After Hours Other Medical Practitioners Program – DoHA. The AHOMPs program provides access to the higher A1 Medicare rebate to non-vocationally recognised medical practitioners providing after hours general practice services through an accredited general practice or an accredited Medical Deputising Service (MDS). Normally non-vocationally recognised medical practitioners would access the lower A2 Medicare rebate.
Australian Health Practitioners Registration Agency. As of July 1st 2010, all State Medical Boards are no longer in existence as they have been replaced by one National Board which is the organization responsible for the registration and accreditation of 10 health professions across Australia. AHPRA‘s operations are governed by the Health Practitioner Regulation National Law Act 2009, which came into effect on 1 July 2010. This law means that for the first time in Australia, 10 health professions are regulated by nationally consistent legislation.
Australian Medical Council. The Australian Medical Council (AMC) is an independent national standards body for medical education and training and has four core functions. The AMC:
- assesses medical courses and training programs (both medical school courses and the programs for training medical specialists) and accredits programs which meet AMC accreditation standards
- assesses international medical graduates who wish to practise medicine in Australia
- advises medical boards on uniform approaches to the registration of medical practitioners and the maintenance of professional standards in the medical profession
- advises the Commonwealth on the recognition of medical specialties
Australian Medical Council Multiple Choice Questions. The MCQ consists of two x three and a half hour examinations administered in morning and afternoon sessions on the same day. Questions are multiple choice, with one correct answer to be selected from five.
Australian and New Zealand Standard Classification of Occupations. This is the list of occupations on the Critical Skills Shortage List in the Department of Immigration. We use the ANZCO Code 253111 – General Medical Practitioner to sponsor our clinicians on Temporary Resident 457 Visas. ANZSCO is also used within skilled visa programs, where it is a requirement for visa eligibility, as the standard by which a visa applicant’s skills to undertake a specific occupation in Australia are assessed.
Area of Need. Areas of Need are determined by the State and Territory Governments and methods of defining them vary – not to be confused with DWS which are determined by Department of Health and Ageing. An Area of Need (AON) is any position/location in which there is a lack of specific medical practitioners or where there are medical positions that remain unfilled even after recruitment efforts have taken place over a period of time. Area of Need applies to both public and private sector positions. Most overseas trained doctors (OTDs) are required to work in an Area of Need when they first come to Australia, unless they hold full Australian medical registration or have completed the standard pathway for specialist assessment or for GP/family physician assessment.
Category 1. GPs that hold:
- Fellowship of The Royal New Zealand College of GPs (FRNZCGP);
- Certificates in Family Practice from the College of Family Physicians of Canada (CFPC) and successful completion of both parts of the Medical Council of Canada Qualifying Examination;
- Both Membership of the Royal College of General Practitioners (MRCGP UK) and Certificates from Joint Committee on Postgraduate Training for General Practice (JCPTGP) UK.
Doctors who hold these qualifications are eligible for admission to Fellowship of the RACGP ad eundum gradum.
Category 2. GPs that hold:
- Membership of the Royal College of General Practitioners UK (MRCGP)
- Membership of the Irish College of General Practitioners (MICGP);
- Membership of the Faculty of General Practitioners; or Member of the College of Family Practitioners, South Africa by examination (MFGP or the new MCGP)
- The Certificate of the American Board of Family Practice USA (ABFP);
- The Certificate of the Joint Committee on Postgraduate Training for General Practice (JCPTGP) UK;
- Masters of Medicine (Family Medicine) from the National University of Singapore;
- Registration as a Family Physician with the Health Professions Council of South Africa ( formerly the South African Medical and Dental Council of South Africa)
- Masters of Family Medicine, South Africa;
- Masters of Prax Medicine, South Africa.
Doctors who hold these memberships/qualifications are required to undertake the RACGP Fellowship exam. They have 2 years in which to successfully complete the exam.
Department of Health and Ageing. The Department of Health and Ageing has a diverse set of responsibilities but they determine DWS, provide 19AA and 19AB exemptions and work closely with both Medicare and the state Medical Boards to ensure compliancy with limitations and laws.
District of Workforce Shortage. A District of Workforce Shortage (DWS) is an area in which the general population’s need for healthcare has not been met. DWSs are determined by the Department of Health and Ageing and are linked to the provision of Medicare provider numbers. For the purpose of DWS evaluation, geographic divisions used by the Australian Bureau of Statistics are used. In general, a location is deemed a DWS if it falls below the national average for the provision of medical services. DWS only applies to medical jobs that need to provide services that attract Medicare rebates.
International Credentials Service of the Educational Commission for Foreign Medical Graduates of the United States (EICS verification). In order to be eligible to sit the AMC MCQ or AMC Clinical Examinations, doctors must have their credentials verified by the International Credentials Service of the Educational Commission. Generally the doctor is only required to provide their EICS number before sitting the exam, and the credentials will be verified before the exam results are released.
Employee Nominated Scheme. This is the visa on which doctors are able to apply for Permanent Residency. See “Permanent Residency” under the visa section in this manual.
Fellowship of the Royal Australian College of General Practitioners. In order to become a Vocationally Registered GP in Australia, you are required to have either your FRACGP qualification or equivalent. The Fellowship exam is a long and involved process and requires a minimum of 4 years of GP experience, one of which at least must be in Australia in order to be eligible to enrol in the exam. The actual exam involves
- The Written Component
- AKT (Applied Knowledge Test) 150 questions to be completed in four hours
- KFP (Key Feature Problems) 26 questions to be completed in three hours.
- The Clinical Component
- This consists of approximately 17 stations, 14 active stations and three rest stations. It takes approximately four hours.
A medical practitioner under the supervision of a Fellow of the Royal Australian College of General Practitioners in a job recognised as leading to the award of Fellow of the Royal Australian College of General Practitioners.
International English Language Testing System. IELTS is the world’s proven English test. Over 1.2 million candidates take the test each year to start their journeys into international education and employment. IELTS is recognised by more than 6000 institutions across 120 countries. This is what is used in Australia for IMGs wishing to work, and the results are required as part of the FRACGP exams. Note: the IELTS does have an expiry date and doctors are often required to resit their IELTS or to have Statutory Declarations signed by 2 Australian Trained Doctors as affidavits to a doctors’ English ability for the RACGP if their IELTS has expired.
International Medical Graduate. An International Medical Graduate (IMG) is someone who has gained their primary medical qualification outside of Australia or New Zealand and is now a registered and practicing general practitioner in Australia.
A locum is a medical practitioner who acts as a substitute for another medical practitioner while another practitioner is temporarily absent from their practice. Their periods of cover may vary from one day to a few months or even years. Locums are still required to have a provider number for each area they cover.
Medical Deputising Service. A medical practitioner, or group of practitioners, who provides after hours primary care, but not continuing care to the patients of the subscribing primary care medical practitioners. An MDS is usually after hours care, and part of the Practice Incentives Program (PIP) from Medicare is that a practice provides after hours care for their patients.
Medicare is the National Health Insurance Scheme.
The time in which you, as an overseas trained doctor, are required to work in an Area of Need or District of Workforce Shortage.
Non Vocationally Registered.
Other Medical Practitioners Program. The OMPs programs provide access to the A1 Medicare rebate for non-vocationally recognised doctors who provide services in approved locations and meet other eligibility criteria specific to the particular program.
Overseas Trained Doctor (see IMG). This term is not used widely in Australia anymore since OTDs are now referred to as IMGs. They are one and the same.
Pre Employment Structured Clinical Interview. A PESCI is one of the assessments of clinical knowledge and skills which an International Medical Graduate (IMG) must undergo as part of the nationally consistent assessment process for IMGs. It provides an assessment of an applicant’s clinical knowledge and experience using a set of structured questions and scenarios, in an interview situation. Candidates who are not eligible for general registration via the ‘Competent Authority’ or Specialist Pathway with the Medical Board will usually progress via the ‘Standard Pathway’. Queensland Health will require all doctors progressing via the ‘Standard Pathway’ to be assessed as ‘suitable’.
Practice Incentives Program. This is an initiative generated by The Australian Government and Medicare where accredited practices are paid additional financial incentives for providing quality care to patients.
Medicare allocates prescriber numbers to all GPs so that they are able to prescribe medication. This number is generic and can be used anywhere in the country. However, the right to practise medicine is linked to the state medical registration so, if you are not registered in a particular state even when you have a prescriber number, you cannot write a prescription in that state.
To work as a doctor in Australia, you need to have a Medicare Provider Number. There are different levels of Medicare access under the provider number scheme depending on medical board registration and satisfying the legislative requirements on accessing Medicare rebates. A Medicare provider number does not automatically allow a doctor to attract Medicare rebates for their services, as there are various levels of Medicare access for a provider number. If the position is in an approved District of Workforce Shortage, then you may apply for an exemption to the Medicare provider number restrictions. This is referred to as a ‘section 19AB exemption’. An application for a section 19AB exemption is made on the same form as your application for a Medicare provider number. A Medicare Provider Number may allow a doctor to:
- raise referrals for specialist services
- make requests for pathology or diagnostic imaging services. Where the doctor satisfies the legislative requirements (by obtaining a 19AB exemption as above) their provider number may also be used to:
- attract Medicare rebates for professional services rendered (that is, treat private patients). A Medicare provider number uniquely identifies the medical practitioner and the location where they render the service. If a practitioner works in more than one location, they are required to have more than one provider number.
Remoteness Area (classification). The Remoteness Area classification was developed by the Australian Bureau of Statistics as a statistical geography that allowed quantitative comparisons between ‘city’ and ‘country’ Australia. The purpose of the structure is to classify census collection districts (CDs) which share common characteristics of remoteness into broad geographical regions called Remoteness Areas (RAs). The defining difference between ‘city’ and ‘country’ is physical remoteness from goods and services. RAs are the spatial units that make up the ASGC Remoteness Classification. The RA categories are listed below. NOTE: the RA system is to replace the RRMA system commencing in July 2010. To see the incentives available to each RA, please visit http://www.doctorconnect.gov.au/internet/otd/Publishing.nsf/Content/RA-intro and look at each individual RA incentive.
Major Cities of Australia (RA1)
Rural Other Medical Practitioners Program. The ROMPS program provides access to the A1 Medicare rebate to non-vocationally recognised medical practitioners providing general practice services in eligible rural and remote areas. Normally non-vocationally recognised medical practitioners would access the lower A2 Medicare rebate. To be eligible for this program a doctor must:
- be non-vocationally recognised (also known as Other Medical Practitioners – OMPS) and
- agree to express an interest in achieving Fellowship of the Royal Australian College of General Practitioners or Fellowship of the Australian College of Rural and Remote Medicine. A doctor must also be providing services in any of the following designated locations: Rural, Remote Metropolitan Area (RRMA) classifications 4-7 Defined ‘areas of consideration’ or Approved RRMA 3 locations which have significant medical workforce shortages (as deemed eligible by the Departmental Delegate).
Rural, Remote and Metropolitan Areas. The Department of Health and Family Services Rural, Remote and Metropolitan Areas Classification, November 1994 has been used to classify the geographic location of the job of responding medical practitioners in the following seven categories. The data used in determining these categories are based on the 1991 population census.
- Capital cities consist of the State and Territory capital cities of Sydney, Melbourne, Brisbane, Perth, Adelaide, Hobart, Darwin and Canberra.
- Other metropolitan centres consist of one or more statistical subdivisions which have an urban centre population of 100,000+ in size. Examples: Newcastle, Wollongong, Townsville.
- Large rural centres are statistical local areas where most of the population reside in urban centres of population of 25,000 to 99,999. Examples: Dubbo, Orange, Bundaberg, Cairns, Launceston (Tas)
- Small rural centres are statistical local areas in rural zones containing urban centres of population between 10,000 and 24,999. Examples: Armidale, Bathurst, Coffs Harbour, Caloundra, Gladstone, Geraldton, Mandurah; Burnie–Somerset, Devonport (Tas).
- Other rural areas are the remaining statistical areas within the rural zone. Examples: Cardwell Shire, Whitsunday Shire (Qld); Barossa (SA); York Shire (WA); George Town, Ross (Tas).
These are generally less densely populated than rural statistical local areas and hundreds of kilometres from a major urban centre.
- Remote centres are statistical local areas in the remote zone containing urban centres of population of 5,000 or more. These centres are: Bowen, Emerald, Mount Isa, Broome, East Pilbara, Esperance, Kalgoorlie/Boulder, Port Hedland, Karratha (WA); Alice Springs, Katherine.
- Other remote areas are the remaining areas within the remote zone. Examples: Cobar, Lord Howe Island (NSW); French Island, Orbost, Walpeup (Vic); Longreach, Coober Pedy, Coolgardie, Exmouth, Laverton, Shark Bay (WA); King Island, Strahan (Tas); Daly, Jabiru, Nhulunbuy (NT).
Service Incentive Payments. This is an initiative generated by The Australian Government and Medicare where GPs are paid additional financial incentives for providing quality care and additional services to patients and fellow GPs. Payments go to the doctor rather than the practice and may include incentives for pap smears; diabetes or asthma treatment programs or teaching medical school students.
Unmet Area of Need (see AON). An Area of Need (AON) is any position/location in which there is a lack of specific medical practitioners or where there are medical positions that remain unfilled even after recruitment efforts have taken place over a period of time. Area of Need applies to both public and private sector positions. Most overseas trained doctors (OTDs) are required to work in an Area of Need when they first come to Australia, unless they hold full Australian medical registration or have completed the standard pathway for specialist assessment or for GP/family physician assessment. NOTE: Unlike the Districts of Workforce Shortage, which are determined by the Department of Health and Ageing, Areas of Need are determined by the State and Territory Governments and methods of defining them vary.
Vocational Registration (VR) for general practice was introduced in 1993, in an attempt to improve professional standards and reward high quality practice. It also gives recognition to general practice as a discipline, or even a specialty, in its own right, rather than just a ‘catch all’ grouping for doctors who are not surgeons, physicians, gynaecologists etc. Being a VR GP gives access to special Medicare item numbers and higher Medicare rebates, which translates into a higher income. GPs with VR are required to fulfil the RACGP Quality Assurance & Continuing Professional Development (QA & CPD) criteria in order to remain vocational registration. This involves a combination of educational activities and assessment/audit of practice which is completed in rolling 3 year periods (triennia).