Applying for basic physician training as a British graduate
In a previous post I detailed the hurdles to overcome getting to Australia as a doctor, but now you’re here, what next?!
If you are like me and enjoy internal medicine and particularly fancy spending a year in Emergency Department then a post FY2 position to consider is an unaccredited medical registrar.
This is a great position to be in, you are exposed to lots of different specialties on rotations, meet lots of different people throughout your rotations in hospital and having come from the British system will more than likely have an excellent work ethic and good clinical skills pre-installed.
If you enjoy your time as a med reg start thinking early that you may want to apply for Basic Physician Training (BPT).
What is BPT?
The easiest way to think about it is analogous to CMT in the UK, it is the next medical entry point up from FY2/residency and a necessary building block towards advanced training in Australia, the equivalent of a British medical registrar.
The structure is that of 3 month rotations in either specific specialties or more general rotations is smaller hospitals, rural hospitals and more general medical wards in your tertiary centre. An example of a year of my rotations would include:
- Acute Medicine Unit
- Rural Hospital
- Neurology
- Cardiology
As you can see a nice mix of specialties and general medicine for broad exposure. You don’t have a specific log book with procedures to fill in but you do have a portfolio of case presentations and reflections similar to the UK to complete.
In addition to rotations there is intensive exam preparation for a written exam which occurs once a year and a clinical exam should you pass the written. A lot of focus is placed on these exams and the study requirements can be quite taxing.
The level of the exam from what I have seen is similar to that of MRCP 1 and 2 combined but with a slight increase in awkward questions and an equally meaty focus on basic sciences as in MRCP1.
The clinical exam is structured differently to PACES, however having not yet sat PACES I can’t comment exactly. The Australian clinical is separated into short examination stations and long cases with history and full examination with a subsequent questioning period by examiners.
My journey through Australian medicine so far
Feb 2018 – commence working as medical registrar in Australia with provisional AHPRA (GMC equivalent) registration.
It takes essentially a year to then get “general registration” which allows you to join programs and gain the ability to locum
Feb 2019 – commence PREP1, but still working as a registrar – a pre BPT stepping stone where the college requires you to fulfill certain requirements of time on rotations, hours worked. If you enter Australia having only completed foundation training you are essentially back to square one, but you are paid as your year post graduating, not as an FY1 again!
Feb 2020 – commence PREP2, the official start of BPT with intention to sit clinical exams in February 2021 and the clinicals after that.
As you can see this is quite a convoluted pathway but there are certain benefits to doing it this way as opposed to staying in the UK.
- CMT is currently 3 years, BPT is currently 2 (this may change soon to 3).
- The rota in Australia even in the busiest centres to me appears kinder than those in the UK
- Excellent standard of training and lots of support for Education (Can only speak on behalf of New South Wales)
- If you like the outdoor lifestyle of Australia those benefits are self-explanatory
- Coming from the NHS it still feels dirty to talk about it but the pay is significantly better. You can search online:
Of course there are some tradeoffs that you might want to consider
- Although unbelievably stressful the quality of British medical registrars at the end of their training is some of the highest in the world
- Relatively little mandatory procedural exposure in Australia for better or worse (chest drains, ascitic drains etc) however plenty of lumbar punctures, ascitic taps etc and also you can of course ask to help out. I’ve been lucky enough to help with coronary angiograms, TOE cardioversions, lumbar punctures, renal biopsies, chest drains and bone marrow biopsies to name a few!
- The exam set up is very high pressure and failure can result in non-renewal of contract and it is only once a year.
How am I disadvantaged as a Brit?
When applying for BPT it is extremely helpful to have permanent residency. If like me you don’t this can cause a few issues. Essentially when you apply you could be the best candidate in the world, but all the Australian candidates need to be considered before you get a look in. Essentially you need to be top of the second pile. It really helps to give a good account of yourself and whilst working towards applications. Make sure you attend “pre-meets” if you want to explore other hospitals, essentially a chance to get your face around and meet the people who may employ you.
As a side note, if you don’t have permanent residency prior to working start working on it as soon as you get general registration, just get the English exam done (seriously) and put in your application.
So far for me I’m having a wonderful time. I’ve felt very supported, I’ve made some great friends and my rural placement has been incredible but you just have to knuckle down and jump through the appropriate hoops if you want it badly enough.
Learn Well!
@medicine.daily
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