GP JOBS IN AUSTRALIA

FAQ

Below are some of the general questions we’ve been asked, together with additional information –  all to do with having a GP Job in Australia.

19AB,  DWS and non-DWS

19AB is the law which Australia passed in 1996 to restrict the locations where overseas trained doctors (IMGs – International Medical Graduates) can work in Australia. An IMG coming to work in Australia for the first time is subject to a 10 year moratorium on where he or she can work. For these first 10 years, doctors subject to the moratorium need to work in areas designated as District of Workforce Shortage (DWS). GPs not subject to the moratorium are able to work in any area (DWS or non-DWS). By and large, this latter group of doctors is made up of Australian medical graduates and those IMGs who have been released from the Moratorium. There are some exceptions to the restrictions under the 19AB rules:

• if you work in more remote areas, the moratorium may be 7 years.
• if you’ve held prior registration with the AMC, then the Australian authorities may agree to the moratorium start date being the date of your first registration. Hence, if you are returning to Australia more than 10 years after first registration, then you may be able to work in non-DWS areas (this bit of legislation is complex and there may be a requirement to hold permanent residency for this to apply to you – please ask for further advice)
• if your spouse or partner has a profession listed on the Skilled Occupation List (http://www.immi.gov.au/skilled/_pdf/sol-schedule1.pdf) and has a job in an area which would not be DWS, then you may be able to obtain an exemption to work in that area.

There is an online map showing the current DWS areas:  http://www.health.gov.au/internet/otd/publishing.nsf/Content/Locator

5 Steps to Registration to Work as a GP in Australia

There are 5 steps - AMC / RACGP / AHPRA /Visas / Medicare number

1) First step is registering with the AMC. Please see the attached documents, including FAQ. The main hurdle in this section is getting all your (original) documents together and getting two sets of notarised copies.

2) Once you’ve sent one set of all your documents to the AMC, they carry out a paperwork check. If everything is in order, they send them on to the RACGP, who in turn, check that you meet their requirements to be a category 1 or Category 2 GP. As well as the documents that were needed by the AMC, the RACGP will ask for: Letter of good standing from the RCGP and (most likely) a formal offer from your employer (please ask us about this if it hasn’t been sent to you by the time of your application).. (N.B. the websites say that these documents should be part of the application process to the AMC. However, you only need to send a covering letter saying “documents sent with application to AMC”). See this link:http://www.racgp.org.au/assessment/pathways/specialistpathway   If all is OK, then they will give you category 1 status as “FELLOWSHIP ad eundum gradum”. If you get Category 2 status, the RACGP may ask you for a Fitness for Intended Clinical Practice Interview. See notes here: http://www.racgp.org.au/Content/NavigationMenu/educationandtraining/Assessment/AssessmentPolicies/SPBusinessProcess_Chapter2.pdf

3) This then allows you to apply to the AHPRA (the national health board – a bit like a national version of our PCTs) who will give you actual registration to work as a GP. (N.B. You can start the AHPRA part while the RACGP are signing off the fellowship but they won’t finalise it until the RACGP gives their approval). The AHPRA require you to send them the second set of notarised copies of all your documents. You then get a letter “in principle” from the AHPRA confirming registration, which you use to get your work visa.

4) The work visa you’ll need is a 457, which is sponsored by your employer. Assuming the employer is a registered sponsor, this part takes between two to four weeks. The 457 visa covers your partner / family

5) Once you get to Australia, go to the local AHPRA office to pick up your actual registration document using the “in principle” letter you received earlier. You then need to arrange for a Medicare number, so you can bill Medicare for your work. To do this, you’ll need to visit the practice you’re going to work for to sign the forms and then have them sent off for approval. This stage takes a further 2 weeks.

6) Then you can start work!

Notarising Documents in the UK

You’ll need to send various key documents to the AMC (and then later to the AHPRA). Rather than send originals, it is safer to send to notarised (certified) copies. The notarising can be done by a local Notary Public (look up Notary Public in [your town/city] in Google). Alternatively, the Australian Consulate in London can provide this service at a cost of £20 per document, which I think will be less expensive than a local solicitor. See here for more information:http://www.uk.embassy.gov.au/lhlh/Consular1.html

N.B. We have a standard letter of advice on how to go about AMC registration, which we can send to you once you’ve got a job offer

What does “Bulk billing”  and “Mixed billing” mean

GP practices usually bill for each GP appointment. Ideally, the practice will bill (& receive payment from) the patient for 100% of the invoice. The patient would then claim a rebate from Medicare (the Australian NHS). This is called “mixed-billing”. However, in poorer areas, patients don’t have the resources to pay for the bill upfront and claim for a rebate from Medicare.  In recognition of this, Medicare allows the practice to bill just the Medicare portion (typically 85%) directly to them.  This is called “bulk billing”. In doing this, the practice foregoes the patient element of  the money but gains a secure cash flow, reduced admin time & debt collection.  The payment method used has knock on consequences for how the practice goes about scheduling patient appointments, hours of work etc.

What is DWS?
DWS stands for District of Workforce Shortage. It is the mechanism by which the Australian Government directs GPs to areas where there are fewer GPs per head of population than other areas. With the exception of Out of Hours and purely private medical services, all vacancies in Australia for doctors newly arriving in Australia are in a DWS area.

The areas covered by DWS change over time. They are listed on this website: http://www.health.gov.au/internet/otd/publishing.nsf/Content/Locator

It is important to note that DWS status can be taken away from a practice – even if they haven’t found a suitable doctor. However, if that practice has found a doctor and agreed contracts, it is usually possible to get a DWS extension to allow the doctor time to get AMC registration and visas etc. Also, once you’ve started work in a practice in an area which subsequently loses its DWS status, this will not affect you.

What type of visa do I need?
Usually, you’ll need a 457 visa. This is a temporary long stay visa for skilled employees. This will cover you for up to four years, after which you can apply for another one. Or, if you want, you can apply for permanent residency. If you are coming with family, then the 457 visa covers family members as well. The employer will sponsor you for the visa and we will assist. However, you may need to employ a visa agent if you don’t have time or the inclination for all the form filling. This can cost $2,000 to $3,000. The 457 Visa will allow you to work part time if you want to (and have agreed it with the practice) – there is no requirement to be full time

How many Australian $ to the UK £?
Around $1.57 to the £ as of October 2011. Usually, the Australian $ matches the US $ 

I want to come in 6 to 12 months time. Will the employers work that far ahead?
The short answer is that some will, some won’t. It depends on location. In Perth, yes they will. In other areas, it is a bit hit and miss – it depends on how the individual practice and what other candidates are applying.  

Do the practices offer any financial help with moving?
Some clients offer help, some don’t. Those that do, tend to be the bigger corporately owned practices who are used to helping doctors come from the UK. The smaller, privately owned practices generally don’t have a lot of money available for up front payments (typically a maximum of $10,000).  There is a balance in all this though. Any upfront payment made by a surgery is usually set against a reduced % in terms of remuneration.  So, the corporates will offer an upfront payment of say $35,000 plus a 60% of takings as remuneration. A privately owned practice might offer a $10,000 up front payment and a 65% of takings. These figures get adjusted according to the length of contract you’re willing to sign (shorter equals less money).  Having said all this, there is quite a bit of negotiating to be done and there are no hard and fast rules.

Malpractice Insurance?

Yes, you’ll need this. It is based on your total billings. A rough guide is: if your billings are $400,000 per year, then the insurance will be $5204.  If your billings are up to $500,000 then it becomes $5370.

Language testing?

If you’ve taken your original medical diploma in English, then you don’t need to take a language test. If not, then you will need to have taken one. If you came to the UK via PLAB, then its likely that you took IELTS then and that will be fine (no matter how long ago – you just need to have been working as a doctor in an English speaking country since then though). If you need to take the test, please note that it is Academic IELTS that’s needed and you’ll need a score of at least 7 in all modules. This page on the AMC website will give you more information: http://www.amc.org.au/images/forms/mba-elp.pdf

How long are the contracts?

Most practices would like you to commit for three years or more. However, 12 month and 2 year contracts are available in some areas. Please note that the longer the contract you sign up for, the more money they’ll pay you as an upfront payment (and vice versa).