Living and Working in Adelaide: a guide for overseas doctors. Part 4: The Work Stuff

This mini-series provides some basic advice for overseas doctors interested in coming to work in, or just setting themselves up in, Adelaide. In this series:

  • The Basic Stuff: basic living requirements and getting around
  • The Fun Stuff: getting out and about, food and wine and travel
  • The Touring Stuff: travel and touring destinations for those days off
  • The Work Stuff: registration, workplaces and training programmes
  • The Admin Stuff: banking, visas, tax and health

Don't forget to checkout out current jobs on offer via the SA Health Careers website.

The Work Stuff

Registration

AHPRA deals with all medical registrations (and nursing, chiropractors etc) in Australia, and has replaced individual state medical boards. You will need registration with the Australian Medical Council (AMC) and AHPRA before you can work.

AHPRA is not known for being the most efficient, so be prepared for them to ask for a billion different documents, and then once you have provided them to ask you for more. When you first arrive you will be given limited registration, which allows you to work in a specific place under supervision. You cannot locum or work in a different hospital network on this registration. To achieve full registration, you will need to work for a year. Then, if you are from certain countries (e.g. UK), you can get a document signed by your supervising consultant and voila you have full registration.

Unfortunately, if you are from a whole list of other countries it is a HARD slog to get general registration. This involves the AMC MCQ exam, followed by the extremely challenging AMC clinical exam, which is renowned for being fairly evil. Until you have this, you can’t get full registration, therefore can’t get permanent residency (PR), and can’t get on most training programs. This leads to all kinds of hassles if you don’t complete in the 4 years allowed by your 457 visa and APHRA start getting twitchy.

You also need a provider number through Medicare before you can work (a different one for EVERY hospital you work at) and a prescriber number (one of these covers everywhere) before you can sign prescriptions.

Adelaide's Hospitals

There are 7 main public hospitals in Adelaide—3 major, each with a smaller one linked to it that tends to see less acute stuff, and the Women’s and Children’s (WCH).

  • Central Adelaide has the Royal Adelaide Hospital (RAH) and Queen Elizabeth Hospital (QEH)
  • The north has Lyell McEwin (Lyell Mac, LMHS) as its main hospital supported by Modbury, which is smaller
  • The south has Flinders Medical Centre (FMC) and Noarlunga

The hospitals are all pretty bus,y and regularly have major problems with accessblock (although things are improving a little from 2 day waits for medical beds and 7 days for mental health). The RAH and FMC deal with major trauma, with FMC doing obstetric trauma and RAH seeing neurosurgery and spinal more. FMC and RAH have helipads allowing the MedSTAR retrieval service to bring patients in.

The RAH

The RAH is moving into a brand new and extremely fancy (and expensive) facility in 2016, and eventually the WCH should co-locate with it. It will still be on North Terrace and so very handy for the CBD.

newRAH

The RAH is as you would imagine for a big busy tertiary centre, with transfers in from the Northern Territory. ED is busy here, but probably significantly better staffed than you will be used to and with extremely supportive seniors. In Australia we do more “stuff” in ED—usually our own tubes and lines, LPs, chest drains etc and you will get a chance to do more of a work up than you may be used to which is fun. There is the opportunity to do a 3 month rotation at RAH (for RAH people or for trainees from FMC) dealing solely with trauma to get some good experience here.

The QEH

The QEH is a smaller, 311-bed, district hospital to the west of the city. It is well situated for living by the beach and easy commutes. It provides inpatient and outpatient medical, surgical and psychiatric services, with cardiac cath lab and ICU support. Similarly to the RAH, you'll have the opportunity to do a number of procedures.

Training Programmes

Training programmes are hard to come by here, especially in surgery where even the best people can spend years doing service jobs before they get on the programme. It is not a case of wandering in and taking a training position at a major Sydney hospital any more! You will need full registration now to join any training program and PR. There are still jobs out there but you may need to consider rural work and be flexible about travelling around a bit. GPs will have to spend some time outside the metro area before they are allowed to work in a city (although in SA some of the “rural” areas are pretty close in!) and you cannot do private work as a consultant for 10 years after arriving in Oz and if you were coming over as a consultant physician or surgeon this is actually quite a big deal.

Obviously this is less of an issue in ED and if you do all your training here you will be almost up to your 10 years anyway. Joining ACEM as a trainee also requires full registration, but there are currently few other obstacles to joining.

 

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