19AA and the 3GA Programs (2020 Update)
WHO IS RESTRICTED BY 19AA?
All Non-Vocationally Registered Australian Citizens or Permanent Residents are restricted by 19AA.
This means if you are born in Australia, have become an Australian Citizen or hold Permanent Residency you will be restricted until you achieve Fellowship with either RACGP or ACRRM and are recognised as a Specialist in General Practice, you will continue to be restricted by 19AA.
WHAT DOES IT MEAN TO BE RESTRICTED BY 19AA?
If you are restricted by 19AA, you are required to join a 3GA program to gain access to Medicare benefits.
If you are restricted by 19AA and not on a 3GA program, you will not be granted access to Medicare Benefits. Medicare can issue a fine if they discover you have continued to claim Medicare Benefits without being on a 3GA Program. You will also be required to return 100% of the money you billed to Medicare. As soon as you receive Permanent Residency (from 5pm the day you become PR) you will need to cease practice until you are on an approved 3GA program.
WHAT IF I JUST DON’T WANT TO JOIN A 3GA PROGRAM?
If for some reason you don’t want to join a 3GA program, you are still able to practice, you just won’t be able to bulk-bill through medicare. Therefore, your patients, even if they have medicare and are eligible to be bulk-billed, will have to pay the full cost of the appointment out of pocket and will not receive a rebate.
WHAT ARE THE OPTIONS FOR 3GA PROGRAMS IN 2020?
Your 3GA program options will depend on if you meet the eligibility criteria and on your practice location, if relevant. We have put together a summary of all the 3GA programs below:
Australian General Practice Training Programs (AGPT)
AGPT is a 3 – 4 year training program for registrars on the journey to either RACGP or ACRRM Fellowship and Specialist Registration as a General Practitioner.
There are 2 different pathways available for GPs and these depend on your 19AB restriction. If you are restricted by 19AB you will join the Rural Pathway with AGPT. GPs in this pathway will undertake all of their training in rural areas that fulfil their 19AB restrictions.
The General Pathway of the AGPT program is for GPs that are not restricted by 19AB. GPs on this pathway will work in inner and/or outer metropolitan areas.
If you have a 19AB exemption specifically for AGPT, such as a spousal exemption, you are eligible to join the General Pathway instead of the Rural Pathway.
You aren’t able to choose a specific area to practice in on this program, but you can nominate your preferred area regions. Once you have been accepted for a region, you will be provided with a list of practices to contact to try to join their practice.
Applications for AGPT generally open in April each year and you can apply through their website.
To be eligible you need to currently hold General Registration, or you will hold General Registration with AHPRA prior to the commencement of the program. You must also be a Permanent Resident or Australian Citizen.
AGPT offers a great level of support for participants, clinics are thoroughly vetted and contracts are negotiated for you.
ACRRM Independent Pathway
The ACRRM Independent Pathway is a 4 year Specialist training program that assists GPs on the pathway towards ACRRM Fellowship and Specialist Registration.
If you hold General Registration, Provisional Registration or Area of Need Limited Registration and have completed 1 year of postgraduate hospital experience in Australia or in an approved Competent Authority you will be eligible for the program.
You will be required to find a practice to work in and as of July 2020, practices will need to be in an MMM 2-7 location.
Applications are open various times in the year and are listed in the key dates calendar on their website. If applications are not open when you apply, you can submit an expression of interest to be notified when applications next open.
The ACRRM Independent Pathway does have a substantial fee, so you will need to be prepared to cover these costs if you plan to join.
More Doctors for Rural Australia Program (MDRAP)
MDRAP is a new 3GA program that has been created to encourage more doctors to work in rural and remote communities.
To be eligible for the program you need to hold current AHPRA Registration, have a job offer in an eligible location and have the necessary skills and experience to perform the role. If you do not have previous General Practice experience, you can still apply for MDRAP. You will just need to have a Supervisor in the Practice that is willing to assist you in this transition.
As part of this program you will need to find a practice in a DPA area with a Modified Monash Model (MMM) Classification between 2 – 7. All Aboriginal Medical Services are eligible regardless of location criteria.
This program allows GPs 2 years on the program before they will need to transition to an alternative 3GA Program. Whilst on the program, you are expected to submit 1 application for either AGPT, ACRRM Independent Pathway, RVTS or PEP every year.
Applications for MDRAP are open throughout the year and you can apply for this program by emailing the Rural Workforce Agency in your State or Territory. Applications take around 28 business days to process.
Practice Experience Pathway (PEP)
PEP is a self-directed education program created to assist Non-VR GPs on the pathway to RACGP Fellowship. There are 2 pathways available, the Standard Stream for GPs who do not hold Specialist Qualifications and the Specialist Stream for GPs with Specialist Qualifications that have been recognised as Comparable by RACGP.
To participate on PEP, you will need to hold current General, Provisional or Limited (Area of Need) AHPRA Registration, have a job offer in an eligible location and pay the associated fees.
To be eligible for a PEP Provider Number, your practice will need to be in an MMM Classification of 2 – 7 and in a DPA area if you are restricted by 19AB.
To apply for PEP, you will need to sit the PEP Entry Assessment (PEPEA) Exam. There are various dates for the PEPEA throughout the year and your results will be valid for 3 years.
Applications for commencement of PEP are open at different intervals throughout the year. You can find out if applications are currently open at this link: https://www.racgp.org.au/racgp-pep-apply-now
The benefits of PEP are the learning resources you will have available to help you prepare for the Fellowship exams, but you will need to be self-motivated to complete all set activities.
Additionally, you are not able to sit the Fellowship Exams until you have completed your allocated time on the program, which can be between 6 – 18 months.
After Hours Medical Deputising Services (AMDS)
This program allows you to gain clinical experience during the after-hour periods whilst preparing for and taking the Fellowship exams with either RACGP or ACRRM.
AMDS services can either be clinic based or involve visiting patients’ homes and these practices are available in both metropolitan and regional areas.
Your eligible working hours are between 6pm to 8am on weekdays, all-day Saturday and Sunday and on Public Holidays.
As your patient base is restricted, your experience will be assessed at 50% outside of the clinic and 75% in clinic. Additionally, this time will be capped at 2.5 years assessed.
You can apply for AMDS at any time through an AMDS accredited practice after you have received a job offer. The practice will need to be accredited through AMDS – a practice that operates in the after-hours but is not accredited with AMDS will not be accepted in an application. Essentially, all AMDS clinics are after hours, but not all after hours clinics are AMDS. So make sure you check!
If you have Limited or Provisional AHPRA Registration, you will only be able to join AMDS in an in-clinic position and will need to meet the Supervision Requirements of AHPRA.
Remote Vocational Training Scheme (RVTS)
RVTS is a Fellowship training program designed to provide educational opportunities for GPs in rural areas with limited education opportunities.
RVTS provides training via distance education and remote supervision, so this allows GPs working in remote communities’ access to support whilst providing highly needed medical services.
You can apply to RVTS through either the Remote Stream or AMS Stream. To apply through the Remote Stream, you need to be practicing as a GP in an MMM 4 – 7 classification area. To apply through the AMS Stream, you need to be working as a GP in an Aboriginal Community Controlled Health Service with an MMM Classification of 2 – 7.
To apply, you must hold either General Registration, Provisional Registration or Area of Need Limited Registration. If you have Provisional/Limited Registration, you will be required to have level 3 or 4 supervision
You will need to be working in the practice at the time of applying and remain in the same practice throughout the program. You can apply to RVTS if you are an Australian Citizen, if you hold Permanent Residency and if you are a Temporary Resident.
Every year only 22 GPs are approved for the Remote Stream and 10 GPs for the AMS Stream, so this program is competitive!
HOW WE CAN HELP YOU:
If you are looking for further guidance on 3GA Programs or would like to ask further questions about the information mentioned, this is something our team can help you with. Contact us directly at [email protected].
Information for this blog has been taken directly from:
People Medical Consulting are a team of professionals with a passion for guiding those specialising in the Medical industry to find their career pathway and settle into Australia. Working with both Australian trained and Overseas trained professionals, we have extensive experience in Recruitment of General Practitioners and Document Assistance for those requiring support with RACGP, AHPRA, 19AA and 19AB Medicare Exemptions.