Overseas-trained doctors in Australia: the AMC and Medical Board registration pathways

Registration is one gate; Medicare billing under section 19AB is another

Section 19AB stops Medicare benefits being paid for an overseas-trained doctor's services without an exemption until 10 years after their first Australian registration, and the restriction ends then only for a citizen or permanent resident. The Department of Health, Disability and Ageing's main route to an exemption is the location: a Distribution Priority Area for GPs or a District of Workforce Shortage for other specialists. It says there is no restriction on salaried work that doesn't attract Medicare benefits, such as in a public hospital.

Nothing in the AMC or Medical Board processes decides any of this, which is why it is easy to miss. Our guide to section 19AB covers the rules, every exemption type, the scaling credits for remote work and how the restriction meets the 482 and 494 visas.

Four pathways, and the AMC runs the assessments for one

The AMC lists the pathways as the Standard pathway, the Competent authority pathway, the Specialist pathway (Expedited Specialist pathway, Specialist recognition, Specialist area of need) and the Short term training in a medical specialty pathway. It is clear about its own role: "The AMC manages the assessment process for the standard pathway (AMC assessments) only; it does not assess IMGs on the competent authority pathway or SIMGs on specialist pathway (Expedited specialist pathway, recognition or area of need), or short-term training in a medical specialty pathway."

The Medical Board describes where each leads:

• Competent Authority pathway: general registration.
• Standard pathway: general registration, for IMGs not eligible for the Competent Authority or Specialist pathways.
• Specialist pathway and Expedited Specialist pathway: specialist registration.
• Short term training in a medical specialty: usually up to 24 months of training; it doesn't lead to specialist registration or ongoing registration in Australia.

Whichever pathway applies, every IMG needs a primary qualification in medicine and surgery from an institution recognised by both the AMC and the World Directory of Medical Schools.

The Competent Authority pathway

The Medical Board says this pathway is for IMGs, "non-specialists and specialists, including general practitioners", seeking general registration, who have been assessed by a competent authority and have practised in a competent authority country. IMGs on this pathway don't sit the AMC exams. The AMC's role is advisory: "The AMC provides advice to the Medical Board of Australia (the Board) to make decisions on which competent authorities are recognised."

The Board-approved competent authorities:

You must meet one of the seven competent authority categories (A to G), each with an assessment part (a course or an exam) and an experience part. The Board's steps include primary source verification of your qualifications through the AMC, securing a suitable position in Australia (which can be an area of need position), a pre-employment structured clinical interview for general practice roles in some cases, and an application for provisional registration. After that, the Board says you complete 12 months of supervised practice before moving to general registration.

The Standard pathway: CAT MCQ, then a Clinical Examination or a Workplace-Based Assessment

This pathway is for IMGs seeking general registration who aren't eligible for the Competent Authority or Specialist pathways. The AMC says "The following assessment options must be passed to obtain an AMC certificate": the AMC CAT MCQ Examination, and either the AMC Clinical Examination or a Workplace-based assessment (WBA). The MCQ is compulsory; what follows it is a choice.

• CAT MCQ: a computer adaptive test of 150 multiple choice questions, each with one correct response from five options. The AMC says it is delivered by a United States registered company that must comply with US Treasury (OFAC) sanctions, so candidates with primary residency in a sanctioned country may not be able to sit it.
• Clinical Examination: 16 assessed stations and four rest stations, each 10 minutes long (two minutes' reading and eight minutes' assessment), covering medical, surgical, women's health, paediatric and mental health presentations.
• Workplace-based assessment: the AMC says it "is designed for international medical graduates (IMGs) who have passed the AMC computer adaptive test multiple choice question (CAT MCQ) examination, hold registration as a medical practitioner and are appointed to a hospital or general practice position". It assesses knowledge and performance over a 6 to 12 month period. It formalises the assessment of someone already working under supervision; it doesn't create that position.

The Specialist and Expedited Specialist pathways

The AMC describes the Expedited Specialist pathway as one for "specialist international medical graduates (SIMGs) with a specialist qualification the Medical Board has assessed as substantially equivalent, or based on similar competencies, to an approved Australian specialist qualification in the specialty". The qualification must be on the Board's Expedited Specialist pathway: accepted qualifications list.

As at 30 October 2026, the Board lists the specialties on that list as anaesthesia, general practice, obstetrics and gynaecology, general paediatrics, general medicine, psychiatry and diagnostic radiology, with dermatology, emergency medicine, general surgery and otolaryngology to be considered next. Eligible specialists can apply directly to the Board for specialist registration, and the Board says they need to complete six months of supervised practice, cultural safety education, orientation and workplace-based assessments.

For general practice, the RACGP's fellowship policy names three overseas qualifications: Membership of the Irish College of General Practitioners from 2009 onwards with a Certificate of Satisfactory Completion of Specialist Training; Fellowship of the Royal New Zealand College of General Practitioners from 2012 onwards; or Membership of the Royal College of General Practitioners (UK) from August 2007 onwards with a Certificate of Completion of Training. It also requires at least six calendar months full-time equivalent of supervised Comprehensive Australian General Practice within the past four years, which the RACGP says can be done while on the Board's Expedited Specialist pathway.

Specialists whose qualification isn't on the list use the Specialist pathway, which the AMC describes as covering specialist recognition and applications for an area of need specialist-level position.

English language: the Board's rule

The AMC is direct about who owns it: "The Medical Board of Australia requires International Medical Graduates to provide proof of English language proficiency for all registration categories unless it has granted an exemption," and "English language proficiency is a requirement of the Medical Board of Australia, not the AMC. Therefore only the Medical Board is responsible for granting exemptions." It advises that "All applicants should make arrangements to obtain proof of English language proficiency before they apply under any of the assessment pathways."

Ahpra's list of accepted tests applies to the Medical Board as to other Boards. For tests taken on or after 23 April 2026 the IELTS Academic minimum is 7 overall, with 7 in listening, reading and speaking and 6.5 in writing (or the OET, PTE Academic, TOEFL iBT or Cambridge equivalents). Ahpra adds that the Medical Board also accepts successful completion of New Zealand's NZREX and the UK's PLAB test.

An AMC certificate is a step to registration, not registration

The AMC says "The AMC certificate is required for the standard pathway to registration with the Medical Board of Australia." Passing the Standard pathway assessments produces the certificate; the Board then makes its own registration decision.

Two points follow. First, for skilled visas the Home Affairs list names the Medical Board of Australia as the assessing authority for doctors' occupations, so the registration body and the skills assessment body are the same. Second, passing the exams, holding an AMC certificate, being registered and being able to bill Medicare are four different things, decided by different steps.

Does the ten-year moratorium stop me working as a doctor in Australia?

No. Section 19AB of the Health Insurance Act 1973 decides whether Medicare benefits are payable for your services, not whether you can be registered or work. The department says there is no restriction on salaried work that doesn't attract Medicare benefits, such as in a public hospital. See our guide to section 19AB for the full rules.

Can the ten-year moratorium be reduced?

The time you must work in a Distribution Priority Area or District of Workforce Shortage can be shortened. Scaling credits from billing in remote areas can bring it down to as little as 5 years. The Department of Health, Disability and Ageing also lists the 5-Year International Medical Graduates Recruitment Scheme, which it says lets IMGs reduce that time to as little as 3 years by working in an eligible regional, rural or remote location for a set period and obtaining permanent residency and specialist registration in general practice while on the scheme.

Which pathway applies to me?

It depends on where you trained and what you hold. Competent Authority is for doctors assessed by the GMC (UK), MCC (Canada), ECFMG or NBOME (USA), MCNZ (New Zealand) or MCI (Ireland) who have practised in that country. Expedited Specialist is for specialists with a qualification on the Board's accepted list. The Specialist pathway is for other overseas specialists. Standard is for IMGs not eligible for the others.

Who decides which countries count for the Competent Authority pathway?

The Medical Board of Australia, on the AMC's advice. The Board-approved competent authorities are the General Medical Council (UK), the Medical Council of Canada, the Educational Commission for Foreign Medical Graduates and the National Board of Osteopathic Medical Examiners (USA), the Medical Council of New Zealand and the Medical Council of Ireland.

What's the difference between passing the AMC exams and being registered?

Passing the Standard pathway assessments produces an AMC certificate, which the AMC says is required for the standard pathway to registration. The Medical Board then makes a separate registration decision.

Is the Expedited Specialist pathway open to any specialist?

No. Your specialist qualification must be on the Medical Board's accepted qualifications list, which as at 30 October 2026 covers anaesthesia, general practice, obstetrics and gynaecology, general paediatrics, general medicine, psychiatry and diagnostic radiology. Successful applicants complete six months of supervised practice.

Can I use the Workplace-Based Assessment as my first step, before I have a job?

No. The AMC says the WBA is for IMGs who have passed the CAT MCQ, hold registration as a medical practitioner and are appointed to a hospital or general practice position.