Competent Authority Pathway: A Guide for UK and Irish IMGs Moving to Australia

If you graduated from a UK or Irish medical program (or passed PLAB) and completed Foundation Year 1 or an Irish internship, you are likely eligible for the Competent Authority pathway, a streamlined route to independent general practice in Australia with no AMC exams. If you also hold a CCT (UK) or CSCST (Ireland) in general practice, look at the Expedited Specialist pathway too; see Is MRCGP recognised in Australia?. This article covers every step, with realistic timelines, costs, and the regulatory details that are easy to miss in the official guidance.

Why the Competent Authority pathway exists

Australia recognises certain examinations and training programs in the UK, Ireland, New Zealand, the USA, and Canada as equivalent to Australian standards. Eligibility depends on which exam or program you passed plus the supervised experience that goes with it, not on your nationality: a non-UK graduate who passed PLAB and completed 12 months of supervised training in the UK is on this pathway too. Instead of sitting the AMC exams (which Standard pathway candidates must do), you apply directly for provisional registration as a Competent Authority applicant. There is no separate Competent Authority assessment or assessment fee.

The result: you skip the AMC MCQ and AMC Clinical exams entirely. Your path to general registration in Australia is 15–17 months, not the Standard pathway's 24–30 months or more with exams. See the interactive timeline for a visual breakdown of each stage.

Step 1 — Eligibility check and primary source verification

What you do: confirm you fit one of the Board's Competent Authority categories for the UK or Ireland, then have your primary medical qualification verified at source through the AMC and ECFMG (EPIC). There is no separate application to the Board at this stage; you lodge your Certificate of Good Standing, recency evidence and qualification documents with your provisional registration application.

Timeline: Several weeks. Verification is what takes the time, so start it early.

Cost: no separate assessment fee. You pay the application and registration fees when you apply for provisional registration (Step 2).

Requirements:

• A UK or Irish medical degree, or PLAB, plus the matching supervised experience (Foundation Year 1, an Irish internship, or 12 months of supervised training in the UK after PLAB). This is your Competent Authority category; current full registration is not the test.
• Certificate of Good Standing from every regulator you are or have been registered with, sent directly to AHPRA and dated within three months of AHPRA receiving your application.
• Evidence of recent clinical practice (typically within the last 2 years). The MBA does not publish a hard hour-count threshold, but doctors who have been out of clinical practice for more than 2 years are flagged for additional scrutiny.

Source: MBA Competent Authority pathway ↗

From the GMC / IMC side

The Australian process runs on documents your home regulator issues, so sequence them deliberately:

• Certificate of Good Standing — order it from the GMC or the Medical Council of Ireland (and from any other regulator you have been registered with) shortly before you submit: it must be sent directly to AHPRA and dated within three months of AHPRA receiving your application, so an early order can lapse while you assemble the rest of the application.
• Degree and internship evidence — your UK or Irish degree (or PLAB result) and your Foundation Year 1 or internship certificate are what make you eligible. MRCGP or MICGP is not required for this pathway; with a CCT or CSCST it points to the Expedited Specialist pathway instead. See Is MRCGP recognised in Australia? and the MICGP equivalent.
• Keeping your home registration — most doctors keep their GMC or IMC registration at least through the supervised year; whether the retention fee is worth it depends on your return plans. The trade-offs are covered in the GMC retention guide and the IMC version.

Your document checklist

Everything below is asked for somewhere between primary source verification and your provisional registration application. Gather the time-sensitive items (the good-standing certificates) last.

Each row links down to the section that explains it. Tick any box to keep this list in your free personal checklist — it opens at the Eligibility + Primary Source Verification step, the one you are reading, with the 9 items below and the documents each one needs.

Step 2 — Provisional registration with AHPRA

Once your qualifications are verified and you have a position, you apply to AHPRA for provisional registration. There is no earlier approval step: the Board checks your Competent Authority category as part of this application.

Timeline: 4-6 weeks processing (Ahpra: most in 4-5 weeks, up to 6; apply at least three months before your start date, up to six months ahead; in its peak period Ahpra asks for at least 8 weeks) once your application is complete.

Cost: $1,316 (Medical Board application fee plus registration fee for provisional registration).

What provisional registration means:

• You can practise medicine in Australia.
• You must have an approved supervisor — the MBA assigns a supervision level (typically Level 2 or Level 3 for CA-pathway doctors).
• You can bill Medicare under your own provider number.
• You can work after-hours shifts independently at Level 3 supervision — this is the income-earning mechanism from day one of supervised practice.

What you need before applying:

• A confirmed position with an approved supervisor at an Australian practice.
• Professional indemnity insurance (premiums vary with scope and hours — confirm with an insurer; your employer may cover this or you may need your own policy).
• For a general practice position, a PESCI ↗ (pre-employment structured clinical interview) for that specific position, run by an AMC-accredited provider before you apply.

Source: AHPRA registration process ↗

Step 3 — Supervised practice

You work under supervision for a period determined by the MBA — 12 months (minimum 47 weeks FTE) for CA-pathway doctors. During this time:

• You see patients, bill Medicare, and earn income — this is not unpaid training.
• Your supervisor provides regular meetings and progress reports to the MBA.
• The supervision level (Level 2 or 3) determines how closely your supervisor oversees your clinical decisions. At Level 3, you practise independently with the supervisor available for consultation — this is the most common starting level for UK/IE doctors.

After-hours earning during supervision: At Level 3 supervision, you can work evening and weekend shifts independently. This is a significant income stream — practices in metropolitan areas value after-hours coverage, and Medicare rebates for after-hours consultations carry a premium.

Source: MBA supervision guidelines ↗

Step 4 — General registration

After completing your supervised practice period with satisfactory reports:

Timeline: 6-8 weeks processing.

Cost: $1,645 (annual AHPRA renewal; replaces the provisional fee, not additional).

What general registration means:

• You are fully registered as a medical practitioner in Australia.
• No supervision requirements — you practise independently.
• You can bill Medicare unrestricted (subject to Section 19AB location rules — see below).

Requirements:

• Satisfactory supervisor reports covering the full supervision period.
• No adverse findings, complaints, or conditions on your registration.

Source: AHPRA registration standards ↗

Section 19AB — the 10-year Medicare billing restriction

This is the part AHPRA's guidance often under-explains.

From your first medical registration in Australia, a 10-year moratorium under Section 19AB of the Health Insurance Act 1973 restricts where you can bill. In non-DPA (non-Distribution Priority Area) locations — primarily inner-metropolitan areas classified as MM1 — you cannot bill Medicare unless you hold an exemption. For who the restriction applies to, how the 10 years are counted and every exemption type, read Section 19AB explained.

Exemptions that apply to UK/IE CA-pathway doctors

• After-hours exemption — work between 6pm and 8am on weekdays, or any time on weekends and public holidays, at an MM1 practice. Medicare allows billing for after-hours services even under 19AB, because the government wants after-hours coverage in all areas. This is the most commonly used exemption for CA-pathway doctors in Sydney, Melbourne, and Brisbane metro areas.

• Spousal exemption — if your spouse "is a medical practitioner or a skilled migrant", you may qualify for an exemption to work in the same location as them. Conditions apply; check the Department of Health 19AB exemptions page ↗.

• DPA / regional exemption — work in a DPA-classified location (every MM2–MM7 location on the Modified Monash scale is DPA, as are the Northern Territory and Tasmania) and you need no 19AB exemption. Regional and rural areas are always open.

• Split arrangement — combine metro after-hours (for income) with regional daytime (for training credit). This is a specific arrangement some practices offer where you work evenings and weekends at an MM1 site and daytime sessions at a regional site. Both count toward your supervised hours; the metro sessions use the after-hours exemption for billing.

Source: Services Australia — Section 19AB ↗

Total costs

Item	Cost (AUD)
AMC portfolio (primary source verification)	$642
ECFMG EPIC verification (US$110 account + US$35 portfolio + US$110 per credential; USD, not in the AUD total)	US$255 for one credential
AHPRA Registration (provisional: application + registration)	$1,316
AHPRA Registration (general: application + registration)	$1,645
Police checks & documents	$200-500
Professional indemnity (annual)	Varies — confirm with your insurer
Total (minimum)	$4,058+

Excludes visa fees, relocation, accommodation, and living costs. Visa costs depend on subclass — 482 (Skills in Demand) is the most common employer-sponsored route.

Total timeline

Most UK/IE doctors begin earning from supervised practice about 3–4 months from starting their application. The supervised period is paid clinical work, not a training gap. Model your expected first-year earnings with the income estimator.

What makes this pathway different from Standard AMC

Common questions

Do I need to sit the AMC exam?

No. The Competent Authority pathway exists specifically to waive the AMC examination requirement. Your UK or Irish degree (or PLAB) and your Foundation Year 1 or internship are accepted as equivalent.

Can I start earning immediately?

You start earning from the day your provisional registration is active and you begin supervised practice. At Level 3 supervision, you can also take after-hours shifts independently — this is typically available from your first week of practice.

What visa do I need?

Most UK/IE doctors use the subclass 482 (Skills in Demand) visa, sponsored by the employing practice. The 482 visa grants full work rights for the nominated occupation. Some doctors on existing partner visas (820/801) or skilled migration visas (189/190/491) may already have work rights. Visa specifics should be confirmed with a registered migration agent.

What happens after 10 years with 19AB?

Ten years after your first medical registration in Australia — the anchor Services Australia uses for the moratorium, not your first billing date — the 19AB restriction lifts, if you are a permanent resident or citizen by then, and you can bill Medicare anywhere in Australia. While you remain a temporary resident it continues. Scaling credits for rural and remote work can shorten the period. Until then, the exemptions described above govern where you can bill.

Is there an age limit?

No formal age limit for the Competent Authority pathway. The MBA assesses recency of practice, not age. Doctors who have been in continuous clinical practice are assessed on merit regardless of career stage.

Should I keep my GMC or IMC registration?

Many doctors keep their home registration at least through the supervised year — re-registering later is slower and costlier than retaining. The annual-fee trade-offs are covered in the GMC retention guide and the IMC version.