Australia's Medical Shortage Specialities

Australia is a favoured expatriate destination, constantly ranking highly in global expatriate surveys. Its quality of life, stable economy and political system, warm climate and natural resources attract entrepreneurs, investors and professionals looking for promising opportunities.

Doctors are privileged as a professional group which is constantly featured in skills shortage lists and granted priority for visas. However, not all medical specialisms are short of native Australian talent. So before you consider Australia as your destination of choice and make preparations to move, it is worth researching the demand for your skills and the opportunities available to you.

Some medical disciplines are saturated with local physicians and have few openings for international medical graduates; neurosurgery, orthopaedics, plastic surgery and cardiothoracic surgery are among the most competitive specialities and difficult to enter. However other specialisms face constant shortages, some regional and some national.

Medical Specialities with Strong Demand

The specialities with national and regional shortages of qualified physicians have remained consistent over many years, in part due to a shortage of Australian and New Zealand trained physicians willing to work in the speciality or particular area of the country, and exacerbated by a lack of international physicians. Australian and New Zealand medical graduates favour work in the cities and suburbs, for the most part avoiding the rural and more remote areas of the country. Surgical specialities, paediatrics and medical specialities are favoured and competitive and general practice is popular. But for the international medical graduate (IMG) willing to pursue the less popular specialisms and work in less fashionable areas, Australia offers some wonderful opportunities to receive a sound postgraduate medical training, internationally recognised qualifications and develop a stimulating and rewarding career.

1: General Practitioners - Family Physicians

General Practitioners (GPs) make up the largest number of qualified specialist physicians in Australia and work in primary care clinics and small hospitals throughout the country. Their role is to provide generalist primary care to a wide range of patients of all ages within the community, referring to specialists for appropriate secondary and tertiary care.

Most GPs work office hours in clinics seeing patients who have booked appointments with a few slots reserved for emergencies. There are no on call duties, no house calls and in most cases, out of hours work is voluntary. Remuneration is on a fee for service basis whereby each item of service attracts a fee paid for by the government scheme or private insurance. The GP retains a percentage of total remuneration (billings) - usually in the range of 60-75% - and the rest goes to the practice to cover administrative costs, rental, repairs and staff salaries. Some GPs chose to work evenings or weekends to provide care for patients unable to attend the clinic during normal hours of operation. Most GPs can generate billings of over AUD 400,000 per annum.

However, Australia offers more challenges for the enterprising GP who is looking for more than out patient consultation work. This is the role of the Rural Generalist, an enhanced role for GPs who specialise in working in the small hospitals with 10-100 beds located in rural areas. These hospitals are staffed by experienced GPs, often titled District Medical Officers, who manage pout patients, emergencies and in patients. Some hospitals are visited by specialists but in many cases the GP will decide to transfer the patient, usually by air ambulance to a regional hospital, or manage the patient themselves. Training for this role is provided by the Royal Australian College of General Practitioners (RACGP) and Australian College of Rural and Remote Medicine (ACRRM). GPs can pursue further specialist training in anaesthesia, emergency medicine or obstetrics, obtain higher qualifications and practice these specialities in secondary care settings.

GPs are sought for permanent and full time positions in new and established practices throughout all states and territories of Australia. General Practitioners with postgraduate qualifications from UK, Ireland, Canada, USA, New Zealand, Spain, Malta and Belgium are accepted as having equivalent training to an Australian GP and have a short course to obtaining Fellowship of the Royal Australian College of General Practitioner (FRACGP) status. Physicians who have trained in other jurisdictions will be assessed for the status of partial equivalence and will be allocated to alternative and longer routes to Fellowship.

There is more independence of practice for a GP than in the National Health Service (NHS) of the United Kingdom which makes Australia a popular and desirable location for GPs seeking an escape from the faltering NHS. Life for a GP in Australia is far more enjoyable and productive than it is in the UK. Working hours are shorter, facilities are well staffed and managed and consultation times are longer.

International medical graduates have geographical restrictions (moratoriums) on practice for the first 10 years in Australia and will be required to work zones out with the city centres, usually in the suburbs or towns slightly further from the metropolitan areas. Moratoriums can be shortened by electing to work in remote areas.

2: Psychiatrists

Perhaps the fastest growing medical speciality in the country, if not the world. Australia and near neighbour New Zealand are facing a massive battle with increasing disorders of mental health, exacerbated by a chronic shortage of qualified psychiatrists. The demand for psychiatric specialists in the country has probably never been higher.

Psychiatrists are employed predominantly in the public healthcare system with the majority of positions in adult general psychiatry. A smaller number of vacancies exist in child and adolescent psychiatry, old age psychiatry, addictions psychiatry, liaison psychiatry and forensic psychiatry.

Qualified psychiatrists wishing to practise in Australia will need to undergo assessment by the Royal Australian and New Zealand College of Psychiatrists and work under supervision for a period of 12 months, occasionally longer. Junior doctors wishing to undertake postgraduate training in psychiatry in Australia will need to obtain provisional general registration with the Australian Medical Board and apply for registrar or house officer posts.

3: Anaesthetists

Anaesthetists are in high demand across Australia in both urban and rural areas. Most posts are located in the secondary care hospitals where the specialist anaesthetist will work within a department providing general and regional anaesthesia services and often pain management services for surgical and interventional radiological procedures.

Qualified specialist anaesthetists will have to undergo assessment by the Australian and New Zealand College of Anaesthetists to ensure that their training and practice is compatible with that of an Australian trained Anaesthetist and then undertake a period of supervised practice. Junior doctors seeking training in anaesthesia should be eligible for provisional general registration with the Australian Medical Board and apply for registrar or house officer posts.

4: Emergency Medicine Physicians

In a young and active country like Australia, it will come as little surprise that Emergency Medicine Consultants are often in high demand. With a lifestyle focused on living outdoors, and sport playing a major role in everyday life, treating patients with head injuries, bone factures and and even more serious traumas is one of the most common tasks for doctors in the country. Abundant wild animals, some quite dangerous, also create a plethora of unusual emergency cases with snake bites and kangaroo attacks being some of the most common.

The challenge of providing a decent quality of emergency care to rural and remote areas of the country is being met by telemedicine services which offer an exciting new scope of practice for specialist emergency physicians and general practitioners specialising in emergency medicine.

Prospective candidates for specialist emergency medicine physician roles must be assessed by the Australian College of Emergency Medicine and will then undertake a period of supervised medical practice in an approved hospital. Junior doctors seeking training in this speciality should be eligible for provisional general registration with the Australian Medical Board and apply for registrar or house officer posts.

Consultants are also expected to be involved with the education of junior doctors and medical students and the leadership and continuous improvement of local and regional emergency services, which provides great opportunities for learning new skills. Demand for locum and permanent emergency physicians is huge, right across the country, offering an unprecedented opportunity to experience a diversity of work settings.

5: Internist - General Physician

Internal medicine physicians both with a broad general scope of practice, and subspecialist interests are sought throughout the country, mostly for general hospitals providing secondary medical care in suburban or rural areas, some just one hour's drive from the major cities. Working conditions and salaries are excellent with paid annual leave, pension contributions and ample opportunities for research, teaching and continued medical education.

Specialists must be assessed by the Royal Australasian College of Physicians (RACP) to ensure the compatibility of their training with that of the Australian graduate and will then undertake a period of supervised medical practice. Junior doctors seeking training in general medicine should be eligible for provisional general registration with the Australian Medical Board and apply for registrar or house officer posts.

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