10 year moratorium for international medical graduates (IMGs)


Advocacy Position statements Health systems and environmental 10 year moratorium for international medical graduates (IMGs)

1. Background to the Moratorium

International Medical Graduates (IMGs), including overseas medical students, first registered with an Australian medical registration board on or after 1 January 1997 are not able to attract Medicare benefits for their services for a minimum period of ten years, unless they hold a section 19AB exemption. A section 19AB exemption requires IMGs to work in a district of workforce shortage (DWS) in order to access the Medicare benefits arrangements. The determination of DWS is made by the Department of Health & Ageing (DoHA) and relates to whether a particular community has less access to general practitioners than the national average. This regulatory arrangement is known as the “10 Year Moratorium”.

A “Section 19AB exemption” refers to Section 19AB of the Health Insurance Act 1973.

2. Position of the RACGP 

The Royal Australian College of General Practitioners (RACGP) and its National Rural Faculty acknowledge the severe rural doctor shortage in Australia and the valuable contribution made by international medical graduates to rural communities. However, for some doctors working in Australian general practice under the 10 Year Moratorium, there have been no entry standards applied at a level acceptable to the RACGP, and no universal requirement to participate in continuing professional education activities.

The RACGP calls on the Federal Government to ensure that medical practitioners who are working in Australian general practice but are not recognised general practitioners are better supported to prepare for RACGP Fellowship and are working to the same standards as apply to Australian Graduates including:

  • standards of supervision
  • standards for continuing professional development.

The RACGP has never supported or endorsed the 10 Year Moratorium and believes the policy needs review.

3. Background to the RACGP Position

The need for consistent general practice standards 

The RACGP believes that the core of general practice is the same in all clinical contexts, as described in the RACGP curriculum and well supported in the literature. However, this core is practiced in widely differing clinical, community and geographic contexts, and each context imposes its own unique demands.

For over 50 years, the RACGP has provided or overseen a program of education with a view to equipping medical practitioners with the skills and competence to provide high quality unsupervised general practice care. 

The RACGP has demonstrated that general practice is a distinct and unique specialty (recognised by the Australian Medical Council) and the education and training program standards leading to Fellowship of RACGP are evidence based, reliable and valid. 

The Federal Government legislated in 1996 that all Australian graduates seeking recognition as general practitioners are required to gain recognition through the attainment of Fellowship following structured, robust training and assessment processes.

The RACGP also provides advanced training options including the Fellowship of Advanced Rural General Practice, and certification of procedural skills for doctors wishing to increase confidence to practice in rural and remote locations. 

International medical graduates working as GPs

The federal government has been actively recruiting doctors trained overseas since the late 1990s to overcome medical workforce shortage; very often from countries in which there is no established equivalence between Australian and country-of-origin professional standards or qualifications. 

Some IMGs affected by the Moratorium are working in areas of isolation with little support or adequate supervision and some enter practice without appropriate orientation to Australian general practice, the Australian health care system, or Australian culture. While many IMGs provide high quality medical care to their communities it is often without adequate professional support.

As a consequence of the 10 year moratorium doctors without appropriate training or supervision may be working in areas that offer the least professional support.

The RACGP calls on the Federal Government to ensure that medical practitioners who are working in Australian general practice but are not recognised general practitioners are better supported to prepare for RACGP Fellowship and are working to the same standards as apply to Australian Graduates including:

  • standards of supervision
  • standards for continuing professional development.

Rural communities deserve the same standard of medical care as any other Australian community.


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10 year moratorium for international medical graduates (PDF 36 KB)