So You Want To Be A Doctor In Australia? Read This First.

 

 

 

Personally, a move to Australia is EXTREMELY tempting, so I was delighted when I was offered this amazing guest post from AussieDocFreedom.com. If you’re considering a move, then read this first!!


Some of the Female Money Doctor readers may be considering a move overseas.

I thought I would share my experiences as a UK doctor in Australia.

I left the UK to start work in Australia as an F2 and really enjoyed the year.  The second and third years of practicing medicine are a popular time for an Aussie gap year, as the move across is fairly easy, and doesn’t interrupt postgraduate training.

Loads of UK doctors come over each year, there is a lively social life in Australian hospitals and we all seem to have a great time.

UK Doctor in Australia: HEALTH SYSTEM IN AUSTRALIA

I think of the Australian health system as a kind of hybrid between the UK and US system.

Everyone gets free health care, but those on higher incomes are strongly encouraged (with tax incentive) to pay for private health insurance

Around half of Australian citizens have private health insurance.  Those that can afford it often opt for faster and more convenient private health treatment, taking some strain off the public system.

Medicare is the universal healthcare system in Australia, where most treatment is provided for free.

Under Medicare, patients can see certain (bulk billing) GPs for free, receive free emergency department and public hospital management for illnesses and injuries as required.  If you need an elective surgery, the waitlist can at times be annoying (months), but it is all free.

Australian hospitals are well resourced, providing excellent care and reasonably timely treatment for the Australian public.

As a junior doctor in the ED, waiting times for patients are reasonable, appropriate investigations and treatments are accessible, and the standard of care is generally high.  Australian ED’s are certainly not immune to ramping, but this (in my experience anyway) tends to related to temporary surges in presentations.

Australian doctors have a strong union.  Overtime is paid.  There are exceptions of course, but there seems to be far less taking advantage of junior doctors in Australia.

UK Doctor in Australia: PRIVATE SYSTEM

Patients can choose to contribute to the cost to see a non-bulk-billing GP.  The appointments are often longer, and you are more likely to be able to see the same doctor regularly (as long as you book in advance).  These GP visits are subsidized, but do come with an out of pocket cost.

Utilising the private hospital, specialist, allied health and dental services all come with out of pocket costs, even with health insurance.  It is far more expensive to utilise the private health system, but usually means little waiting.

The standard of care is not necessarily better, but patients enjoy a far lower chance of surgery cancellation, less waiting around, and a glass of wine with dinner!

UK Doctor in Australia: INEQUITY IN THE HEALTH CARE SYSTEM

The Australian health care system makes a good attempt at being fair, asking those with resources to contribute more, but providing decent health care to all.

But, unfortunately, there is still inequality.  The indigenous population have a life expectancy 10 years less than non-indigenous.  Australia is still working on improving health literacy, preventative health programmes and culturally safe health care settings for indigenous Australians.

The tyranny of distance is the other great challenge to Australian health care.  Australia’s population is around 38% of the UK’s, but the Australian land mass is around 32 times the size of the UK.

There are large population centres, largely placed around the coast, but vast sparsely populated land, for which it is hard to provide cost effective and equitable healthcare.  For complex multifactorial reasons, life expectancy in remote locations is significantly lower than in urban centres.

Rural medicine provides a rather unique, challenging and extremely rewarding career path for many ambitious Australian doctors.  Retrieval medicine, such as with the Royal Flying doctor services is a dedicated career path, aiming to help provide the services in those hard to reach places.

UK Doctor in Australia: LIFESTYLE

Weather

One of the most appealing aspects of moving to Australia to Brits, is the weather.  But Australia is actually hugely diverse in its climates, it’s not all board shorts and bikinis!   There are even snow fields where you can allegedly ski if you time it right.

The Southern third of Australia has a cold winter, getting down to freezing at times.  Summers here are bloody hot (40 degrees) and dry.

The Northern third of Australia is very different, with hot (30-35 degrees) summers with super high humidity (90%!) that makes it feel bloody hot.  Winters are beautiful, more similar to a British summer.
There is a gradual transition from the Southern to Northern climate.  The West side of Australia is more sandy, dry and isolated.  The East side is more populated, and vegetated.

The Lucky Country

Australia is known as the lucky country, and lives up to this name.  There is a climate to suit anyone, a laid-back atmosphere and a fantastic standard of living.  Due to Australia’s relative remoteness, it seems to escape most international dramas relatively unscathed.

The lucky country can also be unlucky for some, with extreme weather events including floods, bush fires and cyclones.  There are advanced warning systems for these weather events, that are generally more problematic outside large population centres.

There is also the matter of bugs, spiders, snakes, crocs and jelly fish.  Just check your shoes and never be the first to get into the water and you’ll be fine!

An Outdoor Lifestyle

Because of the favourable Australian climates, living is a lot more outdoor based here.  In the heat of summer, activities are based around pools, water falls, the ocean and swimming holes.  Work, cars and homes are air conditioned.

The perfect winters up North are the perfect time for camping, fishing, hiking and exploring.  Free outdoor barbecues at most beaches and parks provide easy and free places to gather with friends.   Down South, the winter lifestyle becomes more indoor based due to the cold.

Property Prices

There are frequently news articles about the housing price crisis in Australia, lamenting the difficulty first home buyers have getting in to the market.  However, this is literally in Sydney and Melbourne.  Move an hour out of the city, and prices drop dramatically.

The median house price for the entire of Australia is $549,918 (equivalent to £311,157).  In a lot of places this will buy you a big family home with pool.  There is plenty of land, so blocks tend to be larger, and most houses stretch out with only a single storey.  For those, like me, that like to daydream Realestate.com.au is the place to find your dream home!

Rental properties are available in every city.  Some hospitals will provide free accommodation for a couple of weeks on arrival to allow you time to find an appropriate home.

Melbourne & Sydney

If you like the big smoke, Melbourne or Sydney are the cities for you.  They have the best shopping, cafes and restaurants, sporting events and entertainment.  Melbourne has repeatedly been voted one of the world’s most liveable cities.

For those that feel they can get all that in London, the rest of Australia is your oyster to explore.  The other cities are far smaller, with more of a town feel, and plenty of outdoor attractions within a reasonable drive.

Cost of living

The cost of living is Australia is a little more expensive than the UK.  Living in Melbourne and Sydney are the most expensive.  With wages being far higher than in the UK, most young UK doctors end their time in Australia with savings.

UK Doctor in Australia: WORKING IN AUSTRALIA

Pay

GPs and private specialists vs hospital doctors.

Level Nhs PAY NSW Health QLD Health
GBP AUD GBP AUD GBP AUD
PGY 1 28,243 50,885 38,556 69,469 42,745 77,016
PGY 2 32,691 58900 45,866 82,639 46,308 83,434
PGY 3 56,445 101,698 49,870 89,853
PGY 4 61,278 110,406 61,448 110,712
SPR (CT1) 38,691 69710

Currencies converted 29/11 ($1.80 to 1GBP)

A full-time week for Australian doctors is 38 hours.

The pay rates listed above are basic pay, based on Monday to Friday office hours.

Evening and weekends and overtime attract bonus pay rates.

Pay among fully qualified specialists, particularly GPs is highly variable.  Based on tax data and a survey of doctors, a GP can be expected to earn around $200,000+ and a non-GP specialist $300,000-$1million (upper end private proceduralists).

Taxation

UK Australia
12,500 GBP 0% 18,200 AUD (10,101 GBP) 0%
12,501-50,000 GBP 20% 18,201-37,000 AUD (up to 20,535 GBP) 19%
50,000-150,000 GBP 40% 37,001-90,000 AUD (up to 49,952) 32.5%
150,001+ 45% 90,001-180,000 AUD (up to 99,904) 37%
180,001+ (99,904 GBP+) 45%

The average British PGY 2 doctor would pay 4,038 GBP

The average Australian PGY 2 doctor would pay $18,520, or the equivalent (today) of 10,279 GBP.  Net pay (post tax) would equal $64,480 (equivalent to 35788 GBP) for the Australian doctor, 28,653 GBP for the UK doctor

Anecdotally, nursing staff tell their incomes are much better in Australia in comparison with the UK also.

Pay Less Tax

Health care workers (and other industries) get the ability to pay less tax, by signing up for “Salary Sacrifice”.  Not really much of a sacrifice, you feel in some forms and pay for certain expenses (e.g. rent) out of pre-tax money, saving a truckload of tax in the process.  Each health district is different, but some even allow a “Meals and entertainment card” where you literally get to pay for any meals out from pre-tax money.  These don’t have to be work related!

The NHS pension is complicated (oh so complicated!) but a type of defined benefit account.  In Australia, there is a mandatory Superannuation (pension) system.  Employers have to pay 9.5% of your gross base pay into superannuation.  If you contribute some, employers will often add in even more.  This is preferentially taxed at only 15%.  It is invested in the stock market.

If leaving Australia permanently, you are allowed to withdraw your superannuation (and invest it back home please!).

UK Doctor in Australia: SOLD? HOW TO GET STARTED

Doctors need to have completed F1 successfully to be eligible to apply for registration as a doctor in Australia.

AHRPRA are the body in Australia responsible for registering doctors.  AHPRA recognise UK medical school qualifications as equivalent to Australian medical schools.  Therefore, UK non-specialist doctors get an easier and simpler path to register as a doctor in Australia, no exams involved.  This is known as the competent authority pathway.

Non-specialist  doctors trained outside the UK may have to take the Standard pathway, involving written and clinical AMC examinations.

UK specialists wanting to be recognised in Australia need to take the Specialists pathway, and need to find the relevant college website to work out requirements.  This will be a lengthy process, and is generally only worthwhile if planning to move to Australia long term.  Otherwise, most UK doctors would enter under the competent authority (or short term training process) and seek specialist recognition if they decide to stay long term.

The First Step

The first step in general is to get a job offer.  This is best achieved reaching out to a specific hospital you want to work through, through a contact already in Australia or through a recruitment agency.  I used Wave.  The hospital or recruitment agency will then walk you through all the steps required to acquire a visa and medical registration.

Competent authority pathway candidates are provisionally registered for 12 months of supervised practice before achieving general registration assuming performance is satisfactory.  UK doctors usually settle very easily into the Australian health care system (it’s easier than back home), so the supervised practice is just a few more forms for your supervisor to complete through the year.

Those wishing to stay in Australia can then apply for general registration and permanent citizenship.

Hospitals that rely on UK doctors will often pay for their return flights to the UK and short-term accommodation on arrival.

Ten Year Moratorium

Overseas trained doctors are all limited by the 19AB restriction.  This lasts 10 years, and limits your Medicare claims to certain areas of need.  This is not relevant to doctors working in hospitals, but does limit where overseas trained GPs can work.  The moratorium can be reduced to 5 years by working in a rural scheme.   RDWA – Five Year Overseas Trained Doctor Recruitment Scheme (ruraldoc.com.au)

Find Jobs at These Websites

SA RDWA – Welcome to Rural Doctors Workforce Agency

WA Supporting Rural Community Healthcare in WA – Rural Health West

QLD Health Workforce Queensland

VIC Rural Workforce Agency Victoria improving rural health in Victoria and GP, GP locum, nurses, allied health job vacancies Australia (rwav.com.au)

NSW NSW Rural Doctors Network (nswrdn.com.au)

TAS NSW Rural Doctors Network (nswrdn.com.au)

NT Positions (ntphn.org.au)

WAVE Wave.com.au

UK Doctor in Australia: Not Sure?

Check out Australia’s typical cheeky invitation to Brits.

UK Doctor in Australia: Coming Home?

F2 for me was a distant 15 years ago now.  Like many poms, I just couldn’t leave the lucky country.  And now, quite frankly, I’m probably too spoiled to work in the NHS again!

I’ve trained up as an emergency specialist (a completely different specialty in Australia) and started a doctor’s finance blog at Aussiedocfreedom.

If you are heading over to join me, check the blog out to work out the confusing but lucrative salary sacrifice and superannuation systems.  I’m happy for questions to be emailed to [email protected].

 

 

 

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