After training, somehow in practice OTDs are only restricted to the Areas of Need (maybe the state's need trumps the DWS designations? I dunno).
this is concerning to me. i question if the state government has the power to do this. i have realized since i've been here that what is written on paper is not necessarily how things are done, but usually reality is somewhat easier that the written rules and what you are saying suggests reality is harder. the moratorium is a federal law. unless the state has it's on law regarding this, it shouldnt not be enforceable and if it does have its own law i'd be surprised it has not been challenged and overturned already.
To be clear though, sydbd, your partner wouldn't be prevented from private practice for the moratorium period, just private practice that's not in an area of shortage (whether DWS or Area of Need).
to be clear, the federal law regarding the moratorium has nothing to do with areas of need. OTD's must work in areas of need until they gain unconditional registration. however, under the current law, the moratorium doesnt start until the OTD gains unconditional registration anyway, unless they gain PR after unconditional registration - then their moratorium starts when they gain PR.
My partner is currently on an anaesthetic-ITU training rotation here in the UK and would like to specialise probably in ITU but how, as an intensive care consultant (once he is one!), would he be able to work in a small outback town in order to get this moratorium down to 5 yrs??
the simple answer is this will be difficulty, maybe impossible. the moratorium can only be reduced to 5 years by working in the most rurally classified areas. these are basiclly considered remote. being so remote they are unlikely to be seeking anything other than GP's. however, the there are certainly less rural areas which would provide a reduction of the moratorium and would have jobs for other specialists. but they will not provide the maximum reduction. as noted above, things are not always how the rules are written here. in the past there have been formal ways to reduce the moratorium to as little as 3 years. they may still exist but i think they specifically required you to be a GP. i've heard of people having their moratorium reduced to 1 year. again, it is dependent on how rural you go, so these people most have been willing to work in some extremely isolated locations.
This link here is the one confusing me
http://www.health.gov.au/internet/ot...dard+pathway-2 as it says that a specialist can ask to be assessed and it only mentions anything about needing to work in an 'area of need' IF the applicant "is assessed as not equivalent" to an Aussie-trained specialist. It then also says "If the OTS will be treating private patients in the position, he/she will need to understand Medicare provider number restrictions and obtain specialist recognition for Medicare billing purposes" and doesn't mention anything about a moratorium. However, I can't seem to find any more info on what obtaining 'specialist recognition' entails so maybe that explains it more.
if an OTD wants to work as a specialist and recieve reimbursements from medicare, they will have to pursue a path to fellowship in Australia in that specialty. under the medicare laws, a doctor must be a fellow to get a medicare provider number, which allows them to bill medicare for services rendered to patients eligible for the medicare medical benefits scheme (exceptions noted below). if a doc does not have a medicare provider number, his/her patients cannot use medicare to pay for services rendered by him/her, and as such it will be very difficult for him/her to attract patients and make a living as most patients would prefer to go to another doc for which they can use medicare because it will save them a considerable amount of money. in fact, while i think it would be generally feasible to work without a medicare provider number so long as you could find enough patients to earn a living, i believe a condition of OTD's conditional registration or their temporary visa is that they gain fellowship within 5 years (or something to that effect; that may be just for GP's; if there is a similar requirement for other specialists the duration would likely be different given the training length of specialties vary). keep in mind there are exceptions for working in areas of need, public hospitals, and clinics: OTD specialists can get a provider number without being a fellow of specialist college if they work in these places.
so an OTD will need a medicare provider number and will need to either be a fellow of a specialist college or work in an area of need or a public hospital or clinic. in the first case, being a fellow, they will need unconditional registration. in the other two cases, they will need to have unconditional registration. gaining registration will require one to first apply, and doing so as an OTD specialist will entail applying to the AMC through the specialist pathway, which is described in the link you provided. it is my understanding that the AMC does not actually undertake the assesment of specialist, though application generally must be through the AMC if you are an OTD. the AMC forwards the application to the relevant specialist college and they will assess whether the applicant's training and experience is considered equivalent to the training of an Aus trained specialist in that field. if it is deemed equivalent they will be eligible for unconditional registration and fellowship is fast tracked to the point where it may only be more paper work. if it is not deemed equivalent they will not be eligible for unconditional registration and will have to undergo further training and/or supervised practise. however, they will likely be given conditional registration similar to the registration interns have. with conditional registration they can complete the required further training/supervised practice. once they meet the requirements for unconditional registration they can then switch from conditional registration to unconditional registration. until one gains unconditional registration they are not subject to the moratorium, instead they must work in an area of need.
i recognize what i just wrote was long and possibly quite confusing. i invite anyone to correct any misinformation i may have given and for additional questions. i always try to emphasize it is best not to rely on info on this forum as if it were 100% correct. it is always best to double check, but i think what i have provided is correct.
