The aim of this article is to describe some of the steps involved in moving from the UK to Australia to work. It is a very generic document, given that each individual’s circumstances will be unique.
Finding work in Australia
There are a number of routes to finding employment in Australian ICUs, each dependent upon your individual requirements and eligibility for jobs. As a very broad principle, posts can only be offered to non-Australasians after it has been demonstrated that no Australasian has applied and can do the post. Consequently, EU passport holders will usually be actively discriminated against when applying for jobs. They will only be eligible for posts once it has not been possible to recruit an Australasian to the post.
In terms of finding a post, each state has a website containing all health posts (see links). Each year in July & August, posts for the following academic year, namely to start in January, are advertised via these websites. Often, it is a requirement to have permanent residency to be eligible for these posts. Consequently, EU passport holders are usually left applying for posts that are unfilled by Australian residents. Outside of the main annual recruitment periods, jobs are continually advertised on the aforementioned websites. Often these vacancies exist since they have been unfilled by local candidates, making EU-passport holders eligible.
One alternative to obtain your ideal post is to contact an individual hospital or ICU directly. If they have vacancies, it may be possible to ‘navigate’ around the issues of non-residency. Certainly, in posts that they struggle to recruit to, such as Senior Registrar posts, it is entirely feasible to work though non-residency issues fairly easily.
If you are not concerned about working at a particular hospital or ICU, the numerous locum agencies which advertise in the UK, in the BMJ for example, would provide a valuable source of employment in Australia. They may have the additional advantage of assisting with the immigration process.
Applying to take Leave from your UK post
For those who are fortunate enough to have a rotational, deanery-based, training post in the UK, it will often be necessary to apply to the deanery for leave. Additionally, depending upon your individual circumstances, you will have to apply to your parent Royal College, plus potentially the Faculty of Intensive Care Medicine, to have the training prospectively approved. These two approval processes occur concurrently, but may take up to 6 months to complete. Depending on what you wish to have approved, it will involve filling in both deanery and College paperwork, obtaining numerous signatures, and submitting the application forms and supporting documentation to the relevant bodies. You are advised to make early contact with your Training Programme Director to seek advice as to what approvals will be required.
Registration with the Australian Medical Authorities
To be eligible to practice in Australia, it is necessary to be registered with Australian Health Practitioner Regulation Agency (APHRA), the Australian equivalent of the GMC. The first step in the process is to apply to the Australian Medical Council (AMC), also like the GMC, but a separate organisation!
The AMC’s role is to assess the competence of the particular doctor in question. When the AMC is satisfied, it will issue a letter confirming this, which will, in part, be used by APHRA to grant medical registration. The AMC’s website has a detailed section on International Medical Graduate’s (IMGs) but essentially there are two main routes by which you can demonstrate your medical competence.
Firstly and most commonly, if you have graduated from an approved medical school, and successfully completed an internship/foundation programme/residency, you will be able to apply via the ‘Competent Authority Pathway’. If this is not the case, you will need to apply via the ‘Standard Pathway’. Most EU medical graduates ought to be able to apply via the Competent Authority Pathway, which requires an on line application, followed by submission of a number of certified documents to the AMC. These documents may include copies of your degree certificate, current medical registration, passport, Certificate of Good Standing, and proof that completed your internship/Foundation Training. The current cost of AMC assessment via the Competent Authority Pathway is $AUS825.
Once the AMC is satisfied with your competence, either via the Standard or Competent Authority Pathway, it will issue an AMC Certificate. It takes approximately 2 months from submitting the documents to the AMC, to receiving this AMC Certificate.
The next step is to apply to APHRA for medical registration. Unfortunately APHRA is a new national organisation, having taken over from state-based medical boards in July 2010. It has been a difficult transition and problems still remain with the registration process. Nevertheless, the process of registration consists of submitting an application form to APHRA with all the necessary documentation attached. It takes APHRA approximately 6 weeks to process an application. Only when APHRA has approved your application, will you be granted registration, and thereby be eligible to work.
Certification of Documents
Both AMC and APHRA are very specific about who can certify documents as being true copies of the originals. This has important financial implications since both organisations often need multiple certified copies of documents such as your passport, degree certificate, current medical registration etc. Whilst it is an easy process if in Australia, by using the free services of a Justice of the Peace, the process is considerably more time-consuming and expensive in the UK. According to the AMC guidelines (see links), the only person who will realistically be able to certify documents for you will be a Notary Public. Notary Publics are often solicitors who have undergone a period of extra training, but can be simply a Notary Public. Unfortunately this means that not all solicitors can certify your documents to AMC/APHRA standards.
It is worth spending time looking for the best quote for the certification of all your documents. Ideally, make one trip and get all the necessary documents certified in one go. Public Notaries are unfortunately expense, charging either for their time or per document. Hourly rates, can be anywhere between £200-500, often with a minimum charge. Alternatively, you could be charged per document, with prices ranging from £25-100 per document certified. It is entirely possible to spend a several hundred pounds getting all the necessary documents certified.
Unless you have the automatic right to work in Australia, you will need a visa to work. This is usually a 457 visa. Your prospective employer will make an employer nomination online and once this is approved, will enable you to apply for your visa via the immigration website. As part of the application process online, you are required to upload a series of documents to support your application. These documents may include your passport, proof of ability to speak English, a police check etc.
Since you will be working within healthcare, you will be required to undergo a medical and chest x- ray, which can only be undertaken by a limited number of approved places. Since there are only a small number of approved doctors within the country, it is advisable to plan the medical well in advance. The fee for the medical and chest x-ray is approximately £400.
An additional requirement to gain a 457 visa is to have private medical cover. Whilst UK passport holders theoretically have immediate access to healthcare as part of the reciprocal healthcare agreement, to get a 457 it is necessary to have adequate insurance for your initial period in Australia and provide evidence of this insurance as part of your application.
A number of health funds provide insurance suitable to fulfil this requirement including HICA, HBA and Medibank. Theoretically, it is not necessary to have private healthcare for the duration of your time in Australia, simply for your initial period in Australia. The minimum period available by most health funds is one month.
The visa application cannot be processed until after provisional approval has been received from APHRA. Furthermore, APHRA approval is dependent upon AMC certification. Consequently, while approval is being awaited by AMC and APHRA, it is well worth looking into the issues surrounding the visa application, particularly the medical and health insurance requirements. From receipt of the 457 application, it normally takes between 4-8 weeks for the visa to be issued. This time can be limited by having all the necessary documentation ready to upload to the visa application site.