Two ways to Reduce Your 10 Year Moratorium

Medicare’s 19AB rules require doctors who studied their medical degrees outside Australia to work in an area of distribution priority area (DPA) for their first 10 years of practice here.

By committing to work in certain doctor-short locations, its possible that an overseas GP will be able to complete GP Fellowship, gain permanent residency, and have no restrictions on their work within 4 years of commencing work in Australia.

There are two ways to reduce the length of time that you are bound by the moratorium

1. Moratorium Scaling

Medicare operates the Department of Health’s Moratorium Scaling scheme, which automatically calculates additional reduction on a monthly basis.

Under the scaling system, working in rural and remote areas earns scaling credits. The more remote the location, the more credits you earn.

• This is measured against the ASGS Remoteness Areas, using the Health Workforce Locator Map.
• For example, the coastal city of Bunbury, is listed as “Inner Regional Australia, RA 2”
• According to the table, this means that your 10 year moratorium is reduced to 9 years
• If you work in Port Hedland (two hour’s flight to Perth), the RA4 Remote classification means that your moratorium will be 6 years
• This could be a great option for a doctor who worked in another setting for 4 years, and is now moving into primary care (but look below at the second moratorium reduction method)
• Scaling occurs for each month that you work, and produce the minimum Medicare billings in that location (so you don’t need to have been in that location for the whole time, in order to see the benefit)
• Scaling only applies if your work in a General Practice achieves a minimum of $5000 Medicare billings in the month
• So, if you work full-time in a hospital-based role, then you would also need to work in private General Practice for long enough to achieve that minimum billings for the month
• Checking your scaling status through your Health Professional Online Services

*Note: Its possible to work in a DPA location until you have completed 9.5 years of the 10 year moratorium, then apply for a 6 month locum provider number in a non-DPA location.

**Note: if you leave the location, you will maintain all of the accumulated reduction of moratorium (this is different to the Five Year IMG Scheme, below).

The factsheet is here.

2. Five Year IMG scheme

The “5yr IMG scheme (IMG) aims to attract and retain appropriately qualified and experienced OTDs to work in private General Practices in some of Australia’s smaller rural communities.

Contrary to its title, by committing to work in remote locations under the 5 Year Scheme you may reduce your moratorium to as little as three years.

To gain the benefits of the 5 Year Scheme, applicants must be willing and able to:

• Complete the required number of years that you commit to in the location deemed eligible for the Scheme; and
• Attain Fellowship of the Royal Australian College of General Practitioners (RACGP) or Fellowship of the Australian College of Rural and Remote Medicine (ACRRM); and
• Attain permanent residency of Australia and/or Australian citizenship

Five Year IMG Scheme Eligibility

• Hold or obtain appropriate registration with the Medical Board of Australia
• Be eligible to be assessed for FRACGP or FACRRM within two years of commencing on the Scheme
• Provide at least seven sessions a week (ie 3.5 days of full time equivalent) in a private General Practice as part of their placement (ie, not in the hospital setting)

Five Year IMG Scheme Locations

The full list of locations isn’t published, we will check on each location, as to what the number of years will be.

For example, currently, we can confirm that the scheme offers:

• Albany                         5 years
• Broome                       4 years
• Geraldton                   5 years
• Hall’s Creek                3 years
• Kalgoorlie                   4 years
• Katanning                   4 years
• Manjimup                   5 years
• Newman                     4 years
• Port Hedland             4 years
• Tom Price                   3 years
• Karratha                     4 years
• Darwin                        5 years

Note: if you leave the location before your required number of years have finished, you won’t gain any benefit from the Five Year OTD Scheme, although you will always be able to fall back on the reduction attained from the scaling (as above).

The fact sheet is here.

Benefits of Rural Work and Lifestyle

When making these plans, its worth considering all the other positives of working in the bush.

• You’ll have a chance to practice a broad range of medicine, as well as develop and refining your skills
• You’ll have a greater opportunity to develop a GP sub-specialty
• The shortage of GPs in many areas means that you will be in demand, this will increase your earnings
• Higher incidence of private and mixed billing in some rural areas, and government incentive bonus payments mean that rural and remote GPs tend to earn higher incomes

While a lot of IMGs based in rural areas do move to metro practices when their moratorium is completed, many people also end up staying on for much longer, as they get used to the pace of life away from the big city.

Remember, that there are systems in place to support IMGs in their transition to work in rural and remote placements.

The rural workforce agencies, primary health authorities, your practice, colleagues, the colleges, and other agencies ensure that GPs moving to the bush receive suitable orientation, and are supported sufficiently to be able to provide good care to the community.

So that’s the overview about how you can have a tree change, fast forward your career, increase your earnings, and provide care for some communities who need you, and will be grateful.

If this is something that you might like to find out more about, drop me a line on 0407 896 608 / dave@doctorconnect.health

We have vacancies with rural and remote practices that can help you take advantage of this.