What is 19AB and DWS?
Section 19AB of the Health Insurance Act applies to all Overseas Trained Doctors (OTD/IMG/FGAMS) who gained their first medical registration in Australia on or before 1 January 1997. There is a requirement for all general practitioners trained outside of Australia to work in a District of Workforce Shortage (DWS) for their first 10 years of medical registration in Australia. If you are an OTD you need to be a temporary resident or have your fellowship with the RACGP to be eligible for a 19AB exemption.
Working in a DWS location is one of the most common 19AB exemptions used to allow OTD/IMG/FGAMs to work in Australia as GPs.
This requirement is enforced through the Medicare provider number program. In order to bill patients through the Medicare system you will need a provider number, and in order to get a provider number (if your medical degree is not from Australia), you will need an exemption (like DWS).
Who is affected by a DWS and 19AB?
Overseas Trained Doctors (IMG/OTDs) and foreign graduates of an accredited medical school (FGAMS) who are restricted by section 19AB of the Health Insurance Act 1973 (the Act) will be affected by DWS restrictions.
This means that if you obtained your primary medical degree in another country or commenced your degree in Australia before you were a citizen, then you could be subject to 19AB and DWS.
What is the purpose of a 19AB/DWS?
DWS are a key mechanism that the Australian Government uses to achieve an equitable distribution of medical services across Australia. DWS is a 19AB exemption.
How is a DWS determined?
DWS are determined by the Department of Health and Ageing (the Department) using both Australian Bureau of Statistics population data and Medicare Australia billing data.
In general, a location is deemed to be a DWS if it falls below the national average for the provision of medical services of the type provided by the applicant. Population needs for health care are deemed to be unmet if a district has less access to medical services than the national average.
Although the Department uses the GP to population ratio in determining DWS status, other information is available to assess whether DWS status should be considered. Sophisticated mapping and other workforce statistics are used to determine the locations of medical practices, a number of GPs and patient movements to and from practices.
Which areas have DWS?
The department maintains a map that allows you to look up addresses across Australia.
There are still small pockets of DWS around most of the Metropolitan cities in Australia, however, there are usually fewer jobs available in these areas. From time to time the areas that have DWS change.
How long does it take to get a DWS exemption approved?
The complete process (from finding a job through to receiving a Medicare provider number) can take a few months, so the sooner you get started the better. The actual Medicare application process for your DWS/19AB exemption can take a maximum of 6 weeks to be approved. In practice, we are often able to get these approved in around 3 weeks for our GPs.
When do my 10 years start?
It starts when you are first awarded medical registration in Australia. You do not need to have held continuous registration for 10 years.
What happens if an area loses its DWS status after I accept a job but before I get my Medicare provider number?
As per the guidelines issued by the Department of Health they will give you a 19AB exemption (DWS) provided that the area was a DWS at the time you were negotiating the contract.
How to get a 19AB Exemption
There are a few 19AB exemptions available to overseas trained GPs; DWS is the most common one.
Here is a quick summary of the various 19AB exemptions available:
- District of Workforce Shortage– It is possible to work in any District of Workforce Shortage location in Australia – you will be able to work all day in these locations.
- After hours exemption – it is possible to work anywhere in Australia in an after hours capacity. This is from 6pm to 8am weekdays, and all weekend.
- Locum exemption – it is possible to work anywhere in Australia as a locum for a period of up to 6 months. This is eligible for a 19AB exemption. We have a few clients with multiple practices in the same city, so it is possible to have a 12-month contract, with 2 x 6-month placements. Scheduling these can be a bit tricky but if your dates are relatively flexible it is possible.
- Spousal exemption – if your partner is a GP one of you may qualify for an exemption. The criteria for these exemptions has recently been tightened up so it is actually very difficult, contrary to what some agents will tell you. For the most accurate advice please contact us to discuss your situation.
- Other exemptions – There are other exemptions that may be practice or situation specific, contact us and we will be able to let you know if you qualify for one of these 19AB exemptions
If you have any more questions about becoming a GP in Australia, please get in contact with our Registration Manager Megan Lewis on +61 452 644 764 or firstname.lastname@example.org
At Alecto Australia we are very experienced in 19AB, 19AA and DWS having worked in the industry for years and specialise in all types of exemptions.
We have a number of DWS vacancies across Australia, including rural and regional locations, as well as more sought-after metro DWS positions in Perth, Melbourne, Sydney and Brisbane. To see what’s available right now, visit our GP jobs page.