10 Year Moratorium

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dude, go look up racism in a dictionary. i'm from a background similar to many australian natural born citizens and i would be subject to the moratorium. it has nothing to do with my race.

and 'new' citizens should be discriminated against in the name of well-being of the rest of the pre-existing citizens.

thats life. a lot of people dont like it because it is a barrier. it is a barrier to me. but it is in place for important reasons. people in the bush are much more desperate for health care than those in cities. thus they make people work there.

i suggest you do a lot more research and reading before you post on this topic again.

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The australian policies are not any better or worse than the US american or canadian policies. In the US, foreign trained docs are often forced to practice in areas of need (called 'medically underserved' or 'healthcare personnel shortage areas' here) for a period of 3 years after they graduate residency. If you go to a different country to practice medicine, you have to deal with the rules the locals come up with. In most countries that import physicians, you are limited to the crumbs that the locals don't want (at least initially). Get used to it.

I am sorry to inform you but the Australian system is the worst in the world. Even after you become a citizen, you are discriminated against for 10years. Even if you do all your medical studies in Australia, and your internship, and become a citizen you cannot work in area of choice for 10 long and painful years. In effect this makes a distinction of a citizen who is not born in Australia and one who is. This is totally wrong and such a system should never be supported.
 
Well, people going to AU for medschool schould know it to the extent that you can't count on immigrating into the country afterwards.

Anyone putting this 'information' out here should also be honest enough to inform people that:
- you don't need a medicare # in order to go through specialty training
- certain employed physicians in public hospitals are able to bill medicare under their hospitals billing #
- 'areas of need' which are exempt from the moratorium are plentiful in AU and certainly not limited to the outback or rural areas.

The australian policies are not any better or worse than the US american or canadian policies. In the US, foreign trained docs are often forced to practice in areas of need (called 'medically underserved' or 'healthcare personnel shortage areas' here) for a period of 3 years after they graduate residency. If you go to a different country to practice medicine, you have to deal with the rules the locals come up with. In most countries that import physicians, you are limited to the crumbs that the locals don't want (at least initially). Get used to it.


This is just not the case. Australia does not have a term for "new citizens". You are either Australian with Citizenship or you are not. There is not catogory for "new person", "new citizens".

Further despite what you are being told here you will have to work 10 years in an area of workforce shortage which if you look at a map of Australia involves very isolated places that can days to reach the city.

Further if you look up the dictionary for racism you will find it is wher one racial group thinks they are superior to another.

eg Australian born citizens to people who are not born in Australia.

As my partner works in the medical workforce unit of a large major hospital in Melbourne he has the taks of telling people who are suprised, that they cannot work in Australia where they chose for 10 years once there internship is over, as they were not born and became a citizen at the after they started medicine.

Further the Patron of the Rural Doctors Association is Time Fischer, the former leader of a right wing farmers political party.

People who come to Australia and become a citizen should not be treated different from people who are born in Australia.
 
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I cannot help but agree with jaketheory on this one.

The ten year moratorium is in place because it benefits people in underserviced areas. Sure, we can argue about the ethics of this forever, but the aim of this legislation is ultimately to ensure social well-being for a portion of the population that would otherwise not receive adequate health care.

Within the ten years, you still are able to work within the public health care system, just not as a consultant with your own private clinic. For some people, it can mean not as lucrative a salary, but nevertheless you still make a decent living (quoting another forum member "a FP in Tasmania makes ~$250 000 a year).

As for the comment that the Australian system is the worst, other countries also have similar legislation. I believe that in Canada, most provinces have a return of service clause. If you are an internationally trained physician, EVEN IF you are a Canadian citizen, you still must serve the number of years equal to the duration your residency training in an underserviced area. So you see, this discrimination is not just present in Australia.

Finally, please go to wikipedia and look up racism. http://en.wikipedia.org/wiki/Racism
There you go, did all the work for you.

Cheers!
 
You are exactly right. It is a penalty as you were born overseas. As an Australian it is disgusting to me. Most workforce places are in very remote areas. You have an increased workload as a result of this penalty compared to doctors who are born in Australia.
 
You are exactly right. It is a penalty as you were born overseas. As an Australian it is disgusting to me. Most workforce places are in very remote areas. You have an increased workload as a result of this penalty compared to doctors who are born in Australia.

You might want to actually look at the underserved area maps. Many of them are actually quite close to population centers.
I looked into moving to AU a couple of years ago and the deal seemed to be pretty straightforward: You work in the public sector for 10 years (or even shorter if your state goverment sponsors you), afterwards you are free to compete in the private market.

Some of my medschool classmates went to AU. The picture they give me doesn't jive with your claims of racism and drudgery in remote desert locales.

And again. Every country that imports physicians has their own little rules to either benefit local candidates or to fulfill health policy objectives. The AU rules seem to be a bit dated and probably counterproductive in todays environment, as an Aussie citizen feel free to lobby your legislator to change them.

PS

Just some general rules regarding life in general:

- It's not fair.
- You pay taxes.
- You die.
 
Not many GP's in remote areas earn $250,000. Those that do would have work like a dog. The money does not justify discrimination. Anyway go have a look at our tax rate in Australia. You would pay half in tax, then what little life you have left would involve travel to see your friends and family, that would take up more.
 
F_W,

Poeple on this Forum have written about working in Alice Springs which is the desert town in the middle of Australia. I appreciate that most doctors by nature want to help the community they work in. This leglislation in Australia has lead to a great fall in the medical workforce since it was introduced. If people like you or other doctors or students do not write to our government then we might end up with a 20year monotorium instead of a 10.

Cheers,

Dave

Yes life is unfair, but 10 years working in a remote area of need is just to big a part of anyones life.
 
Not many GP's in remote areas earn $250,000. Those that do would have work like a dog. The money does not justify discrimination. Anyway go have a look at our tax rate in Australia. You would pay half in tax, then what little life you have left would involve travel to see your friends and family, that would take up more.


Sorry but do you have actual experience with this? I've done a lot of placements all around the country, and now that I'm working I've been looking into GP programs pretty hard, so I'd like to think I'm uptodate with the latest stats:

1. The average salary for a GP to most areas is around 200K now. Typically you earn about 70-75% of what you bill the practice. I have access to general practice journals that have job postings, and most salaries start at the $200K range, with quite a few in decent locations around the $250K range.

2. No one works more then 8 hours a day, 5 days a week. Some rural areas have on calls, and some hospital based work, but it's usually optional and not compulsory. A large majority of GPs only work part time. That is the trend, and even with the new graduates coming in, there are still going to be plenty of jobs simply because of the increasing number of people who are actually choosing to work part time.

3. Owning a practice is a lot more lucrative, then working under a salary. Depending on how "hard" you work the earning potential is great. It also depends on how good you are at business. There are plenty of things you can do to increase your earnings (ie. Medication reviews $110 in your pocket for a simple referral to a pharmacist, 1 home visit increases your medicare rebate for all your patients by 25% per year, mental health plans, care plans etc. all of which a nurse in your practice can do.) I have lots of little anecdotal things that can take a GP salary much higher then a general physicians salary (but not a general surgeons). However a lot of doctors are simply not good at business, and that's why their earnings are poor - but maybe they are happy with those earnings.

4. Working as a GP registrar you are looking at a salary of $100K - $150K plus depending on your area you are also entitled to a Rural Practice Incentive Scheme. This can vary between 60K over three years, to as much as $240K (on top of your salary). Please tell me any other country where even non-citizens (ie international doctors) can earn that much. In countries like Canada, citizens (who are IMGs) can't even get a match in FM let alone earning that much.

Link:
http://209.85.173.104/search?q=cach...FAQ&hl=en&ct=clnk&cd=1&gl=au&client=firefox-a

Unfortunately I can't seem to find a proper version of this document, but I have a hard copy of this at home. It basically outlines the new (increased) sliding scale payments (which are now outdated on the department of health and ageing website) as well as the inclusion of RRMA 3 zones for RRIPS and people under the moratorium. This includes areas around metropolitan Brisbane, as well as Melbourne. Basically any population centre with a population <100 000
 
Just want to say thanks for all the info you are providing on this thread an others...not sure what that other guy's problem is but I find your posts to be extremely helpful!!!
 
Sorry but do you have actual experience with this?

<100 000


Actually I do have experience. My partner has worked in Medical Workforce Units for Rural and Country Hospitals. In most rural areas doctors at GP clinics are oncall to country hospitals. We are living in a rural area at the moment and my partner is working at the hospital. They do get calls at all hours and have to go to the clinic and do a full day the next day. This is the case in most country hospitals but I am sure not all.
Is the money really worth 10 years of your life? I think it is wrong to penalise doctors who are not born in Australia based on their place of birth. I think discrimination should only happen on ability.
Anyway, here are some facts about the moratorium.
1. The recent restrictive changes were made by the Liberal National Party who have been in power for years in Australia and only recently lost the last election. They were closely linked to several extremist religious cults.
2. The person who prepared the report on the moratorium for the government was Dr Bob Birell (not a medical doctor). He has also made major contributions to the Australia Family Association who makes it there mission to get doctors who do abortions etc. They are run by The Festival of Light. Go check there website http://www.fol.org.au .
3. Recently Bob Birell has been going on about the doctors in Australia form "Third World Countries". They "Dubious standards in medicine". Of course he could not actually name any country specifically or where the problem was, but the usual foreign doctor scare stuff. He has also turned his attention to the bad English of Foreign workers in Australia.
4. Amongst other things the 10 year moratorium places doctors who are born overseas and do all their study overseas in remote areas with the least amount of help and supervision. This is just plain wrong.
5. I think we can say that after almost 30 years, and the recent changes not working, the legislation has been an utter disaster as there is a lack of doctors in the city and country. Many GP clinics in the city areas are now closing their books to new patients. Much has been written about the doctor shortage only in country areas and Bob's report has been attacked by many doctors as simply not stating the facts.
Well I do have a problem with my fellow Australians being discriminated against, and this is what the Moratorium does, secondly it actually reduces the amount of GP's. Many people my partner worked with chose to stay in the hospital system rather then become a GP which was their first choice. As all hospitals are areas of medical workforce shortage this has been a good option for many as they can choose where to work based on ability, and not where they were born. They can also freely live where they chose, not the government.
 
foreign doctor scare stuff?

how about Dr. Death, AKA Patel.

And if you think the country areas have it rough, with your partner having to work such hellish hours, just think how bad off they would be if they could not make the foreigners work there. like i said, there is a real reason the moratorium exists. simply because you dont like it and it cramps your style doesnt mean its wrong and it should or will go away. why do you think they make foreign docs work out there? because they are in desperate need for them. your present case simply illustrates how badly help is needed out there.

what? you want to abandon everyone in country and rural areas and leave them with no health care at all for hundreds of miles away? what makes you, a foreigner, so much more valuable than a born and bred australian living in the country? i certianly dont think they should bring foreigners in and give them the same rights as natural born citizens if they could not care the least for the well being of the other citizens of the nation.

yes, there are problems. but looking the other way and running away sure will not help the problem go away. sounds like what you want to do.
 
what? you want to abandon everyone in country and rural areas and leave them with no health care at all for hundreds of miles away? what makes you, a foreigner, so much more valuable than a born and bred australian living in the country?

Well Jake I am born and bred in Australia, in a country town where the there was a post office and that was it. Sorry to tell you that. Sorry for talking about a ban on fellow Australians choosing where to work if they were born overseas. The Australian Medical Association has written to me saying they do not support the discrimination and see it as counter productive to getting doctors to fill the medical workforce shortage. I guess I am not alone!

There are many ways to get doctors into the country. For examply currently we rotate city doctors to country hospitals to fill country hospitals with great success. It is not perfect and GP's have to be called out but prior to this there were almost no doctors at country hospitals. Next year we will have flood of doctors for this as the local training places have been increased.

You can also limit the medicare provider numbers for GP's in the city and distribute them in country more evenly.

Secondly you can setup GP clinics in country hospitals. The governemnt has been trialing this with great success. Doctors can be rotated from the city for this.

Thirdly you can pay more. Why should doctors not get paid well for working in remote areas? Minning industry people with little skills get over a $150k and accommodation and meals paid for. Pay more you get more. Simple.

Fourthly some organsations are looking at two weeks on, and two weeks off. Flown in like in other remote industry in Australia.

But all this is another topic. You can call it How to get doctors to rural areas in Australia. I am telling you it is wrong to discriminate. And with the doctor you mention in the rural area who has been accussed of stuffing up, further makes the point that people need help and supervision who are new to Australia working in medicine, and not placed in remote areas such as this doctor was without almost no supervision. It was a nurse who had to raise hell over this person.
 
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The 10 year Moratorium is more a way to protect established consultant physicians from future competition. Despite a lot of talk most of the "physician shortage" in Australia is mostly in regional areas of the country. Most of the large cities are adequately serviced by physicians.

I think there is one way out of the 10 year service rule. I believe a doctor has to work in a specific region of Australia for a year or two. Despite this many international students complete internships and registrar training in big cities. The 10 year rule excludes you from private practice for that set period of time.
 
Many interns who are thinking of becomming a GP in Australia and are subject to the discrimination, get out of the the 10 year ban by not becomming a General Practioner.

The rules make it so you have to work in an area of Medical Workforce Shortage. All public hospitals are areas of Medica Workforce shortage. If you do something else such as become a basic physician register, you can work freely accross Australia at any public hospital that holds those positions.

Overseas trainned medical doctors can also do this.
 
imageblue. i dont get you. your last post points out that OTD's can work any where including big cities so long as its in a public hospital. if this is true, it doesnt sound like you have that much to complain about. if you dont like the rural areas, simply look for a position (or your partner) somewhere else in a public hosp. no?

and i think some of your ideas about how else to get docs out to areas of need are logical, i might question whether they would be sufficient to fill the void. it was my understanding that GP's in those areas already get paid handsomely.

and dont get me wrong. im not actually a supporter of the moratorium; its a thorn in my side too. just felt you seemed hysterically opposed.
 
Hi Jake,

I know I can come across as screaming nutter but this discrimination has been a disaster for the medical workforce shortage in country areas, especially where I live.

I think the confusion you have is in Australia you can become General Practitioner (GP). You might in America etc refer these people as Physicians; In Australia Physicians work in hospitals not medical clinics in the community. We call the medical clinics in the community GP clinics, as General Practitioners work there. Go to http://www.racgp.org.au/ for information about this training program.

Normally if one is sick, unless it is an emergency, they go to a medical clinic and see a GP. In my rural area several women have died of cancer as they did not get a lump checked out due to the lack of GP's. It was all to hard for them. The 10year ban on doctors who become a GP has been a disaster with many people choosing to work in the hospital system and do things like basic Physician training.

The discrimination sends people out of medicine, or they seek to work in hospitals, anything but becoming a GP. That is why I am so angry about the moratorium. It has not worked and has only made things worse. Like I said GP's in country areas should get a paid a lot more, and given a lot more support. The overseas doctors that stuff up are often in remote areas without support or supervision. I think we all would make a lot of mistakes in those situations.

I hope this clarifies things.

Cheers,

Dave
 
Ok,

I think there is a lot of misinformation and confusion on this thread, so I'll try and set the record straight to the best of my knowledge.

1. I've done a rural elective in Tennant Creek an outback town of <10 000 (closer to 5000) there was not a single on call for any of the doctors there. They worked purely 9-5 hours, and even had an hour (paid) lunch. It's unfortunate your partner is on call that much, but trust me you can simply move to another rural area, they'll be jumping for you to come out there.

2. These places not only pay handsomely, but offer incentives such as a "free house (ie no rent)" electricity, car, fuel etc. included. Some even offered free flights every year to a place of your choice. Not all places are like this, but there are quite a few out there with very attractive packages. That is in addition to the tax free benefits you get for being out there (ie. the tax free Zone 3-7 laws) + the RRIPS.

3. The 10 year moratorium does not mean you have to work in the outback. There are plenty of nice places you can work - ie. Geelong. 70Kms from Melbourne 200,000 and area of need. These are places where people can afford to live as well, so most likely you would have been working there anyway. Who can afford the prices in the CBD anyway? The point is that I've found lots of these little gems of places that are in "need". It's not easy and you have to do a lot of research, but the onus is on you to do the research!

4. This is not an escape route for non GPs. Trust me the 10 year rule applies to anyone. However specialists probably have a lot more of their time absorbed by the 10 year moratorium, because of their longer training programs, but when they complete their training, they have to work in a public hospital, or move to an area of need, just like GPs.

5. America (and for that matter Canada) also discriminate against their IMGs. In America if you don't have a citizenship you have to get a J1 waiver, meaning you have to work in a rural/under served area for 5 years, or you have to go back to your country for 2, and then try and get back to the US. Canada also does the same thing now with IMGs who get a match for most training programs. 1 year training = 1 year rural service. They don't even pay you extra for going to the bush. These countries have a right to insure that their patients get doctors where they are need most. I don't think that this policy will change anytime soon, especially since most cities do not have a shortage of physicians.
 
Serving in specific regional areas will allow you to cut the ten year moratorium to a year or two. I don't think this is that big of a deal. A lot of former internationals where I am are undergoing training in a big city, Brisbane.

I have to add the Aussie racism thing is a bunch of nonsense and garbage. I love how people like to use the racism excuse whenever something does not go their way. People who label Oz as racist have obviously never been to other places, there are a lot of countries in Asia and Europe, even Latin America which have far more serious racism issues.

In many parts of Europe and in Asia, racism is far worse. I can name a number of countries where if you are "foreign" they won't even let you enter certain establishments.
 
I came across this forum tonight and read some of the most in depth discussions on the 10-year moratorium I have seen!

I am not going to repeat all the things that have been said before, as most are quite accurate and insightful. However there are a couple of points I can add to the discussion.

I am a senior resident doctor who is subject to the 10 Year Moratorium. Almost all of my colleagues who are in this situation get around this by doing specialist training, as most specialties require at least 7-8 years of post-graduate training.

Personally I am managing this problem by doing a few general years, then hospital specialist training, as well as a PhD. By the time I finish all these my 10 years would have lapsed. This is despite the fact that I probably would have chosen family practice as my number one career choice, which is too bad, as this country needs more GPs. Moving to a rural location is not a location for me because of the type of work my partner is doing is not available outside capital cites. I had to choose between my work and relationship. I chose my family and relationship.

There is a lot of discussion on whether the 10-year moratorium is a racist or discriminatory policy. There is NO black and white answer to this as those concepts are rather subjective. Personally I don’t think this is a case of racism, as many of my Caucasian colleagues who are from the UK, Ireland, New Zealand and South Africa are also subject to the same rule. Like most people they are getting around this by doing hospital specialist training. Therefore this rule is not racially specific.

However, is this discriminatory? It may be, depending on your point of view. The reality of this rule is that I am limited to where I can live and work not by demand, but arbitrary by the government. The government, and not the market, is telling me where I can live and not live. The government is making rules that are indirectly impinging on my freedom. (Although I can in theory practice as a GP in city with getting Medicare rebates, the reality is that no one would come and see you.)

Australia does not have a Bill of Rights. But I would imagine this rule might not stand up against the Canadian Charter of Rights and Freedom’s “freedom of mobility” clause, as the government is limiting a physician rights to choose where to practice. However I would imagine the government could defend this by using rural residents “rights to medical care.” As it is often the case regarding Charter of Rights the decision, at the end of the day it’s about balancing the rights of different individuals and stakeholders. (Obviously Canada has similar laws requiring overseas doctors to work in rural areas, but I am not aware of any constitutional challenge on those laws.)

The other point that hasn’t been touched on is the existence of “Bonded Medical Places” (BMP) program in Australia. Initially these places have a $22000+ per year scholarship attached to it (eg the government pays you money during your medical studies), but MOST places nowadays do not attract a scholarship. At the commencement of medical school, the student has to agree (by singing a legally binding contracting) to work in an area of need for the duration equivalent to the medical course, which is 4-6 years, after graduation There are currently 500 MBP per year (or about 2000 total, about 20% of all medical school places).

Unlike the 10-year moratorium you can’t get around this by doing hospital specialist training, or spend time doing a PhD. You actually have to train and work in an area of need for 4-6 years. However the MBP requirement is obviously much shorter than the 10 years.

All people who sign up for these MBP places are Australian citizens and permanent residents. This further supports the case that the 10-year moratorium is not racism. Even though former overseas students do not have to sign a contract, most should have been aware of 10-year moratorium prior to the start of the course. This information is public information.
 
I want to add that in addition to the 10 Year Moratorium and BMP (the sticks), the Australian government has put in countless programs (the carrots) to attract doctors to rural and remote areas. This is not an exaggeration:

-National scholarship programs for rural high school students
-National scholarship programs for general students to do rural electives
-Easier entry to medicine (or “access schemes”) for student of rural or indigenous origin (eg cut off entry scores in medicine for rural students are much lower than for city student)
-Special medical school places “reserved” for rural students
(It’s interesting to note that the above programs do NOT bond students to rural practice. In fact many of my friends who got these scholarships ($50000+) or access places, see these programs as a “ticket” for them to get out of their rural towns!

-Mandatory rural rotations for students
-Mandatory rural rotations for doctors
-Funding for numerous rural health organizations
-Creation of student rural health clubs
-Creation of 14 rural clinical schools and university department of rural health
-Creation of numerous state rural workforce agencies
-Allowing overseas doctors who have not pass the required exams in work in AON/DWS (bad doctors are better than no doctors!)
-“HECS” reimbursement (eg canceling student debt) in exchange for service in AON/DWS
-Establishment of the Australian College of Rural and Remote Medicine, which can award postgraduate GP qualifications
(AON=area of need; DWS=districts of workforce shortage)

and many more....

Compared to Canada, Australia has done so much for rural health, and yet we still have a shortage.

To me there is only one solution.

Australia has a mining boom, and in order to attract workers to these remote areas, workers get paid a lot to move and/or work in these areas. For instance, non-professional people such as bricklayers, cooks, cleaners, and truck drivers can EASILY earn in excess of $100,000 per year, by the most conservative estimates. Obviously professionals make much more.

Many workers also have a 2-weeks-on, 2-weeks-off roster, meaning they can still spend time with their family. This is how Australia is fixing the worker shortage crisis in remote areas, including for all professional groups such as engineers and dentists, as well as for non-professionals.

And then there is medicine.

Yes there are incentive payments. But trust me, they don’t come close to what’s offering in the private sector. The bottom line is that rural doctors attract essentially THE SAME Medicare rebate as city doctors. (Only exception: if you bulk-bill a child or pensioner you get a $2.5 more than what a city doctor would get!)

There is certainly no 2-week-on, 2-week-off roster, as a sole GP may even be expected to be on-call 24/7!

If you ask any economist, or anyone with common sense – the obvious way to fix this problem is to do what the private sector is doing, by offering differential rebates, or loading to the current rebates, to doctors practicing in rural and remote areas. This is to compensate for social, family and professional isolation. This is fair.

If it works in all other fields (even dentistry, optometry, public service, police), then why not for medicine?

Can anyone see any problem with my proposal?
 
Hey, don't confuse people with factual information here.
 
Hi everyone,

I have some great news and not so great news. A senior government Minister has written to me informing me that in the spring session of Parliament the ban will nolonger apply to my partner, who is a New Zealand Citizen and an Australian Citizen, who has left medicine due the ban on him being able to work freely as other citizens can. They expect that the changes will not be delayed, so my partner can work freely as a GP and return to medicine. This will effect all New Zealand doctors who are working in Australia, or thinking of doing so.

The not so great news is that this will only apply to doctors in my partners situation who hold a New Zealand Passport and would normally be subject to the ban.

If you do not agree with the laws as I do not then write to the Health Ministers whos email address I have posted on here, write to the GP school, and as many people that can have an impact on this as possible.

Cheers,

Dave
 
Many people have written to me asking when the changes will take effect to end some of the discrimination against people like my partner. I was initially told in the Spring session of parliament. The latest I have is in the link below.

http://www.6minutes.com.au/articles/z1/view.asp?id=503067

I hope this helps. When in opposition Lindsay Tanner, who is a Federal Minister, wrote me telling me about how disgraceful the situation of the Moratorium was for my partner. To get him to tell Nicola (the Health Minister) to change it, I had to remind him of that little email that I kept. Now he is in government, and I assume wants to be Prime Minister one day, so he has moved to change it.

I hope the government changes it for everyone, but Lindsay has only said it is for New Zealanders as my partner is New Zealand Passport holder.

I do not mean to be selfish but I have stopped the battle as I had a victory for my partner.

I hope you all write to Nicola and still keep the pressure up. Even write to Australian News Papers. Every bit of action will help end this discrimination. Our Federal Equal Opportunity said that it is discrimination but would have to be argued in a Federal Court. The government has more money then I do so I could not go down that path at the time. It has taken me years to get this changed but I have been a lone voice. The AMA is trying to take credit for this but they have been very unhelpful at the time of pushing for the changes. If you all start writing then I am sure you can get the moratorium buried where it belongs. You have to remember it was introduced just after the White Australia Policy ended where people could only migrate to Australia based on the colour of there skin. The year it was introduced was 1973.

Incidentally my partner is the Director of Medical Services so he has gone back to doing clinical work. It all worked out for us, I hope it works out for all of you.

Cheers,

Dave
 
The reduction of the moratorium to as little as 3 years is taking place this year depending on how rural you work. This has always been the policy, but it was always under the rug ie. it was organised by the area you worked in and wasn't easy to find on websites. Now that this is basically legislated (and therefore more transparent) the DH&S can basically recalculate your moratorium automatically based on where you worked.

BTW Like I said earlier in the thread, why was it such a big deal? I easily found a DWS area 20 minutes from the Melbourne CBD that I posted in another thread...this means it would have been exempt from the moratorium for your partner. Also s/he could have worked in any public hospital without any problem with the moratorium.

http://www.nswrdn.com.au/client_images/439730.pdf

http://www.rripa.com.au/LinkClick.aspx?fileticket=+kY7MY1aV30=&tabid=56&mid=736&language=en-AU
 
I just happened to see an article on this in the NZ Herald yesterday. They stated that it was for NZ citizens and residents, however that article posted earlier in the thread i states NZ citizens only. Can anyone clarify if this relaxation will be for permanent residents as well as citizens?
Cheers,
Jen
 
New Zealanders are to be exempt from the moratorium.

Others will be able to shorten the moratorium based on how rural they work. The moratorium period will also start as soon as full registration is obtained -- for former int'l students, after completing internship here; for IMGs, afte compleing the AMC process -- rather than the LATER of obtaining registration and Permanent Residency, which had been a real drag (extending things by 1-2 years). This will also be retroactive for those who are currently under the moratorium.

Back in October, Roxon anticipated the new rules would be in effect from April this year.

She also stated recently in an ABC radio interview that she agrees with the RACGP and ACRRM that foreign docs coming to Australia should not be sent remote, due to minimal support available to them, and wants to have them remain in regional centres (e.g., Bundaberg, Rockhampton or Townsville in Queensland) while under the moratorium. I'm not sure if/when that will translate into policy.

http://forums.studentdoctor.net/showthread.php?p=8789678
http://www.6minutes.com.au/articles/....asp?id=503067
 
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curious if this applies to Aus citizens/residents as well. i.e. aus citizens/residents that obtain their primary medical qualifications outside Aus or NZ. previously even Aus citizens that obtained their med degree overseas were subject to the 10yr moratorium, which i found ludicous. think if they did that in the US: all the US citizens going to caribean schools would have to work in the middle of nowhere for 10 years. those schools would go out of business!
 
This is rascism. The discrimination is against citizens of Australia who are of a different ethnic origin.

That's not what racism is.

It is certainly protectionism, as a discrimination against former non-Australians (their ethnicity, strictly speaking), and it is a double standard (having two distinct classes of citizens -- which btw someone should challenge in the courts), but there's nothing whatsoever about 'races' involved in the discrimination.

Might I suggest 'ethnicism' (as subtley distinct from traditional uses of nationalism).
 
That's not what racism is.

It is certainly protectionism, as a discrimination against former non-Australians (their ethnicity, strictly speaking), and it is a double standard (having two distinct classes of citizens -- which btw someone should challenge in the courts), but there's nothing whatsoever about 'races' involved in the discrimination.

Might I suggest 'ethnicism' (as subtley distinct from traditional uses of nationalism).

i am no sociologist, but i'd say the general use of the term racism includes discrimination based on ethnic background. and ethnicism has a different meaning. look it up.

i'm quite sure the contemporary scientific consensus is that there are no actualy distinct races of humans. from a scientific viewpoint, it is impossible to categorize people from different goegraphic areas into distinct 'races'. the wide consensus is that humans originated in Africa. hence the term racism must refer to ethnic background. some ethnic backgrounds happen to have more distinguishable physical attributes than others depending on the frame of reference: one 'black' ethnic group refering to another 'black' ethnic group would not characterize skin colour of that other group as a highly distinguishable feature of that group, but a 'white' ethnic group would.

you used the phrase "former non-Australians". this simply means not Australian by birth, right?. i think any behavior that disadvantages anyone not Australian by birth is surely racist. there certainly is no Australian race, and racism certainly exists in Australia even among those that are Australian by birth.

I'VE REALIZED I'VE LOST THE POINT OF THIS THREAD SO I APLOGIZE IF MY POST ARE STARTING TO SEEM CONTRADICTORY.
 
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Even if you don't believe there are people belonging to one particular race, that does not mean the term has no practical meaning. Anthropologists still refer to race (negroid, mongoloid, caucasian...) to discuss anthropological origins, just as it still certainly makes sense to consider people to have genetic/anthropological origins closer to one or more races (or some derivatives thereof) than to others, whether or not that's a simple, or politically correct, thing to determine.

For example, it is not terribly difficult to quite reliably distinguish between Australian Aborigines and Torres Strait Islanders based on their physical attributes, and the reason is that they arose from at least two separate migrations separated by about 50000 years, with the latter being considered closer to Melanesian. Such an exercise refers back to race.

Even if you buy into the argument that there is no such thing as 'race', it is not necessary to change the term's meaning in order to use it -- what matters when calling something racist is the attitude toward a reference (explicit or not) to race. If for example one says, "I don't trust them darkies", that is still a reference back to race, whether there is such a thing as a "darkie" race or not, and is precisely why such statements might be considered racist. Racism still relies on the traditional meaning of race.

On the other hand, if you don't believe in the term race and believe that it's irrelevant whether the perp believes he's discriminating against (while referencing) a race, then surely you can't in the same breath re-define race as ethnicity just so that you give the term some meaning: ethnicity already means ethnicity. Commonly confused or not, it is and has always referred to something else.

Take the OED's defn of ethnic:

"1. relating to a group of people having a common national or cultural tradition. 2. referring to origin by birth rather than by present nationality."

Discriminating against someone based on where they were born, or where they grew up, is not racism -- one is not said to perceive Canadian race or Australian race, for example; it is not racism (though may be counter-productive) to discriminate against Chinese immigrants as, say, a collective punishment against human rights abuses in China; nor is it racism to say, "I hate Australians, those footy-fanatical bogans". Both are discriminatory, the second is also a prejudicial judgment, but neither is racist.

The discrimination at hand is instead based on ethnicity in the traditional and formal senses of the word, and thus why I suggested ethnicism (not to be confused with its very different obscure meaning, which is why I suggested it, jaketheory).

This all assumes the discrimination against former non-Australians is deserving of an -ism at all. I think maintaining a careful distinction between ethnicity and race also highlights the distinction between discrimination [prejudice against a class], and the various -isms [beliefs in or implications of the superiority/inferiority of one group over/under another]. One does not logically imply the other, particularly when what's being discussed here is a prejudice, as in, "tendency to injure or impair" [a class], and not as in, "leading to premature judgment or unwarranted opinion".

For example, the American Heritage Dictionary eloquently alludes to both these distinctions in its usage examples for discrimination:

"Treatment or consideration based on class or category rather than individual merit; partiality or prejudice: racial discrimination; discrimination against foreigners."

My point is that if there's to be any -ism inferred from the discriminatory policy, it is not racism.
 
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Hey guys, do any of you know whether the 10-year moratorium affects oveseas doctors who come to Australia and are recognised there as specialists? My partner is nearly finished his specialist training in the UK, and we were thinking of moving to Australia after, but I can't figure out how the moratorium affects specialists. It would suck if he had to wait 10 years before doing any private work but this might be the case?
 
Hey guys, do any of you know whether the 10-year moratorium affects oveseas doctors who come to Australia and are recognised there as specialists? My partner is nearly finished his specialist training in the UK, and we were thinking of moving to Australia after, but I can't figure out how the moratorium affects specialists. It would suck if he had to wait 10 years before doing any private work but this might be the case?

Yes this will apply to specialists as well. However it's very complicated because different specialists may have different areas of need. So an area of need for a neurosurgeon is vastly different then an area of need for a renal physician.

Also if your partner works in an area of need they can still undertake private work, however if they stick to a large city then it's very unlikely they will be able to work privately.
 
Yes this will apply to specialists as well. However it's very complicated because different specialists may have different areas of need. So an area of need for a neurosurgeon is vastly different then an area of need for a renal physician.

Also if your partner works in an area of need they can still undertake private work, however if they stick to a large city then it's very unlikely they will be able to work privately.

it should be noted that OTD's are only required to work in an area of need, which are mostly non-existent in metro areas, until they qualify for unconditional registration. after gaining unconditional registration they are then required to work in a district of workforce shortage and there are some DWS in outer suberbs of major metro areas.

http://www.doctorconnect.gov.au/internet/otd/publishing.nsf/Content/work-Registering-and-qualifying

searchable map: http://www.health.gov.au/internet/otd/Publishing.nsf/Content/locator

it should also be noted that there are now formal rules in place that can allow you to reduce the moratorium to as little as 5 years. the more rural you go, the shorter your moratorium 'sentence'.

http://www.health.gov.au/internet/otd/publishing.nsf/Content/program-otd-factsheet
 
it should be noted that OTD's are only required to work in an area of need, which are mostly non-existent in metro areas, until they qualify for unconditional registration. after gaining unconditional registration they are then required to work in a district of workforce shortage and there are some DWS in outer suberbs of major metro areas.

It may have been the progression from Area of Need -> DWS was from more to less restrictive, but in Qld in practice, areas of need are all over the place, many in Brisbane itself.

That's because the feds define the DWS as *regions* which are under-served medically (like how far to the nearest tertiary hospital, or how many GPs per capita), while the states define an Area of Need as any JOB that has difficulty being filled. I think Qld is the most liberal with how they define that (and they're created sometimes to get the candidate), but at any rate certainly has areas of need even in tertiary hospitals all over Brisbane and up and down the coast depending on specialty.

In other words, for Brisbane, DWSs are strictly outside the city (~20-30 minutes in some directions), while Areas of Need are speckled throughout. 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). So they'll typically start in regional/tertiary centers while undergoing "training"/observation to complete the AMC process, then either find a job in a public hospital with an unfilled opening or they go outside the regional cities, for the remainder of their servitude.

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).

And yeah, after years of conditioning, we need to de-program ourselves and just refer to The Moratorium :)
 
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It may have been the progression from Area of Need -> DWS was from more to less restrictive, but in Qld in practice, areas of need are all over the place, many in Brisbane itself.

That's because the feds define the DWS as *regions* which are under-served medically (like how far to the nearest tertiary hospital, or how many GPs per capita), while the states define an Area of Need as any JOB that has difficulty being filled. I think Qld is the most liberal with how they define that (and they're created sometimes to get the candidate), but at any rate certainly has areas of need even in tertiary hospitals all over Brisbane and up and down the coast depending on specialty.

In other words, for Brisbane, DWSs are strictly outside the city (~20-30 minutes in some directions), while Areas of Need are speckled throughout. 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). So they'll typically start in regional/tertiary centers while undergoing "training"/observation to complete the AMC process, then either find a job in a public hospital with an unfilled opening or they go outside the regional cities, for the remainder of their servitude.

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).

And yeah, after years of conditioning, we need to de-program ourselves and just refer to The Moratorium :)

Hey guys, thanks a lot for your answers - my partner and I are still trying to get our heads around this whole thing so it's really useful to get your input! Though I'm more interested than he is, haha. The one thing I don't really get is that all the discussion and info around DWS for example seems to refer only to general practice as opposed to other specialties? 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??

This link here is the one confusing me http://www.health.gov.au/internet/otd/publishing.nsf/Content/work-Standard+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.

My partner's actually coming out to work in Sydney (on the helicopters, eek!) and in Melbourne next yr as part of his rotation but I heard something about the moratorium starting from either the moment you're registered or when you become PR - whichever is later - so I wanted to make sure we weren't gonna lose time by not finding out this kind of thing beforehand. But it's kinda hard to do, it's also SO confusing!!

Thanks again for your pointers, I'm slowly getting to grips with all the acronyms like DWS, haha. :)
 
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.
 
if your other half already has plans to complete some training in Sydney and Melbourne he would be very wise to speak to as many people currently working in the system as possible. once he starts that training he should be able to find numerous others that either are currently in the process or that have already completed it.
 
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.

Who would be challenging that?? I'm not sure you've understood what I was saying. Originally the idea of the Areas of Need was to ADD to the places where OTDs could go, on top of the federally defined DWS. Allowing OTDs to go to an Area of Need means they can conceivably be in regional centres (including Brisbane), while the DWS would limit them outside of those areas. So OTDs wouldn't be challenging this. And domestics wouldn't be, because by definition an Area of Need is a position that can't be (reasonably) filled by a domestic.

Now it *could* be that things have officially changed over the years. But I think more likely either the website is wrong, or worded poorly, or the state is indeed over-riding the harsher federal requirement. There's precedence where the states have done this with impunity. For example, SA a number of years ago decided to give int'l students higher ballot priority than AMC candidates with PR, which was against federal regs which require PR holders to have higher priority. It was odd, and it was known, but there were no repercussions. In 2007 when I was Qld's Ballot Officer, Qld took advantage of a new visa class which meant holders were on a 'fast-track' to getting PR and used that as an excuse to call us int'ls "equivalent" in status and bump us up above AMC candidates. It turns out that that visa didn't even apply to us, but the change stuck. Soon after, I think it was at a COAG meeting where doing this was formally (retroactively) allowed by the states.

So yeah, the moratorium and Areas of Need have everything to do with each other.
 
not seeing how the moratorium and areas of need have everything to do with each other. like i said, if you are required to be working in an area of need then you are not even to the point where your moratorium clock has started ticking. the area of need is an interim period spent working until you are eligible for unconditional registration; the moratorium doesn't apply until you hold unconditional registration, at which point you must work in a DWS, not an AoN.

you make it sound as if areas of need were created to give OTD's more options. they were not. they are meant to ensure OTD's work in the area of greatest need. "An Area of Need (AON) is any position/location in which there is a lack of specific medical practitioners or where there are medical positions that remain unfilled even after recruitment efforts have taken place over a period of time".

as far as i know there is no definition that states that districts of work force shortage must be outside regional centres. and i don't consider brisbane a regional centre. it is the largest city in Qld and the 3rd largest in all of Australia. it is a metropolitan centre. regional centres are in regional areas which cannot be in metropolitan areas as they are two different things.

areas of need are determined by state and used to place OTD's without unconditional registration. as registration will be transfering to the federal level in July, noone knows if or how it will even continue to be used.
 
if i were an otd and they tried to force me to work in an area of need when the law does not say i must; i.e. i hold unconditional registration, you can bet your arse i'd challenge it. generally from what i've found the vast majority of area of need positions are out in the middle of nowhere where there a considerable number of DWS's in outer suburbs of capitol cities.

but then again, i'm a permanent resident that will never be subject to the 10 year moratorium so i won't argue about it any longer.
 
if i were an otd and they tried to force me to work in an area of need when the law does not say i must; i.e. i hold unconditional registration, you can bet your arse i'd challenge it. generally from what i've found the vast majority of area of need positions are out in the middle of nowhere where there a considerable number of DWS's in outer suburbs of capitol cities.

but then again, i'm a permanent resident that will never be subject to the 10 year moratorium so i won't argue about it any longer.

Let me explain more carefully.

1) IN PRACTICE, in Queensland, the Areas of Need are LESS restrictive (geographically) than DWS. Brisbane, indeed all the regional cities of Queensland, are OUTSIDE of DWS (check the same map that you referenced above). On the other hand, there are Areas of Need ALL OVER THESE REGIONAL CENTRES. And yes, Brisbane can of course be called a regional centre, as the largest one in the largest region, just as nothing prevents a nation's capitol from being a provincial capitol (why be pedantic about the semantics anyway when I was clearly talking about all regional centres +/- Brisbane?)

2) I didn't mean to suggest that those registered OTDs were restricted to Areas of Need only, I meant that in practice they only had to go to an Area of Need (rather than being restricted to a DWS only, i.e., they can do either). But in Queensland, in practice, that means they're only (less-)restricted in their geographical choices by wherever there are Areas of Need, since Areas of Need are indeed all over the freaking place. This is why no doc would have any interest in challenging the matter, even if the state was in fact doing something against federal stipulations. And it is this which makes Areas of Need have everything to do with the moratorium. In practice. In Queensland.

Aside from the misunderstanding, I'm not sure what if anything you're really arguing with.
 
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i made a reply that was totally ****ing warranted. then i realized that i said i would not argue this any longer, so i'm swiping it.
 
Miles & others - thank you very much for sharing this information which together has been extremely useful to me.

I have a question - as a UK international student - theoretically after 4 years of medical training in as an international graduate in Australia - what are the chances of permanent residency / a training job / continuing to GP training as an international - I am fully willing to relocate to DWS, I am just finding it very hard to commit to the 4 years at such high monetary expense for uncertainty?

Have any of you lived through studying as an international medical student in australia? what are the options following the degree? what are the main risks and is a job easy to comeby following the degree?
 
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