Reduce Your 10-Year Moratorium

Medicare’s 19AB rules require doctors who studied for their medical degrees outside of Australia to work in an area of distribution priority (DPA) for their first 10 years of practice in Australia. By committing to work in certain doctor-short locations, an overseas GP may be able to complete a 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 reductions monthly. 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, working there reduces your 10-year moratorium to 9 years.

If you work in Port Hedland (Remote classification RA4, two-hour’s flight to Perth) 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. In addition, 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. That means that you do not need to be in that location the whole time to see the benefit. Scaling only applies if your work in a General Practice achieves a minimum of $5 000 Medicare billings in the month. This means that 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 those minimum billings for the month

Note: It is 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 the moratorium. This is different from the Five-Year IMG Scheme, below.

2. The Five-Year International Medical Graduates Recruitment Scheme

The 5-year International Medical Graduates Recruitment Scheme (IMG) aims to attract and retain appropriately qualified and experienced Overseas Trained Doctors (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 in 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 (i.e. 3.5 days of full-time equivalent) in a private General Practice as part of their placement (i.e., not in the hospital setting).

Five-Year IMG Scheme Locations

As the full list of locations is not published, we check each location to determine the number of years required.

As an example, currently the scheme offers:

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

Note: If you leave the location before your required number of years is complete, you will not gain any benefit from the Five-Year IMG Scheme. However, you will always be able to use the reduction attained from the moratorium scaling, as explained above.

Benefits of Rural Work and Lifestyle

When making these plans, it is worth considering all the positives of working in the bush. 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 a suitable orientation. They are supported to be able to provide good care to the community.

You will have a chance to practice a broad range of medicine while developing and refining your skills. There are greater opportunities to develop a GP sub-specialty. The shortage of GPs in many areas means high demand which leads to increased earnings. Higher incidence of private and mixed billing in some rural areas, together with government incentive bonus payments means that rural and remote GPs tend to earn higher incomes.

While many IMGs based in rural areas do move to metro practices when their moratorium is completed, others will stay on for much longer as they get used to the pace of life away from the big city. This outlines how you can make a change, fast forward your career, increase your earnings and provide care for grateful communities in need. We have vacancies with rural and remote practices that can help you to reduce your 10-year moratorium.

If you would like to find out more, please contact us.