DWS, DPA and the Modified Monash Model: Where Can IMG Doctors Work in Australia?
Three overlapping government classifications decide where an International Medical Graduate (IMG) can work and bill Medicare in Australia: the Modified Monash Model (MM1–MM7), the Distribution Priority Area (DPA) classification, and the older District of Workforce Shortage (DWS). Together with the section 19AB moratorium, they form the geographic-restriction maze that determines whether a newly arrived doctor can earn in a major city or must work regionally first. This guide explains each acronym, how they interact, and how to look up any address.
Note on "DPA": On this page, DPA always means Distribution Priority Area — a Commonwealth Department of Health classification of a location's GP access. It is not a reference to Doctor Pathways Australia. The two are unrelated.
The one-paragraph summary
The Modified Monash Model scores every Australian location from MM1 (major city) to MM7 (very remote) by how rural and remote it is. The Distribution Priority Area classification flags which locations have too few GPs relative to need. Section 19AB uses these classifications to restrict where a new IMG can bill Medicare for their first 10 years — generally steering them toward DPA-classified and higher-MM (more rural) locations. The District of Workforce Shortage is the older predecessor classification, now largely replaced by DPA for GPs but still relevant for some non-GP specialists.
The Modified Monash Model (MM1–MM7)
The Modified Monash Model (MMM) is the Commonwealth's geographic classification system. It groups locations into seven categories based on population size and remoteness, replacing older systems that treated all "rural" areas as one undifferentiated block.
| Class | Description | Typical examples |
|---|---|---|
| MM1 | Major cities (metropolitan) | Sydney, Melbourne, Brisbane, Perth, Adelaide CBDs and inner suburbs |
| MM2 | Regional centres (>50,000 people) | Newcastle, Wollongong, Geelong, Townsville |
| MM3 | Large rural towns (15,000–50,000, ≤20 km from MM1/2) | Many large coastal and inland towns |
| MM4 | Medium rural towns (5,000–15,000) | Smaller regional service towns |
| MM5 | Small rural towns (under 5,000) | Rural communities |
| MM6 | Remote communities | Remote townships |
| MM7 | Very remote communities | Outback and island communities |
The official methodology lives at the Department of Health and Aged Care — Modified Monash Model page. The further down the scale (higher MM number), the more rural the location and, generally, the more workforce incentives apply.
Distribution Priority Area (DPA)
A Distribution Priority Area is a location the Department of Health and Aged Care has identified as having a shortage of GP services relative to its population's need. The DPA assessment uses a needs-based model that considers the local population's health, age, and socioeconomic profile — not just headcount.
- Working in a DPA location generally satisfies the geographic conditions attached to the section 19AB moratorium for GPs, meaning a new IMG can bill Medicare there without a separate exemption.
- DPA status is reviewed and updated periodically, so a location's status can change. Always confirm the current classification before committing to a role.
- Most MM2–MM7 locations are DPA; many MM1 (major city) areas are not DPA, which is why metropolitan Medicare billing is restricted for new IMGs.
Check the current DPA and MM classification of any address using the official Health Workforce Locator. This is the authoritative tool — it returns the MM number, DPA status, and DWS status for a specific street address.
District of Workforce Shortage (DWS)
The District of Workforce Shortage is the older classification that DPA replaced for GPs in 2019. A DWS was an area where the local population had less access to medical services than the national average.
- For GPs, DPA has largely superseded DWS — the DPA classification is what governs section 19AB billing conditions today.
- For non-GP specialists (and some other professions), DWS assessments are still used, often determined by specialty and location together.
- If you read older guidance referring only to "DWS," check whether it has been updated to the DPA framework for your profession. The Department of Health and Aged Care — Distribution Priority Area page sets out the current position.
How they interact with section 19AB
Section 19AB of the Health Insurance Act 1973 restricts where most IMGs can bill Medicare for 10 years from their first Medicare provider number. The classifications above are the levers that decide what counts as a permitted location:
- MM1, non-DPA (e.g. Sydney CBD): restricted. A new IMG generally cannot bill standard Medicare daytime here without an exemption.
- DPA location (most MM2–MM7, and some MM1 pockets): generally open — billing permitted without a separate 19AB exemption.
- Exemptions can unlock restricted locations even where the area is not DPA — for example the after-hours exemption, a spousal exemption, or an area-of-need exemption where a state health department has declared a need.
So the practical question for an arriving IMG is rarely "is this a nice suburb?" but "what is this practice's MM and DPA status, and do I need an exemption to bill here?" The answer determines income from day one.
A worked example
A UK GP arriving on the Competent Authority pathway wants to live in Sydney. Their options typically look like:
- Bill at a DPA practice in outer/regional Greater Sydney or a regional centre (MM2+) — open, no exemption needed.
- Use the after-hours exemption at an inner-Sydney (MM1) practice — permitted for evenings, weekends, and public holidays. See after-hours work in Sydney from day one.
- Combine the two in a split arrangement: regional daytime plus metro after-hours.
Why the system exists
Australia has a long-standing maldistribution of doctors — an oversupply in inner-metro areas and persistent shortages regionally and remotely. The MM, DPA, and 19AB framework is the policy instrument that channels new prescriber and Medicare-billing capacity toward the communities that need it most. For an IMG, the system is a constraint, but the higher-MM and DPA locations it points toward also carry the strongest rural workforce incentives and, often, the fastest route to general registration.
Key takeaways
- MM1–MM7 measures how rural a location is; DPA flags GP shortage; DWS is the older predecessor (still used for some specialists).
- New IMGs are generally free to bill Medicare in DPA / higher-MM locations and restricted in MM1 non-DPA locations for 10 years under section 19AB.
- Exemptions (after-hours, spousal, area-of-need) can open restricted locations.
- Always verify the current classification of a specific address on the Health Workforce Locator — classifications change over time.
To model how location choice affects your registration timeline and earnings, explore the pathway explorer.
Sources: Health Workforce Locator · Modified Monash Model · Distribution Priority Area · Services Australia — Section 19AB