Specialist Assessment Pathway

Specialist Pathway

Specialist medical training and practice in Australia arose from the model of postgraduate advanced clinical training developed in the United Kingdom. National specialist medical colleges set the standards of training and coordinate the training, education and examination of medical specialists in Australia. The areas of medical practice assessed by the specialist colleges in Australia are set out in.

The areas of approved medical specialties are listed in the AMC List of Australian Recognised Medical Specialties. The list includes those organisations, specialties and qualifications that are recognised and approved by the Australian Minister for Health and Ageing.

The table and the AMC list differ, as the areas of medical practice assessed by specialist medical colleges includes emerging areas yet to be approved as new medical specialties.

Applicants for specialist assessment are expected to have satisfied all the training and examination requirements to practise in their field of specialty in their country of training. The standard applied to the assessment of overseas-trained specialists is the standard required for admission to the relevant specialist medical college as a Fellow. Since January 2009, applicants have been required to also demonstrate evidence of English Language Proficiency prior to assessment by the relevant specialist medical college. Where components of the college's examination and assessment procedures are applied, they are the same as, or derived from, those that apply to local specialist trainees.

The AMC has received advice from the Royal Australian & New Zealand College of Obstetricians & Gynaecologists (RANZCOG), advising that if an applicant's specialist training was completed in Malaysia the applicant will need to include in their application a 'Gazetted' letter confirming the date they were recognised as a specialist in obstetrics and gynaecology in Malaysia.

The AMC has received advice from the Australian and New Zealand College of Anaesthetists (ANZCA), advising that Sri Lankan applicants must have completed their specialist training and examinations plus two years further experience in either the United Kingdom or Australia to be considered as an independent specialist in Sri Lanka. As an applicant must be recognised as an independent specialist in their country of training, any Sri Lankan applicants seeking assessment through ANZCA must meet this requirement to be eligible.


Area of Need Specialist Pathway

From June 2002, arrangements have been introduced to fast-track the processing of applications from overseas-trained specialists, whose primary medical qualifications are not recognised in Australia, for assessment for Area of Need specialist positions.

The documentation requirements and arrangements for processing Area of Need Specialist Pathway applications are broadly similar to those for applications through the Standard AMC/Specialist Pathway for overseas-trained specialists. However, there are some differences because of the need to process Area of Need Specialist Pathway applications rapidly and in parallel with the assessing college.

If you are considering applying for the AMC Area of Need Specialist Pathway, you should note carefully the requirements and the steps involved.

Before your application can be processed, you must have been selected by an employer as suitable for consideration for appointment to a designated area of need specialist position.

Details of the position must be provided on the application to determine eligibility to be assessed for appointment as an area of need specialist form at the time the employer lodges the required documentation on your behalf.

AMC and English

Overseas trained doctors have become an important part of the Australian medical workforce and there are a set of processes which have been developed to assess and recognise the skills and qualifications of overseas trained medical professionals. A part of this process includes meeting English language proficiency requirements. It is therefore essential that doctors and other medical professionals improve English communication skills to ensure effective patient care.


To be a practicing doctor in Australia, overseas trained doctors must meet the Medical Registration Board language requirements plus the English language proficiency requirements as set by the Australian Medical Council (AMC).


Australia is an English speaking country, therefore it is essential that overseas trained doctors have a very good knowledge and understanding of the English language. Having good English language skills enables doctors to communicate with their patients, other doctors and health professionals, and to keep up to date with medical information and research.


In all Australian states and territories, proficiency in English is a legislative requirement for registration of overseas trained doctors. All applicants are required to undertake and successfully complete one of the English language proficiency tests recognised by the AMC. Two of the tests are the International English Language Testing System and the Occupational English Test. Both of these tests include a speaking component which may involve the candidate speaking about a workplace situation.


The requirements are that the candidate must complete the IELTS examination (academic module) with a minimum score of 7 in each of the four components (listening, reading, writing and speaking); or completion and an overall pass in the OET with grades A or B only in each of the four components; or successful completion of the NZREX; or PLAB test.


The next step is to pass the Australian Medical Council Examination. The AMC Examination has been developed to assess the medical knowledge and clinical skills of overseas trained doctors whose basic medical qualifications are not recognised by the state or territory.


Both examinations include questions that address a number of medical principles at the same time. The clinical examination also assesses the candidate’s capacity to communicate with patients, patients’ families and other health workers.


The AMC Examination consists of two parts, a Multiple Choice Questionnaire (MCQ) Examination and a Clinical Examination. The clinical examination includes a consulting skills assessment which includes simulated case scenarios incorporating role plays. Assessment is based on performance in rapport building, examination technique, accuracy of findings, diagnosis, management, investigations, procedures and counselling.


On passing the clinical section, a candidate will be awarded an AMC Certificate. The certificate will entitle an overseas trained doctor to apply for registration in any state or territory of Australia, subject to the requirements of each state or territory Medical Board. This usually includes one year of supervised medical practice. Further information can be found by checking the website of the Australian Medical Council.

The Australian Medical Council

The Australian Medical Council (AMC) is the Australian national standards advisory body for medical education and training.

Its mission statement is:
"To promote and protect public health and safety by ensuring a safe and competent workforce distributed across Australia to meet community needs."

Within Australia, it:

Accredits Australian and New Zealand medical schools and medical courses
Accredits Australian/Australasian programs of specialist medical training
Advises on the recognition of medical specialties and sub-specialties
Assesses overseas trained medical doctors who wish to practise medicine in Australia
Advises State and Territory Medical Boards on uniform approaches to the registration of medical practitioners and maintains a national network of State and Territory medical registers
Advises the Australian Health Ministers' Advisory Council on the registration of doctors

What is PLAB ?

The PLAB test is relevant for international medical graduates.

Those who wish to take up a period of limited registration (which you can do only if you are in supervised employment) and who need evidence that they have the necessary skills and knowledge to practise medicine in the UK.

The PLAB test is designed to test ones ability to work safely in a first appointment as a senior house officer in a UK hospital in the National Health Service (NHS).

Professional and Linguistic Assessment Board test

The Professional and Linguistic Assessment Board test (PLAB) is the assessment procedure conducted by the General Medical Council of the United Kingdom that is required for overseas doctors outside the European Union before they can practice medicine in the UK.

The PLAB test has 2 parts:

Has EMQs (extended matching questions) and SBAs (Single Best Answer questions), This part is conducted in a number of countries including Egypt (Cairo), India, Pakistan, Nigeria, Sri Lanka, Bangladesh.

Part 2 : Consists of an objective structured clinical examination (OSCE). This Part is available only in United Kingdom. It consists of 14 clinical stations, a pilot station and a rest station. The pilot station is usually unannounced and mixed with the clinical stations. The marks for the pilot station do not count towards the final score. All the stations are of five minutes duration. The level of difficulty of the clinical part of the PLAB exam is set at the level of competence of a senior house officer (SHO) in a first appointment in a UK hospital. The skills assessed in this exam are: clinical examination, practical skills, communication skills, and history taking.

Useful things to buy during medical school

The following is a brief list of some of the things I think have been useful and worth their money in my first two years of med school:

1. Large, widescreen computer monitor. The volume of information required to internalize during the preclinical years of medical school can’t be compiled and organized on paper. You would end up with bookshelves filled with those gigantic 4″ binders. Therefore, almost everything happens on a laptop. Of course, the advantages of portability afforded by laptops are offset by the tiny screen size. Plugging into an external, gigantic screen when at home is a huge advantage. You can actually see what you need to be looking at. It’s brighter and generally has better resolution. More important, the additional real estate allows you to have multiple windows open side-by-side so you can take notes in one and look at material or watch videos in the other.
2. Robbins Pathologic Basis of Disease. One of our professors once said, “You could lock a med student in a basement for two years with a copy of Robbins and they would come out and not miss a question on Step 1.” A single textbook doesn’t exist for medical school, but this one pretty much covers everything you need to know in the first two years. Unfortunately, Robbins often goes into too much detail, but it is the best reference book for anything during the preclinical years. This is a required book for any med student.

3. Smartphone. If for nothing else, to keep track of your email and schedule. I don’t know exactly how much email I get in a given day, but it’s a lot. Being able to check these emails anytime without sitting down at a computer is a huge advantage. The other thing smartphones are getting better and better at is on-the-go studying. I can pull up a set of anatomy flashcards while I’m waiting for a meeting to start and quickly hit high-yield information. You can also use it for quick reference while in the clinics — either to teach yourself about a condition/medication relating to a patient or help out your preceptor/attending (be careful with this one, though, they might not appreciate your help).

4. A decent stethoscope. The key word here is “decent.” Get one better than the base model, but don’t go out and drop $500 on an electronic cardiology stethoscope — (1) you’ll look like an idiot, (2) it’s not worth it at this point and (3) you’ll probably lose it at some point. A good quality stethoscope will help tremendously, both in terms of hearing what you’re supposed to be hearing and comfort.

5. A good bed. You may not get a lot of sleep, so what you do get you want to be very good.

6. Question and review books. Hundreds of question and review books exist. Some advise med students against getting any of these until they are actually preparing for Step 1. The fear is two-fold:

1. Students will use review books as a primary source for studying and miss out on some of the nuance provided by studying actual textbooks or materials from professors.
2. Students will become too focused on prep Step 1 and look past the fact that they need to focus on their current courses and pass them.

Both risks are very real for students. However, review books and question books can effectively be incorporated into normal test prep during coursework in Year 1 and 2. The benefit of using these tools in your preparation for regular course tests is that you become familiar with these materials before you begin your arduous Step 1 preparation. Also, many of the review books contain very helpful mnemonics and tools for memorizing complicated pathways or concepts. Instead of wasting time coming up with your own, often inferior, memorization tools you can use some of the most effective ones from previous students. But don’t fall into the aforementioned traps — study primary materials first and only use these as your last bit of review/self-testing before an exam.

7. A good anatomy atlas. I think it’s important to have a true anatomy atlas, meaning one that is simply labeled pictures/diagrams. Several anatomy texts exist that are a combination textbook and atlas. I generally don’t like these because I find the text only functions to make the book thicker and makes finding the diagram you want difficult.

8 . Not over-paying for med school. A recent study in the Archives of Internal Medicine showed physicians who went to med school at US News & World Report Top 10 research or primary care medical schools did not perform any better on quality measures than their peers who went to less prestigious institutions. Med school debt is bad enough, don’t exacerbate the problem.

101 Things You Wish You Knew Before Starting Medical School

Simple enough, here are 101 things you wish you knew before starting medical school.

1. If I had known what it was going to be like, I would never have done it.
2. You’ll study more than you ever have in your life.
3. Only half of your class will be in the top 50%. You have a 50% chance of being in the top half of your class. Get used to it now.
4. You don’t need to know anatomy before school starts. Or pathology. Or physiology.
5. Third year rotations will suck the life out you.
6. Several people from your class will have sex with each other. You might be one of the lucky participants.
7. You may discover early on that medicine isn’t for you.
8. You don’t have to be AOA or have impeccable board scores to match somewhere – only if you’re matching into radiology.
9. Your social life may suffer some.
10. Pelvic exams are teh suck.
11. You won’t be a medical student on the surgery service. You’ll be the retractor bitch.
12. Residents will probably ask you to retrieve some type of nourishment for them.
13. Most of your time on rotations will be wasted. Thrown away. Down the drain.
14. You’ll work with at least one attending physician who you’ll want to beat the shit out of.
15. You’ll work with at least three residents who you’ll want to beat the shit out of.
16. You’ll ask a stranger about the quality of their stools.
17. You’ll ask post-op patients if they’ve farted within the last 24 hours.
18. At some point during your stay, a stranger’s bodily fluids will most likely come into contact with your exposed skin.
19. Somebody in your class will flunk out of medical school.
20. You’ll work 14 days straight without a single day off. Probably multiple times.
21. A student in your class will have sex with an attending or resident.
22. After the first two years are over, your summer breaks will no longer exist. Enjoy them as much as you can.
23. You’ll be sleep deprived.
24. There will be times on certain rotations where you won’t be allowed to eat.
25. You will be pimped.
26. You’ll wake up one day and ask yourself is this really what you want out of life.
27. You’ll party a lot during the first two years, but then that pretty much ends at the beginning of your junior year.
28. You’ll probably change your specialty of choice at least 4 times.
29. You’ll spend a good deal of your time playing social worker.
30. You’ll learn that medical insurance reimbursement is a huge problem, particularly for primary care physicians.
31. Nurses will treat you badly, simply because you are a medical student.
32. There will be times when you’ll be ignored by your attending or resident.
33. You will develop a thick skin. If you fail to do this, you’ll cry often.
34. Public humiliation is very commonplace in medical training.
35. Surgeons are assholes. Take my word for it now.
36. OB/GYN residents are treated like shit, and that shit runs downhill. Be ready to pick it up and sleep with it.
37. It’s always the medical student’s fault.
38. Gunner is a derogatory word. It’s almost as bad as racial slurs.
39. You’ll look forward to the weekend, not so you can relax and have a good time but so you can catch up on studying for the week.
40. Your house might go uncleaned for two weeks during an intensive exam block.
41. As a medical student on rotations, you don’t matter. In fact, you get in the way and impede productivity.
42. There’s a fair chance that you will be physically struck by a nurse, resident, or attending physician. This may include slapped on the hand or kicked on the shin in order to instruct you to “move” or “get out of the way.”
43. Any really bad procedures will be done by you. The residents don’t want to do them, and you’re the low man on the totem pole. This includes rectal examinations and digital disimpactions.
44. You’ll be competing against the best of the best, the cream of the crop. This isn’t college where half of your classmates are idiots. Everybody in medical school is smart.
45. Don’t think that you own the world because you just got accepted into medical school. That kind of attitude will humble you faster than anything else.
46. If you’re in it for the money, there are much better, more efficient ways to make a living. Medicine is not one of them.
47. Anatomy sucks. All of the bone names sound the same.
48. If there is anything at all that you’d rather do in life, do not go into medicine.
49. The competition doesn’t end after getting accepted to medical school. You’ll have to compete for class rank, awards, and residency. If you want to do a fellowship, you’ll have to compete for that too.
50. You’ll never look at weekends the same again.
51. VA hospitals suck. Most of them are old, but the medical records system is good.
52. Your fourth year in medical school will be like a vacation compared to the first three years. It’s a good thing too, because you’ll need one.
53. Somebody in your class will be known as the “highlighter whore.” Most often a female, she’ll carry around a backpack full of every highlighter color known to man. She’ll actually use them, too.
54. Rumors surrounding members of your class will spread faster than they did in high school.
55. You’ll meet a lot of cool people, many new friends, and maybe your husband or wife.
56. No matter how bad your medical school experience was at times, you’ll still be able to think about the good times. Kind of like how I am doing right now.
57. Your first class get-together will be the most memorable. Cherish those times.
58. Long after medical school is over, you’ll still keep in contact with the friends you made. I do nearly every day.
59. Gunners always sit in the front row. This rule never fails. However, not everyone who sits in the front row is a gunner.
60. There will be one person in your class who’s the coolest, most laid back person you’ve ever met. This guy will sit in the back row and throw paper airplanes during class, and then blow up with 260+ Step I’s after second year. True story.
61. At the beginning of first year, everyone will talk about how cool it’s going to be to help patients. At the end of third year, everybody will talk about how cool it’s going to be to make a lot of money.
62. Students who start medical school wanting to do primary care end up in dermatology. Those students who start medical school wanting to do dermatology end up in family medicine.
63. Telling local girls at the bar that you’re a medical student doesn’t mean shit. They’ve been hearing that for years. Be more unique.
64. The money isn’t really that good in medicine. Not if you look at it in terms of hours worked.
65. Don’t wear your white coat into the gas station, or any other business that has nothing to do with you wearing a white coat. You look like an ass, and people do make fun of you.
66. Don’t round on patients that aren’t yours. If you round on another student’s patients, that will spread around your class like fire after a 10 year drought. Your team will think you’re an idiot too.
67. If you are on a rotation with other students, don’t bring in journal articles to share with the team “on the fly” without letting the other students know. This makes you look like a gunner, and nobody likes a gunner. Do it once, and you might as well bring in a new topic daily. Rest assured that your fellow students will just to show you up.
68. If you piss off your intern, he or she can make your life hell.
69. If your intern pisses you off, you can make his or her life hell.
70. Don’t try to work during medical school. Live life and enjoy the first two years.
71. Not participating in tons of ECs doesn’t hurt your chances for residency. Forget the weekend free clinic and play some Frisbee golf instead.
72. Don’t rent an apartment. If you can afford to, buy a small home instead. I saved $200 per month and had roughly $30,000 in equity by choosing to buy versus rent.
73. Your family members will ask you for medical advice, even after your first week of first year.
74. Many of your friends will go onto great jobs and fantastic lifestyles. You’ll be faced with 4 more years of debt and then at least 3 years of residency before you’ll see any real earning potential.
75. Pick a specialty based around what you like to do.
76. At least once during your 4 year stay, you’ll wonder if you should quit.
77. It’s amazing how fast time flies on your days off. It’s equally amazing at how slow the days are on a rotation you hate.
78. You’ll learn to be scared of asking for time off.
79. No matter what specialty you want to do, somebody on an unrelated rotation will hold it against you.
80. A great way to piss of attendings and residents are to tell them that you don’t plan to complete a residency.
81. Many of your rotations will require you to be the “vitals bitch.” On surgery, you’ll be the “retractor bitch.”
82. Sitting around in a group and talking about ethical issues involving patients is not fun.
83. If an attending or resident treats you badly, call them out on it. You can get away with far more than you think.
84. Going to class is generally a waste of time. Make your own schedule and enjoy the added free time.
85. Find new ways to study. The methods you used in college may or may not work. If something doesn’t work, adapt.
86. Hospitals smell bad.
87. Subjective evaluations are just that – subjective. They aren’t your end all, be all so don’t dwell on a poor evaluation. The person giving it was probably an asshole, anyway.
88. Some physicians will tell you it’s better than it really is. Take what you hear (both positive and negative) with a grain of salt.
89. 90% of surgeons are assholes, and 63% of statistics are made up. The former falls in the lucky 37%.
90. The best time of your entire medical school career is between the times when you first get your acceptance letter and when you start school.
91. During the summer before medical school starts, do not attempt to study or read anything remotely related to medicine. Take this time to travel and do things for you.
92. The residents and faculty in OB/GYN will be some of the most malignant personalities you’ve ever come into contact with.
93. Vaginal deliveries are messy. So are c-sections. It’s just an all-around blood fest if you like that sort of thing.
94. Despite what the faculty tell you, you don’t need all of the fancy equipment that they suggest for you to buy. All you need is a stethoscope. The other equipment they say you “need” is standard in all clinic and hospital exam rooms. If it’s not standard, your training hospital and clinics suck.
95. If your school has a note taking service, it’s a good idea to pony up the cash for it. It saves time and gives you the option of not attending lecture.
96. Medicine is better than being a janitor, but there were times when I envied the people cleaning the hospital trash cans.
97. Avoid surgery like the plague.
98. See above and then apply it to OB/GYN as well.
99. The money is good in medicine, but it’s not all that great especially considering the amount of time that you’ll have to work.
100. One time an HIV+ patient ripped out his IV and then “slung” his blood at the staff in the room. Go, go infectious disease.
101. Read Med School Hell now, throughout medical school, and then after you’re done. Then come back and tell me how right I am.