‘DPA no longer holds any merit as a distribution mechanism,’ says one rural health stakeholder.
A total of 128 overseas-trained specialists entered Australia during the first six months of the regulator’s new expedited registration scheme, with none refused registration so far.
But despite the rule requiring overseas-trained doctors to work for 10 years in areas of workforce need – the vast majority of which are rural, regional and remote locations – four in five of the specialist doctors registered through the expedited program are working in major cities.
Commencing in October 2024, international medical graduates from the UK, New Zealand and Ireland who had completed certain postgraduate training in their country of origin were allowed to apply for expedited registration in Australia.
It essentially gave these doctors a shorter pathway to practice in Australia; in doing so, it allowed doctors to gain specialist registration without joining an Australian medical college.
The colleges were none too pleased with this.
When the pathway initially opened, only doctors who were specialist GPs in their country of origin could apply for expedited registration.
Since then, it has opened up to psychiatry, anaesthesia and obstetrics and gynaecology specialists.
A report released by AHPRA this week revealed that UK-trained general practitioners had made up the bulk of the fast-track applications over the six months to April 2025.
Around 250 of the 288 total applications received were for general practice, and 86% of all applicants were from the United Kingdom.
At the time of reporting, 150 of those applications had been processed and 128 had been granted registration.
All bar two were GPs.
All internationally qualified GPs are required to serve 10 years in a recognised Distribution Priority Area (DPA), unless their spouse is a skilled migrant or doctor, they have an Aboriginal and Torres Strait Islander primary health services exemption, or they are working in a salaried position that does not attract Medicare rebates.
Under the current rules, all areas classified from MM2 (inner regional) to MM7 (very remote) are technically DPA locations.
Geographically, this covers the vast majority of the country and includes some smaller state capitals like Hobart.
Just 20% of the fast-tracked doctors, though, are working in an MM2-7 region.
The rest are working in MM1 locations, which represent Australia’s major cities.
A limited number of MM1 outer-metropolitan locations are granted DPA status; typically, practices in a given suburb or area will have to apply directly to the government and prove exceptional circumstances.
“With four out of five of the doctors under this expedited pathway heading to our metropolitan areas, it shows that it’s not really meeting community need where we most need these doctors to work,” RACGP rural chair Associate Professor Michael Clements told The Medical Republic.
“It’s a slightly faster pathway for doctors to go into urban areas, which is disappointing, because at the same time that [AHPRA has] invested this time and energy into making it faster for doctors to work in urban Australia, they haven’t done anything to increase capacity to deal with the doctors going to where we do actually need them.”
Professor Clements said he had heard anecdotally that some of the GPs who had registered via the new pathway and were working in outer metropolitan DPA areas were struggling to find patients.
“As the rural chair, it breaks my heart when I hear about these doctors being brought in from overseas into what’s supposedly a DPA region … saying that they’re still only a quarter booked, so they’re just not seeing enough patients per day to sustain a good income,” he said.
“Yet we know that just a short drive away, in real areas of priority, patients are still waiting far too long to be able to get the care that they deserve.”
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Rural Doctors Association of Australia CEO Peta Rutherford said the new AHPRA figures showed the DPA system was now at the point where it “no longer holds any merit as a distribution mechanism”.
“What we need to see is how we then support other programs in relation to GP training and making sure that … producing a workforce for our rural communities is an attractive option, as opposed to forcing people to go [rural],” Ms Rutherford told TMR.
“The way they’ve treated DPA, it is no longer a mechanism of – we talk about sticks and carrots regularly – and it’s no longer a stick. That’s okay, but then we need to double down on the carrots.”
ACRRM president Dr Rod Martin had a slightly different view.
“It would be pretty hard for someone who has come through general practice training in the UK with no rural generalist understanding or skill set to come and start working in an MM3,” he told TMR.
In that sense, he said, it was preferred that doctors coming from another country to work in rural Australia had the support of a college, which the fellowed, fast-tracked doctors did not necessarily have.
