Contract disputes, rota gaps, and increasing workloads in the NHS make the shorter hours, better pay and better weather in Australia an attractive prospect, whichever stage you’re at in your medical career. But how do you go about finding a job, getting a visa and what is life like for doctors? A British doctor who has already made the move tells us about his experience.
Taking the leap
After two years of work, nearly two thirds of junior doctors are now choosing not to progress straight into specialty training after their Foundation Programme, with working overseas a popular choice.
For me, the chance to live and work abroad during this natural break in the career ladder was too good an opportunity to turn down. Although a well trodden path for many doctors, moving to the opposite side of the world is still a daunting prospect. This article gives a rough overview of how to make the move, and what to expect once you’re there.
Choosing what to do and where to live
The first step is deciding what you want to do, and where you want to do it. Australia is vast, and there’s an enormous difference between living in cosmopolitan Sydney and the outback, both personally and professionally.
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A rural GP, miles from the nearest major hospital, will have a very different job to a GP in a major city, with easy access to specialists in tertiary referral centres. You may be happy to work in any specialty, so long as it’s in the right place; or more career-driven where clinical experience is more important than location. Either way, the first step is knowing what you’re looking for.
I decided location was more important, and chose to look for jobs in Melbourne; at the time rated “the world’s most liveable city” for seven consecutive years by the Economist. I was open minded about which specialty to work in: I looked for jobs in Emergency Departments (Australia’s term for A&E) as I had heard they were easier to find, particularly in bigger cities. I also opted to apply for jobs as a resident (similar level to an “SHO” in the UK): although in Australia you can apply to be a registrar after 2 years of working as a doctor, I didn’t want to add more job responsibility to the stress of emigrating.
Finding a job
There are a few different ways to go about finding your job; agencies, online applications, or contacting hospitals individually.
I started by looking online, and found each health trust within Melbourne advertises jobs online, with a simple system to sign up for email alerts when new jobs become available. I did find a few jobs I liked and applied, but most wanted people already registered to work in Australia (i.e. they wouldn’t sponsor overseas candidates), leading to several rejected applications.
I next approached a couple of agencies. However, neither were hopeful of finding a job in a major city. I got a few offers, but they were quite different to what I was looking for (mostly rural or in smaller towns, sometimes in specialties I hadn’t expressed an interest in working in).
I eventually found my job through contacts. I was the first doctor in my family, and didn’t have family or family friends working in Australia. However, I’d met enough doctors through medical school and my foundation years to ask around. Eventually, I found a friend of a friend working in an Emergency Department in Melbourne (exactly what I wanted to do), who was able to give me the right contact. An email with a CV and a phone interview later, and I had a job sorted.
However, once I’d gotten over the initial elation of getting my dream job, I began to feel apprehensive about getting through the mountain of bureaucracy it would take to turn that dream into reality.
Registering to work as a doctor
Although everyone hates red tape, it’s unavoidable if you want to work in Australia. There are a number of well defined pathways to registering as a doctor. Unfortunately, they are not as streamlined as they could be, and are an expensive and time-consuming process to complete. The first step is to apply to the Australian Medical Council (AMC – https://www.amc.org.au/) for verification of your medical qualifications. It is a relatively straightforward (though expensive) process, requiring an AMC portfolio to be set up (AUD500) and then your degree to be certified through the Educational Commission for Foreign Medical Graduates (https://www.ecfmg.org/) (USD135). The ECFMG requires a notary to verify your degree (which can easily be done online via a webcam for USD79). From start to finish, the AMC process took just over a week.
Once your qualifications are verified, you can apply to the Australian Health Practitioner Regulation Agency (AHPRA), who are the body responsible for granting your licence to practice. There are several different pathways, depending on which country you went to medical school in, and your level of seniority.
As a graduate of a UK medical school, who completed my Foundation Programme in the UK, I was eligible to apply through the “Competent Authority Pathway”.
As a graduate of a UK medical school, who completed my Foundation Programme in the UK, I was eligible to apply through the “Competent Authority Pathway”. This also applies to graduates from Ireland, New Zealand, Canada and the USA, who are not yet specialists. The Competent Authority Pathway will grant you “provisional registration”. This means you are required to have a consultant to be your named supervisor (and hence a job offer before you apply) for your first year of work in Australia. After a year of full-time work, you can gain full registration, providing your supervisor has no concerns.
The paperwork for AHPRA was a relatively straightforward form, requiring mostly personal details, employment history, and details of your professional qualifications (including your AMC candidate number). The most difficult parts were their requirement to have documents notarised by a notary public or Australian embassy official, and requiring a paper form to be posted to them. Despite living in the 21st century, you’ll still need to print, complete and sign your form, post it to your hospital in Australia, have it signed by your supervisors, and post it to AHPRA. Allow plenty of time for this, or you may end up having a delay to your visa application or your start date. Add another $742 to your credit card bill, and your AHPRA registration should be completed. Make sure you also apply for a Certificate of Good Standing from the GMC, which can be done easily from the GMC website and is valid for 3 months from the date of issue.
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Once you’re registered with AHPRA, you will also need to apply to the Australian Government Department of Human Services for a “Provider number”, which lets you order investigations for patients under medicare, and a “Prescriber number” to allow you to prescribe for patients under medicare. Yet another form, but at least it’s much shorter and doesn’t cost you anything this time.
Getting your visa
Once you’ve got a sponsor, getting a visa should be fairly straight forward (providing the only skeleton in your closet is the one you bought to study anatomy). Your visa application can be completed and evidence uploaded online through your “immi” account.
There are multiple visa types, depending on your level of qualification, how long you’re planning to stay for, and how long your employer wants you to work for them. Doctors are classified as “skilled workers” and the full list of skilled occupations and the visa types available to you can be seen online.
The most common type of visa would be the Subclass 482 TSS (Temporary Skill Shortage) visa. This has recently replaced the old “457 visa”, with the major difference being the creation of a short-term stream, allowing stays of up to 2 years (costing AUD 1175), and a medium-term stream, allowing stays of up to 4 years (costing AUD 2455). Both will also allow you to apply to bring your partner or family with you. Unfortunately for the more junior doctors, “Resident Medical Officer” is only the short-term stream now, which makes it harder to apply for permanent residency if you decide you want to stay. There has actually been a recent influx of overseas-trained doctors to Australia, with the number of GPs growing three times faster than the population! They have therefore recently introduced the requirement to gain a “Health Workforce Certificate” for overseas-trained doctors. The aim of this is to try and have fewer doctors working in major cities, and more working in rural areas where they are most needed. This shouldn’t affect hospital-based positions at present, as certificates are automatically issued for these roles. Full details are available on the Australian Government website.
The Health Workforce Certificate aims to have fewer doctors working in major cities, and more working in rural areas where they are most needed.
As part of your visa application, you will need to undergo a medical. If you’re in the UK, this needs to be done by one of the Australian Government approved “Panel Physicians”. Unfortunately, there are only eight approved practices throughout the UK, meaning you’ll likely have to travel. Add this to the mandatory chest x-ray and bloods tests (to screen for TB, Hepatitis and HIV), and the whole lot will set you back around £345. After you’ve proved you’re healthy, you’ll also need health insurance to meet the visa conditions. Most companies will issue a letter to you instantly to show you’re covered. Although British Citizens are entitled to free health care throughout Australia through the “Reciprocal Health Care” agreement, you will still need to get the insurance for the visa. However, once in Australia, you’re well within your rights to apply for Medicare and cancel your insurance policy.
You’ll also need a UK police check. This must be done through ACRO and will cost you £45.
Starting your new life in Australia
Once you’ve found a job, passed the interview, registered yourself as a doctor, got your visa, cleared immigration and made it to Australia, give yourself a pat on the back and a get yourself a pint (anything except Fosters). My experience of Australia has been a shorter working week (38 hours as full-time), a salary which is nearly double my UK salary, and a fantastic place to live.
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The work in Australia has been largely similar to the UK; I worked in a busy, metropolitan hospital, with long waits, bed shortages and stretched resources – just like home. The presenting problems are similar, with far fewer snake or spider bites than I had expected. Of course, the computer systems, drug charts and processes are different, but it’s no harder than moving between trusts in the UK.
I did find there was a more relaxed, more supportive atmosphere, and a much better chance of getting your lunch break. Coupled with fewer hours each week, I found the work much less draining than before. I’ve also used my time to travel around Australia and see as much of this wonderful country as I can. The real question hasn’t been whether it was worth moving to Australia, but whether it’s worth moving home.