International doctors working in Australia often ask us for advice about the migration process and how they can move jobs once they’re working here, or how they can confidently apply for a GP role after working in a hospital position.
For the majority of overseas doctors working in Australia, the ultimate goal is to secure Permanent Residency, which then opens the door to more opportunities for jobs, training, favourable mortgage terms, favorable tuition rates for schooling and university for dependent children, and access to Medicare.
But the immigration system can be difficult to navigate, and common mistakes can lead to costly delays and confusion, so we caught up with Sam Brouff from Boyd Migration & Legal, to get an update on what doctors need to be considering before they make their next move.
Boyd Migration & Legal is a Sydney-based immigration law firm. Principal lawyer Samuel Brouff specialises in advice and visa applications for medical practitioners seeking temporary and permanent migration options into Australia. We facilitate visa applications for sponsored placements into private general medical clinics.
If you’re a sponsored temporary resident on a 482 visa, then you can move to a new role before transferring your visa sponsorship to your new medical centre operator.
Unlike the majority of sponsored temporary visa holders in Australia, there’s a legal exemption allowing doctors this privilege, so you don’t need to have your visa sponsorship transferred before taking on a new role.
All medical practitioners have the flexibility to both work for their sponsor and elsewhere - either concurrently or consecutively. This means you can work at another medical centre at the same time, or can start with a new medical centre operator before having your visa officially transferred. However, this exemption only applies where your visa occupation code is consistent with the work you are performing at subsequent medical centres.
Further, there may be restraints in your contract with your medical centre operator sponsor against working for two or more clinics at the same time.
This exemption is not spelt out in your visa documentation, so many doctors working in Australia aren’t aware of having this flexibility around how they can work outside of their initial sponsorship approval.
Have a conversation with your potential new medical centre operator. Ideally you want to have an upfront conversation with your potential new medical centre operator about your current visa requirements. This will give you both an opportunity to understand the timelines involved, and where responsibilities lie.
While you don’t need to transfer your visa to them as a sponsor immediately, it will need to happen at some point, and the medical centre by law must pay the costs of a 482 visa transfer, although the cost allocation of permanent residency is more flexible.
The pathways available to doctors differ depending on your age and your registration status. Doctors under the age of 45 have more options available to them than those over the age of 45, and doctors with limited registration have different options to those with general registration.
There are independent or sponsored routes to permanent residency, impacted by your age, your eligibility, your experience and your registration status.
In order to maintain a pathway to Permanent Residency as a self-employed GP, you will eventually have to have your visa transferred to your new medical centre operator. This is because the sponsor you have for your temporary visa needs to be the same as the sponsor for your permanent residency under the Subclass 186 temporary resident transition stream.
If you’re under 45, you have a few more pathways available to you for permanent residency.
You can apply for permanent residency sponsored by your medical centre operator, as a self-employed contractor with general registration.
If you’re under the age of 45 on a limited registration, becoming an employee of the clinic is a way to fasttrack your pathway to permanent residency in the Subclass 186 Direct Entry stream, without securing general registration. However, not many clinics are open to this, so ask your potential medical centre operator about what their approach would be.
You also have the option of independent points-tested migration without a sponsor, but only if you hold general or specialist registration, rather than limited registration.
If yes, then your options are more limited.
Your only pathway to permanent residency is via the Subclass 186 temporary resident transition stream., and you can only do this after working for three years in Australia as a doctor. This three-year eligibility period can be built up across multiple sponsors and across different occupation codes (subject to some limitations).
At the time of your eligibility you can hold limited or general registration, and you may have a history of working as a contractor in a self-employed capacity, and as a direct employee at hospitals or medical centres.
A common issue we’ve seen recently is that some practices would like to operate without legal advice when engaging international doctors, which can lead to mistakes that then impact on your potential to progress towards permanent residency.
So for example, lodging an application for a doctor based on an employment relationship rather than a contractor relationship. This confusion then impacts the whole visa process and results in having to withdraw the application or having the application refused. So it’s important to be confident that the clinic you’re working with has a good track record of understanding their sponsorship obligations, and if in doubt, request they work with a specialist to ensure there are no bumps along the way.
There are hundreds of occupation codes on the skilled lists for temporary and permanent visas, and up to 20 of these apply in the medical field.
If you were originally sponsored by a hospital, they might have recommended an occupation code relevant to hospital work, which doesn’t necessarily apply in a GP clinic setting. The code applied to you might be based on the hospital’s protocol or your level of experience, and hospitals don’t necessarily assign codes with a view to helping you on your pathway towards working as a GP in Australia.
The ones we most frequently see in general medical practice are:
General medical practitioner: This code is the best option - as it can equally apply to migrant doctors working at a hospital or a doctor working as a GP. It means your visa is easily transferable between contracts for a hospital or a private medical clinic.
Resident medical officer: This is often assigned to junior doctors in the hospital system and is also a generalised occupation code. It generally means you’re a doctor working under the supervision of a specialist. However, there is contention around whether a doctor working under this occupation code is also eligible to work in a GP clinic. Some clinics are happy to accept GPs with visas under this occupation code, whereas other clinics will ask to have your occupation code updated by way of new 482 Nomination and Visa before they’ll engage you as a medical practitioner.
To change an occupation code, a nomination application needs to be lodged by the medical clinic and a new corresponding visa needs to be lodged by the doctor. This can be a costly and time-consuming exercise. So it’s worth seeking advice in this situation, as there may be a way around it without having to change your occupation code.
Emergency medicine specialists: This occupation code is not compatible with working as a GP in Australia, so in this case new 482 nomination and visa applications would definitely need to be lodged in order for your visa to be compliant to working in a private medical clinic setting.
A Health Workforce Certificate is a process of certifying positions (not medical centres) for general practitioners to direct overseas trained doctors to areas that need them most.
So, your new medical centre operator will apply for a Health Workforce Certificate, providing details of their need.
There are many factors that impact your eligibility to work as a GP in Australia, and to progress towards securing permanent residency. Contact us and we can shortlist your best options regarding locations, GP training pathways, and other factors.
We can also arrange a free migration consultation, so that you can discuss options in more detail.
From Monday 11th March 2019 the new ‘Visas for GPs’ initiative will require all overseas trained doctors (OTDs) to obtain a position eligible for the new Health Workforce Certificate (HWC)….
