Living and Working in Adelaide: a guide for overseas doctors. Part 5: The Admin 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 Admin Stuff

Visas

The basics… You will need to come over on a 457 visa sponsored by the employing hospital, which is valid for 4 years, and can be extended if required. Once you have full registration, you can apply for permanent residency (PR) and then you can stay forever. However, after you have had PR for 5 years, you need to get a Resident Return Visa every time you go overseas, which is a pain. Luckily, after you have been here 4 years in total (including a specific length of PR), you can apply for citizenship, get a passport and you are sorted! All the applications are online through www.border.gov.au.

However, getting a 457 visa is painful. Australia is big on getting everything “certified” by a Justice of the Peace and, while there are hundreds of them in Oz willing to sign stuff for free (even many working in the hospital), you can’t do that in the UK, so you need to pay money for a solicitor to do it. You will end up needing piles of copies of your passport, registration, etc for visa, AHPRA, AMC and so on. The rules change all the time though, so have a good read.

For the 457 visa you need to allow around 6 months, to make it less stressful to get through the application process. When they ask what date you need it from, ask for a couple of weeks before you actually start work. They tend to tell you VERY last minute (like a few days before) if it has been granted, so you end up running the gamble of booking flights and potentially having to change them, or not booking flights and having to buy them a week before you leave! Do NOT try and enter on a tourist visa and then wait for your 457 to come through—you may get away with it, but if you do this then, when you arrive, you either have to lie to them or tell them you intend to work both of which can get you kicked out of the country! These are going to get harder and harder to get. You also need to have private health insurance to be allowed to get into the country on a 457, but once you are here you can register with Medicare and cancel that if you want (don’t cancel before you register!).

PR is another painful process with many forms, and requires letters from your school saying you were educated in English among other things. Once you get started it is actually fairly quick. You will need to put in an Expression of Interest online and then immigration will tell you when you are invited to apply. This can take weeks or months. Once you can apply you only have a limited time to get all your documents in or your application is cancelled. Unfortunately it is a little unclear what documents exactly you need until you are allocated a visa officer so be prepared. There is a list online so try and get everything you could imagine they would want before you apply. There are also several occupations you could list yourselves as if you are a normal trainee (as opposed to a consultant/GP) but the feeling was the “General Medical Practitioner” was probably the one to go with. This is a pricey process (>$2000).

Citizenship, on the other hand, is pretty easy—another online application, a lot less cash, an online test (which allows 45 minutes but has never taken anyone more than 10), and then singing the anthem and you are done!

Getting Paid

This is likely to be a pleasant surprise! You will get paid a base salary and then generous penalty rates for afternoon shifts/nights/weekends/public holidays/overtime. Starting salary for a PGY3 (3rd year after graduating med school) starting from April 2016 is $82,532. You will need to fill in a time sheet every fortnight to get paid and have your penalties calculated—the average ED roster will easily add 20% in penalties. There is a pay rise each year, and you will also increment up a pay level each year.

This package includes 5 weeks of paid annual leave, 1-2 weeks of professional development/study leave and copious sick leave (if you ever need it in this healthful environment).

As an extra perk, you are also entitled to Professional Development funds in SA—$4000 for a non-trainee and $8000 for a trainee—which can be used for textbooks, courses (including transport/hotels) and college fees (not including registration via AHPRA or AMC). It is also usable for work-related technology such as a phone, tablet and laptop. Enjoy!

Public workers are also allowed to salary sacrifice part of their income, which means it is removed pre-tax and paid to you nominally to cover some of your living expenses. There will be a company that does this for your hospital who can help. To get it paid direct into your bank account you need to show in theory what it is for e.g. a rental agreement or school fees. Otherwise they will load it up on a credit card every month and you can use the card as you would normally, with the only proviso being that it is all spent by the end of March each year.

Banking

There are the big banks over here which include NAB, Commonwealth, ANZ, Bank SA etc. You will be charged if you take out money from an ATM not run by your bank, so be aware it is worth banking with one of the big ones. However you can also get “cash out” at supermarket checkouts as a free way of withdrawing money.

Some of the banks will set up an account for you and allow you to transfer money while you are in the UK, so it is waiting for you when you get here and means you have access to money almost straight away. NAB seemed to be the most straightforward for this and then once you arrive you can go into a branch, show you ID and get set up. You may have to ask for a proper visa debit card otherwise they will just give you an ATM/shop card that you cannot use online.

Most banks have links with an airline frequent flyer scheme—if you are going to get a credit card (these have big annual fees), make sure you get some kind of perk from it!

Tax

You will need to obtain a tax file number (TFN) to work here before you start. The great news is that you will find a LOT of things can be claimed on tax here so find yourself a tax accountant! Phones, internet and laundry may all be partly claimed. Everything work-related that is not fully refunded for Professional Development is tax deductible. The tax year is July - June.

All That Other Paperwork

There is a lot of paperwork to complete, and you should prompt the admin people to send them through to you ASAP, even with the initial contract. The main hit list of forms are:

  • General details for your personnel file
  • Credentialling application (the process of making sure you're a doctor, not a criminal—more certified copies of everything)
  • TFN declaration
  • Bank details (so Shared Services, who do all the payroll, can set up your file)
  • Immunisation records (Hep B, measles, TB—on that note, you'll need to visit the Chest Clinic here for Mantoux testing, etc)

General Living

Mobile Phones

Telstra has the widest coverage of all the providers in Australia, so if you are planning on travelling anywhere rural (or wish to have reception in more of the hospital, for example) it is the one to go for. Having said that it is significantly more expensive than main competitors Optus or Vodafone, so if you are not bothered about being able to get a text on Kangaroo Island then you can probably go with one of these. Otherwise they are pretty much the same as mobile phones the world over! There are shops all over the place and Rundle Mall has everything you need. Again, anticipate them feeling expensive when you first get here… You will need proof of address and a passport to set up a contract and ID even to buy a pay as you go phone so make sure you have something from your bank before you go in.

You do not need to put the 08 prefix in front of local numbers but you will need to add this if you are calling somewhere in country SA.

Healthcare

Healthcare provision in Australia is quite different from the UK. There is a very big private sector which many people use and a large proportion of the population have health insurance which is very variable and seems to sometimes end up leaving people more out of pocket than if they had just used the public system. As a doctor you will get good treatment in the public system, but it is like the NHS in that it has the financial pressures and waiting lists as you would expect. Outpatient care in the public sector is dire and if you are old and crumbly, decent private insurance will get you a long way. There is also DVA and Gold Card which are for veterans and these essentially give the top level of health cover.

The private system is extremely variable—some of the big hospitals are good (although will still transfer the sickies/complicated out) ,but some are not the best. Ask around if you want to go private—if you are really sick, they are not the place to go as your out of hours medical cover is pretty limited. Private emergency departments will charge several hundred dollars for care too, and your health insurance does not cover this so probably best to avoid. You will learn the intricacies of all of this once you arrive but suffice to say you are probably best off at the RAH/FMC if you are genuinely sick.

While you are on a 457 visa, Medicare essentially replaces the NH,S so things should be free (e.g. GP visits). However you MUST get a card before this works, so go to the Medicare offices on Currie Street and register as soon as you get here. Once you have PR you are treated as an Australian. This means when you go to a GP for example you need to pay the full rate for the consultation and then part of this is refunded leaving a “gap” payment. The exception to this is “bulk billing” GPs which are free. Globe Medical in Hindmarsh Square are used to overseas people and a place to start otherwise look at www.doctorshealthsa.com.au, designed to find you a GP who likes looking after other doctors. Some providers will bulk bill you as a professional courtesy even if they don’t normally, but don’t assume it! Prescriptions for contraception are NOT free so stock up before you come. If you need sexual health help Shine and Clinic 275 (opposite RAH) can help.

Dentists are EXPENSIVE here. If you have insurance you will be partly covered for visits, but you will still end up ≥$100 out of pocket. If you are only here for a year, you may want to avoid them unless you really need them. There is almost no emergency dental care either unless you are a “health card” holder (those on a very low income), in which case the dental hospital and peripheral dental services may see you. Anticipate seeing a lot of people in ED with really bad teeth, but you will have more sympathy once you realise how much it would cost them to look after them!

Bear in mind if you have private cover you may be allowed 1 ambulance trip otherwise ambulance trips are NOT FREE and will cost you several hundred dollars (and more if it is from outside the metro area). Get ambulance cover at $50 a year—it is worth it!

 

And that's it from me! You are now a fully settled Adelaidean, enjoying life in the lap of luxury. If you have any more tips, feel free to ladd them in the comments below. On ya, mate.

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