Visa Planning for Medical Practices

Many medical practices and hospitals sponsor doctors from overseas due to shortages of locally trained doctors in various areas. If you have any questions about this process, we invite you to join our FORUM

For an International Medical Graduate (IMG) to work in Australia as a medical practitioner the most common pathway is:

  1. Get a job offer
  2. Obtain a successful skills assessment
  3. Get registered with the Australian Medical Board (AMB)
  4. Get a visa

For most IMG’s migrating to Australia, the main pathway is the 457 visa program which will be replaced by the TSS visa program from March 2018.

Temporary Skills Shortage (TSS) Visa

This will replace the 457 visa in March 2018 and is likely to become the most common pathway for medical practitioners to migrate to Australia. We anticipate that the requirements and conditions will be similar to the 457 program for medical professionals, however this visa is considerably more expensive and has different Training Benchmark requirements which need to be met by the practice. 457 visas issued before March 2018 will continue to be valid until their normal expiry date.

Accessing the 457 Visa Program as an Employer

To be able to sponsor medical practitioners under this program, a medical practice must be an approved 457 Standard Business Sponsor. The Department of Immigration and Border Protection is currently taking about 3 – 4 months to process 457 visas. The visa is usually granted for up to 4 years and it enables the doctor to work for the sponsoring medical practice or hospital and in some circumstances other medical practices. This visa can provide a very useful stepping stone on the pathway to a permanent residence visa for the doctor. 

 Stage One: Standard Business Sponsorship

 To obtain approval as a business sponsor from the Department of Immigration and Border Protection (DIBP), you must be able to satisfy DIBP that your practice meets a number of criteria that include the following:

  1. That the medical practice or hospital is financially sound
  2. That the medical practice or hospital is committed to training Australian citizens / permanent residents.
  3. The medical practice or hospital must be able to prove that:
    • it spends at least 1% equivalent of its annual gross wages bill on the training of its Australian citizen or permanent resident employees OR
    • it pays at least the equivalent of 2% of its annual gross wages bill into an Industry training fund or approved scholarship fund.

There is some flexibility/elasticity built into the training benchmark requirement. This means that even if your medical practice or hospital does not meet the training benchmark requirement today, it is often possible to take a few steps that will enable your medical practice or hospital to meet the training benchmark requirement at the date of application. The details of what spending can be counted towards meeting the training benchmark changed on 1/7/2017. Contact Us for more details.

 Stage Two – Nomination

 The position to be filled by the overseas employee must “Nominated” by the medical practice or hospital. The position must be full-time and approved by DIBP. This can be a complex application.

Stage Three – 457 Visa application

 The prospective employee needs to make an application for a 457 visa if they don’t already hold one. If the doctor already olds a 457 visa, they can begin working for the medical practice or hospital which has nominated them as soon as the new nomination is approved. To be eligible for a Subclass 457 visa, the nominated employee will need to demonstrate that he or she:

  • has been nominated by an approved sponsor (the medical practice or hospital)
  • has the skills to match the approved nomination (for instance if you nominate a General Practitioner, then the doctor must have the necessary skills and be eligible for registration as a GP in Australia)
  • meets health and character requirements
  • meets English Language proficiency requirements, (which in the case of medical practitioners are the same as the english language requirements for registration)
  • has suitable private health care / Medicare cover/Reciprocal health care cover

 Some of the supporting documentation can take several weeks to obtain, for example, evidence of professional registration (or “in principle” registration)

Wherever possible, the supporting documents should be obtained prior to lodging a visa application.

Once the visa application is approved, the employee must work for their sponsor whilst the visa remains in effect. However there are certain provisions which apply to doctors which allow them to work under a contract arrangement or take on additional work (such as private patients) outside of their normal working hours with their sponsor. 

Note: There is no age limit for the applicant in this visa subclass.

Sponsorship Obligations

All sponsors of Subclass 457 visa holders (457 sponsors) are required to adhere to a set of Sponsor Obligations

Permanent Residence Options – Employer Sponsored

Doctors who want to stay in Australia may have several different visa options, dependent on a number of factors. The table below shows which visas are available to the various medical professions and specialisations. Many of these visa options can be accessed by the doctor independent of the medical practice or hospital, however there are two options which do involve nomination by the medical practice or hospital:

Employer Nomination Scheme Visa (Subclass 186) requires that the doctor is nominated by an Australian medical practice:

  • they must have the level of registration required to perform the duties of the position for which the doctor is nominated* 
  • they must be a full time employee of that medical practice or hospital (direct entry stream)
  • they may be a contractor or a full time employee of that practice (temporary residence transition stream)
  • The age limit for this visa is 44 at time of application. There are certain exemptions for Doctors (see below)

Regional Sponsored Migration Scheme Visa (Subclass 187) requires that the doctor be nominated by an Australian medical practice or hospital in a Regional part of Australia (as defined by the Department of Immigration) :

  • they must obtain Regional Certifying Body (RCB) approval for the Region where the medical practice or hospital is located
  • they must have the level of registration required to perform the duties of the position for which the doctor is nominated* 
  • they must be a full time employee of that medical practice or hospital (direct entry stream)
  • they may be a contractor or a full time employee of that medical practice or hospital (temporary residence transition stream)
  • The age limit for this visa is 44 at time of application. There are certain exemptions for Doctors (see below)

*EXAMPLE
A hospital has nominated Dr Smith under the Employer Nomination Scheme with the full understanding that the applicant is the holder of ‘Limited registration – Area of Need (Supervision Level 4)’. For the purposes of this visa program, Dr Smith is, at time of application, the holder of a licence and/or registration that enables him to perform the duties of the occupation in which the hospital has nominated him. Based on this, the applicant is considered to have met the licensing and/or registration requirements for the occupation of Medical Practitioner. (This is an abridged version of DIBP policy)

Age Exemptions for Doctors

Applicants for Subclass 186 and Subclass 187 who are not required to be below the age of 45 (Direct Entry Stream) or 50 (TRT Stream) at time of application must meet the following requirements:

  • The applicant must be a Medical Practitioner (ANZSCO Minor Group 253)
  • the applicant must have been employed as a medical practitioner for a period of at least four years immediately before applying for the Subclass 186 or 187 visa.
  • during that period the applicant must have been a holder of a Subclass 457 visa
  • the applicant must have been employed in regional Australia for at least two years during the period of four years
  • the nominated position must be located in regional Australia

If you were previously the holder of a Subclass 422 visa, contact us

Questions?

If you have a question, please join our FORUM