situational judgement test. If you are selected for an interview then this is conducted as a Multiple Mini Interview held as part of a national process.

    Anaesthetist

    Australian and New Zealand College of Anaesthetists (ANZCA)

    According to the ANZCA website, “Anaesthetists are highly qualified specialist doctors with unique clinical knowledge and skills. They have a major role in the perioperative care of surgical patients and are closely involved in other important fields of medicine such as resuscitation, intensive care medicine, pain medicine, retrieval, disaster response and hyperbaric medicine. Core anaesthesia practice involves assessing patients thoroughly and applying both physiological and pharmacological knowledge to best care for them through surgery.” 

    The ANZCA fellowship training program is a 5-year program broken down into 4 training blocks, each with an assessment called a Core Unit Review at the end of the clinical placement. The program starts with 6-months of fundamental clinical skills called introductory training, followed by 18 months of basic training where trainees sit their primary exam (formerly Part 1) costing $5525. Next is 2 years of advanced training where the Final exam (formerly Part 2) is sat costing $6145. The final year of training is called Provisional fellowship training and focuses on clinical training and workplace-based assessments.

    Entry Requirements for Specialty Training in Anaesthesia

    Application to the training program is available to any medical practitioner who has secured an accredited training position in Australia or New Zealand. Citizenship requirements are dependant on the position applied for.

    You must be at least completing PGY 2 at the time of application with a minimum of 12 months of experience in specialties other than anaesthetics or intensive care. There is a $750 application fee, and a $2435 trainee registration fee if successful.

    Intensive care specialist

    College of Intensive Care Medicine of Australia and New Zealand (CICM)

    As described by the CICM website, “An intensive care specialist is a medical specialist trained and assessed to be proficient in the comprehensive clinical management of critically ill patients as the leader of a multidisciplinary team.  Critically ill patients include patients with life-threatening single and multiple organ system failures, those at risk of clinical deterioration as well as those requiring resuscitation and/or management in an intensive care unit or a high dependency unit.”

    The CICM has two training programs: General Intensive Care Medicine and Paediatric Intensive Care Medicine. Both programs are a minimum of 6 years in duration and have the same application requirements.

    The programs differ in the rotation requirements with the Paediatric program requiring a minimum of 18 months of the 24 months of core training to be in a Paediatric ICU and the additional 12-month medicine rotation to be in Paediatric medicine.

    Both programs require a 3-month rural rotation during training. The assessments of the course include 2 exams, one during the first year of training, and the second after completion of at least 12 months of ICU core placement.

    Entry Requirements for Specialty Training in Intensive Care Medicine

    Application to the training program is available to any doctor who meets the citizenship or visa requirements to work at the hospital they intend to train at. Trainees are required to have general registration and have completed a minimum of 1-year post-graduate experience, as well as a minimum of 6 months supervised experience in an ICU accredited by the CICM within three years of application.

    A trainee registration fee of $2160 must be paid before the submission of your application. Three referees are required for the application, two of which must be CICM fellows and one a senior ICU nurse who has worked directly with the applicant. A situational judgement test has been implemented in 2021 as part of the application process and is mandatory to sit for a valid application, however, results currently do not impact applicant performance.

    General Practitioner

    Royal Australian College of General Practitioners (RACGP)

    The RACGP website describes the role of the General Practitioner as the “most likely the first point of contact in matters of personal health.”

    The RACGP is one of two colleges recognised for training for general practice. The other being ACRRM.

    A GP “coordinates the care of patients and refers patients to other specialists; cares for patients in a whole of person approach and in the context of their work, family and community; cares for patients of all ages, both sexes, children and adults across all disease categories; cares for patients over a period of their lifetime; provides advice and education on health care; performs legal processes such as certification of documents or provision of reports in relation to motor transport or work accidents.”

    The RACGP has a single training program for all trainees but has a general and rural pathway for entrance. The general pathway is for all applicants training in an accredited general practice, and the rural pathway is for applicants applying to work in rural general practice with the option for an additional extra year of training to obtain the additional Fellowship in Advanced Rural General Practice (FARGP).  

    Entry Requirements for Specialty Training in General Practice

    Application to the Australian General Practice Training Program is available to all Australian and New Zealand citizens or permanent residents with general medical registration.

    You must have a primary medical qualification obtained in Australia or New Zealand, or be an international graduate with an AMC certificate. Trainees must have completed one year of postgraduate experience in any specialties to be eligible but can apply during this first year.

    If you are an IMG or completed your medical degree in Australia as an international student you are only eligible to apply for the rural pathway.

    Similar to ACRRM there are a number of other routes for completing the FRACGP. However, these are generally only accessed by IMG doctors. So we have not listed them here. You may wish to also view the related post on general practice training pathways here.

    Medical Administrator

    Royal Australasian College of Medical Administrators (RACMA)

    RACMA describes the role of a Fellow as a doctor who is involved with “administration or management utilising the medical and clinical knowledge, skill, and judgement of a registered medical practitioner, and capable of affecting the health and safety of the public or any person. This may include administering or managing a hospital or other health service, or developing health operational policy, or planning or purchasing health services.”

    The RACMA fellowship training program is a minimum of 3 years of clinical experience in an accredited training post. The program involves training in health care systems, health law and ethics, health economics, financial management, epidemiology, and statistics.

    Entry Requirements for Specialty Training in Medical Administration

    Application to the training program is available to any doctor working in a RACMA accredited training post. There are no specific citizenship or residency requirements if the applicant is approved to work in an accredited training post. Applicants must hold a primary medical degree and general registration, and have a minimum of 3 years of postgraduate clinical experience with direct patient contact. An application fee of $1433.50 is required to be paid before the submission of your application to the program.

    Physician

    Royal Australasian College of Physicians (RACP)

    The RACP website describes the role of Fellows of the RACP as “physicians and paediatricians are medical doctors who have completed Advanced Training in a medical specialty with the RACP to diagnose and manage complex medical conditions.”

    The RACP is by far the most complex college in the types of specialists and subspecialists it trains and supports as Fellows. It also has a lot of overlap with other colleges for certain join training schemes.

    The two largest RACP training programs are for adult internal medicine and paediatrics and child health. Both are 6-year programs with 3 years of basic training undertaken by all trainees, followed by 3 years of advanced training in an advanced training program. A fee of $3646 if required to undertake basic training.

    Trainees can select the Adult Internal Medicine pathway, or the Paediatrics and Child Health Pathway.

    The Paediatric and Child Health pathway requires 24 months of the 36 months of core teaching to be done in paediatric specialties. Completion of the RACP Divisional Examinations and basic training allows paediatric trainees to apply to do advanced training in areas such as General Paediatrics, Community Child Health, Neonatal/Perinatal Medicine, Paediatric Rehabilitation Medicine, and Paediatric Emergency Medicine.

    Entry into Advanced Training in Paediatrics is conducted by a separate and new application and interview process.

    The Adult Internal Medicine pathway requires a minimum of 12 months of training in medical specialties and a minimum of 3 months in general and acute care medicine. Once again, you will also need to complete the Divisional Examinations in order to progress. This pathway is required for trainees wishing to do advanced training in areas such as General and Acute Care Medicine, Geriatric Medicine, Respiratory Medicine, Neurology and Cardiology.

    Similar to Paediatrics entry into Advanced Training in Adult Medicine is conducted by a separate and new application and interview process.

    There are a number of other specialty programs that you can undertake with the RACP. These are:

    • Occupational and Environmental Medicine
    • Rehabilitation Medicine
    • Sexual Health Medicine
    • Palliative Medicine
    • Public Health Medicine
    • Addiction Medicine

    In addition, there are a number of joint training programs, including 4 with the Royal College of Pathologists of Australia (RCPA) in:

    • Haemtaology
    • Immunology and Allergy
    • Endocrinology and Pathology
    • Infectious Diseases and Microbiology

    A link to a full list of the RACP Advanced Training programs is below

    Entry Requirements for Specialty Training in Adult Internal Medicine and Paediatrics and Child Health

    To be eligible to enter basic training applicants must have general registration and have completed at least one year of clinical experience (intern year).

    Applicants must also be employed in an accredited hospital where basic training will be undertaken, with approval to apply for Basic Training from the hospital/network Director of Physician Education. Submission of an application, as well as a $1173 application fee, is required.

    Surgeon

    Royal Australasian College of Surgeons (RACS)

    The role of a RACS surgeon is described on their website as, “highly qualified specialists who stay up-to-date with the latest developments in their area of skill. They have considerable knowledge and provide the best possible care to their patients.

    “With a proven commitment to lifelong learning and the highest standards of professionalism, RACS Fellows offer you and your family caring, safe and comprehensive surgical care.”

    “Being a RACS surgeon requires ongoing learning and maintenance of knowledge and skills demonstrated through Continuing Professional Development (CPD) programs ensuring that Fellows not only maintain competency but also continuously build on and improve their clinical knowledge and skills to provide high-quality contemporary healthcare.”

    Each surgical specialty is applied for separately through the surgical specialty societies or associations. They all have their own specific entry requirements for specialty training, however all specialties are also required to follow the RACS Generic Eligibility requirements for Surgical Education Training (SET) as well. To apply for any surgical specialty, applicants must first register to apply for SET on the RACS website before registering for SET training on the appropriate surgical specialty website. The exception is the Cardiothoracic and Paediatric surgery SET programs where the applications are made through the RACS online system.

    The 9 Surgical Specialties in Australia are:

    • Cardiothoracic Surgery
    • General Surgery
    • Neurosurgery
    • Orthopaedic Surgery
    • Otolaryngology
    • Paediatric Surgery
    • Plastic and Reconstructive Surgery
    • Urology
    • Vascular Surgery

    RACS Generic Eligibility Requirements for Selection

    Anyone wishing to apply to surgical specialty training in Australia must have Australian citizenship or permanent residency and General Registration.

    Applicants must also complete a RACS specific Hand Hygiene Learning Module and the RACS Operating with Respect eModule to submit with their application. The final generic eligibility requirement for the RACS is passing the General Surgical Sciences Exam (GSSE), an exam covering anatomy, pathology and physiology costing $4145 to sit.

    All SET training schemes generally require an application process where your CV and referee reports are scored and this determines whether you progress to the interview phase.

    This year the RACS has introduced a Situational Judgement Test (SJT) as part of their selection criteria. This is mandatory to complete for application to any of the surgical specialties, however as it is newly implemented the results of the test do not impact application results for this year. The RACS SJT is designed to test the domains of the RACS competencies of professionalism and ethics, Management and Leadership, Collaboration and Teamwork, Communications, and Health Advocacy.

    The format of the interview is generally a multiple mini interview format.

    Entry Requirements for Specialty Training in Cardiothoracic Surgery

    Applicants to the cardiothoracic surgery training program are required to have specific experience prior to application. Within the last 6 years, the applicant must have had a minimum of 2 surgical terms of at least 10 weeks duration in any surgical specialty, plus a minimum 10-week rotation in cardiothoracic surgery (cannot be just cardiac or just thoracic).

    Applicants must also have proof of competency for the procedural skill of inserting a chest drain, harvesting a long saphenous vein and harvesting a radial artery.

    The referee requirements for cardiothoracic surgery training is for 12 total referees who are specialists and have been your supervisor in the past 4 years. At least 2 must be from the most recent cardiothoracic rotation, at least 1 from the rotation the applicant is currently on, and at least 3 from rotations in either anaesthesia, cardiology, oncology or respiratory medicine where the referee had clinical interaction with the applicant for at least 3 months.

    The application fee is the RACS selection processing fee of $825.

    Entry Requirements for Specialty Training in General Surgery

    The General Surgery Australia (GSA) website describes the role of a general surgeon as a surgeon who, “is trained to provide expert treatment across a broad range of emergency and planned surgical procedures”.

    The minimum experience requirements for entry to General Surgery includes 26 weeks of General Surgery in rotations of at least 8 weeks, and 8 weeks of critical care experience in a single rotation.

    As well as this experience, applicants must also provide proof of competency in the areas of common procedural skills and professional capabilities. GSA provides a document listing all 26 skills and capabilities and requires applicants to get surgical consultants to sign the applicant off as competent in all skills and capabilities to be eligible for training. More information about which specialty rotations can be used for general surgery and critical care rotations, and the list of procedural skills and professional capabilities at the link below.

    Referee requirements for General Surgery SET involve 6-10 surgical consultants who have directly supervised you as an applicant during their eligible surgical rotations. Included in this must be at least 2 specialist General Surgeons. All applicants must also pay the General Surgery Selection fee of $935 to be eligible for selection into training.

    Entry Requirements for Specialty Training in Neurosurgery

    The role of a specialist neurosurgeon according to the Neurosurgical Society of Australasia (NSA) is to “treat conditions and diseases related to the brain, spine and nervous system.”

    Applicants are allowed a maximum of 4 attempts at selection into the NSA training program. For entry into the specialty neurosurgery SET applicants are required to have 24 weeks FTE of direct neurosurgical experience within the 3 years prior to application.

    Applicants must pay the $985 selection application fee prior to the application closing date. This fee pays for the neurosurgery anatomy examination which must be attempted prior to selection and a score over 70% must be achieved to pass.

    Referee requirements for neurosurgery SET require the reporting of every neurosurgical specialist who has been a direct supervisor of the applicant in the previous 3 years. 3 of the specialists will be selected at the NSA’s discretion to provide a referee report.

    Entry Requirements for Specialty Training in Orthopaedics

    The Australian Orthopaedic Association (AOA) describes an orthopaedic surgeon as “a medical doctor with extensive training in the diagnosis and surgical, as well as non-surgical, treatment of the musculoskeletal system.”

    Applicants are allowed a maximum of 3 attempts at selection into the AOA training program. The experience requirements for specialty orthopaedic training involves a minimum of 26 weeks FTE orthopaedic surgical experience within 2 years of application, made up of rotations of at least 6 weeks duration. Experience must be completed during PGY 3 or later.

    All applicants must also complete a Radiation Safety Course, licenced in the state of their application.

    The referee requirements for AOA SET involves providing a ‘departmental referee report’ from all orthopaedic rotations completed in the past 2 years. The ‘departmental referee report’ is a single report per rotation completed involving the opinion of the surgical team and non-surgical colleagues working with the applicant during the rotation.

    The Selection Application Fee of $1,480 must be paid prior to the application due date.

    Entry Requirements for Specialty Training in Otolaryngology

    According to the Australian Society of Otolaryngology Head and Neck Surgery (ASOHNS), otolaryngologists are “specialist Surgeons who investigate and treat conditions of the ear, nose, throat, and head and neck”.

    Applicants are allowed a maximum of 4 attempts for selection into the ASOHNS training program. The minimum experience requirements for application include 10 consecutive weeks in otolaryngology and 20 weeks of surgical experience completed in rotations of at least 10 weeks duration, completed 1 January 2019. Applicants must also have completed a rotation of at least 8 weeks duration in both a dedicated Emergency Department, and a dedicated Intensive Care Unit, but these rotations can be completed at any time from the first year post-graduation.

    Application processing fee of AUD $900 must be paid before the application due date.

    The referee requirements involve a minimum of 8 and a maximum of 12 referees who must all be surgical consultants who have directly supervised the applicant during a rotation of at least 10 weeks. All specialist otolaryngologists who have been supervisors during the required otolaryngology rotation must be included for reference.

    Entry Requirements for Specialty Training in Paediatric Surgery

    The Australian and New Zealand Association of Paediatric Surgeons (ANZAPS) website describes paediatric surgery as “the specialty that includes surgeons who have specialist training in the management of children who have conditions that may require surgery. Specialist paediatric surgeons manage non-cardiac thoracic surgery, general paediatric surgery and paediatric urology. Their responsibilities include involvement in the antenatal management of congenital structural abnormalities, neonatal surgery and oncological surgery of children.”

    The minimum experience requirements for the paediatric SET program involves 26 weeks FTE experience in any surgical specialty working at a registrar level, and at least 10 weeks of FTE experience in a paediatric surgery unit. Both must have been completed within the 3 years prior to application.

    Applicants must also show competence in a range of procedural skills and professional capabilities to be eligible for selection. These skills are recorded in a report provided by RACS which included 27 skills that applicants must get signed off by a surgical consultant who has supervised the applicant on a surgical rotation in the past 3 years.

    The referee requirements for the paediatric SET involves the submission of all supervising surgical consultants from all surgical rotations in the past 2 years, and from all paediatric surgical rotations at any time post-graduation. The selection board will then contact 3 consultants from this list for reference.

    The application fee is the RACS selection processing fee of $825.

    Entry Requirements for Specialty Training in Plastic and Reconstructive Surgery

    The Australian Society of Plastic Surgeons (ASPS) describes the role of a plastic surgeon on their website as, “a broad scope of practice from procedures to improve your aesthetic appearance to reconstructive surgery.”

    Applicants are allowed a maximum of 3 attempts for selection into the ASPS training program.

    The experience requirements for eligibility involves 3 specific rotations. The first is an Emergency Department or Intensive Care Unit rotation for a minimum of 8 weeks FTE completed at any time post-graduation. Second is a rotation with direct experience in Plastic and Reconstructive Surgery for a minimum of 10 weeks FTE at any time from first-year post-graduation but within 5 years of application. The final is a surgical rotation in any surgical specialty for a minimum of 26 continuous weeks, completed at post-graduate year 2 or later, but within 5 years of application.

    The Plastic and Reconstructive Surgery SET program requires a reference from 3 to 5 consultant surgeons, with direct contact with the applicant, from every surgical rotation of any surgical specialty completed in the past 3 years. It requires at least 1 reference from a clinical nurse who has worked directly with the applicant, for each surgical rotation of any surgical specialty completed in the last two years prior to application. It also requires a reference from all consultant Plastic and Reconstructive Surgeons from the most recently completed Plastic and Reconstructive Surgery rotation.

    An application fee of $860 must be paid at the time of application.

    Entry Requirements for Specialty Training in Urology

    The Urological Society of Australia and New Zealand (USANZ) describes the role of a urologist on their website as “surgeons who treat men, women and children with problems involving the kidney, bladder, prostate and male reproductive organs. These conditions include cancer, stones, infection, incontinence, sexual dysfunction and pelvic floor problems.”

    The minimum experience requirements for eligibility for an application involves 26 weeks of Surgery in General at PGY2 or above, a further 26 weeks in Urology at PGY 2 or above and 10 weeks in Emergency medicine at PGY 1 or above. All experience must be completed in rotations of a minimum of 6 continuous weeks. The Surgery in General requirement can only be met on a surgical rotation in the specialties of General Surgery, Acute Surgical Unit, Breast and Endocrine, Colorectal, Surgical Oncology, Transplant, Trauma, Upper GI/Hepatobiliary, Vascular Surgery, Paediatric Surgery or Urology (cannot also count as the urology specific rotation).

    Eligibility for an application requires references from 8 consultants and 6 allied health professionals. The consultants must have been direct clinical supervisors during any rotation in the last 3 years, they can be surgical or non-surgical consultants. Of the 8 nominated, 6 are the primary referees and 2 will be reserve referees. No more than 3 consultants nominated as primary referees can be from rotations undertaken during the same year. The allied health references are divided into 4 primary referees and 2 reserve referees. Eligible allied health is ideally a senior nurse with direct and regular clinical interactions with the applicant during a rotation, though other allied health professionals can be nominated if there is proof of significant clinical interaction between the nominated referee and the applicant.

    An application fee must be paid before the application due date. There is no current indication of the cost of this fee.

    Entry Requirements for Specialty Training in Vascular Surgery

    The Australia and New Zealand Society for Vascular Surgery (ANZVSV) describes Vascular Surgery as “a specialty of surgery in which diseases of the vascular system, or arteries and veins, are managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction. The SET Program in Vascular Surgery is designed to provide trainees with clinical and operative experience to enable them to manage patients with conditions that relate to the specialty”.

    The experience requirements for Vascular surgery involves 8 weeks of General Surgery, 8 weeks of Intensive Care, and 16 weeks of Vascular Surgery completed within the last 5 years prior to application. Experience can be completed in no more than two rotations for each requirement, and rotations must be at least 4 weeks in duration. The Vascular Surgery rotation must have at least 2 specialist Vascular Surgeons employed at the hospital to be eligible.

    The referee requirements for the ANZVSV training program is a minimum of 7 and a maximum of 10 supervising surgical consultants, with at least 2 being Vascular Surgery Consultants. At least 1 and a maximum of 3 referees must be nominated from each surgical rotation listed on the application.

    An application fee must be paid before the application due date. There is no current indication of the cost of this fee.

    Ophthalmologist

    Royal Australian and New Zealand College of Ophthalmologists (RANZCO)

    According to the RANZCO website, “the objective of the Vocational Training Program (VTP) is to produce a specialist ophthalmologist who, on completion of training, is equipped to undertake safe, unsupervised, comprehensive, general ophthalmology practice… Training and assessment through the VTP continues to produce ophthalmologists of the highest order through the seven key roles that underpin the selection of trainees. These are ophthalmic expert and clinical decision-maker, communicator, collaborator, manager, health advocate, scholar, and professional.”

    The RANZCO Vocational Training Program is a minimum of 5 years of training. Two years of Basic Training in ophthalmic science and clinical skills, two years of Advanced Training to integrate knowledge and surgical skills, and one year of Final Year Training to develop the trainee into an independent ophthalmologist ready for independent practice.

    Entry Requirements for Specialty Training in Ophthalmology

    Application to the Vocational Training Program is open to all Australian citizens or permanent residents with a medical degree and general registration in Australia. And have completed a minimum of two years of post-graduate experience, at least 18 months of which cannot be in ophthalmology. The RANZCO encourages a broad range of experience for their trainees.

    Entry into RANZCO is under review. But for 2022 will likely involve an application process and scoring of references as well as a situational judgement test. The results of this process will determine which candidates progress to a binational coordinated multiple mini interviews (MMIs).

    Candidates who are successful in the MMIs finally progress to State or jurisdictional interview panels where they are interviewed again for specific posts.

    Obstetrician and Gynaecologist with pregnant woman

    Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG)

    RANZCOG’s website says that “Doctors hoping to become specialists in O&G have an interest in pregnancy, childbirth and the reproductive health of women.” The role of a specialist Obstetrician and Gynaecologist is to hold “the overall responsibility for the care of each patient referred to them. Specialists may lead a team of trainee doctors and are responsible for their training, as well as managing the patients that the trainee doctors see. They also have managerial, educational and organisational roles and will usually have a special area of interest.”

    The RANZCOG Training program is a minimum of 6 years of training comprised of 4 years of the Core Training Program and 2 years of the Advanced Training program.

    Entry Requirements for Specialty Training in Obstetrics and Gynaecology

    Applicants are allowed a maximum of 3 attempts for selection to the RANZCOG specialty training program.

    Eligibility for the training program requires applicants to be Australian Citizens or permanent residents with general registration in Australia who have graduated with a primary medical degree or successfully completed the AMC certificate.

    Applicants must be PGY2 or above to start on the training program, and have secured an accredited training position in Australia with approval to undertake training.

    Applicants are required to provide a minimum of 2 and a maximum of 4 referees for application. Ideally 2 should be Fellows of the RANZCOG, however, if that cannot be achieved, RANZCOG trainees in advanced training are eligible to be referees, or otherwise any other specialist consultant from another specialty who the applicant has close clinical contact. If the applicant has completed a prevocational Obstetrics and Gynaecology rotation of minimum 6 months in the last years, the RANZCOG selection board will also contact the department worked in for reference.

    The application fee is $803 with an additional fee for the interview being $1,242.

    Psychiatrist

    Royal Australian and New Zealand College of Psychiatrists (RANZCP)

    The RANZCP website describes the role of a psychiatrist as, to: “listen to and provide expert care for vulnerable people and their families and whanau; prevent, diagnose and treat mental health conditions; lead teams of other doctors and health professionals; research to lead breakthroughs in psychiatry and mental health; foster new generations of psychiatrists; provide expert opinion to the community, government and courts.”

    The RANZCP Fellowship Training program is a minimum five-year course divided into three stages. Stage 1 is 12 months of adult clinical psychiatry including a minimum of 6 months in an acute setting. Stage 2 is 24 months divided into 6 months of consultation-liaison psychiatry, 6 months of child and adolescent psychiatry, and two 6-month rotations from any of addiction, adult, forensic, indigenous, or old-age psychiatry. Stage 3 is 24 months of training divided into 4 6-month rotations into any RANZCP-approved areas of practice. The assessments for the program include workplace-based assessments, written exams, OSCEs, a written case, and a research project.

    Entry Requirements for Specialty Training in Psychiatry

    Eligibility for the program requires general registration in Australia, a primary medical degree and the completion of PGY1 or later at the time of starting training. Applicants must be appointed to an accredited training post and then selected to enter the Fellowship Training Program and pay the initial registration fee of $702.

    Radiologist

    Royal Australian and New Zealand College of Radiologists (RANZCR)

    The RANZCR is comprised of the Faculty of Clinical Radiology and the Faculty of Radiation Oncology.

    According to the RANZCR website, the role of a Clinical Radiologist is “a specialist medical doctor who has had postgraduate training in performing and interpreting diagnostic imaging tests, and carrying out interventional procedures or treatments, using X-ray, ultrasound, and magnetic resonance imaging equipment.”

    The role of a Radiation Oncologist is “a specialist doctor who uses radiation therapy in the treatment of cancer patients. Radiation oncologists work in teams with other doctors to create and deliver radiation therapy programs.”

    Both the Clinical Radiology and Radiation Oncology training programs are a minimum of 5 years of training and can be applied for directly through the RANZCR website. The requirements for entry to both training programs are the same.

    Entry Requirements for Specialty Training in Clinical Radiology

    Applicants must have completed a recognised primary medical qualification and obtained general registration in Australia. Applicants must have completed PGY2 or above before beginning training.

    A Review Application fee of $1000 is required to be paid at the time of application.

    Applicants are then able to apply for an accredited training position in Australia

    Entry Requirements for Specialty Training in Radiation Oncology

    Applicants must have completed a recognised primary medical qualification and obtained general registration in Australia. Applicants must have completed PGY2 or above before beginning training.

    A Review Application fee of $1000 is required to be paid at the time of application.

    Applicants are then able to apply for an accredited training position in Australia

    Pathologist

    Royal College of Pathologists of Australasia (RCPA)

    The role of a pathologist is described on the RCPA website as “specialist medical practitioners who study the cause of disease and the ways in which diseases affect our bodies by examining changes in the tissues and in blood and other body fluids. Some of these changes show the potential to develop a disease, while others show its presence, cause or severity or monitor its progress or the effects of treatment.”

    The RCPA training program is a minimum of 5 years of experience in accredited laboratories. The training program offers the opportunity to train in General or Clinical Pathology, or to elect to train in a specific discipline of Anatomical Pathology, Chemical pathology, Genetic Pathology, Forensic pathology, Haematology, Immunopathology or Microbiology.

    Trainees can also elect to do a dual Fellowship with the RACP if they have chosen to train in Chemical pathology, Haematology, Immunopathology or Microbiology.

    Before applying for the RCPA training program, applicants must be working in an accredited training position.

    Entry Requirements for Specialty Training in Pathology

    Applicants must have graduated with a recognised primary medical degree from Australia, or have a primary medical degree obtained outside Australia and have completed the AMC certificate. Trainees must have general registration in Australia and have completed a minimum of 2 years post-graduate clinical experience in any specialties.

    Payment of the registration fee of $110 and annual training fee of $1375 is required to be paid pa prior to 2 months of starting training.

    The Basic Pathology Sciences examination is not a requirement for entry to the RCPA training program.

    Dental Surgeon

    Royal Australasian College of Dental Surgeons (RACDS)

    The RACDS describes the role of an oral maxillofacial surgeon on their website as a specialist in “the oral and maxillofacial regions of the neck and head. They diagnose and treat problem wisdom teeth, facial pain, and misaligned jaws.  They also treat accident victims for facial injuries, carry out reconstructive and dental implant surgery, treat tumors, developmental craniofacial abnormalities of the jaws or facial regions.”

    The program is 4 years of clinical education and training in accredited teaching hospitals. The assessments for the program involve a Surgical Science and Training Examination in the first year and a final examination for Fellowship as well as work-based assessments throughout.

    Entry Requirements for Specialty Training in Oral Maxillofacial Surgery

    Applicants to the RACDS training program must hold an accredited training position to be accepted into the program. They must be Australian citizens or permanent residents with General Medical and Dental Registration in Australia. They must have completed both a recognised medical degree and dental degree to be eligible.

    The experience requirements for eligibility are 1 year of Surgery in General with a minimum of 9 months in a related surgical discipline (ENT surgery, orthopaedic surgery, neurosurgery, ophthalmology, general and trauma surgery, plastic and reconstructive surgery, ICU, Anaesthetics and Emergency medicine).

    A fee for Application for Selection into OMS Training Program of $1800 is due at the time of application.

    Disclaimer.

    This information is current as of the 2021 applications for 2022. All costs are in Australian Dollars and include GST where applicable.

    Links have been provided where available to the relevant sources of information on College websites.  If you are set on a specialty already, follow the links and read the detailed information on how to accrue points for your CV. This is another important consideration for Specialty Training that you should start to think about as soon as you know what you want to do. If you notice a broken link or information out of date, please let us know.

    Related Questions.

    What sort of medical registration do I need to undertake specialty training in Australia?

    You will generally need general registration in order to undertake specialty training in Australia.
    The exception is some of the pathways to general practice.
    Medical registration in Australia is conducted through the Medical Board of Australia (MBA) and has 6 types of registration: General, Specialist, Provisional, Limited, Non-Practising and Student. General registration is provided to Australian or New Zealand medical graduates, doctors previously with general registration and international medical graduates in the competent authority pathway or who have an AMC certificate. Specialist registration is granted to medical practitioners eligible for fellowship with one of the specialist colleges. Provisional registration is granted to medical practitioners requiring a period of supervision before receiving general registration. This applies to  Australia or New Zealand medical graduates currently undertaking internship in Australia, or have completed their internship outside of Australia. International medical graduates eligible for the Competent Authority Pathway, or in the Standard Pathway with an AMC certificate. Limited registration applies to medical practitioners with qualifications outside Australia or New Zealand and it can be granted for applicants applying for postgraduate training, working in an Area of Need, for the public interest, or for teaching and research.

    Will I get paid for doing specialty training?

    Generally, you will be paid for undertaking specialty training in Australia. And you should receive the same rates and conditions of employment as other equivalent doctors you work alongside.
    There are some situations where you may not receive a payment. These include fellowship arrangements where an institution in another country may have a relationship with a hospital in Australia. You should be wary of any employer offering for you to work for them on a voluntary basis.

    How much do I get paid when I do specialty training?

    Salaries can range between States and Territories. For hospital-based positions, you can generally expect a starting salary somewhere between $90,000AUD and $160,000AUD depending on your seniority. Bear in mind that on-call and overtime can hugely increase these salaries. You can read our guide on trainee doctor salaries here.

    Do I need permanent residency or citizenship to apply for specialty training?

    As outlined above the majority of training programs will accept suitable applicants with relevant visas. However, there are some colleges that do require you to also have citizenship or permanent residency. At the time of writing this blog, these colleges are RACS, ACSEP, ACD, RANZCO, RANZCOG and RACDS.

  • How to Pass the AMC Clinical Exam. First Time Success Guide.

    How to Pass the AMC Clinical Exam. First Time Success Guide.

    An AMC Part 2 Clinical OSCE Examination Study Guide

    Imagine having spent 6 to 7 years of medical school and tens of thousands of dollars on examinations, tuition, and books in order to gain your first doctor job in Australia. Imagine doing well on all these other exams but failing in one final exam. And failing this exam is severely impacting your chances of gaining a job in Australia. If you are wondering what examination I am talking about, it’s known as the Australian Medical Council Part 2 Clinical OSCE examination. The AMC Clinical Exam has a reputation of being one of the most difficult medical assessment examinations, and one that International Medical Graduates (IMGs) frequently underestimate. This error has led to many candidates failing this examination. This situation is even more painful when you learn that the AMC clinical exam is in fact a straightforward examination to study for, and it requires nothing more than readily available medical knowledge, practice and organization.

    Before diving into tactics and strategies. Here’s a brief overview of the AMC clinical exam:

    • The AMC Clinical Examination is the second of two examinations that comprise the AMC Clinical Certificate. The AMC Clinical Certificate is a prerequisite for many IMGs in order to gain general registration in Australia.
    • The AMC Clinical Exam is set at the standard of a final year medical student in Australia.

    Play the AMC Clinical Exam by the rules.

    The AMC clinical exam is like a game, you need to play by the rules. I have heard others say it is like a dance and you have to know the steps well.

    The exam itself is set at the standard of a final year Australian medical student (and the AMC calibrates its exam questions against Australian medical schools). The exam, therefore, is quite “doable” with the appropriate preparation and understanding of its nature.

    Many IMGs love the format of this examination. They get to interact with standardized patients and diagnose their problems. The play-acting element makes the AMC clinical exam quite interesting, but that doesn’t mean it’s easy to pass.

    And even though you can take the AMC Clinical Exam again if you fail. Clearing it the first time around gets closer to your goal of a medical career in Australia.

    Preparing for the Australian Medical Council Part 2 Clinical OSCE examination can be frustrating. You know it’s a graded pass or fail and that there is a low pass rate. It is expensive and takes a lot of your time away from other pursuits, so no one wants to deal with taking it more than once.

    Here I have assembled the most important pieces of advice for International Medical Graduates who are thinking about or preparing for the Australian Medical Council Part 2 Clinical OSCE examination.

    Format of the AMC Clinical Exam

    The AMC Clinical Exam is a 3 hour and 20-minute examination. That tests for skills necessary for a doctor to work under supervised clinical practice. This is done using 16 different simulated clinical scenarios.

    Most of the time, the scenario is pretty straightforward, you’re a physician meeting a patient in an office that is presenting with some sort of problem that you are asked to address.

    A clinical encounter usually consists of a patient-centred interview, physical examination, sharing your clinical impressions and further workup required, and patient counselling and education.

    The examination assesses your command of the spoken English language, measuring clarity, pronunciation, word choice, and how easily patients can understand your questions or statements. It also assesses your communication and soft skills, including how well you provide information to patients, whether you put them at ease, helped with making decisions, etc.

    Last but not least, the AMC Clinical Exam assesses your clinical reasoning through data collection and data analysis by requiring you to take a focused history driven by a differential and conducting a focused physical examination.

    You will deal mainly with role players and usually the examiner does not ask any questions but just observes your performance. There are sometimes real patients with, for e.g., rheumatoid features, cardiac murmurs, peripheral neuropathy, joint problems, liver symptoms but they are a rarity.

    In general, the patients and examiners are very supportive and want to help you even though you might not believe this. So please listen to them carefully, they often try to give you valuable hints. On many occasions, there is a second examiner present who is there to assess the process of the examination itself and rotates through the stations. The examiner does not judge your performance, so please do not worry about their presence.

    AMC Clinical Exam

    Textbooks for the AMC Clinical Exam

    It is important to remember that the Australian Medical Council Part 2 Clinical OSCE examination assesses your knowledge of the most common diseases in Australia.

    Australian Handbook of Clinical Assessment

    Finding the perfect resource is crucial. The Australian Handbook of Clinical Assessment is by far the most important resource to passing this examination. It should take under 4 days to get through this book. This book includes detailed sample cases for the majority of cases encountered in Australia. It gives you a very comprehensive explanation of the examination process, has incredibly important hints for the different clinical areas with fantastic examples with detailed explanations of all aspects of the scenario.

    Each chapter is prefaced with the most valuable explanatory notes which I encourage you to read thoroughly.

    A great example is an introduction to “The Psychiatric Consultation” which covers in a very brief and precise way what you are expected to consider when examining a mental health patient. I recommend being aware of topics but working through them in a thorough way, realizing that a scenario can easily change.

    For example, Right Lower Quadrant pain in a female patient might be appendicitis in one exam but could be ectopic, a twisted ovarian cyst, renal colic, or domestic violence in another examination.

    You need to have a good understanding of the underlying issues.

    The examiner will generally know very quickly if a candidate has just rote learned a case, and is regurgitating facts, but not demonstrating a thorough understanding of the case.

    I believe that the publication of this particular book has allowed International Medical Graduates to understand the nature and requirements of this examination much better than ever before and it is really important to know about the expectations and to understand the importance of for example critical errors.

    Key Components of AMC Clinical Exam Stations

    Differential Diagnosis

    Reaching a diagnosis involves the process of establishing a “differential diagnosis,” in which all possibilities for a patient’s symptoms are initially considered.

    The possible causal factors are then narrowed down through a systematic collection of information, which makes some diagnoses more likely and rules out others.

    The goal of differential diagnosis is to systematically collect information on the pattern of symptoms to allow you to accurately diagnose what is causing them. Knowing the key buzzwords for the prototypic cases is necessary to nail the diagnosis.

    If in one station you are presented with a 40-year-old female patient with right upper quadrant pain who happens to be obese, you will right away think Cholecystitis. But there are still other diagnoses to consider in this scenario.

    Having someone else quiz you on differential diagnosis tables or challenging yourself by covering up part of the information is useful. So I would recommend studying differential diagnoses from the very beginning of your preparation period, and follow up 1-2 days before you take the examination to keep them fresh in your mind.

    History Taking

    For history taking, it is useful to memorize a skeleton to structure your history-taking. It is generally expected that you cover every category, even if superficially, with every patient, just like in real life. Different categories will yield richer information with different patients. Here is an example structure:

    • Chief Complaint
    • History of Present Illness
    • Review of Symptoms
    • Past Medical History
    • Past Surgical History
    • Social History: Living Situation / Drugs-Alcohol / Sexual History / Smoking
    • Family History
    • Medications
    • Allergies

    All of this should be addressed with every patient and should be recorded in your notes, even if very briefly. This is the basis of the first part of the encounter.

    Physical Examination

    The best way to prepare for the actual physical examinations manoeuvres is to study with a partner. I recommend using the Oxford Handbook of Clinical Examination and Practical Skills to brush up on physical examination skills. A YouTube search will get you to what you’re looking for as well.

    Study Partners and Flash Cards

    I know of many International Medical Graduates who have tried to practice for the AMC Clinical Exam by using Skype or over the phone but the problem is that you do not get to interact face to face and in person with your study partner, and that’s what the AMC Clinical Exam is currently all about. Although it should be noted that the AMC is now establishing a virtual clinical examination.

    If at all possible, rather than practising over a video chat or phone call, work on practice cases in person with other International Medical Graduates, family members, or friends.

    Your live partner does not have to be a doctor, or even in a medical field, all you need is someone to practice with or on. This way, you can try out your communication and interpersonal skills before facing standardized patients during the actual examination.

    Ideally, you have a third partner who can keep time and give feedback about issues like time management and communication skills.

    I suggest practising AMC Clinical Exam long cases with a partner at least twice, and then create flashcards for all the cases.

    Include the patient’s name, age, primary complaint, and vital signs on each of these cards, shuffle them and practice again.

    Since you won’t know which specific cases will show up on your AMC Clinical Exam, shuffling the flashcards simulates a random selection process, which is similar to what you’ll experience on your examination day.

    Also, if you don’t perform well in a certain case then put the corresponding flashcard in a different batch. Ideally, you should organize a real trial exam of a number of cases in a row with your partners, in order to simulate the actual AMC Clinical Exam.

    Try to get as real and authentic as possible. For example, hang the stem to the station on the wall or a door and pretend that you come into the examination room. It helps you to understand the pressure of the exam and to learn how to put a bad performance behind you.

    Time Management for the AMC Clinical Exam

    It is important to time yourself while practising. You cannot perform well if you don’t know how to stick to the time limits. You might think you are going to do okay even without practicing with a timer, but in reality, on the day of the examination, you will be too nervous and stressed to even think about time.

    But if you have practised all of your cases with a timer then your brain will be much better at managing the time for you. Therefore you will have one less problem to worry about, which will enhance your performance.

    Be aware that sometimes there will be a bell ringing during the exam and the examiner might interrupt you after 4 minutes to say “Please move on to your next task” or “It is time to move on to your next task”.

    The Importance of Empathy in the AMC Clinical Exam

    As funny as this may sound, remember that being “human” gets you points in the AMC Clinical Exam.

    Empathy is something many medical associations feel is lost in patient encounters in the new generation of doctors and is something the panel wants you to demonstrate to your patients.

    When you practice before your examination, remember to flex your empathy muscle and make sure your “patient” feels heard and supported.

    Practice PEARLS in each of your patient encounters: Partnership, Empathy, Apology, Respect, Legitimisation, and Support.

    What To Do A Few Days Before The AMC Clinical Exam Day

    The AMC Clinical Exam can be tough if you haven’t developed the stamina for it.

    To prepare for the real thing, I suggest selecting 16 sample cases from amongst the ones you find most difficult and practice performing them a few days before the examination.

    Do this with the same time limits and allotted breaks that you would face on the examination day so they can stay fresh in your mind.

    Simulating the actual exam will give you a really good idea of how rough the exam day is going to be. This will also, allow your brain and your body to adjust and make you more ready and energetic on the day of your AMC Clinical Exam.

    Relying on too many study resources will just leave you overwhelmed. The only primary resources I believe that you need are mentioned in this post.

    We are all different and will experience different emotional and physiological responses to the examination stress, which also influences our social and family environment. Many candidates exhibit symptoms of anxiety or sometimes even depression which needs to be addressed possibly with a referral to a counsellor.

    A healthy balance of mind and body is important and can be supported by relaxation techniques, massage, physical fitness exercises, etc.

    If you’re travelling to the AMC Clinical Exam interstate, allow sufficient time to familiarize yourself with the location of the examination centre. Make sure to have a relaxing evening before the examination day, that might include a massage, a romantic dinner, a walk on the beach, a concert, or whatever tickles your fancy.

    Do not study on that day, what you haven’t learned by then would not be something you would catch up with tonight.

    What To Do On The Day Of The AMC Clinical Exam

    On the day of your AMC Clinical Exam, you should have a good breakfast. Pamper yourself, put your favourite make-up on, dress up a bit, wear loose clothing, most of us start to get very nervous and to sweat a bit and no doubt you’ll feel uncomfortable if you have tight-fitting clothes on with a sweat stain under your arms.

    Try to stay calm and remind yourself that these patients are only actors and they are not sick. The AMC provides all the necessary tools. However, you might have to ask for them and then the examiner will produce them for you. In some stations, things are on the desk and you just have to grab them and it is surprising how often a candidate will not use the provided things, such as cotton wool for sensory testing, etc.

    However, remember to bring the following items to the examination centre:

    • Confirmation notice
    • Unexpired Primary Identification bearing your name, photo, and signature
    • Comfortable professional clothing
    • Clean white lab coat
    • Standard Non-Enhanced Stethoscope

    The following items are not permitted in the AMC Clinical Exam:

    • Electronic devices such as beepers, recorders, watches, cameras, cell phones and other devices
    • Study materials: any type of notes, reading materials and study summaries
    • Other medical equipment

    Carefully Read the Stem of Every AMC Clinical Exam Station

    While reading the stem, every word has a meaning.

    If the stem mentions that a male patient is an abattoir worker, this can be an extremely important fact that. For e.g., he might suffer from Zoonosis, a disease transmitted by working with animals.

    If the stem says that a female patient is on tamoxifen, she probably has or had breast cancer.

    If you are not sure about any aspect regarding the stem, you will have an opportunity to ask the examiner for clarification. The scenarios are usually single topic stations, so the main diagnosis will be apparent fairly early on.

    If, for example, it seems to be a case of cholecystitis, try to demonstrate an organized, structured, and focused approach, honing in on the main problem. However, keep an open mind and talk about differential diagnoses as well, because you might just think it is “cholecystitis” but in reality, it might be pancreatitis or something else.

    This becomes especially important if the patient or the examiner makes comments like: “Dr. last time I had cholecystitis, it felt quite different.”

    Prick up your ears and rethink if the patient is trying to give you a hint that this case is something different.

    Occasionally, one station can contain two separate issues. For example, a paediatric case might be complicated by a parent with a psychiatric or social problem and you might be expected to cover both topics.

    If you deal quite well with the paediatric component but ignore the parent’s drinking problem you could still be at high risk of failing the station.

    In summary, in most stations, you should have a good idea about the task and a well-structured plan of approach in your head at the end of the reading time.

    How to Approach the Patient in the AMC Clinical Exam

    Demonstrating good communication skills, empathy and patient-centredness is an important component of the AMC Clinical Exam. To open the encounter with the patient, I would like to recommend the GRIPS approach:

    G: Greet the Patient

    R: Build a Rapport with the Patient

    1. Introduce yourself and state your position as a doctor
    2. Ensure Privacy
    3. Social Courtesy

    In simple words, greet the patient, smile, and introduce yourself, state your purpose, ensure the patient is comfortable and make good conversational history.

    (Note: Prior to COVID-19, it was generally a good idea to offer to shake the patient’s hand. I would advise against doing this now. Instead, look for a bottle of antibacterial liquid and make a deliberate show of using good hand hygiene).

    Here’s a basic outline:

    1. Knock on the Door Before Entering the Room
    2. Enter the Room
    3. Clean your Hands
    4. Introduce Yourself, “Hello Mr / Ms ______. My name is Dr ____. I’ll be taking care of you today. What brings you in?
    5. Patient: “ABC
    6. You: “Is there anything else you wanted to address today?
    7. Patient: “ABC
    8. You: “That sounds very important. I’m glad you came in today. Could you tell me more about ABC?

    History Taking in the AMC Clinical Exam.

    When taking a history be mindful of your body position, sit upright with an open stance towards the patient, but not too close, and relax, that way you appear more confident. Keep your back straight, lean forward a little bit, and keep your arms relaxed in your lap or on the desk. Try to be super nice to your patients but don’t be fake. It is really important to form a doctor-patient relationship, this is why eye contact and smiling are essential.

    Relax your facial muscles and smile (but not in breaking the bad news stations). Speak, not too fast, avoid being monotonous, and don’t be too loud. Use a moderately pitched, soft voice. It is very useful to ask one or two non-medical-related questions during some of my patient encounters. Show genuine empathy and build rapport, for example, by asking about kids’ names, education and how they like their job where appropriate.

    If, for example, your patient is a retired music teacher, ask her what type of musical instruments he/she plays or which instrument is his/her favourite.

    Just by asking these simple questions, your patient will feel much more comfortable for the rest of your encounter and they might even give you a few hints here and there.

    Let the patient speak as much as possible, and use as few questions as you can. “Could you tell me more about the pain?” ends up being much more efficient than “Did the pain radiate anywhere?”.

    Although of course if it’s an important question and the patient has not elaborated you can be more specific.

    Where appropriate, you can ask how an issue has affected someone’s life. This can lead to appropriate referrals that will help a patient be compliant with treatment.

    Try not to interrupt the patient although you might have to interrupt if the patient goes on and on. If they use terms that you don’t understand, ask them for an explanation. Continue to work your way through the skeleton as above. Make sure you’ve covered all of the elements mentioned above before you move on to the exam.

    Summarize your understanding of the history of the present illness and ask if there is anything he or she would like to add. This reinforces to patients that you are listening to what they are saying. It’s perfectly appropriate to finish with a few quick and direct questions.

    Before commencing your physical examination at each AMC Clinical Exam station, encourage the patient to ask questions whenever possible. They are there to help you and might put you on the right track or give you clues in which direction to go.

    You might ask the patient “Now if it’s okay with you I would like to do a few physical examinations to help me narrow down my diagnosis, but before I proceed is there anything that you feel might be important that you would like to mention?” or “Any questions you want to ask me?” or “Anything else you want to tell me?”.

    Some patients will give you a few hints but others will not, which is fine because this question only takes a few seconds to ask and it can help you if you have somehow missed asking something very important.

    One important thing in the history station is to respond to the patient’s complaints. For example, if he or she has got pain, you could ask the examiner to provide painkillers, or if the patient has photophobia you might offer to dim the lights in the room.

    If the patient is forgetful or confused, they will likely answer your questions by stating, I don’t know or I can’t remember. In such cases, ask your patient, “Is there anyone who knows about your problem, and may I contact him to obtain some information? “ If the patient doesn’t know the names of their medications or is taking medications whose names you don’t recognize: Ask the patient if they have a prescription or a written list of the medications. If not, ask them to bring their list with them as soon as possible.

    If the patient is hard-of-hearing, face the patient directly to allow them to read your lips. Speak slowly, and do not cover your mouth. Use gestures to reinforce your words. If the patient has unilateral hearing loss, sit close to the hearing side. If necessary, you can also write your question down and show it to them.

    If you encounter a crying patient, allow them to express their feelings, and wait in silence for them to finish. Offer them a tissue, and show empathy in your facial expressions.

    With the current pandemic situation, it’s probably best to avoid reassuring gestures such as placing your hand lightly on the patient’s shoulder or arm.

    Don’t worry about time constraints in such cases? Remember that the patient is an actor and that their crying is timed for a certain amount of time. They will allow you to continue the encounter in peace if you respond correctly. If the patient is angry, stay calm and don’t be frightened. Remember that the actor is not really angry, they are just acting angry to test your response.

    Let the patient express their feelings, and inquire about the reasons for anger. You should also reasonably address the patient’s anger.

    For example, if the patient is complaining that they have been waiting for a long time, you can validate their feelings by saying, “I can understand why anyone in your situation might become angry under the same circumstances. I am sorry I am late. The clinic is crowded, and many patients had appointments before yours.

    Reassure the patient that now that it is their turn, you will focus on their case and take care of them.

    If the patient is anxious, encourage them to talk about their feelings. Ask about the things that are causing the anxiety. Offer reasonable reassurance. You can also validate the patient’s response by saying, “Any patient in your situation might react in this way, but I want you to know that I will do my best to address your concerns.

    Performing a Clinical Examination in the AMC Clinical Exam.

    Before you touch the patient, wash your hands with soap and dry them carefully. Make sure your hands are warm, so rub your hands together if they are cold.

    Similarly, rub the diaphragm of your stethoscope to warm it up before you use it. Do not auscultate or palpate through the patient’s gown.

    As you proceed, be sure to ask the patient’s permission before you uncover any part of his or her body (eg, is it okay if I untie your gown to examine your chest? or can I move the sheet down to examine your belly?).

    You may also ask patients to uncover themselves. But you should expose only the area you need to examine. Do not expose large areas of the patient’s body at once.

    After you have examined a given area, cover it immediately. If the patient refuses to let you physically examine them, don’t push.

    What to do if a Patient Refuses a Physical Examination.

    A patient in severe pain may initially seem unapproachable, refuse a physical examination, or insist that you give them something to stop the pain first. In such cases, show compassion for their pain. Say something like “I know that you are in pain.” Offer help by asking, if there is anything you can do to help them feel more comfortable?

    It’s good to ask if the patient has taken any painkillers in the past few hours and if they are allergic to any painkillers before you prescribe any.

    Then ask the patient’s permission to perform the physical examination first then offer painkillers next. If the patient refuses, gently say, “I understand that you are in severe pain, and I want to help you. The physical examination that I want to do is very important in helping determine what is causing your pain. I will be as quick and gentle as possible, and once I find the reason for your pain and to reach the diagnosis, I should be able to give you something to make you more comfortable.”

    If the patient still refuses to cooperate, skip the physical examination or manoeuvre, and document the fact they declined the exam.

    Conducting the Physical Examination.

    During the physical examination, always examine the heart and lungs, even if very briefly.

    Then move on to examining the system of interest to the chief complaint, eg abdomen, shoulder, neurologic, etc.

    In other words, the exam should consist of listening to the Heart and Lungs + “The system of interest” depending on the chief complaint.

    You can examine a body part that the patient says hurts.

    Be gentle, do not poke too hard, apologize or say something nice as you do it, and do not repeat a painful exam manoeuvre.

    If you see a scar, a mole (nevus), a psoriatic lesion, or any other skin lesion or bruise during the physical examination, you should mention it and ask the patient about it even if it is not related to the patient’s complaint and think about abuse as a possible cause.

    When doing a physical examination, it’s often easy to get wrapped up in thought and not explain what it is you’re doing. Thus, you should show and describe that you’re performing a particular exam.

    For example, if performing an abdominal exam and observing the patient’s abdomen, an out-loud statement of “Your abdomen doesn’t look distended, and there doesn’t appear to be any bruising” may earn valuable points as an alternative to simply staring at their abdomen for a few seconds.

    Please note that you cannot do the following physical examinations in the AMC Clinical Exam:

    • rectal
    • pelvic
    • genitourinary
    • inguinal hernia
    • female breast
    • corneal reflex examinations.

    If you believe one or more of these examinations are indicated, say them to the examiner.

    Physical Examination in the Online Version of the AMC Clinical Exam.

    During the online format of the examination, you cannot perform a physical examination but you have to ask the examiner for the findings.

    Please use the same approach.

    Firstly tell the patient that you will ask the examiner for the findings and then be pleased to the examiner and it does not hurt to say “Thank you” at the end.

    Regarding the vital signs, the examiner will normally provide pulse, blood pressure, respiratory rate, oxygen saturation, and temperature but you should always specifically ask for them.

    However, if you suspect a possible difference in e.g. blood pressure in the right and left arm, or if you expect an orthostatic or if there is a chance of coarctation of the aorta, you will have to specifically request the specific corresponding findings like blood pressure in right and left arm, blood pressure while lying and standing and radial as well as femoral pulses.

    You need to realize that the examiner will only give you findings if you specifically ask. For example, it is pretty useless to ask “What are the findings on inspection of the abdomen?” or “Are there signs of liver failure?”, the examiner most likely will respond “What are you looking for?” This wastes a lot of time.

    Please ask straight away “On inspection, I am looking for distension of the abdomen.” The answer will be “It is” or “it is not.”

    Ideally, you should tell the examiner at the same time why you are performing an examination and what you expect to find and what the underlying problem could be, e.g. “I am looking for tenderness in the right iliac fossa over the McBurney’s point to confirm or exclude likely appendicitis.”

    After the physical examination, you must “close” the encounter with some kind of compassionate statement that acknowledges the patients’ frustration by sharing what you think might be going on, and some of the tests that you will order:

    • I’m so sorry you’re dealing with this back pain, it sounds frustrating
    • After hearing about your symptoms and doing the physical examination, I’m going to go over what I think might be wrong and what we can do to further figure it out.” This is a good indication of your intent to transition.
    • I’d like to order a few tests to address the most likely cause.”
    • Thanks again for your time. I’m very glad you came in today to get this taken care of.
    • Do you have any other questions or is there any other aspect of your health care we haven’t already discussed?

    If you don’t have time for a full mini-mental status exam, at least ask patients if they know their name, where they are, and what day it is.

    Note Taking

    During note-taking, do not make up history or physical examination findings. Only write information that you obtained. Note any pertinent positive or negative history or physical examination findings. Note the diagnostic tests that you recommend and make sure these directly address your differential. Do not order unnecessary tests that you cannot justify. Do not order invasive or expensive tests if you can achieve the diagnosis with a less invasive and/or less expensive test.

    Phone Cases

    The AMC Clinical Exam will also include one or two phone cases, where a patient or a patient’s relative calls you with certain symptoms.

    As with other encounters, patient information will be given before you enter the examination room. Once you are inside, sit in front of the desk with the telephone, and push the speaker button by the yellow dot to be connected to the patient.

    Do not dial any numbers or touch any other buttons. You are only permitted to call the patient once. Treat this as a normal encounter and gather all the necessary information. To end the call, press the speaker button above the yellow dot.

    As in the paediatric encounter, there is no physical examination. Here’s a basic outline:

    • Take a focused but thorough history.
    • Express empathy and use patient-centred communication skills.
    • Decide if the patient’s concern can be addressed over the phone or if the patient needs to come into the clinic or the Emergency Department to be seen in person.
    • In general, if the patient expresses pain, fever, wound redness or discharge after a procedure or surgery, then they likely need to be seen in person and examined.
    • When in doubt, ask the patient to come in to be seen. If you think that the patient needs to be seen in person, do not let them talk you out of it such as by saying it is too late at night, or that transportation is difficult, this is likely a distractor. So apologize for the inconvenience, explain to them your differential and why it is important to be assessed in person.

    Management and Counselling

    You should be able to establish a probable or even definite diagnosis after a proper interpretation of the history. Make sure you have a systematic approach and plan your approach to physical examination, investigations and management:

    • What would be the three most likely differential diagnoses?
    • What would be important to concentrate on in physical examination and investigations to confirm or exclude diagnoses?
    • Were there other important factors or risks in the patient’s history supporting one of the diagnoses over another?
    • How do you explain the diagnosis and differentials including prognosis and possible complications to the patient?
    • What is the most appropriate management for the main and other differential diagnoses, including lifestyle, counselling and prevention?

    Often the diagnosis is clear very early, so tell the patient what you suspect it is in lay language and terms the patient understands. Ask the patient if they know the diagnosis and what they know about it.

    If the patient seems hesitant to accept your diagnosis or advice, be prepared to change your mind if the evidence doesn’t support your diagnosis. This is very much a patient-centred examination and it is always appreciated if you draw a picture, a diagram or a decision tree as there are pen and paper on the desk to make your explanations clearer for the patient and the examiner and you can always add that you will give them a hand out to take home so they can remember what you said.

    Investigations

    Regarding investigations, it is not a good idea to ask for “Complete Blood Count, Electrolyte Sedimentation Rate, C-Reactive Protein, Urine Electrolytes, Liver Function Tests, etc.”

    It is best to be specific and indicate to the examiner the relevance of why you order the test, what you suspected and what the test results would mean for either diagnosis or management and treatment.

    Show perspective rather than ordering irrelevant and unnecessary tests!

    For example, don’t just order a complete blood count in a patient with a suspected chest infection. It is much better to focus on the white blood cells count to exclude leucocytosis.

    Order simple investigations first, especially office tests if applicable, and more complex investigations like CT and MRI will come later.

    The most valuable office tests are the urine dip-stick, urine pregnancy test and finger prick for glucose.

    Do not order unnecessary tests that you cannot justify.

    Do not order invasive or expensive tests if you can achieve the diagnosis with a less invasive and/or less expensive test.

    You should also explain to the patient the diagnostic tests you are planning to order. In doing so, you should again use lay language and terms.

    For example, we need to run some blood tests to check the function of your liver and kidneys, or you need to have a chest x-ray and a CT scan of the head.

    You might further explain the latter by saying, The CT scan is a form of x-ray imaging that gives us clear images of sections of the body.

    Specific Types of Patients You May Encounter in the AMC Clinical Exam.

    If you encounter a reserved, unemotional, or upset patient, remember that this is by design. Continue to engage the patient despite their difficult attitude. One of the best ways to do this is to describe your observation and ask them about it: “I see you are angry, would you like to talk about it?”, or “You seem quiet, is something bothering you?”

    If you encounter a patient who uses drugs, alcohol, or tobacco, you will not have time to counsel them on each issue, although you should address them directly. One possible way to do this is to say supportive words such as “I’d like to spend more time with you to discuss this. Will you be back in 3-4 weeks so we can discuss it then?”

    Wrapping Up With the Patient.

    Always state the plan in layperson terms and if the patient is comfortable with the plan moving forward. Don’t use medical jargon, but simple language.

    Sometimes you may want to use a medical term like “Subarachnoid Haemorrhage” to demonstrate your knowledge to the examiner. But you also have to explain in simple terms to the patient, i.e. that this is the space between the skull and the brain or ask the patient if s/he understands what you are talking about in the examination. The patient most likely will answer “Yes, I have heard that term before”, so there is no time wasted.

    Explain the treatment options including both pharmacological and non-pharmacological options.

    Explain red flags e.g. Hypoglycemia & Hyperglycemia in Diabetes & what to do if they happen.

    Always ask for their understanding and if the patient has any questions. Don’t be too firm in your advice to the patient, rather present options. It is the patient’s choice what they are comfortable with.

    Don’t be sucked in to say “Oh, yes, you definitely should have a hysterectomy” for example in menorrhagia. It is only one option of a range of management possibilities.

    Make sure the patient understands the options available to them clearly.

    If the patient does not accept your advice, e.g., Jehovah’s witness refusing to have a blood transfusion or have their children immunised, all you are expected to do in such a situation is to accept their point of view but to explain the issues and consequences to the patient.

    In rare circumstances, you might have to refer to a guardianship board.

    If the patient cannot pay for certain tests or treatments that may not be covered by Medicare, reassure the patient by saying, “Not having enough money doesn’t mean you can’t get treatment.” You might also add, “We will refer you to a social worker who can help you find resources.”.

    The comment of “Don’t worry” does not go down well with the patient because even it is a trivial problem, the patient would be worried and they would think that you just don’t understand their chief complaint which is not a good start to develop a doctor-patient relationship.

    Make Appropriate Referrals

    Never forget that you’re acting as an intern or a junior medical officer. Don’t hesitate to ask for help or a second opinion from a senior doctor. At least mention that you would ask or check with them if you’re unsure. In some stations, it’s important to refer the patient to a specialist.

    But. do not refer a patient to a senior doctor without explaining to the patient exactly what will happen. It is a mistake to try to get out of a situation by saying “I’ll refer you to the orthopaedic surgeon.”. You have to be quite specific about why and what will happen there.

    Follow Up

    Hand out a reading material they can take home so they can remember what you said.

    Always provide a safety net by arranging a follow up often the next day, but maybe a few days or weeks later.

    Be willing to reassure if indicated and medically possible and do not hesitate to arrange admission to the hospital if indicated.

    Everything counts from your attitude, manner, voice, to your language. Don’t end the consultation in a way that patient feels more confused, threatened, without an option, or not being taken care of.

    If time constraints dictate that you choose between a thorough physical examination and an appropriate closure, give priority to the execution of proper closure with:

    • Initial diagnostic impressions.
    • Initial management plans:
    • Need for follow-up tests
    • Ask the patient if they have any other questions or concerns.

    Failing Some Stations

    Most candidates fail a few stations, so be prepared for that.

    Often there is one scenario that you might not know much about at all and you soon think that you have failed that station.

    Remaining calm in unexpected or difficult circumstances is the key to surviving stations or even the rest stations. You may never know that you will still pass that station even if you don’t know much or you feel so bad.

    It is extremely important not to think about it any longer, once you have moved past that station, clear your mind, forget about it, put it behind you and concentrate on the next station and believe in yourself. Even if a candidate fails the examination, it is not a disaster. A wise man said: “Failure is only a word, not a sentence.”

    One Last Word of Advice

    The last and the most important advice that I can truly give you is PRACTICE, PRACTICE, and PRACTICE.

    The only way to pass this exam is to prepare well. The preparation time required will depend on your medical knowledge, your communication skills and how familiar yourself to the Australian healthcare system.

    You may know every little detail in your book. But this is worthless if you cannot perform well. So please make sure not to rush and take as much time as necessary to practice a few times before you schedule your examination.

    The Aftermath

    Just a reminder that you also should look forward to your life after the examination and that means finding a job. Remember you need to have all your paperwork ready for provisional registration with the Medical Board of Australia.

    The most common hold-ups are lack of current language certificate as it has to be within the last 2 years and the certificate of good standing from medical authorities in every country where you have been previously and currently registered. It happens regularly that International Medical Graduates are delayed or refused registration because of some aspects of the paperwork being missing.

    Related Questions.

    How Do I Pass the AMC MCQ Exam?

    Nawaf has also written a guide to the Part 1 Exam where he shares his tips for success. You can read this post here.

    Do I Need to Sit the AMC Clinical Exam?

    As a basic rule of thumb if you gained your medical degree from a country outside of Australia, New Zealand, the United Kingdom, Ireland, Canada or the USA. And you do not have a specialist qualification. Then you will need to sit the AMC exams. However, there are a few exceptions to this rule, these include gaining registration through similar processes in other countries, such as completing the USMLE and PLAB and completing the Workplace Based Assessment program (which is an exception to having to sit the AMC clinical exam). For more information see our Standard Pathway Q&A guide.

    How Do I Obtain a Job After Completing the AMC Clinical Exam?

    The first thing to know here is that you can actually apply for jobs after you pass the AMC Part 1 MCQ Exam. Generally speaking, you will need to look for a vacant Resident Medical Officer type of role in a public hospital. One that the hospital has not been able to fill with local graduates. Unfortunately, a medical recruitment company is unlikely to want to help you with your search so you need to look for and apply for jobs directly. More information is available in our Standard Pathway Q&A guide.

    What Is the Cost of the AMC Clinical Exam?

    As of July 2021, the cost of the AMC Clinical Exam is $3,530AUD

    Can I Sit the AMC Clinical Exam More Than Once?

    Yes. Although there is generally a long wait for each exam.

    What Is the Format of the AMC Clinical Exam?

    The AMC clinical examination is an integrated multidisciplinary structured clinical assessment.

    The examination comprises 16 assessed stations and 4 rest stations.  It is administered either online via a video conferencing format at a location organized by the candidate, or when health restrictions are allowed, at the National Test Centre in Melbourne (NTC).

    Candidates rotate through a series of stations and will undertake a variety of clinical tasks. All candidates in a clinical examination session are assessed against the same stations.

    Most stations are of 10 minutes duration (comprising two minutes reading time, and eight minutes assessment time).

    Stations may use actual patients, simulated patients, or videotaped patient presentations. Other relevant materials, such as charts, digital images and photographs may also be used in the examination.

    How Long Is a Pass on the AMC Clinical Exam Valid For?

    There is no expiry date for the AMC Clinical Exam.

    Can I Sit the AMC Clinical Exam Outside of Australia?

    Unlike the AMC MCQ exam, all of the in-person clinical exams occur at the National Testing Centre in Melbourne. However, with the advent of the AMC Online Exam, you can now sit this anywhere.

  • Medical Internship Australia 2021. For the 2022 Clinical Year.

    Medical Internship Australia 2021. For the 2022 Clinical Year.

    *We will be regularly updating this post as the various States and Territories update their processes. Where information is not currently available for the 2021 year we have used information from the previous year, i.e. 2020.

    It’s that time of the year again, where the whole medical internship Australia system kicks into gear. The time when each of the States and Territories in Australia open up their process to allow applications for medical internships for the following year. For four years I was responsible for running the largest Intern application system in Australia for 4 years. The NSW Intern application system. So I’d like to share with this year’s medical graduates some of the wisdom I gained from that experience.

    (Disclaimer: all information here has been sourced in good faith but things do change so you should always do your own due diligence in such matters, we are providing this information to aid you in your application but take no responsibility for any outcomes)

    As has been the case in past years the main Intern application and allocation dates are aligned across Australia so that every State and Territory opens and closes their systems at the same time and makes offers at the same times. There are some variations to this in relation to special priority categories in some States and Territories. The key things that all medical graduates should consider in preparing their medical internship application for the 2022 year in 2021 are as follows:

    • Applications open on 4th May 2021.
    • Applications close on 3rd June 2021.
    • Make sure that you have an Intern Placement Number otherwise you won’t be able to apply.
    • You should research the application requirements now as there may be some “surprises”. As soon as the application system opens, register or log in and ensure that you have everything you need to complete your application.
    • Understand where you sit in the priority list for any State or Territory you are applying to.
    • If you are required to attend an interview. Make sure that you have obtained leave from your medical school requirements to attend.
    • Also, consider that the interview is likely to be either via phone or video this year.
    • Give yourself time to request referees, put together a Resume, if required and find other documents that you may need.
    • The first main round offers come out from 12th July. So make sure that you have regular access to your email as your time for accepting offers can be quite short.
    • Stay in touch with your medical school. you may be worried about completing your degree on time but they are all working very hard with the other institutions to give you the best chance of completion.

    Tip #1. Your Medical Intern Placement Number.

    The IPN is a unique nine-digit number that has been generated by AHPRA and has been provided to medical schools for distribution to all 2021 final-year medical students. The number is used as part of the national audit process (which ensures that intern positions across the country are made available to as many applicants as possible) as well as to streamline registration.

    This number is not the same number as your AHPRA registration number or student number. If you have not received you IPN you should check with your school.

    If you are not an Australian medical student you won’t be issued an IPN. If you are applying as a non-Australian medical student you do not require an IPN. However, please note that unless you are a New Zealand medical student your chances of gaining an internship are very slim.

    Tip #2. Other Things You Will Likely Need. 

    The majority of States and Territories require you to upload an academic transcript as proof that you are indeed a medical student. 

    They will also request evidence that you satisfactorily meet the AHPRA English Language requirements. This may seem a bit ridiculous given that you have been attending medical school in English for the last 4 or 5 years. But it is the law. So check whether you may need to submit an up-to-date English test result or some other form of documentary evidence such as a high school certificate.

    Most States and Territories will also request a CV or Resume. For tips on your CV or Resume see our ultimate guide to CVs or watch a video series about this.

    Some States and Territories have a CV template that they suggest that you use to fill in your information. In the case of Victoria, you are required to use this template. It’s probably fairly harmless to use the template for the other States and Territories. But if you are thinking about your future career, then nows is a good time to be designing your own CV. The risk of using the template is that you don’t stand out from other candidates.

    You will need to also provide proof of your identity, citizenship, residency, or visa. And if you have had a name change along the way you will probably also need to provide some documentation in relation to this.

    Why All This Information?

    The State and Territory bodies who administer the Intern application process have a responsibility to ensure that you are eligible to apply for provisional registration at the end of the year in order to work as an Intern.  They collect this information to check that everything is in order so that you are indeed eligible to apply. Employers can get rightly annoyed when told that someone who has been allocated to work with them as an Intern will have a several-month delay whilst they resit an English language test.

    However, it’s your responsibility to ensure that you are eligible for registration. So you should also be checking these things yourself. 

    It’s hard to fathom given the amount of communication from health departments, medical schools and student colleagues. But every year there are a handful of medical students who forget to apply for their internship. This means having to wait another year. Don’t let that be you.

    Dr Anthony Llewellyn | Career Doctor

    Tip #3. Research and Apply Early.

    It’s hard to fathom given the amount of communication from health departments, medical schools, and student colleagues. But every year there are a handful of medical students who forget to apply for their internship. This means having to wait another year. Don’t let that be you.

    There are even more students who leave their applications to the last minute. Only to find that they are missing a vital document. For example, this could be evidence you need to substantiate that English is your first language, such as a high school certificate. Or perhaps your last name has changed whilst you have been in medical school? Or maybe you need to submit a CV with your application?

    As soon as the application page opens for each State and Territory you are going to apply to make sure your register. And then go as far through the process of applying as possible so you can see if there is some sort of document you need to obtain.

    Tip #4. Practice Your Video Interview Technique.

    If you are one of the many students who may need to undertake an interview for your internship choices as occurs in certain situations, such as rural preferential recruitment and certain States such as Victoria. Then you should be prepared for the fact that this year your interview is unlikely to be held in person and very likely to be conducted on video.

    There’s a lot more than you think to video interviewing. For a rundown on this check out this recent post.

    Tip #5. Know Where You Sit In The Priority List.

    ts important to know where you sit on the priority list. Each State and Territory has a slightly different order but in essence, it goes something like this:

    1. If you are an Australian Citizen or Permanent Resident and went to Medical School in that State or Territory you are top of the list.
    2. If you are an Australian Citizen or Permanent Resident and went to Medical School in another State or Territory or New Zealand you are probably second.
    3. If you are an International student who studied Medicine in Australia you are probably next.

    Tip #6. Know the Key Dates, including Offer Dates.

    As noted above it’s crucial that you know the key dates. If you miss your application submission date (and it does happen) there is no allowance for a last-minute submission. You also need to make sure you are available to accept your offer. Generally, the window for offer acceptances is quite narrow (often 48 hours).

    For this year the day on which the first round of offers can be made nationally is 12th July and most offers will come out on that day. Thereafter there is a series of offer windows for 2nd and 3rd and 4th rounds etc… in between which there is a mandated pause, which allows the National Intern Audit process to run. This is a system that works to ensure that vacancies are being freed up as soon as possible by highlighting medical students who may have an offer in more than one jurisdiction and ensuring that they accept one offer and decline others.

    Priorities Within Priorities.

    Some States and Territories also have priority pathways to ensure that groups such as Aboriginal and Torres Strait Islanders and doctors who wish to work rurally or regionally can obtain their preferred placement early.

    So if you are an International student and like the idea of working rurally it’s probably a good idea to consider a rural pathway as it will likely boost your chances of gaining an Intern position earlier in the process.

    More Information on Each Jurisdiction

    New South Wales

    Intern Positions ≅ 1,041 (including 173 rural preferential) across 15 Networks
    Annual Salary = $69,649

    The Health Education & Training Institute runs the country’s largest Intern application process. Offering over 1,000 internships.

    Interns can be allocated to one of 15 networks of hospitals. The offer is for a 2-year contract to cover both internship and residency.

    You have the option of applying through one of 4 pathways:
    – Aboriginal Recruitment Pathway
    – Rural Preferential Pathway
    – Regional Allocation Pathway
    – Optimised (or Main) Pathway

    Only applicants who go through the Rural Preferential Pathway need to submit a CV and attend an interview.  All other pathways are based on applications only. A key advantage of the Aboriginal, Rural, and Regional Allocation Pathways is that you are far more likely to be given your preferred hospital network.
     
    Intern Placement Priorities:
     
    Priority 1 – Medical graduates of NSW universities who are Australian/New Zealand citizens or Australian permanent residents (Commonwealth Supported Place and Domestic Full Fee paying). This priority category is guaranteed an intern position in NSW. 

    Priority 2 – Medical graduates of interstate or New Zealand universities who completed Year 12 studies in NSW who are Australian/New Zealand citizens or Australian permanent residents (Commonwealth Supported Place, Domestic Full Fee paying or NZ equivalent). 

    Priority 3 – Medical graduates of interstate or New Zealand universities who completed Year 12 studies outside of NSW who are Australian/New Zealand citizens or Australian permanent residents (Commonwealth Supported Place, Domestic Full Fee paying or NZ equivalent). 

    Priority 4 – Medical graduates of NSW universities who are not Australian/New Zealand citizens or Australian permanent residents and who hold a visa that allows them to work or are able to obtain a visa to work.

    Priority 5 – Medical graduates of interstate or New Zealand universities who are not Australian/New Zealand citizens or Australian permanent residents and who hold a visa that allows them to work or are able to obtain a visa to work in Australia. 

    Priority 6 – Medical graduates of Australian Medical Council accredited universities with campuses that are located outside of Australia or New Zealand who are not Australian/New Zealand citizens or Australian permanent residents and who hold a visa that allows them to work or are able to obtain a visa to work in Australia.

    HETI Medical Graduate Recruitment Page

    HETI Prevocational Training Application Program Portal

    Victoria

    Estimated Numbers = 820
    Annual Salary = $79,138
     
    Internship in Victoria works around a computer matching system which is administered by the Postgraduate Medical Council of Victoria. The system had a significant overhaul in the previous year.

    The Allocation & Placement Service is a mathematical process that matches the preferences of both candidates and Health Services and is designed to be “impartial and transparent”. 

    Candidates create an account then register with the Intern match. The second step is to preference your preferred services. At the same time, the health services also place preferences. The matching process successful candidates to positions according to rankings.

    For Victoria, you will need to submit a CV. In past years this MUST BE on the quite unattractive PMCV standardised CV Template. You don’t have to put a photo on your CV. And I would not recommend doing so.

    In 2020 Victorian Health services began the use of video-recorded interviews. The way these interviews work is you are usually allocated a specific time to log into the system. Once you have gone through a couple of orientation steps you are usually given a series of questions and asked to record your answers. Generally, you don’t get a second go if you are not happy and the time is limited. It is vital therefore that you practice before you do your interview and ensure you have optimised your video environment.

    All health services can use these recordings to rate you.

    Metro hospitals can then elect to also do live interviews. Although I suspect many will not.

    Interns can be allocated to one of 22 hospitals and networks. This includes a small number of community-based internships where the focus is more on community-based models of care, including working in primary care and smaller hospitals.

    You can elect to be prioritised for an internship by entering the Victorian Rural Preferential Allocation (VRPA) match. Where you can be allocated to one of 5 rurally based networks. This pathway involves a live interview. First-round offers for VRPA come out on 5th July, which is one week before the national first-round offer date of 12th July.

    Intern Placement Priorities:

    Priority Group 1 – Graduates from Victorian medical schools holding Australian or New Zealand citizenship or permanent residency, including domestic full fee paying and Commonwealth Supported Place students.

    Priority Group 2 – Australian temporary resident graduates of Victorian medical schools. Interstate Special Consideration candidates (approved by PMCV).

    VRPA Priority Group 2 – Australian permanent resident graduates of interstate universities who meet the following criteria: Completed their Year 12 schooling in Victoria; or Graduates of the University of New South Wales who have undertaken their last two years of clinical placement at Albury Wodonga Health clinical school.

    Priority Group 3 – Australian permanent resident graduates of interstate or New Zealand universities (including previous residents of Victoria); Australian temporary resident graduates of interstate universities; New Zealand temporary resident graduates of New Zealand universities; and Graduates from an overseas campus of an Australian/New Zealand University accredited by the Australian Medical Council (e.g. Monash University – Sunway Campus, Malaysia and University of Queensland Oschner campus).

    PMCV Standardised CV Template

    PMCV Internship Information

    PMCV Match Portal

    Queensland

    Estimated Numbers = 784 (including 65 rural generalist intern positions)
    Annual Salary = $80,913
     
    Queensland has possibly the most complex internal allocation system of all jurisdictions.

    Queensland Health conducts the annual intern allocation process in Queensland.

    Interns can be allocated to one of 20 Employment Hospitals.

    There are 3 pathways for Intern Allocation in Queensland.

    – The Rural Generalist Program offers an opportunity to select a rural hospital centre as part of a program that is a pathway to working as a Rural GP. Applications open (2nd March) and close extremely early (16th March) for this pathway.
    – Aboriginal and Torres Strait Islander Intern Allocation Initiative. The purpose of the initiative is “to promote the success of Aboriginal and Torres Strait Islander medical graduates in the Queensland Health workforce”. Eligible applicants can apply to the Aboriginal and Torres Strait Islander Intern Allocation Initiative to be allocated to their first preferenced hospital.
    – The General Intern Campaign.

    An interesting aspect of the previous Queensland application portal is that you could see a live indication of where other applicants have preferenced other hospitals. This was presumably designed to encourage medical students to consider other hospitals and get the student group itself to work out the allocation. From the information this year it appears that you will not be able to see how many have applied for what hospital. Rather they have put in place an interesting “rollback” system.

    The roll-back process only applies to Applicant Group A candidates who tentatively accepted their first-round offer (because they did not receive their first preference). The roll-back occurs after the ballot and first-round offers have been finalised and aims to match Applicant Group A candidates to a higher preference hospital should a vacancy become available due to another Applicant Group A candidate declining their offer.

    The whole roll-back process happens in 1 day.
    If an applicant is unavailable on the day of rollback they can nominate a proxy to be available via phone.
    All applicants (or their proxies) participating in the roll-back process need to be:
    • contactable on the day.
    • ready to accept or decline the roll-back offer at the time of the telephone call from the Intern Campaign Coordinator.
    Proxy details need to be emailed to the Intern Campaign Coordinator before the day.
    If you or your proxy is not contactable by phone you will miss out on the offer. They apparently do not leave voicemails!
     
    Intern Allocation Priorities:

    Group A
    Medical graduates of Queensland universities who are Australia/New Zealand citizens or Australian permanent residents; and are seeking an internship commencing in the year immediately following graduation;
    OR 
    received Review Committee approval from a previous campaign to defer commencement of the internship

    For Group A Applicants.

    Candidates who nominate an ‘undersubscribed’ or equal in numbers hospital as first preference are automatically allocated to that facility.

    If a hospital is oversubscribed, candidates who have chosen that hospital are randomly selected and offered their next preference until that oversubscribed hospital is at quota.

    Group B
    Medical graduates of Australian (interstate) or New Zealand universities who are Australian/New Zealand citizens or Australian permanent residents;
    OR
    Medical graduates of Queensland universities who are Australian/New Zealand citizens or Australian permanent residents who do not meet the criteria outlined in Group A

    Group C
    Medical graduates of Australian (Queensland or interstate) or New Zealand universities who are NOT Australian / New Zealand citizens or Australian permanent residents who: 
    currently hold a visa that allows them to work in Australia;
    OR
    will need to obtain a visa to work in Australia

    Group D
    Medical graduates of Australian University campuses outside of Australia accredited by the Australian Medical Council.
    OR
    Medical graduates of international universities who have not completed an internship in Australia or another country and have either: 
    – obtained the AMC Certificate (and are eligible for provisional registration)
    – successfully completed the AMC MCQ (multiple choice questionnaire) (and are eligible for limited registration).

    Merit Selection for Groups B-D.

    A merit selection process for applicants in Groups B-D for intern positions is conducted by each individual hospital and is tailored specifically for their service. The selection methods are designed by the hospital but commonly include shortlisting, interviews, and referee checks.

    In order to apply for an internship in Queensland, you will need to submit a CV, regardless of whether you are undergoing merit selection and 2 referees. Queensland Health offers “for your convenience” a CV template. If I were you I would conveniently ignore this template and organise your own resume.


    *Queensland is one of a few jurisdictions that does permit International Medical Graduates to apply for positions as part of the last Applicant Group.

    CV template

    2021 Queensland Intern Campaign Home Page

    Application Guide

    Application Portal.

    Application Portal

    Postgraduate Medical Council of Western Australia

    South Australia

    Estimated Number = 285 (including 12 rural intern posts)
    Annual Salary = $77,084

    SA Health Careers conducts the annual Intern application process in South Australia. There are 3 Adelaide-based Local Health Networks and 3 smaller country-based networks to which you can apply for the priority Rural Intern pathway. Although only two of these appear to be offering intern posts for 2022.

    The Rural Intern Pathway is a strength-based recruitment process for applicants who are interested in undertaking their internship (and potentially subsequent years) in rural hospitals within Country Health SA (CHSA). Rural intern positions provide broad opportunities in unique settings and are best suited for medical graduates with a history of living or working in rural areas or a desire to commence a career in the country. 

    Those applying for the rural intern pathway undertake an interview and offers come out a week early on 5th July.

    International Medical Graduates from non-Australian medical schools can apply for the rural intern pathway so long as they have only graduated in the last 2 years and have completed the AMC Part 1.

    Intern Allocation Priorities:

    South Australia’s intern allocation priorities are the most complex of all jurisdictions.

    Aboriginal and Torres Strait Islander applicants are given priority preference by being placed in the first subcategory for categories 1 and 2.

    Category 1 Australian Citizens, Australian Permanent Residents, and New Zealand Citizens
    1.1: Medical graduates from a South Australian university who identify as Aboriginal and Torres Strait Islander (ATSI)
    1.2: Medical graduates from a South Australian university – Commonwealth-supported (HECS-HELP) or SA Bonded Medical Scholarship Scheme (SABMSS)
    1.3: Medical graduates from a South Australian university – full-fee paying

    Category 2 Australian Citizens, Australian Permanent Residents and New Zealand Citizens
    2.1: Medical graduates from an interstate or New Zealand university who identify as Aboriginal or Torres Strait Islander (ATSI)
    2.2: Medical graduates from an interstate or New Zealand university who completed Year 12 in South Australia
    2.3: Medical graduates from an interstate or New Zealand university
    2.4: Medical graduates from an overseas university who completed Year 12 in South Australia
    2.5: Medical graduates from an overseas university 

    Category 3 Australian Temporary Residents and New Zealand Permanent Residents
    3.1: Medical Students from a South Australian University 

    Category 4 Australian Temporary Residents and New Zealand Permanent Residents
    4.1: Medical graduates from an interstate or New Zealand University 

    Category 5 Australian Temporary Residents and New Zealand Permanent Residents
    5.1: Medical graduates who have spent two or more semesters in an overseas campus of an Australian or New Zealand University (eg Monash Sunway campus, UQ New Orleans campus)
    5.2: Medical graduates of an overseas university

    South Australia is one of few States that specifically permits medical graduates from other countries to apply for internship positions. But they are at the very bottom of the priority list. Please see the above information about the rural internship.

    In addition to a CV and referees, in order to apply for an internship in South Australia, you will need to provide a certificate confirming that you have completed the SA Health online electronic medical record (Sunrise EMR & PAS) training. 

    SA MET Internship Guide

    SA Health Careers Link

    Tasmania

    Only partial information is available for 2021 so far.

    Estimated Number  = 90 (Based upon last year).
    Annual Salary = $71,932
    Internships are coordinated in Tasmania via the Department of Health and Human Services.
     
    All applicants are required to apply online. As part of your application you are asked to preference all of the 3 available sites:
    – Hobart
    – Launceston
    – North West Region

    Candidates need to attach a CV/Resume and any other relevant information to their application and must arrange completion of two electronic referee reports:

    – One (1) referee that is employed in a clinical role (Clinical Academic) with the University where you are studying/or studied medicine and is aware of your studies in the past 12-24 months; AND

    – One (1) that is – a senior clinician (>4 years’ experience post general registration) who has observed you (you have worked with) during your clinical placements in the past 12-24 months, and can comment on your suitability for hospital-based practice.

    Intern Placement Priorities:

    The Tasmanian Health Service currently gives priority, in order, to:
    1. Australian permanent resident Tasmanian-trained Australian Government supported and full-fee paying medical graduates.
    2. Australian temporary resident Tasmanian-trained full-fee paying medical graduates.-
    3. Australian permanent resident interstate-trained Australian Government supported and full-fee paying medical graduates.
    4. Australian temporary resident interstate-trained full-fee paying medical graduates.
    5. Medical graduates of an Australian Medical Council accredited overseas University.

    At this point, it is not clear how selection will work for 2021. In past years there has been an interview process. However, the information to date indicates that priority 1 candidates will be placed on a ballot and allocated according to preferences. This seems to indicate there will be no interview or merit-based selection at least for this group.

    Recruitment Link

    Ularu

    Northern Territory

    Northern Territory
    Estimated Number = 50 (24 for Central Australia Health Service, unknown for Top End Health Service)
    Annual Salary = $78,750

    The NT Prevocational Medical Assurance Services (PMAS) conducts a central review of eligible applicants and all intern positions are allocated within the two NT Health Services:
    Top End Health Service (TEHS) – based upon Royal Darwin Hospital (RDH)
    Central Australia Health Service (CAHS) – based upon Alice Springs Hospital (ASH)

    Eligible applicants are allocated intern positions in line with the Northern Territory category groups. Within the relevant category groups, applicants are allocated to their highest possible Health Service preference, pending availability of a position.

    Intern Priority Categories:

    Category A NT Medical Program Bonded Scheme / Return of Service Obligation (RoSO) applicants (guaranteed placement)
    Category B NT Indigenous applicants who have completed medical degrees at accredited Australian and New Zealand medical schools who are:
    – NT Indigenous scholarship holders
    – Identified as an NT Indigenous resident
    Category C
    Non NT Indigenous applicants.
    Category D
    NT applicants (non-Indigenous) who have completed medical degrees at accredited Australian and New Zealand medical schools who are:
    – NT scholarship holders
    – Identified as an NT resident (may include non-bonded JCU/Flinders NTMP students)
    Category E
    Australian applicants (non-Indigenous / non NT residents):
    – Previous experience working/studying in NT (JCU/Flinders/Other university student placements)
    – Previous experience in a rural, remote and Indigenous health location/s (eg. Aboriginal Medical Services, Rural Clinical Schools, involvement in Rural Student Clubs and those applicants who come from rural, and remote locations)
    Category F
    International applicants on a student visa, now an Australian medical graduate who has:
    – Previous experience working/studying in NT (JCU/Flinders/Other university student placements)
    – Previous experience in a rural, remote and Indigenous health location/s (e.g. Aboriginal Medical Services, Rural Clinical Schools, involvement in Rural Student Clubs and those applicants who come from rural, and remote locations)
    Category G
    International medical degree applicants who have:
    – Previous experience in NT student placements/clinical observers
    – Experience in rural, remote, and Indigenous health locations.

    Overall the intern allocation process is based on an applicant’s category group, Health Service preference, and the number of positions available in each health service.

    The two NT Health Services are responsible for selecting applicants and making their offers of employment, applicants are advised via email.  The Health Service responsible for making the offer of employment will after receiving an acceptance from an applicant arrange an employment contract for an Internship position within their health service to be provided prior to commencing their internship.

    NT Department of Health Intern Recruitment Link (includes information on Categories)
    *NT is one of a few jurisdictions which will consider IMG applicants. Generally, you will have to have had previous experience in the NT.

    NTPMAS Site

    Intern Priority List

    Recruitment Page.

    The Commonwealth – Junior Doctor Training Program Private Hospital Stream

    Intern Positions TBD

    The information below is for the previous year.

    Annual Salary = will depend on which State or Territory you are employed in.

    The Commonwealth provides an additional Internship program for international students who study at Australian medical schools.

    *Any excess posts may be applied for by other IMGs in Australia

    The main function for this program over the years has been to provide additional opportunities for international students studying Medicine in Australia a chance to complete their internship.  This is done by tendering to various private hospitals for additional intern positions.

    The program was retitled in 2020 to the Junior Doctor Training Program Private Hospital Stream when there were 115 positions on offer.

    Normally there is not as much information about the program available until a mad flurry at the end of the year.  And 2020 seems to be no different. They are still sorting out which hospitals will provide internships.  After which there will probably be some information about how to apply.

    For now we know that the eligibility requirements are that you must either be an international full fee-paying medical graduate from an onshore Australian medical school. This is Priority One. If not all positions are filled by priority one medical graduates then the private hospitals may then recruit other medical graduates who have provisional registration. This is the Priority Two category. I am not sure how this priority category two helps any IMG as they must already have provisional registration. I guess it might help some IMGs already employed and on the standard pathway jump into a better training program.

    Eligibility Requirements for Intern (PGY 1) Junior Doctor Training Places under the Junior Doctor Training Program Private Hospital Stream

    Under the PHS, participating private hospitals must prioritise international full fee-paying medical graduates from onshore Australian medical schools (Priority One). Should these places not be filled, private hospitals may then recruit other medical graduates eligible for provisional registration (Priority Two). This means that the Commonwealth Scheme provides one of the few opportunities for IMGs who are applying via the standard pathway process to gain an internship position in Australia.

    To do so you will need to have met the Medical Board of Australia provisional registration requirements as a medical practitioner. And also have met the English language proficiency requirements for registration purposes. And commit to obtaining an appropriate visa to work in Australia during the internship year.
    Private Hospitals funded to deliver the Private Hospital Stream from 2020-2022 are:
    – Mater Health Services North Queensland (delivering PGY1 places)
    – Mercy Health and Aged Care Central QLD – Friendly Society Hospital, Bundaberg; Mater Private Hospital, Bundaberg; Bundaberg Base Hospital, Bundaberg; – — — Mackay Base Hospital, Mackay; Mater Misericordiae Hospital, Mackay (delivering PGY1, PGY2 and PGY3 places)
    – MQ Health (Macquarie University Hospital) (delivering PGY1 places)
    – St John of God Ballarat Hospital – Grampians Intern Training Program (delivering PGY1 places)
    – Mater Hospital Sydney (delivering PGY1 places)
    – St Vincent’s Private Hospital Sydney (delivering PGY1 places)
    – Ramsay Health Care WA (Joondalup) (delivering PGY1, PGY2 and PGY3 places)
    – Greenslopes Private Hospital (delivering PGY1, PGY2 and PGY3 places)
    – Calvary Health Care Riverina (delivering PGY2 places)

    Link to Program details

    How To Decide?

    There are lots of considerations when it comes to putting in your Intern application. Everyone is a bit different. Some graduates feel like they would like to be close to home and family whilst going through their transition to Intern. Others see it as a chance to get away and explore a new place and location. And then others focus on the long-term career prospects of certain locations.

    I think this last consideration is a little overrated for most. You can generally experience a wide range of medicine in your first couple of years of medicine after graduation and there is scant evidence that this affects your prospects of applying for specialty training posts.

    That being said if you have an interest in anything other than Medicine, Surgery or Emergency Medicine as a future career you should probably investigate whether this particular specialty is offered at the hospitals or networks to which you apply.

    Unfortunately, the internship model in Australia is quite antiquated and we have continued to use the experience as a proxy for competency when a large portion of the medical education world has moved on. The result has been the mandating of the 3 core terms for internship of Medicine, Surgery, and Emergency Medicine. There is really no solid educational basis for this approach and one of the unfortunate outcomes is that all the other specialties get squeezed out and few interns get to experience psychiatry, general practice, obstetrics, paediatrics, pathology etc… which ultimately does have an effect on recruitment to these specialties.

    So the basic message is this. If you are really dead set keen on doing radiology as a career you should try to track down the very few locations that might offer this rotation to either interns or residents.

    Each year the Australian Medical Students’ Association produces a very useful Intern Guide with lots of information about the composition of intern training networks across the country. The 2020 version did not appear to eventuate. So I can only assume they are no longer compiling this. But here’s a link to the 2019 version.

    Related Questions

    What If I Have Special Circumstances Which Make It Hard For Me To Work In Certain Places?

    All States and Territories Have processes for considering special circumstances. Some of the types of circumstances that are generally approved are: where you may have certain health conditions that mean you need to be close to certain hospitals or specialists; where you have dependents, such as young children, and are unable to relocate due to care arrangements; and where you and your partner want to work as doctors in the same location. Generally, requests to stay in certain locations, for reasons such as work commitments of partners or needs of school-aged children are not granted.

    I Have Received My Intern Offer. But I Would Like to Defer It. Is This Possible?

    This will partly depend on how long you wish to defer for. If you just wish to defer for a a few months. Once you have your offer and are in discussions with your new employer make enquiries. It may be possible to negotiate a later start with your employer. Most employers will generally prefer that you start on time, so that you are not out of sync with your colleagues. But there might be some advantage for the employer in you attending orientation but then starting a bit later as it will probably help them to fill out roster gaps. On the other hand. If you wish to defer for a complete year. Then you will need to check the policy of the State or Territory that has provided you an Intern offer. In some cases (for example Victoria) you will be permitted to defer and your place will be held for you the following year. In most other cases you will need to reapply the following year and check whether your priority status has altered. In most cases you have the same priority status. Also bear in mind that it is unclear how long you can defer commencing your internship. However, the eMedical Board of Australia expects that once you have commenced your internship you will have completed this process within 3 years.

    I Am a Doctor With a Medical Degree From Outside Of Australia. Can I Apply For Internship?

    Unless you obtained your medical degree from a New Zealand Medical School. Then the brief answer to this question is no. I would love to stop there. And I really think you should as well. But there are rare circumstances where you may be able to obtain an internship with a medical degree from outside of Australia. But the Medical Board of Australia strongly advises against this option and so do I. For good reasons. Firstly the whole Australian medical internship system is designed to ensure that Australian medical graduates are able to undertake an internship. Not for overseas graduates. Secondly (and as a result of the first point) it is very rare to be offered the chance. Some States and Territories will not even consider an application from an IMG for internship. Others will only do so in limited circumstances, for example, the Northern Territory will accept applications from IMGs who may have done a medical student elective or clinical observership in the Northern Territory and who have experience in rural, remote and indigenous health locations. But even then these applicants are at the bottom of the priority list for obtaining an internship. South Australia will accept applications. But again you are bottom of the list. Queensland will also accept applicants, but only if you have never worked as a doctor. And again you are bottom of the list. A final note on this question is that the majority of IMGs who do obtain a medical internship position each year in Australia generally have Australian citizenship or permanent residency.

    I Have Heard That Some Graduates Miss Out On Internship. Is This True?

    Whilst it is theoretically a possibility that some medical graduates miss out on Internship according to information provided by HETI for the most recent year of intern applications no-one was actually left at the end of the process without an offer. Only Australian citizens and permanent residents are guaranteed an intern position under the COAG agreement. However, there are generally enough intern positions available for those students who have come to Australia to study medicine and the Commonwealth Private Hospital program offers additional spaces for those that may miss out. That being said. It is also clear that many graduates choose to drop out of the application process themselves. So not everyone who applies gets an offer. The assumption is that some graduates take up similar intern opportunities in other countries upon graduation.

    I Am Not an Australian Medical Student. How Do I Obtain an Intern Placement Number?

    In this situation you do not require an IPN and will not be issued with one. You can still apply for internships. But unless you are a New Zealand medical student your chances of gaining a place are very very limited.

    (Disclaimer: all information here has been sourced in good faith but things do change so you should always do your own due diligence in such matters, we are providing this information to aid you in your application but take no responsibility for any outcomes)We’d welcome feedback from any Intern programs in relation to the accuracy of the above information.

  • How to Pass AMC Exams – Part 1 AMC MCQ Comprehensive Guide

    How to Pass AMC Exams – Part 1 AMC MCQ Comprehensive Guide

    An Australian Medical Council Part 1 CAT MCQ Examination Study Guide.

    Are you wondering how to pass the AMC exams? Well. Having passed the Australian Medical Council AMC Part 1 CAT MCQ Examination in the first go, I am often asked by doctors questions like “What’s your secret?”, “How can I plan my study schedule to pass the AMC Part 1 CAT MCQ Examination?”, “How long should I study for it”, and “What’s the best study plan?”.

    Chances are, if you’re reading this post, you are preparing to take the AMC Part 1 CAT MCQ Examination within the next few weeks to months, and are looking for actionable advice about how to set yourself up for success in the here and now. I’m going, to be honest: if I had a single secret or silver bullet, I would tell you. The harsh truth is that if you want to pass the AMC Part 1 CAT MCQ Examination, work as early as possible with concerted efforts to build a solid knowledge base that you can then consolidate during your dedicated study periods.

    In this article, I will try to point out the ideal way of doing things. Things I wish someone would have told me while I was preparing. things that would have saved me a lot of money and time (spent scouting for the ideal resources).

    Here’s a summary of what I learnt about how to pass the AMC exams:

    • Start as Early as Possible.
    • Commit to An Examination Date to Give You Something to Plan For.
    • If Possible Study Whilst Undertaking Clinical Rotations or Work.
    • Make Sure You Choose Your Preparation Resources Wisely.
    • You Should Use John Murtagh’s General Practice, the AMC Handbooks and Question Banks to prepare most effectively.
    • Try to dedicate study time each day and take plenty of breaks.
    • Work out the areas you are most week in and focus on them.
    • Try to do some practice where you emulate the actual conditions of the AMC Part 1 CAT MCQ Exam.
    • Work out if you have problems in areas such as time management, understanding the answers, overthinking questions and address these.

    There’s a lot more to it than just that. So let me give you some further details about my approach:

    Starting Early to Pass the AMC MCQ Exams.

    Believe it or not, my preparation for the AMC Part 1 CAT MCQ Examination started at the beginning of the 5th year of medical school. As I went through clerkships, I knew one thing. Studying hard would certainly put me at an advantage for the AMC Part 1 CAT MCQ Examination

    Your best first step in preparing for the AMC Part 1 CAT MCQ Examination is to plan far ahead. Thinking about the AMC Part 1 CAT MCQ Examination 4 to 6 months before your scheduled AMC Part 1 CAT MCQ Examination preparation will ensure that you have enough time to identify appropriate resources, create a daily schedule that works for you, and cover all the material you will need to review before your AMC Part 1 CAT MCQ Examination.

    One thing you do have a fair bit of control over is when you sit the examination. There are normally a few examinations scheduled every month. If you are aiming to sit in a certain international location you might be a bit more limited to when you sit but if you do have an option, pick a date that allows you plenty of time to prepare for it.

    But also, don’t procrastinate around picking your date. Don’t start studying first to get to a certain point before picking your AMC Part 1 CAT MCQ Examination date. It is always helpful to have a hard timeframe to be aiming for. It will keep you motivated.

    Exactly How Long Should You Study to Pass The AMC Part 1 CAT MCQ Examination?

    No matter when you take the AMC Part 1 CAT MCQ Examination if you want to pass in the first go it is critical to have a dedicated study period with no other significant obligations to consolidate your knowledge and hammer home AMC Part 1 CAT MCQ Examination preparation.

    The answer to this question depends on a lot of factors, two of the most important being, your knowledge baseline, and the amount of dedicated time you have.

    Exactly how much-dedicated study time you need depends on how far out you are from core clinical rotations in medical school. Is your knowledge recent or is it rusty? If your schedule does not allow for a prolonged dedicated study period because of clinical or personal obligations, then incorporating study over 6-8 months is sensible.

    In my opinion prolonging dedicated study more than say 8 months is not advisable, however, as the likelihood of forgetting topics studied at the beginning of your review period increases with increasing time spent studying.

    Also, factor in giving yourself enough breaks in between studying in earnest to avoid burnout.

    Building a Firm Foundation: The Importance of Clinical Rotations to Passing the AMC Exams.

    The most common question types in the AMC Part 1 CAT MCQ Examination are “What is the most likely diagnosis?” and “What is the next best test?” rather than “What is the mechanism of action of the appropriate antibiotic?” or “What is the makeup of the genome of the most likely causative virus?”

    As we know from adult learning theory, interleaved practice is crucial to consolidating knowledge and making memories stick. This involves making associations between patients and disease processes you see on clinical rotations and the textbook versions of their diseases you read about in clinical resources like RACGP and Better Health Victoria guidelines, journal articles, review books, and question banks.

    Studying hard pays dividends in both directions: clinical experiences in which you can put a face and a story to a disease increase the salience of the medical information you are reading while gaining a deeper understanding of patients’ disease processes will make you a more engaged and effective physician.

    Because of this, there is no better time to consolidate clinical medical knowledge pertinent to the AMC Part 1 CAT MCQ Examination than during clinical rotations.

    Tip. Squeeze In Study Time At The Hospital Or Clinic.

    If you think about it, there is often a ton of downtime during hospital rotations. That period between completing your rounds and returning home might as well be a black hole where the free time goes to disappear. So how can you fit in some valuable moments of studying while not appearing nonchalant?

    First, study primarily on your tablet or laptop rather than on your phone. This prevents people from thinking that you’re just browsing on your phone. Second, nobody will look twice if you’re reading John Murtagh’s General Practice or RACGP and Better Health Victoria Guidelines during the day, especially if you’re looking up topics related to your patients. Reading up on your patients and their conditions from textbooks during the day will also free up time in the evening for other resources such as question banks’ practice questions.

    But What If You Are Not Working or Studying At the Moment?

    Not every International Medical Graduate is studying or working clinically when they prepare for the AMC Part 1 CAT MCQ Examination. Especially those already in Australia. But in my opinion, it’s a big advantage if you are.

    Here are a few options you may wish to consider that may help.

    1. Consider using your networks to obtain an extended clinical observership. If you have colleagues or family or friends that work in general practices or hospitals. Ask if they can connect you with someone in charge. Even being able to spend a day a week in general practice or an emergency department will be an advantage for you.
    2. Consider returning home to undertake some more clinical practice. This option not only helps with your study. But also will update your recency of practice.
    3. Obtain employment in another clinical role. It may be that you have sufficient qualifications or can gain qualifications to work in another capacity in a healthcare setting. Examples might be as a nurse or phlebotomist. Working as a nurse in Australia (if that’s something open to you) can be a particularly good way to prepare for the AMC MCQ exam process.

    I have specifically not added options such as clinical bridging programs. As, whilst useful for other purposes, I don’t think they give you the real experience of patients to enable your learning for the AMC MCQ Exam.

    What Are the Best Resources for the AMC Part 1 CAT MCQ Examination Preparation?

    A common misconception is that using more resources equates to better AMC Part 1 CAT MCQ Examination performance. One pitfall of utilizing too many resources is that you tend to dabble in each resource rather than focusing on comprehensively utilizing all the material in a handful of high-yield resources.

    In my view, it is important to select three or four high-quality resources and focus all of your attention on the material within these. Your study schedule should include enough time to thoroughly and completely review all of your selected resources.

    In my experience, doctors commonly fall into the trap of assuming that “If I review ‘everything’ in each of these study resources, then I’ll be more prepared than if I only reviewed a single resource”, or so goes the argument. This is a fallacy. Based upon my experience and the consensus of several peers the highest yield resources are:

    Getting through the entirety of your chosen books and question banks and understanding each topic should be your top study priority.

    What Textbooks Should You Use for the AMC MCQ Examination Preparation?

    Many preparation books exist for each subject area, but doctors should avoid studying from 20 books at the same time. Instead, the best strategy is to use a single book. John Murtagh’s General Practice rates highly. It provides a very good review of all important subject areas tested. Do not underestimate any details presented in John Murtagh’s General Practice book. Even the most minute detail can come up in the form of a question on the AMC Part 1 CAT MCQ Examination.

    Even after reading the book multiple times, you may find details that you had missed before. It is imperative to read the small italicized font that you thought wasn’t important, the captions on the images, and the labels of any diagrams.

    Although you might find some sections of the book less interesting or easier, do not skip any of them. I aimed to have everything in John Murtagh’s General Practice memorized, to the best of my ability. The main advantage of using this is you get an excellent but yet detailed overview of the syllabus. The drawback being it’s time-consuming.

    Why this book in particular and not other books? It is true that the AMC MCQ (and the clinical) test across a range of specialties. But Murtagh’s book is considered “the bible” for general practice in Australia and it provides the Australian medical context that no other book does. Its also recommended by the AMC themselves.

    Should You Subscribe to Question Banks for the AMC MCQ Exam?

    Practice questions are the most important part of the AMC Part 1 CAT MCQ Examination preparation, I cannot emphasize that enough. Since the AMC Part 1 CAT MCQ Examination is a multiple-choice examination, it is important to practice applying your knowledge by utilizing question banks, or QBanks in short.

    Avoid using “handed down” questions or so-called “Recalls” that are circulated for free. These are often very poor in quality. And often suffer from “recall bias”.

    Commonly used question banks include AMEDEX and AMCQBank. Make sure that you choose a question bank that gives detailed explanations about why an answer is correct and the others are incorrect. Below, I get into more details on how to approach practice questions, but as a general rule of thumb, you should put a lot of your focus and energy into working through Question Banks.

    They provide hundreds of practice questions that you can take either timed or untimed as full Examination, sections, or by category. They also offer explanations for each answer.

    How To Use Your Question Banks Effectively?

    If you have questions banks to study with. Which you should. Then you want to know how to make the most of them. It’s not as difficult as you might think to make the most of these. Use these tips to make them work for you:

    • If you miss a question, make a note of it and come back to try those questions again at a later time. With just about any question bank, you’re going to have the ability to flag questions if you have a problem with them or if you can’t get them right. That way, you can check your flagged questions later for study or to try and answer them again.
    • Don’t assume that a question bank, or even a couple of question banks, is going to be enough. You need other study materials of different types as well. For example, videos and flashcards are a good idea too. These can help you break up the monotony of just one topic and also help you get a better understanding of the subject rather than just memorizing facts.
    • If you get a question wrong, read through the information that you’re given about just why that answer is incorrect. If you don’t know why it’s the wrong answer, you run the risk of making the same mistake again. Also, read the reason why the right answer is correct. This will help you remember the answers better the next time.

    AMEDEX Question Bank.

    AMEDEX question banks include various question categories covering all topics as well as updated explanations and references. There are approximately 1300+ questions in this question bank. This question bank is considered to be the emperor of the AMC Part 1 CAT MCQ Examination.

    Whenever I’m asked about how to study for the AMC Part 1 CAT MCQ Examination, I will mention the AMEDEX Question bank and give this one simple piece of advice. Use it. The AMEDEX question bank was the closest thing to the real thing I found during my study preparation.

    The vignettes are close to the length of the actual AMC Part 1 CAT MCQ Examination, and questions are also similar in difficulty. I did AMEDEX 3 times before my AMC Part 1 CAT MCQ Examination. I attribute my success in large part to this.

    Many doctors use this resource to get comfortable with the question style. Because practice questions are so critical to effective AMC Part 1 CAT MCQ Examination preparation, make sure that you are using your AMEDEX question bank in a way that most closely replicates real-time AMC Part 1 CAT MCQ Examination conditions. This means using timed-mode and using randomized, mixed blocks as you get more familiar with AMC Part 1 CAT MCQ Examination style questions.

    Initially, you will want to do subject-specific questions to get familiar with and master the concepts that are tested in each subject area, but later on, you should transition to randomized, mixed questions. Using too many subject-specific questions during your prep will give you far more comfort than you’ll have on the Examination day.

    You will need to train your brain to do the mental acrobatics needed to quickly switch from one subject area to another, within time constraints. After your first complete pass through the question bank, do a quick take through all the questions to see which ones you got wrong or right.

    Identify weaknesses and high-yield topics that you struggled with, and work on solidifying your knowledge base in these areas. Then take a second pass. After your second pass, you should go back and do a complete review, spending most of your time on the questions that you got wrong as well as the questions you are uncertain about but got right.

    AMCQBank Question Bank.

    Is another good yet more expensive option and consists of 1,800 on-line questions; similar to AMEDEX question bank. It has a large question bank with an excellent library feature that breaks down the topics covered by each question. The answer explanations that AMCQBank provides are excellent, and they are easily searchable at any time. One of the best parts of doing practice questions is how much you learn from the answer explanations.

    Should You Attend Any Courses for the AMC MCQ Examination?

    There are a number of courses available to help you with preparing for the AMC MCQ. Generally, these also include question banks for you to practice on, with the added benefit of their being instructors to assist you in understanding the reason behind certain questions.  You will also be studying with other students so this can help from a motivation perspective.

    I did not use any courses and personally I don’t feel that they add any benefit over and above having question banks and other good resources and a study group.  So my recommendation would be to save your money for other things.

    Are Flashcards Helpful for the AMC MCQ Exam?

    I recommend also using flashcards to document important concepts or points that you learned. Use Anki to make your flashcards. The web version is free.

    Anki’s spaced-repetition method is ideal for long-term learning and retention. Every flashcard you make should be concise and prompt a short, to the point answer. Be diligent, and keep up with making flashcards on concepts and points that you learn from practice questions. This will give you an extremely solid knowledge base for the AMC Part 1 CAT MCQ Examination.

    Here’s what I recommend. When you’re reviewing your question banks, make short and to the point flashcards for any question, you missed or guessed correctly on. Do your cards the next morning before beginning with a few review cards. This will help you avoid making the same mistakes again on the question bank and the real AMC Part 1 CAT MCQ Examination.

    So if I missed a question about shock, for example, I’d make a short sentence about the key concept or try to replicate the vignette. Then I’d put just the important info that I didn’t understand quite right before.

    Remember these shouldn’t be elaborate flashcards. Don’t waste too much time on making the flashcards and have no time to study them. Make sure they’re in a quick question and answer format. There are also some flashcard banks that you can check out on different subjects if you don’t want to create your own.

    Preparation Strategies to Pass the AMC Exams.

    Here’s how I recommend you prepare for this examination.

    Balance out your schedule. You want to make sure you’re studying about the same amount each day between now and the day that you’re going to take your AMC Part 1 CAT MCQ Examination. That means you should be looking closely at how many days you have available and what you need to study to find a good amount to do each day. Don’t get too rigid about the schedule and study plan that you have.

    You need to be prepared to make changes that fit your life. If something has changed, and you don’t have as much time to study each day as you thought you did then adjust your schedule to reflect that. If you have some areas that need even more practice than you thought to go ahead and change that too. This plan only works if you make it.

    Some claim the only way to ace the AMC Part 1 CAT MCQ Examination is to study 14 hours a day; I disagree.

    Yes, you need to study a lot, but not so much that you’re sleeping less than 8 hours a night. Take frequent, short (15-minute) breaks. Take a day off from studying periodically, exercise and maybe even meditate. Stay attuned to when you feel overworked, and cut back accordingly.

    If you’re a bit of a workaholic, and grinding through the question banks two times makes you truly happy, that’s okay too. Don’t try to dramatically change your way of life during your dedicated study period. You’ve already come so far and had your fair share of successes: do what you can to stay true to that best version of yourself.

    Distractions are the worst enemy of efficient studying. Avoid them at all costs! Stay far away from the computer except for using the question banks. That includes emails as well. Just set up a vacation message in your email, so others will understand.

    If you can achieve a dedicated study period in the end, make sure you do nothing else except study, eat, drink, use the bathroom, and sleep.

    Sometimes the questions in the question banks can be tough. Be not dismayed, but rather use that as motivation to study even harder to overcome it.

    Don’t just sit down and do several hours of questions all in a row. Mix things up a bit and go through some questions and then switch out and watch some videos or read some text. By going to different things each time you come back from a break, you’ll give your mind something different to focus on, keeping you from getting too bored with the study.

    Study the topics that you don’t know. Take the time to figure out where your weak points are. These are the things you want to spend the most time on. Schedule your hardest subjects each day, if you have three subjects, you’re not as good at, schedule one of them for each day you’re studying. Then, schedule the topics that you’re about average or less than average on for every two to three days.

    Finally, plan the topics you feel confident in every four to five days. Many doctors slip into the habit of studying the subjects they’re already confident in, but if you’ve mastered a subject, spend time focusing on areas that give you trouble.

    Study with a friend or study group, and use mnemonics, even humorous ones to help you memorize the material. Remember that the amygdala (emotion) is connected to the hippocampus (memory).

    Schedule breaks, research shows that the ideal amount of time to study is 52 minutes, followed by a 17-minute break. This gives you time to really dive into the material and then relax, take a breath, and process what you’ve read before you start up again.

    Even though you’re working hard to get the passing score, that doesn’t mean you should ignore having some fun. Schedule in some breaks that are a little longer than 17 minutes or a lot longer and take some time to have fun with your family or friends. This is going to help you feel a lot better jumping back into studying, and who knows, you may perform better too.

    Set realistic goals. Do not set reading plans that you cannot possibly fulfil. Even then, you will inevitably fall behind at the time. Let it not discourage you, but catch up as soon as you can. If you finish a task before schedule, great! Don’t use that as an excuse to do something fun, however. Instead, start doing the next item on the list immediately. Trust me, you will fall behind eventually, so you should get an early start to prepare for that.

    Some claim the only way to ace the AMC Part 1 CAT MCQ Examination is to study 14 hours a day; I disagree.

    Nawaf DANDACHI

    Should You Change the Date of Your AMC MCQ Exam?

    As you are approaching the date of your examination you may start to worry that you have not prepared enough.

    It’s okay to change your AMC Part 1 CAT MCQ Examination date. But do so for the Right Reasons. While you should not hesitate to move your AMC Part 1 CAT MCQ Examination date if you’re not feeling 100%, try not to change your AMC Part 1 CAT MCQ Examination date in response to self-doubt.

    The AMC Part 1 CAT MCQ Examination can cause extreme anxiety. But once you have an AMC Part 1 CAT MCQ Examination date, try your best to stick to it, or you can find yourself constantly pushing back your AMC Part 1 CAT MCQ Examination date and self-doubting, preventing the most efficient study plan, and risking burnout.

    Remember most International Medical Graduates pass the AMC MCQ exam at some point. You won’t know 100% whether you are going to pass without sitting it. So better to sit and fail and get feedback than never to sit at all.

    What to do If You Are Sitting for the Second or Third Time.

    If you are retaking the AMC Part 1 CAT MCQ Examination, focus your preparation on the areas where you struggled. Thankfully, the feedback sheet from your previous AMC Part 1 CAT MCQ Examinations provides graphical performance profiles for each station category. These will allow you to see where you need to concentrate your efforts.

    How To Do Well In Your AMC Part 1 CAT MCQ Examination.

    If you can, get a great night’s sleep the night before the AMC Part 1 CAT MCQ Examination. Anecdotally, doctors and admissions counsellors report that this night of sleep is an important and easily accomplished AMC Part 1 CAT MCQ Examination-preparation goal.

    Know how to get to your AMC Part 1 CAT MCQ Examination site. Do a practice run in advance. There is nothing worse than feeling rushed on the morning of the AMC Part 1 CAT MCQ Examination.

    Get to the Pearson VUE AMC Part 1 CAT MCQ Examination site at least 45 minutes early and be sure to have a current picture ID with your name and signature, an acceptable form of a secondary ID bearing your name and signature, along with a printed copy of your scheduling permit.

    Think of the AMC Part 1 CAT MCQ Examination as 3 mini-tests, that is, three blocks of 50 or so questions each.

    Focus solely on the question you are on, complete it, clear your mind, and move to the next question.

    Answer every question. Wrong answers do not count against you. You cannot proceed to the next question without answering the question before.

    You’re Earning Points Not Losing Them

    When we typically take an Examination like the AMC Part 1 CAT MCQ Examination, we see every question as an opportunity to lower our grade. This is a common reason we’re always anxious throughout and after the AMC Part 1 CAT MCQ Examination. We just focus too much time and energy on what we don’t know. But instead, think about earning points!

    Think about getting excited about the questions you know well and see your grade getting higher. If you have a difficult question (which you will) shrug your shoulders at it, guess, and think that getting it right may only help your score. This shift in mindset can help you so much during your preparation and the AMC Part 1 CAT MCQ Examination.

    You’ll feel more confident and not give too much weight to the questions you don’t know. When you’re answering a question that should be the only question that you’re thinking about and when you’ve answered it, you should put it behind you and jump in with the next one. Don’t think about a question once you’ve answered it, or you could find yourself second-guessing your answers.

    Be sure you have checked all the questions before hitting “end.”  Don’t let the timer go off on its own, press “end”  to submit your test.

    If you can manage your time wisely, you’re going to be in much better shape to get the scores that you’re looking for.

    Keep in mind the average amount of time you have per question is generally about 100 seconds and learn how to keep your thought process within that 100-second mark. That way, you have time to think about the answer, but you aren’t going to run out of time before you answer every question.

    How to Plan Out Your Breaks During the AMC MCQ Examination.

    The AMC Part 1 CAT MCQ Examination is long. 3.5 hours to be exact, so it’s all about pacing. Make sure you have a game plan.

    When will you take your breaks? During the last few weeks of your preparation, try to do a few sections of questions in a row. When do you find your energy tanking? This is probably a good time to introduce a break during the real AMC Part 1 CAT MCQ Examination.

    After doing thousands of practice questions I felt I had developed a pretty good sense for how long each question should take, so once that internal alarm went off, I would pick the answer I felt was the most correct and move on. I took a 5-minute break between every 50 questions, in the end, neither fatigue nor timing was an issue.

    I left the AMC Part 1 CAT MCQ Examination centre with absolutely no clue what my score was going to be. Furthermore, I was pretty confident I had surpassed 250 but was unsure beyond that.

    What Are the Reasons Why Doctors Fail the AMC MCQ Exam?

    The passing rate of the AMC Part 1 CAT MCQ examination throughout the years is approximately 53%. However, it can be argued that most candidates do not fail due to a lack of medical knowledge. Failure is caused as a result of one or several of the following:

    • Poor time management, i.e., not finishing due to time running out.
    • Not reading or understanding the question properly, i.e., If you don’t have the correct information to start how can you choose a correct answer?
    • Not knowing how to navigate through the answers, i.e., getting confused with your options.
    • Thinking at too high a level. The examination is set at the level of a graduating medical student in Australia. So if you think like a GP or Specialist you may not be satisfied with any of the answer options.
    • Not understanding Australian medical and social culture: Australia does not deal with many of the serious things that are experienced in other countries, therefore things that may not be so serious in your country may be quite serious in Australia. For example, if a young child has whooping cough. In your country, you are likely to treat them and send them home with follow up. In Australia, this is often considered so serious that you would hospitalize them.

    What to Do About Poor Time Management.

    An effective technique to combat poor time management is called cycling. It may seem strange at first but once you master this it will take you less time to answer the questions, and you will always end up finishing ahead of time.

    How to use cycling can be found on page 44 of ‘Mastering Multiple Choice

    This is explained and should be initially practised on a paper exam.

    After you have been studying for some time, make sure you also go on to the AMC website and try their online mock AMC Part 1 CAT MCQ Examination. It is the same questions as in the AMC Handbook of Multiple Choice Questions, so it won’t be new study material, but it is important that you know how to use the AMC Part 1 CAT MCQ Examination and are comfortable with it when you sit the AMC Part 1 CAT MCQ Examination. You don’t want to waste important time during your 3 hours learning to use it.

    What to Do About Not Reading And Understanding The Question Properly?

    This is a common problem. There are two techniques to overcome this.

    The first is you have to acknowledge the importance of the nonmedical.

    Each question in the AMC Part 1 CAT MCQ Examination has taken hours of labour by several examiners to write before being tested and reviewed by other examiners and then tried in the AMC Part 1 CAT MCQ Examination, 30 non scored pilot questions.

    Every single word in the question is important. So if the question mentions things like clothes or patient’s concerns or similar nonmedical information, do not ignore this as it could be the clue to the answer and of course, this also applies to the annoying words like not and except that change what the question is asking.

    This is also why practising amateur recall questions is often a bad idea. As generally, they do not capture these sorts of nuances.

    The second technique that will assist you in your AMC Part 1 CAT MCQ Examination preparation is to try to think like the examiners.

    Have you ever heard the saying ‘to catch a criminal you must think like a criminal?. Well, this is similar, to successfully take the AMC Part 1 CAT MCQ Examination you must think like an examiner. If you understand how to write an AMC Part 1 CAT MCQ Examination question you will understand how to read one.

    Most examiners use ‘Constructing Written Test Questions For the Basic and Clinical Sciences’ or similar to guide them on writing questions.

    Chapter 4 will give you templates and detailed instructions on how to write a question. You will find if you write your questions for each topic you study it will also help you remember the details you are studying. This is also great to do with a study partner, located anywhere. Choose a topic to study, write a set number of questions each e.g. 5 or 10, and then email the questions to each other to attempt.

    What to Do About Not Knowing How to Navigate Through the Answers?

    You will find some great techniques to use for this in ‘Mastering Multiple Choice’ from page 53 onwards.

    What to Do About Thinking At Too High Level?

    Most doctors who sit the AMC Part 1 CAT MCQ Examination are already medical professionals in their own right. They have usually studied medicine for more than 8 years, have been working in a clinical environment for several years, and have often begun studying and working in a specialist environment. So by the time you sit the AMC Part 1 CAT MCQ Examination your medical knowledge is quite high and developed. So you need to make sure you bring it back down to an undergraduate level. Commonly, people sitting the AMC Part 1 CAT MCQ Examination do the worst in their area of specialty because they are thinking at too complex a level.

    What to Do About Not Understanding Australian Medical And Social Culture?

    There are several ways you can gain knowledge about this. If you are in Australia, get out into the community. Talk to people on the street, watch Australian TV dramas like Neighbours and Home and Away and join a hobby club or group. It might sound like a waste of time but the information you learn from an Australian about the culture you can not find in a book.

    Use Google to locate things near you that might interest you. Council community centres are a great place to start because they are usually close to where you live and their classes/activates are free or cheap e.g. $5. You can also use online resources such as newspapers like The Advertiser or The Age, a Google Australian newspaper to get an understanding of the type of things that are important in Australia, you can also see what local medical stories are included. Some online medical resources include RACGP AFP (this is free in Australia, but you may have to pay if you are overseas) and Better Health Victoria. These can be used as support for your main study material.

    Summary

    1. I would recommend you study from a textbook first. John Murtagh’s General Practice is the most suited.
    2. After finishing the textbook, revise all the notes you took thoroughly.
    3. Then move on to the AMC handbooks, there are 2. The handbook of MCQ and the annotated MCQ. Take notes of the questions. Read the explanations carefully. Be sure to know why the correct option is correct, and why the other options are not.
    4. After finishing both handbooks, revise all the notes you took thoroughly.
    5. Now it’s time for the question banks. Use the same approach for the question banks, carefully reading the explanations, and taking notes.
    6. After finishing both question banks, revise all the notes you took thoroughly 
    7. By now you’ve studied the textbook thoroughly, solved all the questions, and revised them 3 times along the way.
    8. Be sure to check the growth milestones, school exclusion guidelines for communicable diseases in children, cancer screening guidelines, and the immunization guidelines. Always follow the latest guidelines on RACGP and Better Health Victoria websites.
    9. Be sure to know common ECG rhythms and important XRAY presentations, for example, Pneumonia, TB, or Sarcoidosis.
    10. Revise all the notes you took thoroughly again. The key is always revising after finishing a step so the information stays fresh.

    Although the AMC Part 1 CAT MCQ Examination is a difficult Examination, with diligent and focused work, it is possible to be prepared and confident on AMC Part 1 CAT MCQ Examination day.

  • Can Doctors From Ireland Work in Australia? Absolutely. Here’s How.

    Can Doctors From Ireland Work in Australia? Absolutely. Here’s How.

    Whilst doctors from the United Kingdom and India are generally more frequently encountered in Australia. It is not unusual at all to come across a doctor from Ireland who is now happily working 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 Irish doctors on the whole to be a really good group to work with.

    Can doctors from Ireland find employment in Australia? The answer is, of course, yes. The Republic of Ireland provides a significant but steady 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 if you are from Ireland you have a very good chance.

    Because the Irish medical training system is recognized by the Medical Board of Australia as being on par or what is termed “competent”, Irish doctors have good success with either becoming generally registered through the competent authority pathway or being recognized as a specialist through the specialist pathway. In 2019 (the latest year we have figures for) 263 doctors from Ireland applied for provisional registration in Australia with 257 of those applications granted. That is on top of the hundreds of Irish doctors already working in Australia.

    So the prospects for working in Australia as a doctor from Ireland are positive. But it’s important to have a 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 Trainee Option For Ireland Doctors Australia.

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

    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 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.

    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 as those from Australia.

    If you are an international medical graduate (IMGs) 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.

    So it is important to note here that there is no competent authority pathway for IMGs to gain full registration in Ireland and then attempt to gain registration in Australia. You have to have graduated from a medical school in Ireland.

    What are the steps involved in the competent authority pathway for Ireland Doctors Australia?

    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 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 are:

    You need to be a graduate of a medical course conducted by a medical school in the Republic of Ireland which is accredited by the Medical Council of Ireland (MCI).

    (Of note this now includes off-shore courses which are accredited by the MCI which, as of the writing of this post included 3 courses run by the National University of Ireland in Malaysia (x2) and Bahrain.

    AND

    Successful completion of an internship in Ireland (Certificate of experience).

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

    competent authority

    Competent Authority Pathway Course

    A Free Course For Trainee Doctors

    This course covers all the required steps for working as a doctor in Australia if you are a trainee doctor from Ireland, the UK, US or Canada.

    What types of jobs can I apply for as an Irish Trainee Doctor in Australia?

    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 Republic of Ireland. 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 jobs you come across 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 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 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, which is what most Irish trainees 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 Ireland 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 Irish Specialists

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

    Actually, it’s a combination of the Specialist Pathway and the Competent Authority Pathway. More on that in a bit.

    Once again your process 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.

    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 Irish 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 Irish 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 specialists from Ireland 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 specialists from Ireland deemed not to be comparable by the college. This only happened to 1 out of 31 specialist doctors from Ireland in 2018. 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 Satisfactory Completion of Training and relevant college Fellowship and be registered as a specialist with the Medical Council of Ireland
    • You should ideally have worked substantively at a Consultant level in your field for 2 years or more
    • You should be able to demonstrate good standing with the Medical Council of Ireland 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
    Specialist Pathway Course

    Specialist Pathway Course

    Free Course

    You can enrol now in this free course that will step you through all the requirements for working as a specialist doctor in Australia

    Can you enter training in Australia if you are a doctor from Ireland?

    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 doctors from Ireland 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 training you have done already. But this varies and may at best normally shave one or two years off of your training.

    An Alternative But Limited Option.

    There is an alternative but time-limited pathway for Irish doctors who are just seeking a short term experience in Australia to add to their training in Ireland. 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 Ireland 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.

    How many doctors from Ireland are working in Australia?

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

    From data collected by the Australian Government, we know that for 2018 and 2019 (latest available years):

    • In 2018, 263 applications were made for provisional registration via the competent authority pathway by doctors from Ireland with 257 granted provisional registration.
    • In 2019, 39 applications were made for specialist assessment, 8 were withdrawn prior to full assessment. Of the remainder, only 1 was deemed not comparable, 10 partially comparable and 20 substantially comparable.
    • In 2019, 13 out of 13 specialty doctors from Ireland were recommended for specialist recognition.

    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 other wise 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 orGeneral 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 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 an exam fee of $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.

    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.

    We hope that you found this summary about how Irish 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 doctors from Ireland who have made the journey to Australia.

    Related Questions.


    Do I Need to Sit An English Test?

    Doctors from Ireland are amongst a select group of countries for which the Medical Board does not expect an English proficiency test. However, there may still be some circumstances where you do need this. If, for example, some of your schooling was in another country. You should always check the requirements.

    Are there any other options for working as an Irish doctor in Australia?

    Some doctors just want to come to Australia for a limited period of time as an opportunity to train in another country.<br>As we have highlighted above there is an alternative but time-limited pathway for US doctors who are just seeking a short term experience in Australia to add to their training in the US. 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 US or be less than two years from completion. So this is a program mainly for early-career specialists or advanced trainees.

    Should I use a medical recruitment company if I am considering working in Australia?

    It is possible to deal directly with employers in Australia as an Irish doctor. In general, however, when moving from one country to another most doctors find it useful to engage with a medical recruitment company as they can tend to take some of the stress out of the planning for you and help with all the paperwork and negotiating with prospective employers. Some medical recruitment companies also provide migration services and relocation services as well. We have written more on this subject

    Can you do your internship in Australia as a doctor from Ireland?

    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 applying for Intern training in Ireland and completing this year first.

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

    Specialist doctors from the Republic of Ireland are not automatically granted specialist recognition. However, most are. As you can see from above in 2019 there were 39 applications made for specialist assessment to the Australian colleges by Irish doctors and of these, the majority were deemed substantially comparable. Irish doctors tend to get a very favourable outcome in comparison to doctors from most other countries. Ireland has generally one of the highest rates for doctors being seen as substantially comparable.

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

    The majority of specialties have some vacancies and will provide opportunities for Irish 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.
  • Getting Registered In Australia. The Four Options for International Doctors.

    Getting Registered In Australia. The Four Options for International Doctors.

    *The process of getting a job and getting registered as a doctor in Australia is complex, it’s important to understand that you do need to get individual advice on your circumstance. Circumstances do vary for individuals and also things change over time.

    If you are an ad doctor looking for some general information about your options for getting registered in Australia, then this post is for you. I spend a lot of time on Zoom calls these days explaining to doctors from overseas countries (International Medical Graduates or IMGs) what their options are for working as a doctor in Australia. It’s quite a complex process. And inevitably at some point, it makes sense to talk one on one. Particularly if you are starting to get serious about the idea of working as a doctor in Australia. If that’s you I’d recommend booking a strategy call.

    With that being said. Let’s look at the four pathways available for IMG doctors to become registered in Australia from overseas. And let me be quite clear here. These are not the main pathways. They are the only pathways available for getting registered in Australia, at the time of writing this post. If you are a doctor coming from overseas to Australia your pathways to registration are:

    • The Standard Pathway, which is a general registration pathway for doctors from any country who do not have specialist qualifications and are looking to start at junior doctor level in Australia.
    • The Competent Authority Pathway, which is a restricted pathway that enables both specialist and non-specialist doctors from the United Kingdom, United States of America, Republic of Ireland and Canada to commence their work in Australia.
    • The Specialist Pathway, which is a pathway that can ultimately lead to recognition as a specialist in Australia and requires you to be initially assessed by the relevant medical specialty college.
    • The Short Term Training in a Medical Specialty Pathway, which allows for time-limited registration, so that advanced trainees and specialists from other countries can obtain some top-up training in Australia.

    It All Comes Down To the Medical Board of Australia.

    So the first thing to know about getting registered in Australia is that it’s the same final authority wherever you work in the country. No matter what state or territory you are in, it’s all conducted through what’s called the Medical Board of Australia under the overarching umbrella of the Australian Health Practitioners Regulation Agency.

    This is actually a reasonably new thing in Australia. Prior to 2010, the various state and territory medical boards were responsible for registration, which actually made the process even more complex.

    Under the Medical Board of Australia, there are essentially four pathways to becoming registered as a doctor in the country. And if you’re an IMG, you can find some very helpful information about these pathways on the board website.

    There are even handy flow charts that can help you make some decisions about which option might be best for you.

    But It All Starts with the Australian Medical Council.

    Whilst the endpoint for registration for IMGs is the Medical Board the starting point is always the Australian Medical Council. For some IMGs (those attempting the Standard Pathway) you will have a lot to do with the AMC. But for the rest it’s really a very quick but mandatory step where you have to get your medical degrees verified.

    Why Have Pathways to Registration?

    Pathways to registration in this country for international medical graduates are essentially comparisons against the process by which Australian and also New Zealand medical graduates are given registration.

    Australian graduates first become registered in the system upon graduating from medical school as interns and progress through what is called provisional registration to general registration. After this most Australian doctors hope to eventually add what is called specialist registration to their registration status at some point.

    The four pathways to getting registered in Australia are therefore pathways that lead to a form of initial or provisional registration. But which ultimately lead to the IMG being able to gain either general or specialist registration. This is with one notable exception. The Short Term Specialist Training Pathway, which is a time-limited pathway that does not lead to either general or specialist training.

    The Competent Authority Pathway.

    The competent authority (CA) pathway essentially recognises that doctors that come from other healthcare systems, with similar systems, and processes, and standards to the Australian context, have a level of equivalence.

    The competent authority pathway is for both non-specialists as well as specialist doctors. It is a streamlined process for becoming granted registration in Australia. The board has approved a number of international authorities as competent in their assessment of doctors for medical registration. The reason that these authorities are deemed competent (and others are not) is unclear but historically well before the advent of the Medical Board of Australia, these jurisdictions were given preferred status by the old State and Territory Medical Boards. Arguably these countries do have medical training systems that are equivalent to Australia.

    The authorities are:

    • the General Medical Council in the UK for local UK graduates as well as international graduates who go through the PLAB pathway.
    • the Medical Council of Canada.
    • the Educational Commission for Foreign Medical Graduates of the United States and the United States Medical Licensing Exam (essentially, anyone who has the USMLE certificate).
    • the Medical Council of Ireland.
    • And the Medical Council of New Zealand*

    *The Medical Council of New Zealand is only listed here for IMG doctors who go through what’s called the NZREX process. Something akin to the AMC Standard Pathway process in Australia. Actual medical graduates of medical schools in New Zealand are considered absolutely equivalent to Australian graduates of Australian medical schools because these schools are actually also accredited by the Australian Medical Council.

    So if you have primary qualifications in medicine awarded by a training institute, which is recognised in the competent authority jurisdictions and also recognised by the Australian Medical Council you will normally be permitted to apply to work as a doctor in Australia under this pathway.

    This is on the proviso that you have completed some clinical training or assessment within that authority. This differs from jurisdiction to jurisdiction but is either a year of training or two. So, for example, in the UK, that would be the first foundation years. Whereas in the US it would mean completing 2 residency years in an ACGME accredited post.

    Why Is The Competent Authority Pathway Attractive?

    If you are eligible for the Competent Authority Pathway in Australia this is generally a good thing as it is considered to be the easiest pathway to getting registered and being able to start working here.

    Often times employers will also prefer say a UK-trained doctor over a doctor from Sri Lanka when there is a need to employ an IMGs.

    If you are eligible for the Competent Authority pathway essentially all you need to do is convince an employer to offer you a suitable position and have the intended supervision for this position assessed by the Medical Board of Australia.

    Once you are approved for registration you work for 12 months under provisional registration and will need to complete satisfactory supervisor reports. If all goes well at the end of this process you are able to apply for general registration. There’s no need for examinations or other forms of assessment (other than supervisor reports).

    (It should be noted that sometimes doctors from CA countries who are applying for specialist registration also work for 12 months under this pathway. In this situation you do not gain general registration at the end of the process you gain specialist registration in your particular specialty.)

    The Standard Pathway.

    The next pathway is the most common pathway that the majority of IMGs attempt in order to work as doctors in Australia.

    The standard pathway applies to IMGs who are not eligible for the competent authority pathway and who do not have specialist qualifications. To come in through this category, you need to have a recognised primary qualification in medicine. But before you can apply to the Medical Board of Australia for registration or approach employers for jobs, you have to go through some additional steps with the Australian Medical Council.

    These steps include the mandatory check of your degree, which all IMGs have to do. But also include sitting for the AMC Certificate examinations, which is a 2 part examination, consisting of a Part 1 MCQ Exam, and then a Part 2 Clinical Examination.

    You can actually begin to apply for jobs once you have successfully passed the AMC Part 1. But you will only be able to gain general registration once you have completed the full certificate.

    We have a guide to the AMC exam here. The AMC Exam, particularly the clinical exam, is generally considered to be a very tough and difficult examination to complete. Despite this, there are quite a few IMG doctors who have obtained their certificate but have been unable to find employment as a doctor in Australia.

    The Specialist Pathway.

    The final main pathway for most IMGs is the specialist pathway. This pathway is for overseas trained specialists so that they can apply to be assessed against the capability of a similar Australian-trained specialist. A process that is called “comparability”.

    This process includes IMGs applying for what is called Area of Need positions, which are extremely rare to find these days. As well as specialist IMGs just going for assessment with the college.

    As with all other pathways, you need to have a recognised primary degree first. But then just to create more confusion IMGs applying for the specialist pathway don’t apply to the AMC or the Medical Board for assessment they apply to the relevant specialist college. Which then performs an assessment.

    So if, for example, you’re a specialist from a competent authority country, it can be very confusing because you can apply to the Medical Board of Australia for provisional registration under the competent authority pathway to work in a supervised position.

    But at the same time, you need to also apply it to the college to assess your specialty training and experience and qualifications in order to get registered as a specialist and come through the specialist pathway.

    Applying for the Specialist Pathway assessment involves quite a bit of time and money. In general, you will need to fill out an extensive application outlining all of your past experiences to date. The more complete and detailed you make this generally the better the outcome. The college may just reject you based on your application. But generally, in the case of most colleges you are then invited to an interview to further explore your credentials.

    There are only 3 outcomes for this assessment process:

    1. You are deemed not comparable.
    2. You are deemed partially comparable.
    3. You are deemed substantially comparable.

    Being deemed not comparable means you need to think about other pathways.

    Being deemed partially comparable or substantially comparable means that the college views you as either being within 2 years (partially comparable) or 1 year (substantially comparable) of becoming a specialist in Australia.

    If you achieve comparability you will still need to secure an appropriate post where you can receive oversight by other specialists in your field. In the case of partially comparable, it is also likely that you will need to sit further examinations.

    If you gain a post and complete all the requirements you will finally be recommended to the Medical Board for specialist registration.

    We will eventually have a more detailed post about the specialist pathway. But in the meantime the following 2 blog posts are useful:

    As well as our series of videos on the Specialist Pathway on YouTube.

    The Short Term Specialist Training Pathway. The Final Pathway.

    There is actually a fourth pathway option. This option is not as well known to IMGs as the other 3 options. And this is perhaps because it is not a pathway to permanent registration in Australia.

    The final pathway is called the Short Term Training in a Medical Specialty Pathway, or Short Term Specialist Training Pathway. This pathway is limited to IMG doctors who are either already specialists or in the advanced or final phase of their specialty training. Ostensibly the pathway is designed to facilitate additional “top-up” training or experience, i.e. it is designed to give a specialist from another country some additional training and experience to help when they return to their own country.

    The pathway is therefore strictly limited to 2 years and you generally have to complete a form indicating that you are intending to return to your own country at the end of this period of registration.

    To be eligible for this pathway you first need to secure a job offer (usually an Advanced Training post) from an employer. Like all other pathways, you need to verify your degree with the AMC. You also need to apply to the specialist college for assessment of your credentials against the post you have secured.

    Unlike the specialist pathway, the college assessment is only paper-based, requires less information, and generally easier to pass.

    Is Short Term Specialist Training A Pathway to Working Permanently in Australia?

    Even prior to the advent of the one Medical Board there were registration categories in existence that enabled trainee doctors from other countries to come to Australia and work for a limited period of time.

    It was not uncommon for these doctors to take the opportunity whilst working in Australia to pursue other forms of registration and the case is the same still with the Short Term Specialist Training Pathway.

    So, whilst the pathway itself is designed to be time-limited and there is a requirement to state your intention to return at the end of your registration period. There is really no way of enforcing this and there is nothing to say that you might change your mind halfway through the process.

    And I have certainly seen a number of IMG doctors use this particular pathway as a “stepping stone” to a more permanent registration category.

    Whilst, specialist colleges are not permitted to take into account any experience you have gathered under the Short Term Specialist Training Pathway, it is hard for them to ignore the fact that you have already worked successfully in the Australian context and also hard to ignore references from Australian College Fellows attesting to your capability.

    Similarly, if you have proven your work capability in an Australian health service then this tends to dramatically improve your prospects with employers in Australia for other jobs over and above most other things, including things like qualifications and observerships.

    Related Questions.

    I Have More Questions About the Standard Pathway and AMC Exams.

    We recommend you check out this extensive post that we wrote.

    Where Can I Find More Information About the Specialist Colleges?

    We have you covered in this post

    Do I Need to Pass an English Test?

    Unless you have high schooled and trained in English in a small number of countries that the Medical Board recognises it is likely that you will have to pass one of the English competency tests. This is a requirement prior to obtaining registration and may also be required prior to other assessments, such as specialty college assessments. We have a detailed guide about this issue here.

  • A Guide To Specialty Training For Doctors In Australia

    A Guide To Specialty Training For Doctors In Australia

    One of the most frequent questions I receive from doctors from overseas is “How do I get into residency training in Australia?”  Becoming a specialist doctor is generally a very rewarding pathway, which can afford a lot of independence and financial stability and is probably the ultimate aim of most doctors in Australia

    So I have put this post together as an overview of how this all works. In so doing I wanted to make a few key points:

    1. The process of becoming a specialist doctor in Australia is termed “specialty training” and in most cases is conducted via one of the 16 specialist medical colleges.

    2. Residency training, which is often what doctors from places such as North American and Asian countries refer to when they are talking about specialty training, does not exist as a concept in Australia. And in fact, being a “resident medical officer” means something quite different here.

    3. There are around 64 different medical specialties to choose from in Australia, and this includes general practice, which is recognised as a specialty in its own right.

    How and when do local graduates enter into specialty training?

    Medical school has been rapidly evolving in Australia of late with the majority of schools phasing out the old MB BS programs in favour of 4 or 5 year MDs. Some of these are graduate programs. So its not surprising to hear that for some the process of choosing and targeting a particular specialty begins early in medical school.

    However, unlike say the North American system you can’t simply apply for specialty training at the end of your medical school.

    Upon graduating there is a requirement for a minimum of one year supervised training which is referred to as an “internship”.  It is only after you satisfactorily complete your internship that you gain general registration. Doctors from the United Kingdom and the Republic of Ireland would be familiar with something similar.  The Australian medical training system has largely been adapted from the UK system.  

    The internship period is heavily supervised and there are a formal training and assessment processes, with oversight provided by bodies in each State and Territory called Prevocational Medical Councils.

    This prevocational period often extends for at least another year and we call it prevocational training.

    Resident Means Something Different in Australia.

    A Resident or Resident Medical Officer, or RMO in Australia is a doctor in their second year out of medical school, i.e. someone who has completed their internship. 

    Whilst it is technically possible to enter into some specialty training programs as a Resident (Psychiatry and General Practice being examples) generally most doctors wait until the end of their second year to enter into training. And in the case of some particularly competitive specialties, such as surgical specialties and anaesthesia, may wait several more years to get on to a training scheme.

    A doctor who is still a resident in their third year is generally referred to as a Senior Resident.

    For most senior resident doctors, there is no set standard or oversight for training. So the quality of support provided can vary quite considerably.  And it can often be left up to the individual to develop their own program. This situation has unfortunately led to some fairly famous recent cases of exploitation of doctors working what are termed “unaccredited posts”. These are posts that are not oversighted as an official training post by a college. Often referred also to as service roles.

    It’s for this reason that doctors in Australia are often relieved when they finally make it into a specialty.

    For International Medical Graduates coming via the standard pathway or in some cases also the competent authority pathway. Its a Resident post that you are looking to fill as your first job in Medicine in Australia, i.e. a pre-specialty training position.

    Key Requirements for Specialty Training.

    The requirements for entry into specialty training differ between colleges and this post is not intended to address each one specifically.  But let’s look at some of the general requirements.

    You Must Have General Registration to Enter Specialty Training.

    One thing that every doctor must have to enter into specialty training in Australia is general registration.  So for local graduates, this means completing an internship first. For IMGs this means completing a provisional year, normally as a resident, either via the standard pathway or competent authority pathway, after which you will also be granted general registration.

    This is why I often tell IMG candidates that once you have completed your supervised year you are almost on an equal footing with local graduates.

    You Generally Need at Least 2 Year’s Experience.

    Most but not all colleges require you to have gained a minimum amount of clinical experience prior to applying. The most common requirement is for 2 years.

    Whether this is a valid requirement or not is somewhat questionable. As noted some colleges now allow doctors to apply after completing an internship.

    A key driver for maintaining a second-year residency in Australia is the need for doctors to fill service level roles.  But to be fair many doctors themselves also value having 2 years to consolidate after medical school.

    Having Permanent Residency Or Citizenship Can Also Be A Requirement.

    In some cases, for example, the Royal Australasian College of Surgeons, you will also need to prove that you are a Citizen or permanent resident. So this can be a discriminator against IMG doctors.

    I am often asked why there is this discrimination in place. To be fair to the colleges they are really only applying the Australian law which essentially dictates that jobs must be provided to citizens and residents first before being offered to someone on a visa. Many other countries have similar arrangements for their own citizens.

    The Application Process Itself.

    The application process itself is similar to a normal job recruitment process.  There are 2 main ways to get selected into specialty training in Australia.

    1. College Goes First.

    The first way is to get selected by the College first. This is the approach that most Colleges adopt. Examples, include RACS, RANZCO, RANZCOG and RANZCP.

    For trainee doctors, this selection process may be the most rigorous job interview that they ever encounter, with many colleges employing scoring criteria for both your CV, as well as referees and submitting candidates to psychometric testing and a multiple mini interview approach.

    There is often a fee of several thousand dollars to apply with no refund if you don’t make it!

    After the college has selected which candidates it prefers for training the employers (the hospitals) may invoke their own second selection process or just accept the finding of the college.

    2. Employer Goes First (Alone).

    If you are applying for Physician training or Radiology training then you will start off by interviewing for a training post which is held by a hospital or health services. This will generally be a more standard affair, with an online application, CV and referee checks and interviews. Normally its just a panel interview but there has been a trend lately to making some of these recruitments multiple mini interviews.

    There will generally be representatives of the respective college on the selection panel.

    Once you have gained a post you will apply to be recognised as a trainee by the relevant college. In the case of Physicians, you can even do this beforehand. The process is generally just an application and fee and rarely are doctors rejected.

    General Practice Selection.

    General Practice Selection is a whole beast to itself, with many pathways.

    The main pathway into GP training is conducted by the regional training providers, which are separate from the GP colleges. Selection is quite rigorous and also involves both psychometric testing as well as formal interviewing. Once selected, candidates then apply for one or both other College training programs for which they have already been deemed eligible bypassing the training selection process.

    What Specialties Can You Apply For?

    If we take the latest view from the Medical Board of Australia there are 64 recognised specialties for medicine in Australia.  And below that many hospitals and employers will recognise even more subspecialties.

    That seems a lot of choices. But actually the initial choice is made a little bit easier by virtue of the fact that many specialties break their training up into Basic and Advanced Training.  Basic Training is usually around 2 or 3 years and more generalised. Once you complete Basic Training you can specialise further in Advanced Training. Which usually requires you to undertake an additional selection step.

    Let’s look at some of the more popular specialty choices in Australia.

    For General Practice. As indicated there are a number of pathways but the main pathway is the Australian General Practice Training Program under which you train for a Fellowship with either the Royal Australian College of General Practitioners or Australian College of Rural Remote Medicine.

    For both Adult Medicine and Paediatrics you commence Basic Training with the Royal Australasian College of Physicians. After which you can choose to stay general in your Advanced Training or do one of many different specialties. The RACP also looks after some other smaller training programs, including Occupational Health and Rehabilitation Medicine.

    For Radiology, you apply to the Royal Australian and New Zealand College of Radiology. This is a relatively straight forward specialty. There are really only two options. Diagnostic Radiology and Radiotherapy.

    For Psychiatry, you apply to the Royal Australian and New Zealand College of Psychiatrists.

    For Emergency Medicine, it’s the Australasian College for Emergency Medicine.

    Surgery is a little different. Because its such a competitive specialty trainees have generally completed a lot of experience and courses just to get in. So you apply directly for “SET” (Surgical Education Training) in either of General, Vascular, Orthopaedics, Ear Nose and Throat, Paediatrics, Cardiothoracic, Neurosurgery, Urology or Plastic Surgery.

    We have a more detailed post about the Specialty Colleges here.

    Other Related Questions.

    How Long Does Specialty Training Run For?

    Answer. Most training programs are around 5 or 6 years minimum. Although General Practice can be as little as 3 years.

    Do You Get Paid When Training?

    Answer. It’s surprising how often this question is asked. And I guess it must be because in many countries you have to pay for a specialty training post or residency position.  If you are employed as a doctor in Australia you are paid. This includes training roles. The salaries are pretty good although the work can be quite long in some cases. We have a salary guide here.

    How Do You Enter Training Via the Competent Authority Pathway?

    Answer. First of all. Like any other IMG you will need to get your credentials reviewed by the Australian Medical Council and then gain an appropriate job offer which permits you to have provisional registration with the Medical Board of Australia.

    What post you are able to fill will largely depend on your current level of experience and training. If you have just finished Foundation Year in the UK then you will probably only be able to apply for Resident level jobs.

    But let’s say you have almost finished your Residency in Anaesthetics in the US. Then you will probably be permitted to fill an unaccredited Anaesthetic Registrar post. But not something that you are not experienced in, such as a Psychiatry post.
    Once you have completed your 12 months supervision successfully you can apply for general registration, after which you can apply to enter training in Australia. You may be eligible for some recognition of prior learning.

    How Do You Enter Training Via the Standard Pathway?

    You must register with the Australian Medical Council and complete your AMC Certificate (Part 1 and 2). As well as obtain a post that allows you to work towards general registration. Its at this point that you can start applying for training posts.

    Is There Some Recognition For Prior Learning?

    Answer. In the past, it has been difficult to obtain much in the way of Recognition of Prior Learning from colleges but recently I was successful in helping one trainee doctor get almost 3 years credit for Psychiatry!  Generally, you might expect to get one or two years off your basic training. Depending on how much training you have already done and how similar it is to training in Australia. Candidates from competent authority countries tend to do better with this process.

    How Are Specialists From Overseas Treated?

    Specialists from other countries can apply directly to the relevant college for an assessment of their capability to work as a specialist in Australia. This is known as the specialist pathway.
  • 3 Common Mistakes to Avoid When Applying for the Specialist Pathway Australia

    3 Common Mistakes to Avoid When Applying for the Specialist Pathway Australia

    In this post, I want to go over a few of the common mistakes that I see specialists from other countries make when going through the process of applying to work via the specialist pathway in Australia. If you are reading this post. You are probably a specialist doctor in another country who is thinking about applying to work in Australia. Thanks for putting your trust in our blog. I have helped several doctors just like you to make this career move in the past.

    I’d like to highlight that I now have a short course on the specialist pathway on my website that you can take for free that will help you to better assess your readiness to embark on this journey. There is a handy checklist in this course that will help you to make sure that this is the right option for your and if so that you are on track with your application and you don’t overlook a key element (such as the ones we have talked about already).

    And a reminder that there may be other ways that I can help you out, including my RISK-FREE Strategy Call which is a great option if you just have a few questions or are struggling to know how to get started with the process.

    In this post, I want to go over the 3 key mistakes that I see the majority of Specialist IMGs ignore to their detriment when attempting to work via the specialist pathway in Australia. These are mistakes that I see time after time. And the sad thing is that it is only often that someone comes to me late in the process to seek help on one of these problems. When, if they had come to me earlier or known about these issues, they could have saved themselves a lot of time, pain and heartache.

    Specialist Pathway Mistake Number 1.  English Language Proficiency.

    So the first mistake often made with the specialist pathway is a pretty simple one. It’s not having the right English language proficiency. I’ve blogged and vlogged on this matter before. So I won’t give a detailed overview about English language proficiency in this post.

    But suffice to say. An Australian specialty college is not going to assess you if you are required to prove your English Language proficiency.

    Now if you are from a country where English is the main language, like the UK or Canada or the United States you are probably okay (BUT YOU SHOULD ALWAYS CHECK).

    But if you are from most other countries such as India, for example, you will need to sit one of the four approved tests and achieve the required score.

    It is vital that you do your very best on these tests by the way. As the level at which you score will affect whether employers are interested in interviewing you.  With for example a candidate with an IELTS score of 8/9 being much more likely in my experience to score an interview than a candidate with the par score of 7/9.  (All other things being equal).

    If you haven’t sat your test and you apply to a college. Your application will be rejected until such time as you complete the proficiency test.

    So this is a delay you can avoid. 

    I generally recommend preparing and sitting for your proficiency test whilst you pull together all the information required for your application.

    Specialist Pathway Mistake Number 2. Not Reviewing Your Specialist Pathway Application Against the College Curricula.

    In my experience, most Specialist IMGs (SIMGs) are able to navigate to the relevant college website and read through the relevant pages for IMGs, including finding the application guide and forms.

    However, there are two things that most SIMGs do not look at on these websites, which are crucial to a successful application for the specialist pathway.

    The first of these are the college’s relevant training curriculum

    You see it is vitally important that you are able to demonstrate both in your application as well as your interview that your training and experience is as close as possible to what is expected of a specialist in Australia.

    The best guide to this is what and how the college determines its own locally trainees should do.

    As an example of this if you were applying to the Royal Australasian College of Physician as a General Physician you would be best advised to review your application against:

    the RACP Advanced Training Curriculum for General Medicine & Acute Care

    This document goes over in explicit detail what experiences and learning outcomes local physicians are meant to go through and how these are assessed.

    This is by far the easiest way to work out how your training in your country stacks up against a specialist here and how to explain this training.

    Most of these documents are publicly available. You just need to know where to find them. (See below). And they are normally very detailed. Often going for about 30 or 40 pages in length.

    These documents can give you some hints about extra things you could do now to increase your chances for the specialist pathway.  For example, perhaps there is a certain skill or procedure an Australia trainee is required to demonstrate. Maybe you can do a course on this skill or procedure or take a short post in a service in your own country that performs this skill or procedure?

    Specialist Pathway Mistake Number 3. Not Reviewing Your Specialist Pathway Application Against the College Professional Frameworks.

    The 3rd and last mistake when applying for the specialist pathway is similar to the previous one.  That is not taking the time to find out about the Professional Framework for college Fellows in Australia.

    Again. Most of these frameworks are easily found on college websites.

    They give a guide to the types of behaviour and skills a consultant is expected to demonstrate and have and maintain in Australia.

    Most of these are based upon the famous CanMEDS framework.

    CanMEDS Framework AdvanceMed
    used with permission of RCPSC

    If you are aware of these frameworks then you will be able to avoid a common error I see when reviewing applications for specialist assessment via the specialist pathway.

    This mistake is to poorly describe your consultant experience in a narrow and clinical way.

    Remember. The first thing that colleges tend to look at is the length and then the quality of your training.

    If this is in any doubt (which it can often be). They want to then see that you are working in a consultant role in your own country, similar to how a consultant might work in Australia.

    This not only involves demonstrating medical expertise at an independent level.

    But also other things from these competency frameworks, such as managerial roles and quality improvement roles and of course teaching and supervision roles.

    As a rule its important to document for every consultant job you have worked both:

    • The clinical responsibilities and achievements, including the level of autonomy you worked at (the colleges are generally looking to see that you were the most senior doctor responsible for your patients’ care)
    • As well as a broad range of other skills and achievements, such as teaching and training, performance managing other, being responsible for quality and safety, as well as research activities.

    So these are the 3 key mistakes to avoid when applying for the specialist pathway in Australia.

    Below for you is a handy overview of the colleges themselves.

    A short list of the 16 Australian Specialist Medical Colleges
    (we include the College of Dental Surgeons here):

    Read on further for more details about these colleges and what they do.

    Now that you know what a specialty medical college is.  Let’s talk more about some of the confusing points of colleges.  What types of colleges there are in Australia and importantly how to work out which college is the right college for you.

    The Status of the Specialty Medical Colleges in Australia.

     In Australia the specialty medical colleges remain very powerful.  With the possible exception of general practice (which is a specialty by the way) the specialist medical colleges generally have the oversight of and organize much of the specialty training that occurs in this country as well as continue to monitor the continuing professional development of their members (called Fellows).

    What are the Medical Specialty Colleges in Australia?

    Something that should be pointed out at this point is that most (but not all) of the specialty medical colleges in Australia are also the same college for the country of New Zealand.  This has the handy advantage for Fellows of these particular colleges being able to be recognized and work in either jurisdiction.  You will notice most colleges either refer to themselves and the “Australian and New Zealand College of”… or “Australasian College of”, for this reason.

    See below for a full list of the current Medical Specialty Colleges in Australia along with links to their websites.

    From each College home page there is usually an easily found link in the menu bar for prospective trainees, as well as international specialists looking for information about the specialist assessment process.  We also have the direct links to the specialist assessment page here.

    Our data sources for the table below come from the Colleges themselves as well as the latest available 2017 health workforce data, from the Federal Government. You can find the homepage for this data collection here.

    Royal Australasian College of Physicians

    Number of Fellows: 7661 Adult Medicine, 2258 Paediatrics*
    Main Post Nominals (FRACP).

    *Actual total slightly higher due to other programs offered, some of which are jointly run with other colleges.


    The RACP is one of the biggest Colleges. It also the most complex in terms of training programs. There are about 37 training programs. Fellowship of the RACP covers a range of aspects of specialty medical training, with a focus on Adult Medicine and Paediatrics.

    If you are struggling to work out where your field of medicine fits, chances are it fits within the Physicians College.
    In the two main groups of Adult Medicine and Paediatrics and Child Health there are many subspecialties including General Medicine and General Paediatrics as well as things like Cardiology, Infectious Diseases, Geriatrics and Neonatal Care.

    The RACP also covers 3 Chapter Training Programs in Addiction Medicine, Palliative Medicine as well as Sexual Health Medicine which you can enter after doing your Basic Training with the RACP or via training with another college.

    Finally the RACP also provides 3 Faculty Training Programs in Public Health Medicine, Occupational and Environmental Medicine and Rehabilitation Medicine. Again, you can either enter into these after Basic Physician Training or by completing other prerequisites.

    Fun Fact: The RACP even covers Dermatology for New Zealand!

    Link to Professional Framework

    Link to Advanced Training Handbooks

    Royal Australasian College of Surgeons

    Number of Fellows: 5041.
    Post Nominals (FRACS).

    Fellowship of the Royal Australasian College of Surgeons is one of the most highly sought after fellowships. Entry into any one of the 9 specialty training programs is highly competitive.

    Professional Framework

    The subspecialty areas are (with links to handbooks where available):

    • Cardiothoracic Surgery,
    • General Surgery,
    • Orthopaedic Surgery,
    • Otolaryngology,
    • Head & Neck Surgery,
    • Paediatric Surgery,
    • Plastic & Reconstructive Surgery,
    • Urology,
    • Vascular Surgery, and
    • Neurosurgery

    Royal Australasian College of General Practitioners

    Number of Fellows: 40000+.
    Post Nominals (FRACGP).

    The RACGP is by far and away the largest College in Australia. It is also one of the few colleges which does not have recognition in New Zealand.

    General Practice is recognized as a specialty in Australia. In other countries this specialty may be referred to as Family Medicine, a Family Physician or Primary Care

    Training to be a GP is conducted via a few different pathways. The largest one is the Australian General Practice Training Program, which is separate to the RACGP.

    So the RACGP is a little different to other colleges in that, whilst it still sets training program requirements and conducts examinations, selection into training programs and training itself is done externally to the college.

    The RACGP also provides an extension to its Fellowship where with a small amount of additional training you can be recognised as a rural GP (FARGP).

    Royal Australian and New Zealand College of Psychiatrists

    Number of Fellows: 3753.
    Post Nominals (FRANZCP).

    The RANZCP is one of the last true generalist specialist colleges in Australia. Its training program runs for 5 years and includes mandatory training in Adult Psychiatry, Consultation-Liaison Psychiatry (General Hospital Psychiatry), Child and Adolescent Psychiatry as well as a range of other types of experiences and assessments.


    Towards the end of training, trainees can elect to undertake Advanced Training in a certain area of Psychiatry, including Child and Adolescent, Consultation-Liaision, Adult Psychiatry, Old Age Psychiatry, Neuropsychiatry, Forensic Psychiatry and Psychotherapy, however all trainees emerge from the program considered competent to work in all fields of the specialty.


    It is expected that the position on generalism in Psychiatry will change in the not too distant future.

    Australian and New Zealand College of Anaesthetists

    Number of Fellows: 6400.
    Post Nominals (FANZCA).

    ANZCA ANZCA is responsible for the training, examination and specialist accreditation of anaesthetists and pain medicine specialists in Australia and New Zealand. In any given year there are about 1500 trainees undergoing training accredited by ANZCA in Australia and New Zealand. The College also has a number of trainees in Singapore, Malaysia and Hong Kong.

    Australian College for Emergency Medicine

    Number of Fellows: 2161.
    Post Nominals (FACEM).

    At 35 years ACEM is one of the newer colleges in Australia. It is also one of the first colleges in the world that represented the specialty of emergency medicine that emerged (pardon the pun) in the 1970s from hospital casualty department medicine.


    The Association of Casualty Supervisors of Victorian Hospitals (ACSVH) was the first body in Australia to focus on Emergency Medicine. Its formation followed a 1973 report on the Royal Melbourne Hospital’s Casualty Department and observations of similar facilities in Western Australia, the USA and the United Kingdom.

    Australian College for Rural and Remote Medicine

    Number of Fellows: 2161.
    Post Nominals (FACRRM).

    The Australian College of Rural and Remote Medicine is one of two colleges accredited by the Australian Medical Council (AMC) for setting professional medical standards for training, assessment, certification and continuing professional development in the specialty of general practice. It is the only College in Australia dedicated to rural and remote medicine, and is active in supporting junior doctors and medical students considering a career in rural medicine.

    ACRRM’s training approach is quite different from most other colleges and based partly around modularised learning. ACRRM Fellows receive full vocational recognition for Medicare General Practice Items and are not just restricted to working rurally, they can practise unsupervised anywhere in Australia.

    As a relatively new and small college ACRRM tends to be particularly welcoming to International Medical Graduates.

    Royal Australian and New Zealand College of Obstetricians and Gynaecologists

    Number of Fellows: 2013.
    Post Nominals (FRANZCOG).
    RANZCOG is the College that deals with the specialty of womens’ and maternal health.

    RANZCOG has recently recognised 5 subspecialty fields within its specialty area:
    Gynaecological oncology, Maternal–fetal medicine, Reproductive endocrinology and infertility Ultrasound, and Urogynaecology.

    Royal College of Pathologists Australia.

    Number of Fellows: 1275 + 603 jointly with RACP.
    Post Nominals (FRCPA).
    The RCPA represents Pathologists and Senior Scientists (working in medicine) in Australasia. Its mission is to train and support pathologists and to improve the use of pathology testing to achieve better healthcare.

    It is novel as a college in that it trains non-medical professionals as well.

    There is some degree of overlap in training and representation with the RACP. Particularly in relation to the areas of haematology and microbiology. Post fellowship diplomas are also available in anatomical pathology, chemical pathology, clinical pathology, forensic pathology, general pathology, immunopathology and genetic pathology.


    A Faculty of Clinical Forensic Medicine also exists within RCPA.

    Royal Australian and New Zealand College of Radiologists.

    Number of Fellows: 1945 (Clinical) + 345 (Radiation Oncology).
    Post Nominals (FRANZCR).

    RANZCR encompasses two Faculties, the Faculty of Clinical Radiology and the Faculty of Radiation Oncology.

    Many Radiologists carry out radiological investigative techniques and with the pace of medical technology some are now also delivering treatments.

    College of Intensive Care Medicine

    Number of Fellows: 1000+.
    Post Nominals (FCICM).

    The College of Intensive Care Medicine is the body responsible for intensive care medicine specialist training and education in Australia and New Zealand. The College offers a minimum six year training program, in both general and paediatric intensive care, with a number of assessments, culminating in Fellowship of the College of Intensive Care Medicine (FCICM). The College has over 1000 Fellows throughout the world.


    The College of Intensive Care Medicine was established in 2008 and formally took over the responsibility for training and certification of intensive care specialists from the Joint Faculty of Intensive Care Medicine (RACP & ANZCA) on 1st January 2010.

    Australasian College of Dermatology

    Number of Fellows: 550+.
    Post Nominals (FACD).

    The ACD is the peak medical college accredited by the Australian Medical Council for the training and professional development of medical practitioners in the specialty of dermatology.

    Royal Australasian and New Zealand College of Ophthalmologists

    Number of Fellows: 1155.
    Post Nominals (RANZCO).

    The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) is the medical college responsible for the training and professional development of ophthalmologists in Australia and New Zealand.

    Royal Australasian College of Medical Administrators

    Number of Fellows: 282.
    Post Nominals (FRACMA).

    The Royal Australasian College of Medical Administrators (RACMA) is a specialist medical college that provides education, training, knowledge and advice in medical management. Recognised by the Australian and New Zealand Medical Councils, it delivers programs to medical managers and other medical practitioners who are training for or occupying Specialist Leadership or Administration positions.

    Whilst you generally do not require a Fellowship in Medical Administration to work in a leader role, RACMA is the only college based training program where you can become a Fellow in the Speciality of Medical Administration.

    RACMA also has significant options for recognition of prior learning.

    Australasian College of Sport and Exercise Physicians

    Number of Fellows: 156.
    Post Nominals (FACSEP).

    ACSEP is the professional body representing Sport and Exercise Physicians and Sport and Exercise Medicine in Australasia. Sport and Exercise Physicians are committed to excellence in the practice of medicine as it applies to all aspects of physical activity. Safe and effective sporting performance at all levels is a major focus.

    Alongside this is the increasing recognition of the importance of exercise in the prevention and treatment of common and often serious medical conditions, such as arthritis, heart disease, diabetes and many cancers.

    The goal of all Sport and Exercise Physicians should be to facilitate all members of the community to enjoy exercise safely to 100 years and beyond, knowing that physical activity provides them the ‘best buy’ to prevent chronic disease.

    Royal Australasian College of Dental Surgeons

    Number of Fellows: 282.
    Post Nominals (FRACDS(+/-OMS)).

    The RACDS has been existence now for 50 years providing a broad range of activities to enhance the professional development of both general and specialist dentists through individually mediated studies, examinations and continued professional development. It is responsible for the RACDS OMS Training Program.

    The OMS Training Program is designed to provide trainees with sufficient theoretical and practical background to meet all current standards available in Oral and Maxillofacial Surgery in Australia and New Zealand.

    Eligibility for this program includes the requirement to have both a medical and a dental degree and full registration in both specialties, as well as a year of general surgical experience. So becoming an OMFS surgeon is possibly the longest specialty training program in Australia!

    Related Questions.

    How To Work Out Which College Is For You If You Are A Specialist International Doctor?

    Answer. If you are from overseas it can sometimes be tough to work out how your particular specialty fits into the specialist pathway and the Australian system or in fact how your training may differ from what occurs in Australia.

    Here’s an example, in the United States Child and Adolescent Psychiatrists train primarily within the field of child and adolescent psychiatry and probably learn more paediatric medicine than any other form of psychiatry.  Whereas in Australia, you have to start out training in general psychiatry and only at the stage of Advanced Training do you undertake significant periods of study in Child and Adolescent Psychiatry.

    This can have significant issues for child psychiatrists as much of their training won’t stack up against the program in Australia.

    If you are considering working here as a specialist via the specialist pathway, here are a few tips to consider when working out which college fits you:

    1. There may be an obvious first starting point. For example if you field is within the surgical domain, you are likely (but not always) to be covered by the Royal Australasian College of Surgeons. Exceptions might include Ophthalmic Surgeons and Dental Surgeons.
    2.  If you have worked generally for many years and are considered a specialist in your country. But you do not have a certificate or have not undergone a formal specialty training program or course. You are unlikely to be granted specialist status in Australia.
    3. If you cannot work out where your particular specialty fits and its not surgically related it probably fits within the Royal Australasian College of Physicians and there many programs Or as an alternative it may be covered by General Practice.
    4. You can actually ask the colleges. They will answer some basic questions before charging you to look at your specialist application.  A question likes “this is my subspecialty, do you cover it here?” will be answered free of charge.
  • The PLAB vs AMC: A comprehensive comparison

    The PLAB vs AMC: A comprehensive comparison

    Nick and Kim are guest authors who run a blog in the UK called the SavvyIMG. We partnered with them on this post to help answer a question that often arises for IMGs considering either the UK or Australia as a pathway.

    Life is full of choices, and for the aspiring IMG, one of the first choices is where to work? This choice is often heavily influenced by the difficulty of the licensing exam. So in this article, we’re comparing the UK and Australian licensing exams, otherwise known as the PLAB and AMC respectively, to help you make a choice.

    Questions about how PLAB impacts on the AMC examination process in Australia are some of the most common questions we get here at AdvanceMed. So we invited our guest authors Drs Nick and Kimberly Tan to collaborate with us on this post.

    So what factors should an IMG consider when contemplating which exam to take? These are the ones that we think are important and we’ll explain each in more detail below:

    • Eligibility requirements
    • Exam format
    • Pass rates
    • Fees
    • Test locations and dates
    • Maximum number of attempts allowed
    • Preparation time
    • Level of difficulty
    • Job prospects

    So let’s dig deeper into each of these factors.

    Eligibility requirements

    Before you can think about booking one of these exams, you’ll first need to meet the eligibility requirements. The requirements for the 2 exams are listed below:

    PLABAMC
    Acceptable medical degree (Primary Medical Qualification or PMQ)Verification not required to book PLAB 1Proof of English Proficiency which can be one of the following:IELTS Academic – overall score of 7.5 with a minimum of 7.0 in each sectionOET Medicine – Grade B or score of 350 in all sectionsPMQ was taught in English (this one is quite complex, you can read more about it here)
    Internship is NOT a requirement to sit PLAB.
    ECFMG/EPIC verified medical degree (Primary Medical Qualification or PMQ)
    Proof of English proficiency is not required to sit the AMC, however it is required later on as part of your application for AMC registration.Internship is also not required to sit the AMC, however it is a requirement for provisional registration that you prove that you completed an internship in your own country. (This can be a particularly confusing point for more on this issue check out this post.
    PLAB vs AMC a quick comparison of eligibility requirements

    Source: General Medical Council (2020). How do you book or cancel a place [for PLAB 1]?  [Link] [Accessed 10 Mar. 2020]. Australian Medical Council (2020). AMC Portfolio [Link][Accessed 10 Mar. 2020]

    Exam format

    Both exams consist of 2 parts: a multiple choice test, and a practical exam. 

    PLABAMC
    Multiple choice testPLAB 1
    Paper-based written test with 180 questions over 3 hours
    AMC MCQ examination
    Computer-based test with 150 questions over 3.5 hours
    Practical examPLAB 2
    18 stations, each 8 minutes long
    AMC Clinical examination
    20 stations over 3 hours and 20 minutes
    PLAB vs AMC exam formats

    Pass rates

    In general, PLAB has quite good pass rates. More than two thirds of IMGs pass both exams.

    PLAB

    YearPLAB 1PLAB 2
    201463%65%
    201569%68%
    201672%73%
    201776%79%
    201869%66%
    PLAB pass rates

    Source: General Medical Council (2020). Recent pass rates for PLAB 1 and PLAB 2. [online] [Link] [Accessed 10 Mar. 2020].

    AMC

    The pass rates for AMC are lower than PLAB, especially for the clinical exam, so IMGs should be prepared for potentially multiple attempts. This will require a larger investment.

    YearAMC MCQAMC Clinical exam
    201556%30%
    201660%29%
    201758%28%
    201864%29%
    201963%27%
    AMC pass rates

    Source: Australian Medical Council (2020). Annual Reports. [Link] [Accessed 10 Mar. 2020].

    It is worth noting that there is an alternate option to the AMC Clinical exam called the workplace based assessment pathway. This pathway is only open to IMG doctors who are successfully employed at one of ten sites accredited by the AMC for this purpose in Australia. The rates of completion for this pathway are significantly better at around 99%.

    Fees

    The AMC is significantly more expensive than PLAB 1. Given the low pass rates and expensive fees, we would only recommend sitting for the AMC after very extensive preparation.

    PLABAMC
    Multiple choice testPLAB 1AUD 467 (£ 235) until 31 March 2020 AUD 474 (£ 239) from 1 April 202AMC MCQ examinationAUD 2,720(£ 1,366)
    Practical examPLAB 2AUD 1,708 (£ 860) until 31 March 2020AUD 1,738 (£ 875) from 1 April 2020AMC Clinical examinationAUD 3,530(£ 1,772)
    PLAB vs AMC a comparison of fees

    Source: General Medical Council (2020). Fees and funding [Link] Australian Medical Council (2020). Fees and charges [Link]  [Accessed 10 Mar. 2020].

    Test locations and dates

    The first parts of both PLAB and AMC are available worldwide, however PLAB 1 is only held a maximum of 4 times per year whilst the AMC MCQ is held on multiple dates every month.

    The practical exam of both PLAB and AMC are only available in their respective countries. There is currently no option to take PLAB 2 outside of the UK, or to take the AMC Clinical examination outside of Australia. 

    PLABAMC
    Multiple choice testPLAB 1
    Available 4 times per year worldwide.
    View the dates and locations here
    AMC MCQ examination
    Available on multiple dates every month worldwide.
    View the dates hereView the locations here
    Practical examPLAB 2
    Available on multiple dates every month in the UK only.
    Dates can only be viewed on your GMC online account once you have passed PLAB 1.
    AMC Clinical examination
    Available on multiple dates every month in Australia only.
    Dates are released monthly, view them here
    PLAB vs AMC a quick comparison of test locations and availability

    Correct as of March 10, 2020

    Maximum number of attempts

    There is a limit on the number of times you can attempt PLAB. You have a maximum of 5 attempts for both PLAB 1 and PLAB 2, however after the 4th attempt there are quite a few hurdles to overcome before you will be allowed your 5th and final attempt. You can read more about this here on the GMC website.

    If you fail your final 5th attempt at PLAB 1 or 2, you will no longer be able to gain GMC registration and cannot work as a doctor in the UK.

    There is no limit on the number of times you attempt any part of the AMC.

    PLABAMC
    Multiple choice testPLAB 1
    AMC MCQ examination
    Unlimited
    Practical examPLAB 2
    5
    AMC Clinical examination
    Unlimited
    PLAB vs AMC a comparison of number of maximum attempts permitted

    Level of difficulty

    PLAB is set at the level of a doctor who has graduated from medical school and completed one year of internship, however internship is not a requirement to sit the exam.

    AMC is set at the level of a doctor who has just graduated from an Australian medical school, however despite the supposedly lower level of difficulty, the AMC has a much lower pass rate compared to the PLAB.

    Preparation time

    Since both these exams represent a large investment for IMGs, with the AMC more so than PLAB, it would be wise to dedicate enough time for preparation.

    These are the times that are recommended when preparing for these exams. Keep in mind that the shorter times are suitable if you do not work while preparing for the exam, and the longer times are for if you work while preparing.

    PLABAMC
    Multiple choice testPLAB 1
    1.5 – 4 months
    AMC MCQ examination
    3 months to 1 year
    Practical examPLAB 2
    1.5 – 4 months
    AMC Clinical examination
    3 months to 1 year
    PLAB vs AMC a comparison of recommended preparation times

    Job prospects

    PLAB 

    Once you have gained registration with the medical authority in the UK, the General Medical Council (GMC), you will be able to apply for jobs that are suitable to your previous experience and qualifications. 

    As of October 2019, all medical jobs were included in the UK Shortage Occupation List. This means that IMGs will be given equal opportunity for training and non-training jobs, and UK graduates and UK/EU nationals will no longer be given first priority. 

    So provided you work well on your CV, job application and interview skills, the doors are pretty much open.

    This is an incredible opportunity for IMGs that we write about more in this article: 9 ways the new Shortage Occupation List affects IMGs dreaming of UK specialty training.

    AMC

    The process for obtaining work in Australia via the AMC Standards Pathway is a bit different. You must be offered employment first and you will then be able to gain a conditional form of registration with the Medical Board.  You are essentially required to work for 12 months to prove that you meet a certain level of safety and competency.  However, you can actually start this process after obtaining the AMC Part 1 examination and don’t need to wait for your Part 2.

    The situation for IMG doctors in Australia who pursue the AMC Standard Pathway process is less positive than for the UK.  Good data is not kept but there are likely to be thousands of doctors who have completed the AMC Part 1 still waiting for a job opportunity and hundreds who have completed both Parts 1 and 2, similarly vying for the limited number of posts that are advertised where IMG doctors can apply for provisional and conditional positions.

    Generally the employers will only advertise these positions when they have exhausted the candidate pool for doctors who already have general registration.

    This all may sound a bit gloomy. But its important to understand that hundreds of IMG doctors do still make it through this journey each year in Australia.  And once you do obtain general registration the picture improves significantly.

    Once you have completed your provisional year and completed both the AMC Part 1 and 2 you are permitted to obtain general registration. Your job prospects at this point are much better and you will likely be able to obtain a training position. However, this may not be in the particular area you are most interested in.  Like most other places positions in areas such as surgery and anaesthesia are highly competitive whereas it is generally easier to get into specialty training programs in areas such as emergency medicine, general practice and psychiatry.

    There is also the small chance that you may be overlooked in favour of another suitable candidate who has Australian citizenship or permanent residency. However, once you have worked for a while in Australia as a doctor you can usually apply for permanent residency yourself.

    Summary

    Exams make up just one part of the IMG journey. This article has compared some of the major factors that may influence your decision and here are some take home points for each factor:

    • Eligibility requirements: You must provide proof of English proficiency before you can book PLAB 1. You must have your medical degree verified first before you can book AMC MCQ.
    • Exam format: Both exams have a multiple-choice test and a practical component. PLAB 1 is a written exam while AMC MCQ is a computer-based test. Both PLAB and AMC have a practical exam.
    • Pass rates: AMC pass rates are lower than PLAB, particularly for the practical exam.
    • Fees: AMC is significantly more expensive compared to PLAB.
    • Test locations and dates: PLAB 1 has very few available dates throughout the year. AMC MCQ is available on multiple dates each month. The practical exam of both AMC and PLAB can only be taken in their respective countries.
    • Maximum number of attempts: There is a limit to the number of times you can take PLAB (maximum of 5), while there is no limit for the AMC.
    • Preparation time: Since AMC has lower pass rates, preparation time is longer compared to PLAB.
    • Level of difficulty: PLAB is actually set at a higher level as it is designed for those who have completed internship, while AMC is for new medical graduates.
    • Job prospects: Recent changes in UK immigration law means that the UK currently has its doors open to IMGs. Prospects in Australia are more difficult for IMGs but not impossible.

    Final Thought

    Most IMG doctors are not just seeking to work abroad anywhere. Many have personal reasons for choosing one particular country over another. Having read through all of the above you may be reconsidering your choices. Or you may now be considering a more complicated plan to ultimately work in country X by first working in country Y.

    At the end of the day if you have a definite preference for a certain country then it likely still makes sense to take the direct route for that country.

    Now that you’ve had a chance to compare the 2, which exam do you think you’ll take?

    If you would like to know more about the process of working in the UK we recommend checking out Nick and Kim’s blog thesavvyimg

    Related Questions.

    Question. Is the PLAB A Route to Working in Australia?

    Answer. Yes. But only if you fully complete all steps of the PLAB including working 12 months supervised. Read more here.

  • Medical Internship 2020 / 2021 Australia

    Medical Internship 2020 / 2021 Australia

    *We will be regularly updating this post as information is updated about the Medical Internship process in Australia. The situation is fluid and has been disrupted somewhat due to COVID-19.

    It’s that time of the year again. The time when each of the States and Territories in Australia open up the process of applications for medical internships for the following year. For four years I was responsible for running the largest Intern application system in Australia for 4 years. The NSW Intern application system. So I’d like to share with this year’s medical graduates some of the wisdom I gained from that experience.

    (Disclaimer: All information here has been sourced in good faith but things do change so you should always do your own due diligence in such matters, we are providing this information to aid you in your application but take no responsibility for any outcomes)

    Intern applications and allocations are normally coordinated across Australia so that every State and Territory opens and closes their systems at the same time and makes offers at the same times. It still appears that this will be the case in 2020, despite COVID-19. The key things that all medical graduates should consider in preparing their medical internship application for the 2021 year in 2020 are as follows:

    • Applications open on 4th May 2020.
    • Applications close on 4th June 2020.
    • Make sure that you have an Intern Placement Number otherwise you won’t be able to apply.
    • You should research the application requirements now as there may be some “surprises”. As soon as the application system opens, register or log in and ensure that you have everything you need to complete your application.
    • Understand where you sit in the priority list for any State or Territory you are applying to.
    • If you will need to attend an interview. Make sure you have gotten leave from your medical school requirements to attend.
    • Also, consider that the interview is likely to be either via phone or video this year.
    • Give yourself time to request referees, put together a Resume, if required and find other documents that you may need.
    • First offers come out from 13th July 2020. So make sure that you have regular access to your email as your time for accepting offers can be quite short.
    • Stay in touch with your medical school. you may be worried about completing your degree on time but they are all working very hard with the other institutions to give you the best chance of completion.

    Tip #1. Your Medical Intern Placement Number.

    The IPN is a unique nine-digit number that has been generated by AHPRA and has been provided to medical schools for distribution to all 2020 final year medical students. The number is used as part of the national audit process (which ensures that intern positions across the country are made available to as many applicants as possible) as well as to streamline registration.

    This number is not the same number as your AHPRA registration number or student number. If you have not received you IPN you should check with your school

    Tip #2. Other Things You Will Likely Need. 

    The majority of States and Territories require you to upload an academic transcript as proof that you are indeed a medical student. 

    They will also request evidence that you satisfactorily meet the AHPRA English Language requirements. This may seem a bit ridiculous given that you have been attending medical school in English for the last 4 or 5 years. But it is the law. So check whether you may need to submit an up-to-date English test result or some other form of documentary evidence such as a high school certificate.

    Most States and Territories will also request a CV or Resume. For tips on your CV or Resume see our ultimate guide to CVs or watch a video series about this.

    Some States and Territories have a CV template that they suggest that you use to fill in your information. In the case of Victoria, you are required to use this template. It’s probably fairly harmless to use the template for the other States and Territories. But if you are thinking about your future career, then nows is a good time to be designing your own CV. The risk of using the template is that you don’t stand out from other candidates.

    You will need to also provide proof of your identity, citizenship, residency, or visa. And if you have had a name change along the way you will probably also need to provide some documentation in relation to this.

    Why All This Information?

    The State and Territory bodies who administer the Intern application process have a responsibility to ensure that you are eligible to apply for provisional registration at the end of the year in order to work as an Intern.  They collect this information to check that everything is in order so that you are indeed eligible to apply. Employers can get rightly annoyed when told that someone who has been allocated to work with them as an Intern will have a several-month delay whilst they resit an English language test.

    However, it’s your responsibility to ensure that you are eligible for registration. So you should also be checking these things yourself. 

    It’s hard to fathom given the amount of communication from health departments, medical schools and student colleagues. But every year there are a handful of medical students who forget to apply for their internship. This means having to wait another year. Don’t let that be you.

    Dr Anthony Llewellyn | Career Doctor

    Tip #3. Research and Apply Early.

    It’s hard to fathom given the amount of communication from health departments, medical schools and student colleagues. But every year there are a handful of medical students who forget to apply for their internship. This means having to wait another year. Don’t let that be you.

    There are even more students who leave their applications to the last minute. Only to find that they are missing a vital document. For example, this could be evidence you need to substantiate that English is your first language, such as a high school certificate. Or perhaps your last name has changed whilst you have been in medical school? Or maybe you need to submit a CV with your application?

    As soon as the application page opens for each State and Territory you are going to apply to make sure your register. And then go as far through the process of applying as possible so you can see if there is some sort of document you need to obtain.

    Tip #4. Practice Your Video Interview Technique.

    If you are one of the many students who may need to undertake an interview for your internship choices as occurs in certain situations, such as rural preferential recruitment and certain States such as Victoria. Then you should be prepared for the fact that this year your interview is unlikely to be held in person and very likely to be conducted on video.

    There’s a lot more than you think to video interviewing. For a rundown on this check out this recent post.

    Tip #5. Know Where You Sit In The Priority List.

    ts important to know where you sit on the priority list. Each State and Territory has a slightly different order but in essence, it goes something like this:

    1. If you are an Australian Citizen or Permanent Resident and went to Medical School in that State or Territory you are top of the list.
    2. If you are an Australian Citizen or Permanent Resident and went to Medical School in another State or Territory or New Zealand you are probably second.
    3. If you are an International student who studied Medicine in Australia you are probably next.

    Priorities Within Priorities.

    Some States and Territories also have priority pathways to ensure that groups such as Aboriginal and Torres Strait Islanders and doctors who wish to work rurally or regionally can obtain their preferred placement early.

    So if you are an International student and like the idea of working rurally it’s probably a good idea to consider a rural pathway as it will likely boost your chances of gaining an Intern position earlier in the process.

    More Information on Each Jurisdiction

    New South Wales

    Intern Positions ≅ 1,039 (including 170 rural preferential)
    Annual Salary = $69,649

    The Health Education & Training Institute runs the countries largest Intern application process. Offering over 1,000 internships.

    Interns can be allocated to one of 15 networks of hospitals. The offer is for a 2-year contract to cover both internship and residency.

    You have the option of applying through one of 4 pathways:
    – Aboriginal Recruitment Pathway
    – Rural Preferential Pathway
    – Regional Allocation Pathway
    – Optimised (or Main) Pathway

    Only applicants who go through the Rural Preferential Pathway need to submit a CV and attend an interview.  All other pathways are based on applications only.

    Intern Placement Priorities:

    Priority 1 – Medical graduates of NSW universities who are Australian/New Zealand citizens or Australian permanent residents (Commonwealth Supported Place and Domestic Full Fee paying). This priority category is guaranteed an intern position in NSW. 

    Priority 2 – Medical graduates of interstate or New Zealand universities who completed Year 12 studies in NSW who are Australian/New Zealand citizens or Australian permanent residents (Commonwealth Supported Place, Domestic Full Fee paying or NZ equivalent). 

    Priority 3 – Medical graduates of interstate or New Zealand universities who completed Year 12 studies outside of NSW who are Australian/New Zealand citizens or Australian permanent residents (Commonwealth Supported Place, Domestic Full Fee paying or NZ equivalent). 

    Priority 4 – Medical graduates of NSW universities who are not Australian/New Zealand citizens or Australian permanent residents and who hold a visa that allows them to work or are able to obtain a visa to work.

    Priority 5 – Medical graduates of interstate or New Zealand universities who are not Australian/New Zealand citizens or Australian permanent residents and who hold a visa that allows them to work or are able to obtain a visa to work in Australia. 

    Priority 6 – Medical graduates of Australian Medical Council accredited universities with campuses that are located outside of Australia or New Zealand who are not Australian/New Zealand citizens or Australian permanent residents and who hold a visa that allows them to work or are able to obtain a visa to work in Australia.

    HETI Medical Graduate Recruitment Page.

    HETI Prevocational Training Application Program Portal.

    Victoria

    Estimated Numbers = 820
    Annual Salary = $79,138

    Internship in Victoria works around a computer matching system which is administered by the Postgraduate Medical Council of Victoria. The system appears to have had a significant overall this year and looks to be much more user friendly.

    Portal

    There is no other information available at this stage.

    Below is information from last year.

    Once you have submitted all your details and preferences the match informs the various hospitals and health networks who then conduct a selection process.  Some but not all hospitals and networks perform interviews.  Your selection may just be based on where you sit in the priority list plus your CV and referee reports.

    Interns can be allocated to one of 22 hospitals and networks. This includes a small number of community based internships where the focus is more on community based models of care, including working in primary care and smaller hospitals.

    For Victoria you will need to submit a CV. This MUST BE on the quite unattractive PMCV Standardised CV Template. You don’t have to put a photo on your CV. And I would not recommend doing so.
    Intern Placement Priorities:

    Priority Group 1 – Australian permanent residents or citizens and New Zealand citizens graduating from a Victorian medical schools including CSP and domestic full fee paying students (i.e. graduates of University of Melbourne, Monash University, Deakin University and University of Notre Dame: Melbourne & Ballarat Clinical Schools).

    Priority Group 2 – Australian temporary resident graduates of Victorian medical schools  Interstate Special Consideration candidates (approved by DHHS)

    Priority Group 3 – Australian permanent resident graduates of interstate or New Zealand universities (including previous residents of Victoria); Australian temporary resident graduates of interstate universities; New Zealand temporary resident graduates of New Zealand universities; and Graduates from an overseas campus of an Australian/New Zealand University accredited by the Australian Medical Council (e.g. Monash University – Sunway Campus, Malaysia)

    Queensland

    Estimated Numbers = 776 (including 67 rural generalist)
    Annual Salary = $78,941

    Queensland Health conducts the annual intern allocation process in Queensland. Interns can be allocated to one of 20 primary allocation centres. An interesting aspect of the Queensland application portal is that you can see a live indication of where other applicants have preferenced other hospitals. This is presumably designed to encourage medical students to consider other hospitals and get the student group itself to work out the allocation. I have no indication whether its a useful process or not. If you know anything about this. Leave a comment below.

    Intern Allocation Priorities:

    Group A
    Medical graduates of Queensland universities who are Australia/New Zealand citizens or Australian permanent residents; and are seeking an internship commencing in the year immediately following graduation;
    OR 
    received Review Committee approval from a previous campaign to defer commencement of internship

    Group B
    Medical graduates of Australian (interstate) or New Zealand universities who are Australian/New Zealand citizens or Australian permanent residents;
    OR
    Medical graduates of Queensland universities who are Australian/New Zealand citizens or Australian permanent residents who do not meet the criteria outlined in Group A

    Group C
    Medical graduates of Australian (Queensland or interstate) or New Zealand universities who are NOT Australian / New Zealand citizens or Australian permanent residents who: 
    currently hold a visa that allows them to work in Australia;
    OR
    will need to obtain a visa to work in Australia

    Group D
    Medical graduates of Australian University campuses outside of Australia accredited by the Australian Medical Council.
    OR
    Medical graduates of international universities who have not completed an internship in Australia or another country and have either: 
    – obtained the AMC Certificate (and are eligible for provisional registration)
    – successfully completed the AMC MCQ (multiple choice questionnaire) (and are eligible for limited registration)

    The Queensland Rural Generalist Pathway (QRGP) offers graduating medical students the opportunity to explore a wide variety of clinical training and develop the advanced skill set required to support the health needs of rural communities. It’s a priority pathway that you can opt for first.

    If you are not interested in the Rural Generalist pathway then you need to work out which category you are in.

    Intern Application Info Page.

    How To Apply.

    Application Portal.

    *Queensland is one of a few jurisdictions that does permit International Medical Graduates to apply for positions as part of the last Applicant Group.

    South Australia

    Estimated Number = 260
    Annual Salary = $77,084

    SA Health Careers conducts the annual Intern application process in South Australia. There are 3 Adelaide based Local Health Networks and one small Country Health Network (based at Mt Gambier & Whyalla) to which you can apply for the priority Rural Intern pathway.

    The Rural Intern Pathway is a strength based recruitment process for applicants who are interested in undertaking their internship (and potentially subsequent years) in rural hospitals within Country Health SA (CHSA). Rural intern positions provide broad opportunities in unique settings and are best suited for medical graduates with a history of living or working in a rural areas or a desire to commence a career in the country. 

    Intern Allocation Priorities:

    Category 1 Australian Citizens, Australian Permanent Residents and New Zealand Citizens
    1.1: Medical graduates from a South Australian university who identify as Aboriginal and Torres Strait Islander (ATSI)
    1.2: Medical graduates from a South Australian university – Commonwealth-supported (HECS-HELP) or SA Bonded Medical Scholarship Scheme (SABMSS)
    1.3: Medical graduates from a South Australian university – full-fee paying

    Category 2 Australian Citizens, Australian Permanent Residents and New Zealand Citizens
    2.1: Medical graduates from an interstate or New Zealand university who identify as Aboriginal or Torres Strait Islander (ATSI)
    2.2: Medical graduates from an interstate or New Zealand university who completed Year 12 in South Australia
    2.3: Medical graduates from an interstate or New Zealand university
    2.4: Medical graduates from an overseas university who completed Year 12 in South Australia
    2.5: Medical graduates from an overseas university 

    Category 3 Australian Temporary Residents and New Zealand Permanent Residents
    3.1: Medical Students from a South Australian University 

    Category 4 Australian Temporary Residents and New Zealand Permanent Residents
    4.1: Medical graduates from an interstate or New Zealand University 

    Category 5 Australian Temporary Residents and New Zealand Permanent Residents
    5.1: Medical graduates who have spent two or more semesters in an overseas campus of an Australian or New Zealand University (eg Monash Sunway campus, UQ New Orleans campus)
    5.2: Medical graduates of an overseas university

    South Australia is one of few States that specifically permits medical graduates from other countries to apply for internship positions. But they are at the very bottom of the priority list.

    If you are not a South Australian medical student, in order to apply for an internship in South Australia you will need to provide a certificate confirming that you have completed the SA Health online electronic medical record (Sunrise EMR & PAS) training. 

    Western Australia

    Estimated Numbers = 310 (based on 2020)
    Annual Salary = $78,749

    In WA all interns are employed by a Primary Employing Health Service (PEHS). 

    There are 4 PEHSs and each PEHS is a major tertiary hospital in WA which have been accredited to directly employ interns and provide a high-quality intern training program. Each PEHS normally holds an information night. There is no information available about these at the moment. You can also choose to work as a rural intern by applying to work through Western Australia Country Health Service.

    The process is coordinated by the Postgraduate Medical Council of Western Australia but you apply through the WA Jobs site and selection occurs through panels representing each of the PEHSs. As part of your application, you need to provide a cover letter and CV and will require a range of other documents as well as to nominate 3 referees. If successful you will receive a contract for 3 years.

    Application Portal

    Key Dates

    Northern Territory

    Estimated Number = 50
    Annual Salary = $78,750

    The NT Prevocational Medical Assurance Services (PMAS) conducts a central review of eligible applicants and all intern positions are allocated within the two  NT Health Services:
    Top End Health Service (TEHS) – Royal Darwin Hospital (RDH)
    Central Australia Health Service (CAHS) – Alice Springs Hospital (ASH)

    Eligible applicants are allocated intern positions in line with the Northern Territory category groups. Within the relevant category groups applicants are allocated to their highest possible Health Service preference, pending availability of a position.

    Overall the intern allocation process is based on an applicant’s category group, Health Service preference and the number of positions available in each health service.

    The two NT Health Services are responsible for selecting applicants and making their offers of employment, applicants are advised via email.  The Health Service responsible for making the offer of employment will after receiving an acceptance from an applicant arrange an employment contract for an Internship position within their health service to be provided prior to commencing internship.

    NTPMAS Site

    NT Department of Health Intern Recruitment Link (includes information on Categories)

    *NT is one of a few jurisdictions which will consider 

    Australian Capital Territory

    Estimated Numbers = 95
    Annual Salary = $74,826
    (6 of these positions are normally guaranteed to NSW medical students)

    If you want to apply for an internship position in the Australian Capital Territory you do so via the ACT Health Recruitment page.

    Most of your time is spent at the Canberra Hospital. But ACT is interesting as it is one of the few chances you may have as an Intern to work in 2 separate States and Territories. Rotations may include secondments to Calvary Public Hospital, Goulburn Base Hospital and South East Regional Hospital (SERH) at Bega. 

    Priority is given to:
    – Australian Graduates of ANU
    – Maximum 6 graduates of NSW Universities
    – Graduates of other Universities who completed Year 12 in ACT
    – International Fee Paying Graduates of ANU
    – Graduates of other Australian Universities
    – Graduates of Australian University campuses outside of Australia

    Other details are limited at this stage. 

    Intern Priority List

    Recruitment Page.

    Tasmania

    Estimated Number  = 90
    Annual Salary = $70,315
    Internships are coordinated in Tasmania via the Department of Health and Human Services.

    All applicants are required to apply online. As part of your application you are asked to preference all of the 3 available sites:
    – Hobart
    – Launceston
    – North West Region

    Candidates need to attach a CV/Resume and any other relevant information to their application and must arrange completion of two electronic referee reports:

    – One (1) referee that is employed in a clinical role (Clinical Academic) with the University where you are studying/or studied medicine and is aware of your studies in the past 12-24 months; AND

    – One (1) that is – a senior clinician (>4 years’ experience post general registration) who has observed you (you have worked with) during your clinical placements in the past 12-24 months, and can comment on your suitability for hospital-based practice.

    Intern Placement Priorities:

    The Tasmanian Health Service currently gives priority, in order, to:
    – Australian permanent resident Tasmanian-trained Australian Government supported and full-fee paying medical graduates.
    – Australian temporary resident Tasmanian-trained full-fee paying medical graduates.-
    – Australian permanent resident interstate-trained Australian Government supported and full-fee paying medical graduates.
    – Australian temporary resident interstate-trained full-fee paying medical graduates.
    – Medical graduates of an Australian Medical Council accredited overseas University.

    Selection occurs via face-to-face interviews (likely to change). Following interview successful applicants will be placed in an order of merit with applicant performance at interview accounting for 70% of the overall score, and each referee report accounting for 15% of the overall score. Vacant positions are offered in order of merit and the Tasmanian Health Service Priority Placement Framework.

    Recruitment Link

    Commonwealth – Junior Doctor Training Program Private Hospital Stream

    Intern Positions TBD
    Annual Salary = will depend on which State or Territory you are employed in.

    The Commonwealth provides an additional Internship program for international students who study at Australian medical schools.

    *Any excess posts may be applied for by other IMGs in Australia

    The main function for this program over the years has been to provide additional opportunities for international students studying Medicine in Australia a chance to complete their internship.  This is done by tendering to various private hospitals for additional intern positions.

    The program was retitled in 2020 to the Junior Doctor Training Program Private Hospital Stream when there was 115 positions on offer.

    Normally there is not as much information about the program available until a mad flurry at the end of the year.  And 2020 seems to be no different. They are still sorting out which hospitals will provide internships.  After which there will probably be some information about how to apply.

    For now we know that the eligibility requirements are that you must either be an international full fee paying medical graduate from an onshore Australian medical school. This is Priority One. If not all positions are filled by priority one medical graduates then the private hospitals may then recruit other medical graduates who are eligible for provisional registration. This is the Priority Two category.

    Eligibility Requirements for Intern (PGY 1) Junior Doctor Training Places under the Junior Doctor Training Program Private Hospital Stream

    Under the PHS, participating private hospitals must prioritise international full fee paying medical graduates from onshore Australian medical schools (Priority One). Should these places not be filled, private hospitals may then recruit other medical graduates eligible for provisional registration (Priority Two). This means that the Commonwealth Scheme provides one of the few opportunities for IMGs who are applying via the standard pathway process to gain an internship position in Australia.

    To do so you will need to have met the Medical Board of Australia provisional registration requirements as a medical practitioner. And also have met the English language proficiency requirements for registration purposes. And commit to obtaining an appropriate visa to work in Australia during the internship year.
    Private Hospitals participating in delivering the Private Hospital Stream in past years were:
    – Mater Health Services North Queensland Limited
    – Mercy Health and Aged Care Central QLD
    – MQ Health (Macquarie University Hospital)
    – St John of God Health Care Inc.
    – St Vincent’s Private Hospital Limited
    – St Vincent’s Private Hospital Sydney
    – Ramsay Health Care
    – Greenslopes Private Hospital
    – Joondalup Hospital

    Link to Program details

    How To Decide?

    There are lots of considerations when it comes to putting in your Intern application. Everyone is a bit different. Some graduates feel like they would like to be close to home and family whilst going through their transition to Intern. Others see it as a chance to get away and explore a new place and location. And then others focus on the long-term career prospects of certain locations.

    I think this last consideration is a little overrated for most. You can generally experience a wide range of medicine in your first couple of years of medicine after graduation and there is scant evidence that this affects your prospects of applying for specialty training posts.

    That being said if you have an interest in anything other than Medicine, Surgery, or Emergency Medicine as a future career you should probably investigate whether this particular specialty is offered at the hospitals or networks to which you apply.

    Unfortunately, the internship model in Australia is quite antiquated and we have used the experience as a proxy for competency. The result has been the mandating of the 3 core terms for internship of Medicine, Surgery, and Emergency Medicine. There is really no solid educational basis for this approach and one of the unfortunate outcomes is that all the other specialties get squeezed out and few interns get to experience psychiatry, general practice, obstetrics, paediatrics, pathology, etc… which ultimately does have an effect on recruitment to these specialties.

    So the basic message is this. If you are really dead set keen on doing radiology as a career you should try to track down the very few locations that might offer this rotation to either interns or residents.

    Each year the Australian Medical Students’ Association produces a very useful Intern Guide with lots of information about the composition of intern training networks across the country. We are currently waiting on the 2020 version. But here’s a link to the 2019 version.

    Related Questions

    Question: What If I Have Special Circumstances Which Make It Hard For Me To Work In Certain Places?

    Answer: All States and Territories Have processes for considering special circumstances. Some of the types of circumstances that are generally approved are: where you may have certain health conditions that mean you need to be close to certain hospitals or specialists; where you have dependents, such as young children, and are unable to relocate due to care arrangements; and where you and your partner want to work as doctors in the same location.

    Generally requests to stay in certain locations, for reasons such as work commitments of partners or needs of school aged children are not granted.Question: I Have Received My Intern Offer. But I Would Like to Defer It. Is This Possible?

    Answer: This will partly depend on how long you wish to defer for. 

    If you just wish to defer for a a few months. Once you have your offer and are in discussions with your new employer make enquiries. It may be possible to negotiate a later start with your employer. Most employers will generally prefer that you start on time, so that you are not out of sync with your colleagues. But there might be some advantage for the employer in you attending orientation but then starting a bit later as it will probably help them to fill out roster gaps.
     
    On the other hand. If you wish to defer for a complete year. Then you will need to check the policy of the State or Territory that has provided you an Intern offer. In some cases (for example Victoria) you will be permitted to defer and your place will be held for you the following year. In most other cases you will need to reapply the following year and check whether your priority status has altered. In most cases you have the same priority status.

    Also bear in mind that it is unclear how long you can defer commencing your internship. However, the Medical Board of Australia expects that once you have commenced your internship you will have completed this process within 3 years.
    Question: I Am a Doctor With a Medical Degree From Outside Of Australia. Can I Apply For Internship?

    Answer: Unless you obtained your medical degree from a New Zealand Medical School. Then the brief answer to this question is no.

    I would love to stop there. And I really think you should as well. But there are rare circumstances where you may be able to obtain an internship with a medical degree from outside of Australia. But the Medical Board of Australia strongly advises against this option and so do I. For good reasons. Firstly the whole Australian medical internship system is designed to ensure that Australian medical graduates are able to undertake an internship. Not for overseas graduates. Secondly (and as a result of the first point) it is very rare to be offered the chance.

    Some States and Territories will not even consider an application from an IMG for internship. Others will only do so in limited circumstances, for example, the Northern Territory will accept applications from IMGs who may have done a medical student elective or clinical observership in the Northern Territory and who have experience in rural, remote and indigenous health locations. But even then these applicants are at the bottom of the priority list for obtaining an internship. South Australia will accept applications. But again you are bottom of the list. Queensland will also accept applicants, but only if you have never worked as a doctor. And again you are bottom of the list.

    A final note on this question is that the majority of IMGs who do obtain a medical internship position each year in Australia generally have Australian citizenship or permanent residency.Question: I Have Heard That Some Graduates Miss Out On Internship. Is This True?

    Answer: Whilst it is theoretically a possibility that some medical graduates miss out on Internship according to information provided by HETI for the most recent year of intern applications no-one was actually left at the end of the process without an offer.

    Only Australian citizens and permanent residents are guaranteed an intern position under the COAG agreement. However, there are generally enough intern positions available for those students who have come to Australia to study medicine and the Commonwealth Private Hospital program offers additional spaces for those that may miss out.

    That being said. It is also clear that many graduates choose to drop out of the application process themselves. So not everyone who applies gets an offer. The assumption is that some graduates take up similar intern opportunities in other countries upon graduation.

    (Disclaimer: all information here has been sourced in good faith but things do change so you should always do your own due diligence in such matters, we are providing this information to aid you in your application but take no responsibility for any outcomes)

    We’d welcome feedback from any Intern programs in relation to the accuracy of the above information.

  • Mobilizing the Doctor Workforce to Fight COVID-19 Should Include IMGs.

    Mobilizing the Doctor Workforce to Fight COVID-19 Should Include IMGs.

    With recent announcements, it appears that Australia has lost the initial attempt to tightly contain the spread of the coronavirus. Including reports that it is now starting to spread within the health workforce itself. There is a need to consider how we can develop plans to ensure that we have enough doctors, nurses, allied health and other important staff to cope with a predicted environment where there are increased cases of viral illnesses presenting to our health services and large amounts of staff either sick or in isolation.

    It has been suggested that we will need to pull staff from some of the existing pools that we tend to rely upon to deal with shortages, such as locum or casual staff pools. But these sources are often already closely tapped. It has also been suggested that we may need to bring doctors and other health professionals back from leave or out of retirement. Which may help to an extent.

    A Big Group of Doctors Has Not Been Thought About So Far.

    What doesn’t seem to have been considered so far is that there is another large group of doctors already in this country who are champing at the bit to get involved in helping with this potential increased demand on our health system.

    There Are Literally Hundreds of IMGs Who Could Fill Basic Posts In Hospitals.

    According to the latest sources from the Australian Medical Council, there were 660 international medical graduates vetted to commence supervised training posts, as part of what is called the standard pathway process, in 2019 by obtaining what is called the AMC Certificate (normally a 2-step examination process).

    It is difficult to know exactly how many of these doctors have been able to obtain positions. As it is hard to get a link between those who obtained an AMC Certificate and registration status.

    According to the Federal Governments workforce data set, I could only find data on the number of doctors who had completed the AMC process and been granted provisional registration for 2018. The number of completions was 862 and the number provisionally registered that year was 76. Now some of these doctors may have already obtained limited registration, for which there is no accessible data.

    But I think it is reasonably safe to assume, given that the number will accumulate on a yearly basis, that we are talking hundreds if not over a thousand IMG doctors with an AMC Certificate who have not been able to obtain a position. The number of IMGs who contact me in these circumstances backs up this feeling.

    There Are Also Quite a Few Specialist IMGs Who Could Help Out As Well.

    Whilst the data from the Medical Board of Australia is a little bit older we know that in 2018 755 specialist IMG doctors were approved by medical colleges to commence supervised postings to work towards specialist recognition. Whilst in the same year only 614 specialist doctors were recommended or not recommended for specialist recognition. Whilst we are talking separate groups here (i.e. those at the start of the application versus those at the end), again anecdotally I am aware of many IMG specialists who have been granted approval to work as a specialist under supervision who have been now trying for a position for over 2 years.

    So whilst the number of specialist IMGs who have been approved and are still waiting is likely to be far less than those on the standard pathway it is still likely to be in the hundreds of doctors.

    Why Are These Doctors Not Employed Already?

    The problem for most of these doctors is not their lack of competency or capability. This has already been assessed. It’s just that there are limited available places for them and strong and stiff competition for them. When they do get a chance of a job they generally do very well. And are often willing to work in places and circumstances that locally trained doctors do not.

    Many of these doctors would jump at the chance to work for 3 months to help out with our current emerging health system crisis.

    Just to be clear, I am not talking about using or exploiting IMG doctors to help staff temporary virus clinics or our emergency rooms to save local doctors from being exposed. The most logical way to deploy this workforce would be to relieve or fill in for medical staff in regular roles, such as working on hospital wards to ensure that we are able to continue to manage the regular health needs of patients with other conditions.

    What Would Need To Change To Make This Happen?

    One of the big problems with getting IMGs up and running in positions in Australia has always been the bureaucracy involved. This includes paperwork to establish that they are not competing for a post with an Australian trained doctor, paperwork to satisfy the registration requirements and paperwork to obtain a working visa.

    It is important that we maintain a certain standard of care in the registration requirements of doctors. But given that we are anticipating that there will be many vacancies at various levels in the system. It is reasonable to assume that many of these will be in posts that are supervised and supervisable for which an IMG doctor could be deployed.

    Conversely, a system whereby such an IMG doctor could be more quickly be granted a short period of registration (say 3 months) would provide ease for the system but also reduce the risk of such a doctor not being supervised properly.

    It would also then give the IMG actual experience in the Australian health care system, which is something that would tremendously help their resume and case for future employment opportunities.

  • 5 Key Take Aways From the New National Medical Training Survey

    5 Key Take Aways From the New National Medical Training Survey

    This week the Medical Board of Australia released the findings of the first-ever national medical training survey (MTS). As someone who has previously championed and developed these types of reports on the New South Wales level, it is truly pleasing to see this report launched. And boy did they release some findings!

    With the results of 59 headline questions reported across several different segments, including interns, prevocational and unaccredited trainees, IMGs and specialty trainees. With the main report running 249 pages, several other reports drilling down to College level, State and Territory level and even an Aboriginal and Torres Strait Islander report.  As well as an online interactive dashboard and a page where you can customize your own reports. There’s truly something for everyone in it. 

    So, what are some of the key findings from this report? Key points from this survey are that greater than 75% of doctors in training are happy with their training and workplace, however, 22% had experienced some form of bullying, harassment or discrimination. Most doctors in training are working safe hours but a concerning amount are still working in excess of 60 hours and even 90 hours per week, with surgery being one particularly bad specialty for this. Contrastingly far too many doctors in training aspire to enter a specialty like surgery than there is the actual capacity or need for. The survey shows that individual doctor career plans are out of alignment with medical workforce planning. Finally, even though we do have information about how medical schools are now performing as part of the medical training pipeline this information is surprisingly absent from the survey.

    Let’s drill a bit further into some of the key initial findings from the survey.

    Overall Impressions Of the Medical Training Survey.

    The Medical Training Survey will be run each year to get feedback from doctors in training in Australia (and in time their supervisors) to (according to the Medical Board of Australia):

    • better understand the quality of medical training in Australia
    • identify how best to improve medical training in Australia, and
    • recognize and deal with potential issues in medical training that could impact on patient safety, including environment and culture, unacceptable behaviours and poor supervision.

    It will take a while to assess the impact of this report. What we will need to see over time is the collection of data and the monitoring of trends to see whether the presence of the survey itself can spur on positive change.

    There is some hope that it might do that.  As similar surveys which have been running in the United Kingdom for some time now have shown improvements on parameters such as the extent to which Foundation doctors felt adequately prepared for their posts by their medical school has improved over time.

    GMC Foundation Results

    Image from the UK medical training survey depicting a sharp rise in “preparedness” from 2012 to 2013 (previous surveys would show this trend as going upwards from a lower level, but the 70% appears to be a natural barrier to further improvement). Source gmc-uk.org

    Overall Most Trainee Doctors Are Happy.

    With all the negative stories associated with the lot of trainee doctors in Australia over the past few years.  It may be tempting to conclude that trainee doctors in Australia are a deeply unhappy lot.  However, that’s simply not the case.

    And whilst, those stories should not be ignored and whilst there is empirical evidence of trainee doctors in Australia being exposed to adverse experiences in the workplace at unacceptable rates.  This experience is thankfully not the experience of the majority.

    In fact, 78% of the survey respondents indicated that they would recommend their current training position to other doctors (agreed or strongly agreed), followed closely by 76% of respondents being comfortable recommending their workplace as a place to train (again agreed or strongly agreed).

    Medical Training Survey snapshot

    International Doctors Are Even Happier According to the Medical Training Survey.

    I get asked a lot by international doctors if hospitals in Australia are good environments for IMGs.

    Here’s a table that shows you that overall IMGs are actually even happier than interns about their training post and workplace.

    82% IMGs would recommend their training post to another doctor, compared to 75% of interns. And 80% of IMGs would recommend their workplace to another doctor, compared to 75% of interns.

    Doctors In Training Are Still Working Too Much.

    The survey shows that the majority of doctors in training are now working under 49 hours per week.  However, 17% are in a risky area of working up to 59 hours a week and there are concerning outliers with 13% reporting working greater than 60 hours per week, including up to 90 hours or beyond.

    What is also interesting is that whilst one might expect that excessive work hours are more of a problem for specialty trainees when one compares the figures between, say interns and specialty trainees the difference is the other way with 16% of interns working over 60 hours a week and only 12% of specialty trainees working over 60 hours per week.

    But if we go a bit more granular and check out a specialty like surgery, we see more of what we expect to see.

    52% of RACS trainees report working greater than 60 hours a week. If you spot a worse group than this on the survey, I’d love to know about it.

    Where Did That Unrostered Overtime Go?

    Also, only 47% of doctors in training report being paid for unrostered over time, which is a deep concern.

    There Are Still Too Many Doctors In Training Being Exposed to Bad Behaviour.

    22% of doctors in training report personal experience of bullying, harassment or discrimination and 27% report witnessing this.  This is on part with other reports conducted around this issue, including one I helped write a few years back.

    Similar to our report findings only 35% of the recipients and 29% of the witnesses reported reporting this behaviour.  Which again is consistent with other studies.  What is most worrying is the level of non-witness report as this is probably the key statistic to be focussing in on here.

    If there is a silver lining to all of this it is that 52% of recipients who reported bullying, harassment or discrimination received a follow up to their report.  Now 52% may not seem all that great.  But this is actually a pretty good baseline result given what we know so far about the skills and capabilities of senior colleagues in handling the difficult issue of bullying, harassment and discrimination.

    Career Aspirations Greatly MisMatch the Reality.

    The MTS also included questions about career planning and intentions. Apparently 16% of Interns were unsure whether they did or did not have a training plan.  In my book that means you don’t have a plan.

    But check out the next table for an example of poor expectations management! 

    According to another medical workforce data set, the Health Workforce Australia, Medical Education and Training Dataset there were 1051 accredited surgical training positions in Australia. Now bear in mind that these 1051 positions aren’t just occupied by an individual doctor for one year but several years in order to complete a training program.

    Contrast this with the fact that 26% of the interns, resident medical officers, senior residents and unaccredited trainees indicated they were most interested in pursuing surgery as a career.  That’s a raw number of 351 of survey respondents alone. If we scaled it up to include those in these cohorts who did not complete the survey then we are probably talking 1500 to 2000, when the true capacity is around 200 to 300 per annum.

    If we look at the other end of the spectrum we then see a specialty such as psychiatry which traditionally struggles to attract trainee doctors sitting at only 4% when in fact it has capacity for and needs more trainees than surgery.  By the way, psychiatry also ranks in the top 5 professions for salary in Australia, along with Surgery.  Just saying.

    I was disappointed to see that this particular question was not asked of international medical graduates.  This would be important information to have.

    We Are Not Connecting the Dots (Yet) Between Medical School and Doctors In Training.

    So the last key finding is really a non-finding. I was surprised to see with all the effort that went into making this survey right a failure to ask a really obvious question about the transition from medical school to being a doctor-in-training. 

    As we have alluded to in the United Kingdom survey this has been a key and consistent question in their national report.  And it is an important one as we need to ensure that various parts of the medical training continuum are connecting with each other.

    What is even more surprising is that this question does get asked in Australia. It is asked as part of a survey led by the Australian Medical Council but with the participation of the Medical Board of Australia in a separate survey called the Preparedness for Internship Survey. This survey showed that 74% of respondents (interns) felt their medical school training had been sufficient.

    I believe it’s a mistake not to include this question in the national training survey as it helps us to connect some important dots with other questions.  Hopefully, over time, the Medical Board will find a way of combining the results of both surveys.

    I would encourage you to go and have a look at the survey yourself. Play around with it and see what you find.

    In this post, I haven’t even touched on things like the differences between various States and Territories or touched on very much issues around specialty training or other specific groups.

    I would love to get your feedback on the type of follow up post you would like to see to this one.

    Question. What is the Medical Training Survey (MTS)?

    Answer. The Medical Training Survey is a national, profession-wide survey of all doctors in training in Australia. It is conducted in a confidential way to get national, comparative, profession-wide data. With the aim of strengthening medical training in Australia.

    The survey is designed to be quick to complete and done on all manner of online devices and has the support of key stakeholders, such as doctors in training groups, employers, educators, the AMA and regulatory bodies.

    Question. How does The Medical Training Survey happen?

    Answer. The Medical Training Survey is open during August and September of each year, which coincides with the medical registration renewal period for most doctors in Australia.

    The survey is run independently by research agency EY Sweeney.  The survey is confidential, and data is gathered from online entry. Only aggregated data is ever reported, with the minimum threshold being ten (10) data points on any item and group to report back.

    Question. Who can do the survey?

    Answer. All doctors in training in Australia can do the survey. This includes interns, hospital medical officers, resident medical officers, non-accredited trainees, postgraduate trainees, principal house officers, registrars, specialist trainees and international medical graduates. Career medical officers who intend to undertake further postgraduate training in medicine can also participate.

  • Do International Doctors Have to Work as A Rural Doctor in Australia?

    Do International Doctors Have to Work as A Rural Doctor in Australia?

    In terms of land area, Australia is a large country, the 6th largest in the world. About 7,700,000 square kilometres. It’s a big country and as such has a lot of “country” or rural areas. Australia is also one of the most urban countries in the world, with about 85% of the population living within 50km of the coast. Just like other big countries. When doctors attempt to migrate to Australia from overseas some of the first questions they often will have are: “Whereabouts will I be able to work?” And “will I have to work as a rural doctor?” They will have normally already heard how big Australia is as a country and often heard rumours that international doctors can only work in rural parts of Australia.

    If you are reading this blog as a doctor from another country, I think it’s important to understand the facts and I’d like you to not feel too put off by the thought of potentially working in a rural part of Australia. There are far more important and difficult parts of the process of coming to work here. Don’t be put off by potential work locations.

    The quick facts about whether an international doctor has to work as a rural doctor in Australia are as follows:

    • Both international medical graduates, as well as medical students studying in Australia from other countries, are both subject to a ten-year restriction on being able to access Medicare billings as a service provider which can prevent you from being able to work in certain locations. This is commonly referred to as a 19AB restriction or the 10-year-moratorium.
    • There are many urban, regional and semi-rural areas (as well as more rural and remote areas) where you can still work in under Medicare.
    • But you generally won’t need to access Medicare for all of this ten year period. And if you are working as a trainee doctor or consultant in a public hospital you can potentially work in any part of Australia without having to worry about this restriction.

    The 19AB Medicare restrictions are the most significant policy that impacts international doctors working in Australia. But there is a range of other rules, restrictions as well as incentives that might affect you, including visa restrictions. So let’s look at these a bit more. As well as taking a deeper dive looking at the 19AB 10-year-moratorium.

    Government rules generally require IMG doctors to spend a period of time as a rural doctor. But not always.

    Australia is a vast country with large population centres concentrated in cities on the coastal fringes and much smaller populations throughout its landmass. This creates a problem whereby people who live in smaller population areas tend to miss out on access to a range of services in comparison to those based in the cities. This includes access to health care.

    Doctors themselves as an overall group tend to want to live and work in larger centres. The Federal Government, therefore, provides a range of incentives to entice doctors to work as rural doctors. As well as creating a number of restrictions for IMGs to make working in rural areas the only viable option.

    There are a couple of ways in which the Federal Government attempts to control the distribution of IMG doctors in Australia. The first is through Medicare billings. The second is through visa restrictions.

    Medicare and the 19AB Restriction Explained In More Detail.

    What is 19AB?

    International medical graduates are restricted in where they can work in Australia and access Medicare benefits as health care providers.

    What is Medicare?

    Medicare is Australia’s universal health insurance scheme. It guarantees all Australians (and some overseas visitors) access to a wide range of health and hospital services at low or no cost.

    Australians make more than 150 million visits to a GP every year. Medicare helps pay for the majority of the cost of these visits.

    Patients who have a Medicare card can access a range of health care services for free or at a lower cost, including:

    • medical services by doctors, specialists and other health professionals
    • hospital treatment
    • prescription medicines
    • diagnostic and imaging services
    • psychological services

    The Medical Benefits Schedule (MBS) lists the medical services covered by Medicare.

    The schedule includes an MBS fee for each service. This is the amount (or benefit) the Australian Government believes that the service should cost.

    Whilst it is possible to work as a doctor outside of the Medicare system. On a practical level, without access to the Medicare Benefits Schedule, it is pretty tough for a doctor to make a living. Doctors would have to either significantly reduce their fees to a level which matches the out of pocket costs that other doctors charge on top of Medicare or set up in an area where there was very little competition. Even then it is likely that patients would not be happy as the Australian population is used to being able to access Medicare for their health care.

    Section 19AB of Australia’s Health Insurance Act 1973 sets out the rules for international medical graduates and these restrictions.

    Medicare Provider Numbers.

    In order to bill Medicare for services, a doctor needs to have a Medicare provider number. Most doctors have more than one Medicare provider number. The reason being that you are required to have a provider number for each unique location where you might work.

    By tieing provider numbers to geographical locations, the Federal Government is able to restrict where doctors are able to practice.

    Who does 19AB apply to?

    Restrictions under 19AB apply to two groups of doctors. The federal government calls both of these groups of doctors international medical graduates. This is a bit confusing as really only one of these categories of doctors is really an international medical graduate as most people understand this term to mean. You are deemed to be an international medical graduate if you:

    • got your degree outside of Australia or New Zealand
    • enrolled in a degree in Australia or New Zealand as a temporary resident

    So the second group is basically doctors who graduated from an Australian or New Zealand medical school but did so as a student paying fees from overseas.

    So Australian Doctors Can Just Work Anywhere Then?

    Yes and No.

    In order to charge for Medicare services all doctors, including Australian graduates and those under 19AB restrictions, have to meet certain other qualifications.

    For most doctors, this means being what is called “vocationally-registered” or what many might call recognised as a specialist. General Practice is recognised as a specialty in Australia.

    There are also some restrictions for what is called Bonded Medical Place Scheme.

    Doctors who are Australian Citizens or Permanent Residents are subject to another section of the same legislation Section 19AA.

    What is 19AA?

    Doctors who are permanent residents or citizens of Australia must become vocationally recognised. Doctors become vocationally recognised by getting a Fellowship qualification in a specialty that is recognised in Australia.

    Under 19AA, you can’t get a Medicare provider number if you are a permanent resident or citizen of Australia, and you are not:

    • recognised as a Fellow by the Royal Australian College of General Practitioners
    • recognised as a Fellow by the Australian College of Rural and Remote Medicine
    • recognised as a Fellow by another Australian specialist college
    • on an approved 3GA program

    3GA Explained. Sorry I Promise I Am Going to Finish With the Meaningless Letters and Numbers Soon.

    If you do not hold Fellowship, you can provide services covered by Medicare if you are on a section 3GA approved training or workforce program. As of the time of writing this post, there were a number of open 3GA programs:

    As well as some programs which are closed to new applicants.

    Most of these programs relate to supporting doctors on a training pathway to general practice, e.g. the Australian General Practice Training Program.

    DPA and DWS (Sorry 🙂 )

    Under 19AB, you must work in a Distribution Priority Area (DPA) if you’re a GP, or a District of Workforce Shortage (DWS) if you’re a non-GP specialist, for at least 10 years.

    Distribution Priority Areas are a new concept. They have been developed because the previous concept, which is and was District of Workforce Shortage wasn’t making a whole lot of sense.

    To explain this I am going to use a few images from the Health Workforce Locator tool, which is a very handy and useful tool that you yourself can use to find out more about where doctors in Australia are needed and can work if they are under restrictions.

    Let’s take Melbourne, Victoria as our example. Melbourne is Australia’s second-largest city by population.

    The first image depicts the most current classification scheme for locations in Australia, the Modified Monash Model. It is named the Monash Model as it is based on some work done by researchers at Monash University.

    The Modified Monash Model (MMM) is used to define whether a location is a city, rural, remote or very remote.

    The model measures remoteness and population size on a scale of Modified Monash (MM) category MM 1 to MM 7. MM 1 is a major city and MM 7 is very remote.

    Using the MMM classification system can in theory help distribute the health workforce better in rural and remote areas.

    MMM classifications are based on the previous Australian Statistical Geography Standard – Remoteness Areas (ASGS-RA) framework.

    The Distribution Priority Area classification uses MMM boundaries.

    Some government programs use the MMM to define their eligibility requirements.

    From January 2020, Department of Health programs are transitioning to use the MMM classification.

    Areas of classification from urban to remote around Melbourne, depicting the Modified-Monash Classification
    Areas of classification from urban to remote around Melbourne, depicting the Modified-Monash Classification

    The next image again centred around Melbourne depicts the current status of General Practice using the DPA system.

    The DPA system takes into account gender and age demographics, and the socio-economic status of patients living in an area.

    An area is automatically classified as DPA when it is: 

    • classified under the Modified Monash Model as MM 5 to 7 
    • in the Northern Territory

    Other areas can be classified as DPA when the level of health services for the population does not meet a service benchmark.

    The average level of health services under MM 2 is the benchmark for international medical graduates to work in DPA areas.

    This benchmark is compared to the needs of an area, taking into account gender and age demographics, and the socio-economic status of patients living in an area.

    Areas around Melbourne where IMGs can work as General Practitioners (Yellow is good).

    The next image, again around Melbourne, depicts the previous ASGS Remoteness Area classification system. It is still used to determine a range of programs including District Workforce Shortage. As well as determine how doctors can speed up their 10-year moratorium.

    The previous ASGS Remoteness Area Classification Scheme

    The final image around Melbourne using the same tool shows you the state of general surgery around Melbourne. Notice a difference between this image and the one for General Practice? There are large areas of Melbourne available to work in for an IMG general surgeon. Yet big parts of rural Victoria are seemingly off-limits.


    Areas around Melbourne depicting where IMG General Surgeons could potentially work

    Under the DWS system, you would also see quite bizarre patterns for general practice. This is why there has been a switch to DPA.

    The problem is that the DWS system is a cruder system. It basically looks at Medicare billings for a particular specialty in a certain location and determines if that area is above or below the average of billings.

    For this reason, one would and should expect that all specialties will eventually be switched over to DPA over time.

    Bonded Medical Place Scheme

    Under the BMP Scheme, the Government provides a Commonwealth Supported Place (CSP) at a medical school at an Australian university.

    In exchange for a medical place, once they have graduated, bonded participants agree to work in an area of workforce shortage for one to six years. The length of time depends on your agreement and is called the return of service period.

    The 10-Year Moratorium

    The 10 year moratorium period starts from the first day of medical registration. This is called the 10 Year Moratorium. 

    All international medical graduates are subject to the moratorium. There are no exceptions.

    The moratorium and 19AB restrictions will end for you after 10 years if you are a permanent resident or citizen by this time. Most IMGs, if they have gotten this far, will be eligible for permanent residency.

    If however, a doctor does remain a temporary resident, their moratorium continues until the time they become a permanent resident or citizen.

    But if you do not have a Fellowship qualification when you become a permanent resident, you will subject to the other rules under 19AA.

    Speeding Up Your Ten Year Wait.

    So are there any options for reducing the amount of time under which you are restricted in your Medicare Provider Number?

    Yes, there are some options. But as we have highlighted above you may not necessarily wish to consider these options if you do not have a clear path to permanent residency or citizenship.

    Moratorium Scaling

    Moratorium scaling allows you to reduce the amount of time you must work in an area classified as DPA or DWS.

    Working in eligible locations lets you collect ‘scaling credits’. The more credits you have, the sooner you can work in any location across Australia you want. That is provided you satisfy all the other requirements.

    The more remote a location is, the more scaling credits you will get for working there. In theory, this directs the workforce to the areas that need it the most.

    The moratorium is always 10 years, minimum. However, once you have enough scaling credits, you will have a class exemption for the remainder of your moratorium.

    You can then apply to practise in an area that is not classified as DPA or DWS.

    How Moratorium Scaling Works

    You can scale the moratorium if all of the following apply:

    • you are an international medical graduate working in an eligible regional or remote area under 19AB
    • you are claiming Medicare Benefits Schedule items for services as part of your employment
    • your monthly billing threshold is $5,000

    So for example, you can’t just fly out to Bourke once a month for a day and run a clinic and count this for scaling. Unless you are good enough to collect $5,000 on that particular day.

    Also, if you have worked in multiple areas in a month, Medicare will be able to work this out and your credit will be based on the area where you billed the most, as long as you reached the $5,000 threshold.

    Scaling locations are based on the Australian Standard Geographic Classification – Remoteness Area system.

    ClassificationRA CategoryMonthly scaling benefit (where billing threshold is met)Potential reduction of DPA period under the moratorium
    RA 1Major citiesNilNot reduced
    RA 2Inner regional3.37 days9 years
    RA 3Outer regional13 days7 years
    RA 4Remote20.3 days6 years
    RA 5Very remote30.4 days5 years

    Is Sitting It Out An Option?

    I hesitate to write an answer to this question because I truly do believe that working in regional and rural Australia offers significant benefits to doctors. But if you are truly not inclined to work in one of the more rural regions of Australia then sitting it out may be an option for you.

    Let’s take the situation of an IMG who comes to Australia and works their way into a Resident Medical Officer role in a city hospital as part of the Standard Pathway. So this doctor will work off one of their ten years just doing their provisional registration year to gain general registration.

    Lets then say that they take a further couple of years of Senior Resident roles whilst working themselves towards a specialty training program. So we now have 3 of the ten years done.

    And then let’s say they enrol in Adult Physician training take 3 years to complete Basic training. Take a further 3 years to complete an Advanced Training program and a year off to complete a PhD.

    That’s a fairly common path even for an Australian trainee. And its ten years in total.

    Sitting It Out Is Not An Option For General Practice Training Or Specialist IMGs.

    The situation would be much more different obviously for a trained specialist IMG who comes to Australia. If you are lucky enough to be assessed as either partially or substantially comparable then you will need to find a position where you can work supervised to complete the rest of your assessment. Whilst this post could be potentially anywhere in Australia, we will see below how its likely not to be in a major metropolitan centre.

    You won’t necessarily need to worry about Medicare initially as its most likely you will be working in the public hospital system. But after a while, if you wish to work privately you are definitely going to be subject to 19AB restrictions.

    Similarly, for any international medical graduate who comes to Australia via the Standard Pathway and wishes to enter general practice training. In order to enter the largest General Practice training program, the AGPT program you will be required to training under the rural pathway and not be able to train under the general pathway.

    Once you finish GP training there are very few options for GPs to work salaried in a hospital or medical centre and urban GP practices will be unlikely to offer you a post if you cannot bill Medicare, so you will definitely need to work in a DPA area.

    Visa Restrictions.

    Up until this point we have pretty much solely focused on Medicare Provider number restrictions. But it is also important to point out that the Federal Government is able to and does attempt to control the supply of various professionals working in Australia through visa restrictions.

    Firstly, in order to be able to gain a work visa there needs to be a recognition that there is an undersupply of the work category that you are in. Luckily for doctors, most medical categories are seen as being in undersupply in most parts of Australia.

    If you are lucky enough to gain a post in Australia and are not already a permanent resident or citizen then the most likely visa that you will be able to gain is a Subclass 482 or Temporary Skill Shortage visa.

    482 Temporary Skills Visas

    These visas let an employer sponsor a suitably skilled worker to fill a position they can’t find a suitably skilled Australian to fill.

    They run from about 2 to 4 years depending on whether you are on the short-term or medium-term or labour agreement stream. Your medical area will need to be on one of several lists that the federal government keeps to identify strategic workforce needs.

    In most cases, you are not necessarily restricted to working in a certain location on a 482 Visa. But some may have restrictions (for example Anaesthetics is currently listed as needing to be in a regional area).

    However, you are generally tied to your employer on a 482 Visa and its not very easy to transfer between one employer and another without gaining another visa.

    If you are interested in more information about visa options you should definitely discuss with a qualified migration agent. I am only providing the above information as general information and not specific advice.

    The Labour Market Also Dictates That IMGs Are More Likely To Find Work in Regional and Rural Areas.

    Up until now we really haven’t discussed much about the role of the State and Territory governments or the employers in the whole process.

    Public hospitals in Australia are run by the State and Territory governments and these governments also often pick up a lot of the slack around primary care in the rural regions.

    So unsurprisingly, these governments also attempt to exert some control over where international medical graduates work. Mostly they do this through marketing and the use of incentives. But they can also restrict whether a hospital can advertise a certain position to an international medical graduate and set rules around these circumstances.

    But there’s another big factor that weighs upon where IMG doctors do end up working and that is the labour market itself. Generally speaking, medical positions fill up towards the major capital centres and vacancies will draw doctors in from regional and rural areas.

    So its therefore not surprising that there are simply more opportunities for IMG doctors in regional, rural and remote areas as there are must more vacancies to fill in these places.

    On the flip side, a number of these locations have focussed on the IMG market as a workforce solution and become really good at supporting IMGs to get their headstart in Australia.

    I often hear comments about how IMGs are not wanted by Australian employers. There are always good and bad employers around. If you are applying for jobs as an IMG in Australia you are probably going to find that the big city hospitals are the more inhospitable and that the regional and rural hospitals much more receptive.

    Summary.

    So to summarise. There are many reasons why as an international doctor you may find yourself working in rural Australia. At least for a period of time. But this does not necessarily mean working a long distance from an urban centre. And the experiences of many international doctors who have trod this path before you have often been positive. Compared to things like actually finding a job or putting yourself through the AMC or college assessment process. I frankly think that there are more important matters to be worried about if Australia is your destination.

    Question. How Do I Get Registered To Work In Australia?

    Answer. As an International Doctor, you first need an employment offer to gain registration. After that, there are two main pathways to registration: the standard pathway (if you are not a specialist) and the specialist pathway.

    Question. Where Can I Get Further Information About the Specialty Colleges?

    Answer. We have a post written about that very topic.

    Question. Where Can I Find Information About Jobs?

    Answer. Head over to our IMG resources page.

  • Common Questions (and Answers) About AMC Standard Pathway

    Common Questions (and Answers) About AMC Standard Pathway

    Over the last year, I have been pleasantly surprised by the interest of doctors all over the world in some of the explanations that I have been providing both here on the blog as well as on my Career Doctor YouTube channel about the processes for working as a doctor in Australia. There have been a lot of questions and comments seeking further understanding about the Standard Pathway Process. So here is a list of common questions and answers to help you out.

    What is the Standard Pathway Process?

    The Standard Pathway is a process whereby doctors who have medical degrees from outside of Australia can apply to have their capability as a doctor evaluated in order to work in Medicine in Australia. The process is intended to ensure that doctors are competent to the level of Australian doctors at the point at which they graduate from medical school and go onto successfully complete a provisional intern year.

    Which Doctors Should Apply for the Standard Pathway?

    The Pathway applies to international doctors who do not have specialist qualifications and who are not from one of the “competent authority” countries. So the majority of international doctors seeking general registration do apply for this pathway.

    What Are the Competent Authority Countries?

    The medical regulatory system in Australia recognizes 4 other countries as having medical training systems that are equivalent in terms of outcomes to Australia. The countries are the United Kingdom, the United States of America, Canada and the Republic of Ireland. Doctors from New Zealand are also recognized as having identical outcomes in their medical degree as the Australian Medical Council also accredits New Zealand medical schools.

    This means that if you graduated in medicine from one of these countries you have a more streamlined pathway available for being able to work as a doctor in Australia.

    In addition, some international doctors who have been through the process of gaining registration in a competent authority country will also be able to apply via this competent authority pathway. For e.g. if you have successfully completed the PLAB.

    What Are the Australian Medical Council Examinations?

    According to the Australian Medical Council

    The AMC examinations are set at the level of attainment of medical knowledge, clinical skills and attitudes required of newly qualified graduates of Australian medical schools who are about to begin intern training. They consist of a computer adaptive test (CAT) multiple-choice question (MCQ) examination and a clinical examination:

    • The AMC CAT MCQ Examination tests knowledge of the principles and practice of medicine in the fields of general practice, internal medicine, paediatrics, psychiatry, surgery, and obstetrics and gynaecology. It focuses on essential medical knowledge involving understanding of the disease process; clinical examination and diagnosis; and investigation, therapy and management.
    • The AMC Clinical Examination assesses clinical skills in medicine, surgery, obstetrics, gynaecology, paediatrics and psychiatry. It also assesses ability to communicate with patients, their families and other health workers.

    So an important thing to note here is that the AMC Exams are clinical exams and do not involve being tested around matters of basic science.

    When Can I Sit the AMC Examinations?

    You can sit for the AMC Examinations any time after you graduate from your medical school. All that is needed to sit is proof of a primary medical degree.

    You must sit and pass the first AMC Exam. The MCQ test. Prior to being able to sit for the Clinical Examination.

    Do I Need to Sit An English Test to Sit the AMC Examinations?

    Surprisingly the answer to this question is no. You won’t need an IELTS test or one of the other 3 acceptable tests in order to sit the examination. However, you will likely need one in order to apply for a job and become registered. See below.

    How Often Can I Sit the AMC Examinations?

    You can sit as many times as you wish to. But you can only be preparing for and registered to sit one particular exam at a time. Bear in mind the exams are expensive.

    Is There An Age Limit For Sitting AMC Exams.

    No. You can sit them at whatever age.

    How Long is my Exam Result Valid For?

    Once you pass an AMC exam this result remains valid for life.

    Is There a Time Limit for Sitting the AMC 2 Exam?

    No. There is no time limit by which you may sit this exam.

    How Much Does It Cost to Sit the AMC Exams?

    The AMC Exams are quite expensive. The MCQ exam costs $3,124AUD per sitting and the Clinical exam costs $3,991AUD for an in person sitting and $4,391AUD for an online. These costs are generally more expensive than most College training exams in Australia. There are also other fees that you will have to pay, for example, to establish a portfolio with the AMC, to get your certificate or reissue results.

    AMC Exam Fees 2024

    c/- AMC 2024

    How Hard Are the AMC Exams?

    In essence pretty hard. The MCQ exam is relatively ok with around about a 60% pass rate per sitting. The Clinical Examination is notoriously difficult with a pass rate of around 28%. See this post for a more in-depth explanation.

    When Is the Best Time to Sit the AMC Exams?

    The AMC Exams run constantly throughout the year with a bit of a break over the Australian summer period. There is no best time to sit from this perspective.

    As the exams are a test of your medical knowledge and abilities at the end of medical school it is generally considered that it gets harder to sit and pass these exams the longer it has been since you yourself finished medical school. So its best to sit as soon as possible. Many doctors will sit the MCQ whilst completing their own internship year in their own country.

    Is There a Waiting List for the AMC Exams?

    According to the AMC there is no wait list for the exams and no need for a wait list as they are able to offer enough examination spots to satisfy demand. This is achieved by running a number of MCQ exams both in Australia and across the world as well as having increased the number of clinical examination spots available.

    Whilst it may be true now that there is no wait list there have certainly been concerns in the past particularly in relation to waiting significant amounts of time (18 months or more) for the Clinical examination.

    The process itself also imposes a waiting period. Because once you have applied for and selected an examination date you cannot apply for another exam date. And you have to await the results of your MCQ exam before either applying to do it again or applying for the Clinical exam.

    What’s the Best Way to Prepare for the AMC Exams?

    In the AMC exams you compete against a standard. Not other candidates. So most doctors who have been successful in the AMC exams will tell you that one of the best ways to prepare is to form a small study group.

    Generally, most candidates prepare by using examples of past questions. You can purchase some official questions from the AMC. But there are also a number of other MCQ questions and Clinical stations floating digitally around the internet as many AMC candidates do attempt to recall questions after their exam.

    Given the expense of the exams themselves, it may be difficult to afford to pay for additional resources such as textbooks and online and face to face courses. Most international doctors do recommend purchasing a copy of Professor Murtagh’s book on General Practice as this covers a lot of the Australian specific knowledge for both the MCQ and Clinical. There are also a number of online tutoring and courses available as well as face to face courses and opportunities to undertake observerships if you are able to afford these.

    Follow the affiliate link below to purchase your copy of Murtagh’s General Practice.

    Can the USMLE or PLAB Substitute For the AMC Exams?

    Yes. But only if you complete all the steps required and in the case of the PLAB undertake at least 12 months supervised placement in the UK or in the case of the USMLE undertake at least 24 months in an accredited residency program. Otherwise, these exams are of no use and you have to sit all of the AMC Exams.

    Are There Other Alternatives to Sitting the AMC Exams?

    Yes. If you are from a Competent Authority Country you can apply via this pathway. If you are a specialist you can apply for the specialist pathway.

    If you are fortunate to be employed at one of the 1o places that are accredited for the Work Place Based Assessment Program by the AMC then you will also most likely have the option of completing a WBA program which is an alternative to the Clinical Component of the AMC exam with a much higher pass rate and lower cost for applicants.

    I Need to Complete An Internship. How Can I Obtain An Internship in Australia?

    You have probably read something on facebook or the Medical Board website itself telling you that you need to complete an internship to be able to be registered. In most cases, you probably do not need to complete an internship. As you will have done something similar in your own country. In general, the Medical Board wishes to see evidence that you have been granted a full license or general registration to practice in your own country. In some cases, this may require passing an internship or similar during medical school. In others, it may mean completing a provisional year after graduating.

    If you have not done any of these things so far. Then you do still need to complete an internship. But you are much better off completing this in another country. As the chances of being able to actually gain an internship position in Australia are extremely small.

    Do I Need to Sit an English Test?

    Most likely the answer to this question is yes. However, you may have some options to be exempt from this requirement if you can prove for example that all of your high schooling was in English.

    How Well Do I Need to Do In the English Test?

    There are minimum requirements for the various English Language Standard tests that you can do. For a fuller explanation see here. As an example to be able to gain registration if you sit the IELTS you need 7 or above in all four domains of this test.

    Many doctors think that achieving the minimum requirement in the English test is all that is needed. However, the minimum requirements often correlate with being less than sufficient in English in the eyes of the employer and can often mean that you are rejected for an interview in the first place or find out that your English language skills were the main reason the interview panel felt you were not suitable.

    You should endeavour to practice and build in your Australian English as much as possible and consider taking the test again to demonstrate a better score.

    When Can I Apply for a Job?

    As soon as you are successful in the AMC Part 1 you can begin applying for a medical position. Most doctors recommend this strategy and not waiting until you complete the Clinical Examination. This is because it can often take a lot of time and persistence to obtain a position. The downside of this approach is that you will probably get a lot of rejections and find yourself in a big group of candidates who all just have the AMC Part 1 exam.

    What Are the Best Jobs to Apply For?

    What job you apply for may depend on where you are intending to head in your career, particularly if you are looking at general practice. Bear in mind however that most of the doctor jobs in Australia will not be available to you until you have obtained general registration. The most common type of job that will be available is called a resident medical officer (RMO) job. These are often advertised at times during the year when hospitals have had vacancies in their ranks. The RMO role is normally a position that is one more year advanced than the intern position. But you are generally doing the same roles as interns, i.e. acting as the most junior member on the team looking after the day to day patient issues on the ward.

    A key phrase to look for in any job description which will indicate that you can apply for a position is:

    “eligible for registration”

    How Can I Improve My Prospects of Gaining a Job?

    I’d recommend you watch this video I did with Dr Naj Soomro. In it, we highlight a number of things that can help you gain a job.

    Some of the key things are:

    1. Having a really well put together resume
    2. Establishing networks to identify ad hoc job opportunities
    3. Being prepared to look outside of the major cities
    4. Preparing for job interviews

    Once I Get a Job Offer. What Happens Next?

    It is very important that you ask for a contract. There have been situations where international doctors have been offered a job in the past but this has been withdrawn at a later date. You are really not secure in your job until you have started working. It’s important that you are responsive during the phase between the offer and commencing as you will need to help the hospital sort out things like your registration and visa status.

    Once you are up and running you should make sure that you are aware of your supervision requirements and ensuring that you are getting regular feedback on your performance and completing the reports that need to go back to the Medical Board. It’s much better to identify problems in your performance early on so you can fix these rather than letting them become a big issue and jeopardizing your sign off at the end of the 12 months of limited registration.

    When Can I Apply for Training Positions?

    Once you have completed the process, ie. you have your full AMC Certificate and a satisfactory 12 month’s supervised practice you will be able to apply for general registration.

    Once you have general registration you will be eligible to apply for most of the specialty training schemes.

    There are some exceptions to this where you also require permanent residency. For example, the Australian General Practice Training Scheme and the College of Surgeons training programs. So, if you are aiming for these you will need to consider alternatives or wait a few more years till you can obtain permanent residency.

  • Area of Need Australia. What is it? Who is eligible? How to apply.

    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:

    Area of Need Radiologist Victoria

    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.

    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.