A Guide for International Medical Graduates Who Wish to Work and Live in Australia.

A Guide for International Medical Graduates Who Wish to Work and Live in Australia.

How Do Doctors and Medical Professionals Obtain Australian Permanent Residency?

Background

In Australia, medical practitioners are divided into generalists and specialists. Students finish their studies and generally complete a year or more as generalists. From there, they enter a variety of training pathways to become specialist medical practitioners. Specialisation can take a number of years and is generally subject of a series of examinations prior to admission as a ‘Fellow’ of one of the specialist colleges.

The term ‘Fellow’ is generally reserved as a term denoting recognition as a full member of a specialist field. In medical practice, specialists use the term ‘consultants’ in a hospital or clinic environment.

While some medical practitioners will practice as non-specialists for the majority or entirety of their career this is uncommon.

International Medical Graduates

Medical practitioners who have not trained in Australia are commonly referred to as International Medical Graduates (IMGs) and must complete one of several pathways to become fully registered in Australia by the Australian Health Practitioner Registration Authority (AHPRA). Once they progress through the ‘limited’ registration to obtain ‘full’ registration they can practice without supervision.

Typically, experienced practitioners will complete the AHPRA registration process in parallel with the steps required to re-obtain specialist recognition (ie becoming a Fellow). Information about the APHRA registration process varies depending on the IMG’s background, qualifications and experience.

There are 3 pathways to APHRA registration:

  1. Competent Authority – for UK, Canada, US, NZ, Ireland graduates; or
  2. Standard – leads to general registration only; or
  3. Specialist – involves specialist recognition through direct application to the College responsible for your specialist category.

Please see a table from the APHRA below explaining the 3 pathways.

Depending on the pathway chosen, the assessment may include supervised practice, exams, or both.

Medicare

Australia operates a universal healthcare system, known as Medicare. All citizens and permanent residents of Australia have full access to Medicare. For a number of years the government has encouraged Australians to also access the private healthcare system by paying private health insurance.

Most doctors in Australia operate in a private clinic environment (or a mixture of public and private if working for a state run hospital). As such, almost all doctors access Medicare when billing patients for services. Doctors generally set fees to include a component of private billing and bill Medicare for a further rebate. Some doctors adopt a ‘bulk billing’ approach in which individual patients pay nothing and the only income is derived from Medicare.

The circumstances under which doctors can bill patients through Medicare are governed by the Health Insurance Act 1973.

Temporary Residency, APHRA Registration and Medicare

As a temporary resident on a 482 visa you will be able to work as a medical practitioner provided you hold provisional or limited AHPRA registration. You will also be able to access Medicare billings under an exemption based on s19AB of the Health Insurance Act 1973.

Permanent Residency, APHRA Registration and Medicare

Where an IMG obtains permanent residency (PR) but is not a specialist (ie: not a Fellow) they become subject to the ‘s19AB Moratorium’ under the Health Insurance Act 1973. Section 19AB prevents IMGs from accessing Medicare billing rights unless they work in a ‘Designated Priority Area’ or Area of Need. These are geographic locations with lower levels of medical practitioners and greater healthcare issues. Typically, this moratorium applies for 10 years and is designed to redirect doctors to regional areas and prevent the over-servicing of major metropolitan centres.

It is possible to obtain an exemption from the s19AB Moratorium in limited circumstances.

If you are considering applying for permanent residence you should whether:

  • You can achieve Fellow status with your respective specialist college prior to being granted permanent residence; or

You are willing to work in an Area of Need as a generalist for 10 years.

Next Steps

We assist private and public health services providers throughout Australia.

Please contact us for a discussion on how best to achieve temporary or permanent residence while maintaining your ability to bill under Medicare. We are also able to assist with general visa applications, immigration strategy, and compliance.

The above is a summary only and should not be treated as legal advice. You should seek personalised advice before acting on the above information.

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