Pathways in Medicine

Contemporary medicine is challenging, exciting and dynamic, with many different career pathways to choose from. Here is some helpful information to assist you on your professional journey.

The AMA Careers Service, managed by AMA Victoria, is available to all AMA members.

AMA Victoria also provide a range of other career, professional and leadership coaching services at an AMA member rate, including students. For all states other than Victoria, please select 'other state' member when booking.

To explore these services, please visit Professional Development & Careers on the AMA Victoria website.

Graduating from medical school and commencing your internship is one of the biggest transitions you will make in your professional life. Starting your first post as a new doctor can be challenging.

Your transition from medical student to intern will be informed by your clinical experiences and exposure to medical and allied health professionals.

Speak with your State or Territory AMA for finding information about:

1. transferring your membership from honorary student to full membership
2. orientation week
3. pay entitlements.

The Junior Doctors Employment Guide may provide insights to support you.

Prevocational training – Intern

On completing your medical degree, you receive provisional registration and enter the workforce as an intern or postgraduate year 1 (PGY1) doctor.  This part of your training lasts for 12 months (47 weeks full time), and is usually undertaken in a public hospital, although interns will increasingly spend part of their training in general practice, community-based settings and private hospitals.

As an intern, you will undertake a series of work rotations designed to expose you to a range of clinical situations and environments. This stage will help inform your career choices by providing experience in different medical specialties including general practice, and provides grounding for subsequent specialist training.

Your 12-month internship will incorporate the following.

• Emergency medical care
  Providing assessment and management of patients with acute undifferentiated illnesses – including acutely ill patients.  Can be undertaken in emergency or in some general practice settings that provide equivalent experiences.
• Medicine
  Caring for patients with a broad range of medical conditions.  Participating in assessment and admission of patients with acute medical problems. Managing in-patents with a range of general medical conditions.
  Discharge planning (including preparation of discharge summaries and other components of handover) to the patient's GP and sub-acute/long-term care facility or ambulance care.
• Surgery
  Caring for patients with broad range of acute and elective surgical conditions and/or who exhibit the common features of surgical illness including metabolic response to trauma, infection, shock and tumours (neoplasia).
• Other approved positions
  A range of other approved positions in areas such as aged care, anaesthesia, general practice, palliative medicine, psychiatry, rehab medicine or surgery. 

When you successfully complete your internship you will receive general medical registration through the Medical Board of Australia (MBA).

Employment for doctors in training in Australia will vary, so contact your State or Territory AMA to learn more.

After the intern year

As the competition for medical training positions heats up, proactively managing, planning and reviewing your career is a critical component of helping you secure that much-coveted role.  

The first impression you make upon applying for a new job is through your cover letter, resume (curriculum vitae) and interview.  These tools require attention to detail, ensuring they deliver the message to your potential employer in a clear and concise manner whilst still conveying the right information.  Remember that the information in your CV will determine (together with supporting documents) if you get to interview, so it makes sense to invest time and effort in getting this right.

To engage in free online learning to support your career development, visit doctorportal Learning and search the CPD Learning catalogue.

Don't forget to search our Speciality Training Pathway Guide where you can find details of specialties and sub-specialties, together with important information on the time required to complete the training, whether this can be done in one location, indicative costs and more.

Prevocational training – Resident

Most Doctors in Training spend at least one more year after their internship working in the public hospital system to gain more clinical experience in a range of settings with greater levels of responsibility.  This stage helps equip you with the prerequisite experience and procedural skills for entry into specialist training programs.

While some specialist medical Colleges accept entrants after successful completion of postgraduate year 1 (PGY1), most prefer applicants to have completed a second or even third year of training (PGY2 and PGY3).  Doctors during this period of prevocational on-the-job training are known as Resident Medical Officers (RMO) or “Resident”, Hospital Medical Officer (HMO) in Victoria or Trainee Medical Officer (TMO) in South Australia.

Vocational training – Registrar

After completing your internship and one or more additional years as a Resident, you can apply for admission to a recognised medical specialty training program. This is the necessary training to obtain fellowship of one of the recognised specialist medical Colleges, and allows you to practise medicine independently.

Most specialist Colleges have clinical, practical and exit exams, in conjunction with other assessments to assess the full range of skills and behaviours required as a doctor, such as communication and teamwork.

Specialist training programs and examinations are administered by the specialist Colleges and vary between three and seven full-time years to complete, depending upon the specialty you choose.

Vocational training for most medical specialties is undertaken in a public hospital. However, it increasingly includes rotations in private hospitals, regional, rural and community health settings. The exception is general practice, where doctors undertake most of their training in designated private general practices in a community setting.

If you are uncertain about undertaking a specialty pathway, search our Specialty Training Pathway Guide and compare the options.

Qualifying for independent practice – Fellowship

Upon successful completion of a recognised medical specialty training program you will be awarded a fellowship of the college and can undertake additional sub-specialty training. 

You are now entitled to an unrestricted Medicare provider number, which enables you to practise medicine independently in your chosen field, anywhere in Australia.

Up to this point you would have almost exclusively undertaken your training as an employee of the public health system, except for GPs who undertake their training in private practice.  Upon completing your specialist training, the options open to you will broaden to include:

• private medical practice
• a combination of private medical practice with a VMO engagement at one or more public hospitals
• employment as a staff specialist in a public hospital or health facility.

Not all doctors choose to undertake specialist training.  Some will leave the medical workforce, others pursue a research career, and some choose to work as a locum or continue to work in hospitals as non-vocational doctors, typically known as Career Medical Officers (CMOs).

Check with your specialist college of choice for information about completing your specialist training part-time in order to accommodate family needs, study or research obligations.  Contact your State or Territory AMA for further information.

Tips and Tricks

1. Observe and prepare. Talk to and observe people already in specialities to get an idea of what you should expect and what will be expected of you.  A good place to start is talking to your fellow junior doctors who are already on rotations in that department.  Think about what skills and knowledge would help you deal with typical challenges you might face in that speciality, so you start your rotation well prepared.
2. Take charge of your development. Be proactive and identify what you need to work on most and actively arrange your own learning. Taking an active interest in your education and training will benefit both you and your colleagues. Talk to your Director of Clinical Training to find out how to be involved.
3. Seek regular feedback. Don’t wait for formal feedback from supervisors and assessors. Seek feedback regularly from everyone you work with. Getting more feedback will help you identify key areas to focus on in your learning and development.
4. Ask for help. If you don’t know something, ask. Chances are those senior to you have had a similar experience and can help guide you.
5. Be honest. You’re not expected to know everything as a Doctor in Training, so if you don’t know the answer, be honest.
6. Keep track of your progress. Use your portfolio as a tool to help you continuously record and evaluate your progress. Our CPD Tracker can assist you to track and manage your continuing professional development (CPD). Access is free for AMA Members.
7. Make time for you. Adapting to chronic sleep deprivation, long hours, dealing with sick and dying patients and the many other demands placed on you as a new doctor can lead to burnout. Realistically, you may have very limited spare time, but try to take even 20 minutes out of your day for some down time.
8. Have a good support network. It’s imperative you have a good support network of people you can talk to and share your experiences with while maintaining patient confidentiality.
9. Have a GP you relate to. As a doctor having your own GP to advise you on your health, fitness and wellbeing is invaluable.
10. Get involved with your AMA. The AMA is your partner through your medical career and can offer you many benefits and services. As a member of your state or territory AMA you are automatically able to access AMA Federal resources, including potential participation on committees, policy and advocacy work.

With so many different medical specialties to choose from in Australia, making the decision to specialise in one can seem daunting.

To assist aspiring specialists, the AMA has developed our national Specialty Training Pathway Guide with input from the speciality Colleges. Use this guide to research particular specialties or compare the key attributes across specialties, such as entry requirements, cost and positions available.

Not sure what kind of doctor you want to be? Only available to AMA Members and AMA Student Members, search our Specialty Training Pathway Guide to help inform your career decisions.

Rural and remote medicine is often mentioned in the same breath, but they offer quite different experiences. There is no doubt that both experiences offer some unique challenges not seen in Australian cities. The further away you travel from the major centres, the fewer medical practitioners there are and the more your learned medical skills will be used.

Rural and remote medical practice

Australia needs medical practitioners in “the bush” in both regional and remote areas. These communities need the same medical care as those in cities.

Doctors in “the bush” face some unique challenges. In a regional setting, you are less likely to face the isolation that is faced by doctors in remote Australia, but the remaining issues are often similar. In remote settings the range of medical skills you will need will be broader, the support services physically further away, and colleagues more physically distant. However, medical practitioners who choose this type of medicine find it both challenging and rewarding.

Who should consider rural and remote practice?

Medical practitioners who:

• are interested in a challenge
• want to make a difference to a community away from mainstream medicine
• have internal strength and fortitude
• can withstand a period of social isolation and colleague-challenged environments
• are prepared to pass on their skills to other medical practitioners and students.

Rural and remote medicine is well suited to medical students and doctors in training who may be contemplating a career in the bush, in a small city or a remote community. Experience gained will be different to that of a tertiary hospital.

If you are considering a career in “the bush” there are some questions you should ask before embarking on rural or remote medical practice. Try and speak to someone who has been a rural or remote medical practitioner. Their insights will be invaluable.

Find out as much as you can before making your commitment. In no particular order, here are some questions to help guide your decision.

1. What training (formal and informal) is available?
2. Will it be supported by a specialty College?
3. What equipment is available – at the hospital (public or private, small or medium sized), at the clinic, in the practice? Are there x-ray machines and access to radiologists, defibrillators, anaesthetics, IT?
4. What operating theatre services are available? Is minor surgery all that can be delivered, and if so, what is usually sought or needed?
5. What support is available – access to a car, other doctors (general practitioner and other specialists), allied health, counselling services, aerial ambulances?
6. What are the demographics of the community?
7. What educational opportunities are available?
8. What is the job market like for others who may accompany you?

Visit the Australian College of Rural and Remote Medicine to learn about the many rewarding experiences of practicing in “the bush”.

Planning on opening an independent medical practice in the bush? Click here for some helpful tips to help you prepare.

Going into independent practice can be overwhelming. There is so much to find out about and prepare for.

Independent medical practice

In no particular order, here are some useful tips to help you prepare for independent practice.

1. Keep up to date with the CPD requirements of the Medical Board of Australia, which is part of your annual renewal of registration 
2. Engage in CPD Learning
3. Complete the AMA’s Code of Ethics online module available on doctorportal Learning, free for AMA Members
4. Read the MBA Code of Good Practice for information on aspects of expected behaviours including the mandatory reporting requirements and advertising your services
5. Find yourself a GP who will be your healthcare adviser
6. Notify AHPRA of your change of practice details and update your qualifications, if needed
7. Inform colleagues and the health community with which you work of your move to independent practice. Check with your State or Territory AMA for ideas. Bear in mind the Guidelines for Advertising Regulated Health Services produced by the Medical Board of Australia
8. Apply for your provider and prescriber numbers from Services Australia
9. Ensure you have the prescribed level of professional liability insurance (medical indemnity insurance).  Check the Medical Board of Australia (MBA) for their liability insurance requirements
10. Keep up to date with the latest AMA guidelines and position statements relevant to your practice
11. Determine your professional fees. Visit the AMA Fees List for guidance
12. Check your jurisdiction’s legislation on:
    • legal requirements for certification of death, issuing of death certificates, cremation certificates and when referral to the Coroner is required. Contact your State or Territory AMA for further information
    • Work, Health and Safety requirements (including workers’ compensation)
    • Patient privacy requirements applicable to your practice then establish your privacy governance procedures
13. Understand your Medicare billing obligations by completing the Department of Health’s free Medicare Billing Compliance module available on doctorportal Learning
14. Consider employing a Practice Manager who can help with assessing the staff needed to get the best out of your practice and support their recruitment. Your State or Territory AMA may be able to assist
15. Visit the AMA Training Services website to support the education of your practice staff. A subsidiary of the AMA WA, comprehensive learning of core business skills and knowledge required for high performing workplaces, competitive advantage and business success is available
16. Contact your State or Territory AMA office to see if they can help you to find:
    1. an insurance broker who can advise on general insurance, including workers compensation, sickness insurance, property and equipment insurance and public liability insurance
    2. a bank you with which you are prepared to have a long-term relationship
    3. out about the benefits of leasing vs purchasing equipment
    4. a lawyer you can trust to talk you through medical partnerships, locum tenens arrangements and associateships
    5. a financial adviser and an accountant
    6. an IT adviser who will advise on hardware and software and who will be available when interruptions occur. Firstly, investigate the range of medical software packages in the market and talk to your colleagues about which packages they recommend.

Planning on opening an independent medical practice in the bush? Click here for some helpful considerations about working in rural and remote Australia.

If you are considering whether working in a hospital is for you, find out as much as you can before making your commitment.

In no particular order, here are some questions that may help guide your decision.

1. Will working in a hospital match your career goals?
2. Does a big, bustling hospital or a smaller more personal facility excite you?
3. Are you interested in public and/or private settings?
4. Do you want to work for a corporate employer?
5. Do you like working at a fast pace?
6. Do you enjoy working with a wide range of healthcare professionals?
7. Do you prefer to care for patients at the bedside?
8. Do you like variety in your day?
9. Do you want to engage in research or patient outreach programs?
10. Do you like working in a team?
11. Are you happy working longer than average shifts?
12. Will you like working with multiple patients and their families in one day?

There are a number of pathways your career can follow. Some of the major employers of medical professionals include health departments, commonwealth government departments, research institutes, universities, industry, health insurers and peak bodies.

Some websites of interest are listed below.

State and Territory Health Departments

1. Australian Capital Territory
2. New South Wales
3. Northern Territory
4. Queensland
5. South Australia
6. Tasmania
7. Victoria
8. Western Australia

Australian Government

1. Australian Defence Force
2. Australian Institute of Sport
3. Department of Agriculture, Water and Environment: Australian Antarctic Division
4. Department of Education
5. Department of Health
6. Department of Industry, Science, Energy and Resources
7. National Health and Medical Research Institute
8. Therapeutic Goods Administration

Peak Bodies, Associations, and their Member Companies

1. Association of Australian Medical Research Institutes
2. Australian Academy of Science (AAS)
3. Australian Society for Medical Research (ASMR)
4. AusBiotech
5. Medical Technology Association of Australia
6. Medicines Australia
7. Research Australia
8. Science & Technology Australia

Disclaimer: the AMA is not recommending any of the above organisations, but merely providing them as options for individuals to explore and make their own assessments.

Global health aims to highlight health issues that transcend national borders or have a global political and economic impact. Whether health is viewed in terms of burden of disease or root causes of disease, global health is of relevance across all communities. Working abroad offers opportunities to contribute to global health.

Working abroad

Working abroad appeals across the whole spectrum of the profession – from medical students on electives, young doctors who want some international experience and/or for humanitarian reasons through to skilled and qualified specialists who want to share their skills and knowledge with colleagues for the benefit of the communities they serve.

Overseas medical training and professional work have the potential to enhance the breadth and depth of knowledge for medical students and junior doctors, and can provide challenges and experiences that are not available in Australia. It can also help Australian students and doctors to make a small contribution to global health.

Aspects to consider before working abroad include getting ready for the journey, managing personal and professional affairs during a placement, and what needs to be done to further your career once you return home.

The decision to leave clinical practice is a difficult one. Whether closing your private practice or resigning from an employer there will be a number of requirements you need to consider prior to retiring.

Transitioning

Some requirements to investigate and action are listed below.

1. Patient records
2. Jurisdictional legislation
3. Medicare
4. Employment contracts
5. Leave balances
6. Medical registration
7. Outstanding payments
8. Notifying referring specialists
9. Notifying patients
10. Superannuation
11. Taxation
12. Insurance
13. Leases, including commercial property and vehicles
14. Documentation management
15. Disposal of consumables and clinical equipment.

Please take advice from your:

• State or Territory AMA
• legal adviser
• medical insurer
• accountant
• financial adviser.

Retirement

Upon retirement, there are a number of options where you can use your knowledge and skills to benefit others. Depending on the type of registration held, you can:

1. teach the next generation of medical practitioners
2. mentor and coach future leaders
3. network with past colleagues
4. volunteer. 

This material is generic in nature and is made available on the understanding that the AMA is not engaged in rendering professional advice. Before relying on the material provided, users should carefully evaluate its accuracy, currency, completeness and relevance for their purposes, and should obtain professional advice relevant to their particular circumstances where necessary. Whilst every effort has been made to ensure the accuracy of the information provided, the AMA or its employees cannot be held responsible for any loss or damage arising to any person as a result of using this site.