Are you up for an Aussie adventure?
After emigrating to Australia Dr Amal Paul witnessed a flurry of GP interest in the same move. Here he provides a guide for doctors planning to emigrate.
Recently there has been a renewed interest among the GPs in the UK in work opportunities abroad including Australia. There is a healthcare workforce shortage in Australia, especially with GPs and the government there is encouraging recruitment and retention of doctors, especially for rural and remote areas – not that a GP will be working in the middle of nowhere; it may be a small town within 100 miles of the metropolitan areas. The further out of the centre you choose to work, the better the terms and conditions of your employment, as well as incentives and payments you can expect. Australia has good public and private education system and your children will have fee-free placement in the public schools.
Australia Primary Care Health Service
While European governments are restricting their health budgets, more investment is committed by the Australian government to improve the quality and accessibility of primary healthcare. The primary healthcare services are well organised but need more structural and functional integration. There is a big move to establish a British model of primary health care (although not the NHS model!) to bring care nearer to the patients. The fundamental difference between Australian healthcare and the service in the UK is that in Australia doctors' consultations are not free. The payments are made through either private billing or private health insurance. The patients are free to consult any doctor they like, which is equivalent to NHS ‘patient's choice' policy. This ‘fees for service' policy is a big incentive for the immigrant GPs to work harder and longer hours to boost their financial remuneration.
There is a job is waiting for you
There is no shortage of quality GP jobs in Australia. In addition, the quality of life I very different to the UK - You can choose your own place of work according to your own personal choice and circumstances. You can choose what kind of weather you want depending on which area of the country you choose, eg. warm, cold or hot and the life style, is very outdoor orientated with a strong beach culture and lots of sharing sun shine and surfing. There are lots of beaches and endless outbacks. There are also tropical rainforests, alpine villages, small country towns and stretches of deserts, as well as the famous cosmopolitan cities like Melbourne, Sydney, Brisbane, Perth and Adelaide may not be far away. In short, whatever is your choice of life style and living, there is a very good chance that you will be able to find in Australia.
GP work in Australia
GPs are well respected in Australian society. Generally Australians are relaxed, friendly and helpful. A common saying is ‘no worries'!! You will work in a well organised, mostly paperless practice with support from a practice manager and a management team.
It is very helpful to find that most of the drugs have same name and doses as in the UK and there are hardly any prescribing restrictions. Patient referral is within your professional judgement and will not be ‘evaluated by internal and external peers'.
There is plenty of opportunity for GP specialists but the differences in clinical freedom and independence are significantly different from the UK. For example, GP obstetricians undertake full antenatal care responsibilities and conduct normal and assisted deliveries including caesarean delivery; GP surgeons perform all sorts of surgical procedures; a GP dermatologist can operate on a malignant melanoma with skin grafting, and so on. However, you do need to be accredited and will work under strict clinical protocols and supervision.
A few professional dilemmas
When immigrating to Australia, whether you continue your Registration with GMC (UK) is an important issue. You also need to explore whether you can keep your name in the PCT Performer List. If you are away for more than one year, it may be difficult to be in the local PCT Performer list as you will not have appraisals. If you cancel or suspend your GMC registration, you may have to follow GMC procedures including a face to face interview. Many doctors choose to continue paying normal annual registration subscriptions for one or two years before a firm decision about emigration is made.
As a GP you can accept an employment contract or choose to work as self employed. Employed GP vacancies are limited and financially less attractive. Most GPs work as ‘independent contractors' i.e. self employed. There is a huge variation in GP earning potential depending on where you work, the clinical hours you choose to work, the billing system of the practice, and your capacity to undertake other primary care procedures like minor surgery, shared antenatal care etc. A procedural GP (equivalent to GPwSI) earns a significantly higher amount.
Potential Financial Benefits
Usually a GP working full time can expect an annual income of $250,000 (approx £159,000) to $400,000 (approx. £255,000). Cost of living is more expensive here but you will have better buying power with higher income. The quality of life and life style is mostly much better but again it depends how you want to live your life. Australian medical defence subscription varies from $4,000 to $5,200 where as in U.K. you about pay £5,500, however in your first two or three years your defence union fees may be reduced to $2,000 through government subsidy.
Income tax in Australia
The tax system is Australia is similar to that in the UK; the higher rate is 45%. However, most doctors pay taxes of 35%. Your superannuation payment is 9%. The pension system is excellent here. Your pension payment is tax free (it is taxable in the UK) and a good number of emigrating GPs transfer their UK NHS pension funds to Australia. However, you should always get advice form an independent financial advisor.
Are you ready? Here are few tips -
If you are serious about a GP job in Australia then you should start your homework now.
- Plan well ahead and start working on the project at least 8 months ahead of your anticipated travel date
- Research and acquire as much information as you need
- If you are an IMG, check the pre-requisites for your registration with AHPRA; complete IELTS
- Get your certificates and credentials including birth certificates of all those emigrating and your marriage certificate, if applicable, notarised
- Decide your priorities – working fulltime or part time, locum or substantial post; which placement of work will suit you – semi-rural, rural, employed or self employed; your preferred life style and weather; your family preferences and children's schooling
- Start searching for a job – It is better to contact few recruitment agents expressing your interest and they will look for a suitable job. You can choose and pick your preferred one
- Negotiate terms and conditions of the job with the recruitment agents, especially reimbursement of relocation expenses, joining bonus / incentives, initial support for your housing and a car, guaranteed payments for your initial 3-6 months
- In reality you should make a medium- to long-term commitment for the best outcome of this venture.
It is generally believed that working as a GP in Australia is a very rewarding experience.
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