Already in Australia? How an International Medical Graduate Registers Onshore

Most registration guides assume you are planning a move from London, Dublin, Lahore or Toronto. Many doctors actually start from inside Australia: on a student visa, a partner or working-holiday visa, as the spouse of a skilled migrant, or on an employer-sponsored visa in a non-clinical role. Being onshore changes the practical order of some steps and the visa constraints around them. It does not change the pathway.

To check which pathway your qualifications point to, use the eligibility quiz in the pathway explorer.

Your location does not pick your pathway — your qualifications do

The Medical Board of Australia says your registration pathway "will reflect your qualifications, the type of registration you are seeking, and whether you are intending to work in Australia temporarily or long term." Where you live is not on that list. The three routes are:

• Competent Authority pathway — for doctors "who have been assessed by a competent authority and who have practised in a competent authority country" (the GMC, the Medical Councils of Ireland, Canada and New Zealand, and ECFMG). No AMC exams; leads to general registration. See Competent Authority vs Specialist pathway.
• Specialist pathway — for IMGs "with an international specialist medical qualification". A qualification on the Board's Expedited Specialist list goes straight to the Board; any other specialty goes to the relevant college for a comparability assessment. See AMC Standard vs Specialist pathway.
• Standard pathway — for IMGs "who are not eligible for the Competent Authority or Specialist pathway". Exam-based, through the Australian Medical Council (AMC).

One onshore detail: the Board accepts that "Australian clinical experience can be substituted for the post-examination or post training experience" component of Competent Authority eligibility.

Sources: Medical Board — International medical graduates · Competent Authority pathway · Specialist pathway

Sitting the AMC CAT MCQ from inside Australia

On the Standard pathway the Board is explicit: "To be eligible for the Standard pathway, you must pass the AMC CAT MCQ written exam before you apply for registration." The exam is one 3.5-hour session of 150 questions, and "Pearson VUE conduct the CAT MCQ examination on behalf of the Australian Medical Council" at test centres in Australia and other countries — onshore, you simply book a local venue. You apply for an authorisation through your AMC account (valid 12 months), then schedule with Pearson VUE.

After the MCQ, the AMC Certificate needs the AMC clinical examination or a workplace-based assessment; the clinical exam "can be completed before or after registration is granted". See the AMC MCQ exam guide.

Sources: AMC — CAT MCQ examination · Medical Board — Standard pathway

Primary source verification from inside Australia

Whichever pathway applies, "you must obtain verification of your required qualification(s) through ECFMG and establish an AMC initial portfolio." Verification runs through ECFMG's online MyIntealth platform — your university answers ECFMG directly and the result lands in your AMC account. Nothing about it depends on where you are; qualifications already verified through EPIC "are also still valid". Start it first: it is the one step being local cannot speed up.

AHPRA's identity check is online too ("international applicants can verify their identity before coming to Australia"). If you "have lived overseas for a period of six consecutive months or more as an adult" you also need an international criminal history check through an AHPRA-approved supplier — which covers almost every onshore IMG. See what documents AHPRA asks for.

Sources: AMC — Primary source verification · AHPRA — Registration process

English language evidence

Every applicant must meet the English language skills registration standard — "this includes Australian-trained or overseas qualified applicants." There are four ways to satisfy it: the combined education pathway (two years of secondary schooling plus your medical qualification, all taught and assessed solely in English in a recognised country), the school education pathway, the advanced education pathway (six years of English-medium education including a degree), or a test. The Board also accepts a passed PLAB or NZREX.

Five tests are accepted: Cambridge C1 Advanced or C2 Proficiency, IELTS Academic, OET, PTE Academic and TOEFL iBT — all at a test centre, none at home. For TOEFL you must select "Taking TOEFL for Australia" when registering. Minimum scores changed on 23 April 2026 and depend on when you sat the test, so read AHPRA's current tables. An Australian degree helps only if it fits one of the education pathways, and fully online programs are not accepted. See the English test guide.

Sources: AHPRA — English language skills registration standard · AHPRA — Accepted English language tests

Finding a supervised position: what "approved supervisor" and "approved position" mean

This is the step onshore IMGs most often get backwards: the position and its supervision are part of the registration application, not something you find afterwards. For the Standard pathway the Board says: "You must complete 12 months of supervised practice. The Board must approve the position you have secured and your proposed supervision arrangements." The application includes "details of a nominated supervisor for Board approval", a Supervised practice plan and supervisor's agreement (form SPPA-30) and a supervisor declaration; a general-practice role also needs a pre-employment structured clinical interview (PESCI). The Competent Authority pathway is the same shape: provisional registration, then "12 months of supervised practice before progressing to general registration."

The supervisor is not just any senior colleague. Under the Board's guidelines, principal and co-supervisors "should have specialist registration" and "a minimum of three years full time equivalent practice with general and/or specialist registration in Australia"; "a medical practitioner with limited or provisional registration cannot be appointed as an IMG's supervisor." The Board prefers practices "currently accredited to the RACGP Standards for general practices", and once approved the arrangements "must be in place at all times when the IMG is practising."

The Board sets one of four supervision levels, from Level 1 (supervisor "physically present at the workplace at all times", consulted on every patient) to Level 3 (the IMG "is permitted to work alone provided that the supervisor is contactable by telephone or video link") and Level 4 (periodic review). Being in Australia lets you meet practices, interview and sit a PESCI without time-zone logistics; it does not shorten the 12 months (minimum 47 weeks full-time equivalent).

Sources: Medical Board — Standard pathway · Medical Board — Supervised practice for IMGs guidelines

Section 19AB and the Distribution Priority Area from inside Australia

Section 19AB of the Health Insurance Act 1973 applies to you if you "got your medical degree outside of Australia or New Zealand" — citizenship and visa status do not decide it — and to anyone who "enrolled in a medical degree in Australia or New Zealand as a temporary resident". It means that "from the time you get your medical registration in Australia, you must work for at least 10 years" in a Distribution Priority Area (DPA) as a GP, or a District of Workforce Shortage as a non-GP specialist, to access Medicare benefits. The clock starts at registration, not arrival. The restrictions "end after 10 years if you are a permanent resident or citizen", and scaling credits for remote work can shorten the time.

Two points matter more onshore. First, "there is no restriction if you work in a salaried position that doesn't attract Medicare benefits, like in a public hospital." Second, exemptions exist for working after regular hours (6pm to 8am Monday to Friday, or any time on weekends and public holidays) at any location, for a spouse who "is a medical practitioner or a skilled migrant", and for replacing a doctor who held an unrestricted exemption. Every MM 2 to MM 7 area under the Modified Monash Model is automatically a DPA; MM 1 inner-metropolitan areas are not; check any address on the Health Workforce Locator.

Timing is unforgiving: you "must hold a valid Medicare provider number and 19AB exemption before you can provide medical services that attract a Medicare rebate", exemptions cannot be backdated, and services billed without a provider number "gather a debt". Applications are assessed within 28 working days, and if you become a permanent resident while holding an exemption "you must tell Medicare immediately". See Section 19AB explained, DWS, DPA and the Modified Monash Model and the 19AB overview.

Sources: Department of Health — Section 19AB restricted doctors · 10-year moratorium and scaling · 19AB exemptions · Distribution Priority Area

Working rights while you register

Registration and the right to work are separate systems: AHPRA decides whether you may practise; Home Affairs decides whether, and how much, you may work at all. A Student visa (subclass 500) lets you "work up to 48 hours a fortnight when your course of study or training is in session" (research master's and doctoral students have no work limit). A Skills in Demand visa (subclass 482) "lets an employer sponsor a suitably skilled worker to fill a position", so it is tied to that employer and role. Working holiday visas carry their own conditions. Before signing a supervised practice agreement, confirm your visa conditions with Home Affairs and whether the practice must sponsor you. See working rights for IMGs and which visa doctors use.

Sources: Home Affairs — Student visa (subclass 500) · Home Affairs — Skills in Demand visa (subclass 482) · Home Affairs — Working Holiday visa (subclass 417)

Realistic timelines

• Primary source verification — depends on how quickly your university answers ECFMG. Start it first.
• AMC CAT MCQ — authorisation valid 12 months; dates depend on Pearson VUE availability.
• AHPRA assessment — a "complete internationally qualified health practitioner application may take four to six weeks"; an incomplete one gets 30 days to supply what is missing, then is closed.
• 19AB exemption — assessed within 28 working days.
• Supervised practice — 12 months (minimum 47 weeks full-time equivalent) before general registration.

Being onshore removes travel and time-zone friction, not a single step.

Common onshore mistakes

1. Assuming that living in Australia changes the pathway — your qualifications do.
2. Applying to AHPRA on the Standard pathway before passing the MCQ.
3. Seeking registration before a position — the approved position and supervisor are part of the application.
4. Any clinical work before registration and approved supervision are in place.
5. Billing Medicare before both the provider number and the 19AB exemption are granted.
6. Sitting an at-home English test, or TOEFL without "Taking TOEFL for Australia".
7. Skipping the international criminal history check because you "already live here".
8. Not telling Medicare when permanent residency is granted.

See also: Which Australian registration pathway am I on? · AHPRA documents checklist · Can I work while my AHPRA registration is pending? · Explore all pathways

Sources: Medical Board of Australia — International medical graduates · Medical Board — Standard pathway · Medical Board — Competent Authority pathway · Medical Board — Specialist pathway · Medical Board — Supervised practice for IMGs guidelines · AHPRA — Registration process · AHPRA — English language skills registration standard · AHPRA — Accepted English language tests · AMC — CAT MCQ examination · AMC — Primary source verification · Department of Health — Section 19AB · Department of Health — 10-year moratorium and scaling · Department of Health — 19AB exemptions · Department of Health — Distribution Priority Area · Home Affairs — Student visa (subclass 500) · Home Affairs — Skills in Demand visa (subclass 482)