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Section 19AB

Read about section 19AB of the Health Insurance Act 1973 and its requirements. International medical graduates are subject to the rules under 19AB, including restrictions on where they can work.

What is 19AB?

International medical graduates are restricted in where they can work in Australia and access Medicare benefits.

Section 19AB of Australia's Health Insurance Act 1973 sets out the rules for international medical graduates and these restrictions.

Who does 19AB apply to?

Restrictions under 19AB apply to you if you are an international medical graduate. You are an international medical graduate if you:

  • got your degree outside of Australia or New Zealand
  • enrolled in a degree in Australia or New Zealand as a temporary resident

A temporary resident who holds a 19AB exemption will satisfy the requirements of section 19AA.

The 10 year moratorium

Under 19AB, you must work in a Distribution Priority Area (DPA) if you're a GP, or a District of Workforce Shortage (DWS) if you're a non-GP specialist, for at least 10 years.

The 10 year period starts from the first day of medical registration. This is called the 10 Year Moratorium. 

All international medical graduates are subject to the moratorium. There are no exceptions.

The moratorium and 19AB restrictions will end after 10 years if you are a permanent resident or citizen.

If you remain a temporary resident, your moratorium continues until you become a permanent resident or citizen.

If you become a permanent resident, you must tell Medicare immediately about your change of circumstances to avoid gathering debt.

If you do not have a Fellowship qualification when you become a permanent resident, you will be subject to the rules under 19AA.

Moratorium scaling

Through 10 year moratorium scaling, you can work in more remote areas to reduce the time you must work in a location classified as a DPA or DWS.

The 5 Year Overseas Trained Doctor Scheme

An international medical graduate can reduce the time they must work in a DPA or DWS to as little as 3 years.

The 5 Year Overseas Trained Doctor Scheme lets international medical graduates do this by working in an eligible rural or remote location.

Exemptions in areas classified as DPA and DWS

You might be eligible to receive a Medicare provider number if you:

To see locations classified as DPA and DWS, search the Health Workforce Locator.

Exemptions in areas not classified as DPA and DWS

Temporary residents under 19AB, and permanent residents or citizens who are vocationally recognised, can apply for one of the following exemptions from working in a DPA.

Aboriginal and Torres Strait Islander Primary Health Services exemption

You can work at an Aboriginal and Torres Strait Islander Primary Health Service that holds an exemption under s19(2) of the Health Insurance Act 1973. Your local Rural Workforce Agency can help identify eligible locations.

Assistance at Operations exemption

You can seek an exemption to access the Assistance at Operations items of the Medicare Benefits Schedule.

These items are listed in Group T9 of the Health Insurance (General Medical Services Table) Regulation 2016.

Academic exemption

You can seek an academic exemption if all of the following apply:

  • you have satisfied 19AA
  • you are employed in an academic appointment with an Australian medical school
  • you perform clinical services as part of your academic appointment

This exemption does not apply to private practices without teaching responsibilities.

Specialties in acute shortage exemption

You can work at any location if you are a recognised specialist in:

  • cardiothoracic surgery
  • dermatology
  • emergency medicine
  • endocrinology
  • geriatric medicine
  • gastroenterology
  • general medicine
  • haematology
  • intensive care medicine
  • nephrology
  • neurology
  • neurosurgery
  • orthopaedic surgery
  • otolaryngology
  • paediatric medicine
  • paediatric surgery
  • palliative medicine
  • pain medicine
  • plastic and reconstructive surgery
  • rehabilitation medicine
  • rheumatology
  • sports and exercise medicine
  • thoracic medicine
  • urology
  • vascular surgery

Locum exemption

You can work up to 6 months in an area that is not DPA or DWS while you arrange employment in an area classified as DPA or DWS.

To apply, submit a letter of support with your Medicare provider number application. The letter should say you’re seeking a locum exemption. You cannot extend or repeat a locum exemption.

Spousal exemption

You may be able to practise within a reasonable distance of your spouse’s primary place of employment.

You may be eligible if your spouse is a medical practitioner or a skilled migrant.

Non-vocationally recognised doctors can apply for spousal exemptions to allow them to apply for competitive selection for the general pathway of the Australian General Practice Training Program.

Contact us for the spousal exemption application form.

Replacement exemption

You may be eligible for an exemption from 19AB if you replace a doctor who held an unrestricted 19AB exemption.

The doctor you replaced must have ceased working at the practice and in the local area.

How do I apply for a 19AB exemption?

You will need to include any supporting documentation for a 19AB exemption with your Medicare provider number application.

The Department of Human Services will apply to the Department of Health for the exemption on your behalf.

Health will assess your 19AB exemption application within 28 days of receiving it.

Applications are processed in the order they are received to ensure procedural fairness, and returned to the Department of Human Services.

The Department of Human Services will advise you if your application has been successful or not.

Can a 19AB exemption be backdated?

The Health Insurance Act 1973 prohibits backdating a 19AB exemption under any circumstances.

You must make sure you hold a valid Medicare provider number and 19AB exemption before you see any patients. If you don’t, you will gather debt for any services provided.

Asking for a review of rejected applications

You have 90 days from the date your application was rejected to request a review.

Contact us to request a review.

Last updated: 
16 July 2019