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Resident Doctor Salary Australia: Pay Rates & Titles Explained.

Discussion in 'Doctors Cafe' started by Hadeel Abdelkariem, Jun 30, 2019.

  1. Hadeel Abdelkariem

    Hadeel Abdelkariem Golden Member

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    Resident Medical Officer. Or just plain “Resident”. Is the job title that is most commonly applied to Australian doctors working in their 2nd year of Medicine in Australia. This title can also be given to a doctor working in their 3rd year or later. However, Resident is not the only title used and the situation can be confusing. Add to this, that being a resident doctor in Australia is not the same as being a resident doctor in a country like the United States. What trainee doctors get called and paid after their internship can become terribly confusing. Both for Australian doctors as well as doctors from other countries. So I pulled together this post to help clear it up.

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    Firstly, let's address the key question. What does a Resident Doctor get paid in Australia? As of 2019, a Resident Medical Offcier (RMO) in Australia will make anywhere between $72,837, in Tasmania, which is the lowest rate and $86,328 AUD in Western Australia, which is the highest rate. Bear in mind that this is base annual Full-Time salary. Most Resident doctors are employed Full-Time but work additional overtime hours as well as shiftwork. So take home salaries can increase rapidly and it would not be unreasonable to see about 25-50% more salary on top of this.

    To further clarify, these are the rates paid to doctors in their second year of work in the hospital system. Or what is commonly referred to as a Postgraduate Year 2 (PGY2) doctor. The rates do increase if you are more experienced.

    So let's dive in a bit deeper to the situation. To see how pays compare across the various States and Territories in Australia. As well as what sort of title you might have if you are working at a PGY2 level in one of those particular States and Territories.

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    *Interns (PGY1 doctors) are also employed as Junior House Officers and Hospital Medical Officers in Queensland and Victoria respectively. So the titles are interchangeable and you should check if the position is for a PGY1 or greater.

    An Explanation of Titles
    As I have noted the most common position title you will probably see in most States and Territories is some version of “Resident Medical Officer”. So you might also see just plain “Resident” or the abbreviated version of “RMO”.

    If you see “Senior Resident Medical Officer” this means the position suits someone slightly more senior. Usually someone in their PGY3 or third year of medicine.

    However, employers generally have a choice or even free reign to call these positions whatever they like. Some will stick to the title under the Award or Enterprise Agreement (see below). Some will go for the more generally understood Resident Medical Officer.

    But you may also see titles like “Medical Practitioner” or “Trainee” or “Unaccredited Trainee.”

    Addressing the Confusion.
    If you are confused as to what level the position is there are a few things that you can do:

    Firstly, you can look at the details of the job description:

    • It will often tell you the level under the Award or EBA.
    • There may be a description of how many years of experience you need.
    • You might be able to infer that it is a resident level job because you will report to Registrars or specialty trainees. If you are reporting directly to Consultants then it is a much more senior position.
    • Finally, you might be able to work it out from the salary range.
    If none of that works you can try contacting the person who advertised the position. They will normally have an email contact and often a phone number listed.

    Western Australia Leads Again.
    There are some interesting observations about this list when one compares it to the Intern pay table. Firstly, Western Australia remains the clear leader in trainee doctor pay rates. And in fact, Western Australia continues to stay ahead as one enters into the specialty trainee doctor pay scales. On at least an annual base salary basis it has to be said that Western Australia pays its trainee doctors the best.

    The strong improver on the list is NSW. Which leaps over Tasmania and just squeezes past Victoria and Queensland to no longer be last. Tasmania is in fact well and truly last being almost $7,000 in the rear of Victoria which is second last.

    The two largest States in Australia (by population), being Queensland, Victoria and NSW are actually extremely close in what they pay Resident doctors. There is really not that much difference between them.

    Not All Are Equal.
    But this is oversimplifying the situation.

    Whilst Victoria and NSW pay their Resident doctors approximately the same rate of pay. The Enterprise Agreement for doctors in Victoria (see below for what one of these is) is arguably the most modern in the country. And includes a suite of additional benefits which are not given to doctors in NSW. NSW arguably has the most out of date Award of all the trainee doctors Awards or EBAs in the country.

    There are some things you get when you work as a Resident in Victoria. Which you don't get when you work as a Resident in NSW. These include a provision of up to $3,000 for continuing professional development, as well as specific provision examination leave as well as conference leave.

    How Are Doctor Pay Rates Determined in Australia?
    You may be wondering why there is such a difference in pay rates for trainee doctors in Australia? And also why I am quoting you pay rates by State and Territory with confidence? And not digging into individual rates of pays at certain hospitals or health networks.

    To understand all of this one has to briefly explain what is called the industrial relations system in Australia. Before Australia became a sovereign country it was actually already a collection of individual States. With their own parliamentary and judicial systems based on the UK system. These systems continued with the Federation of Australia, with a division of authorities and responsibilities between the Commonwealth and State parliaments. One responsibility that was maintained by the State's was the ability to determine labour laws. Or the laws that regulate who can work, how and when and for how much.

    On top of this federal system, Australia has always had a strong trade union movement that has worked collectively for its members to secure improvements to work conditions. Over time a system developed in Australia to determine disputes between workers (represented by trade unions) and employers on both a State and later Federal level.

    The Arbitration System.
    This system was and is called “arbitration” and basically involves a court hearing both sides arguments and making a determination.

    So basically whenever there is a dispute over conditions it is determined on an industry basis and either for the whole State or the whole country. Disputes are generally not heard on an employer or workplace basis. Although this has changed a bit of recent times.

    The arbitration courts developed and updated legal documents called Awards. These Awards contained all the rules about what certain workers were required to do, how they got paid and what other “entitlements” (such as leave) they would have.

    Awards are determined based on industrial classifications. So for example, in NSW there is an Award which is called the Public Medical Hospital Officers Award which covers all trainee doctors employed in NSW hospitals.

    More recently in certain States the Award system has altered slightly to a process of what is called enterprise bargaining. Essentially, the employer and the union representing the workers agree to put aside the Award and develop a contract that both parties agree to.

    Awards and EBAs Outline the Conditions of Employment for Everyone.
    Whether it is an Award or Enterprise Bargaining Agreement (EBAs) both documents outline the conditions of employment for all employees of that classification.

    Awards and EBAs normally outline rates of pay based upon years of experience with some progression steps. So for example in Tasmania, you will start out as a Medical Practitioner Level 1 (Intern). And after one year automatically progress to a Medical Practitioner Level 2 (Resident year 1). And the next year move up to a Medical Practitioner Level 3 (Resident year 2). But you have to be appointed to a Medical Practitioner Level 5 (as either a Senior Resident year 1 or Registrar year 1) before you can progress up to this particular salary point.

    So there are names attached to the classification or grading levels under the Awards and EBAs. And these are often also used for the actual position title when you see a job advertised.

    Additional Benefits.
    As I have mentioned most trainee doctors work full time and on top of this are expected to do a certain amount of overtime. As well as what are called penalty rates on top of their normal work hours. Normal work hours in Australia are generally Monday to Friday 8.30am to 5.00pm but can also sometimes vary to be something like 7.30am to 4.00pm.

    You generally work 40 hours per week if your are full time. So if you work 8.30am to 5.00pm you get paid 8 hours for that day's work. The additional 30 minutes is meant to be an unpaid lunch break.

    Penalty Rates.
    Penalty rates are extra amounts of pay you accumulate per hour for working your normal hours in a less favourable time period. So, for example, working evening shifts or night shifts or working on the weekends. You might get paid anywhere between an additional 25% to 75% for a penalty rate shift depending on how undesirable it might be.

    Overtime.
    Overtime is different from penalty rates in that whilst you are also working outside the normal working hours you are doing so on top of your normal 40 hours per week. Overtime rates usually start at time-and-a-half, i.e. you get paid 150% of your normal hourly rate and in most circumstances quickly escalate to double-time (200%).

    The system for penalty rates and overtime does vary a little bit amongst the different State and Territories a little bit. So you need to check out the individual Awards and EBAs to know exactly what you get paid and for what.

    Some Other Benefits.
    There are a range of other benefits that you get when working as an employed doctor in Australia.

    • On top of your salary, your employer is required to pay an additional 9.5% into a superannuation fund to assist with your retirement.
    • As an employee, you are covered by workers compensation for any injury or accident that might occur at work. Although payouts are often fairly poor and below what most professionals earn. So you may wish to consider taking out additional income protection insurance.
    • If you are asked to be on-call you will get a small allowance for this and be paid if you are called back into work.
    • You may get an allowance or even a mobile phone provided to you if you are required to be on call.
    • You might get some meal allowances for shifts.
    • If you have been seconded a reasonable distance from your normal place of appointment you will generally be provided with free temporary accommodation (you may need to pay a bond) and a travel allowance, for example, a free air ticket back home every 13 weeks or so.
    • You will get at least 4 weeks of annual leave per year.
    • Most doctors will also get one extra day off per month. Called a Rostered Day Off or RDO.
    • You will get a certain amount of sick leave every year which you can accumulate if you don't use.
    • You also get access to other types of leave, such as leave to take your child to the doctor.
    What About Health Insurance?
    Unlike in the United States and some other countries Australian employers do not provide health insurance. If you are a citizen or permanent resident you will be well covered for basic care under the Federal Government's universal health care scheme. If you are on a temporary visa you will likely need to take out some form of insurance. Unless your country has a reciprocal agreement in place (for e.g. between the United Kingdom and Australia).

    Related Questions.
    Question: What About Medical Indemnity?
    Answer.

    Medical Indemnity or professional liability insurance is not a requirement if you are only working as a doctor in a public facility or health service. This is because you are indemnified by the employer's insurance. However, it is generally advisable to sign up to one of the Medical Defence Organisations anyway as it generally only costs a few hundred dollars and means that you have an independent provider to turn to whenever you have a medico-legal concern or question.

    If you are working in general practice or a private hospital then you will need some form of indemnity. Again, this may be provided for you. But you should check the details of the cover and particularly ensure that “tail cover” is in place (cover for after you leave the position).

    Question: When Do You Become a Registrar?
    Answer.

    Generally speaking in Australia most doctors enter into vocational or specialty training at postgraduate year 3. These positions are most commonly referred to as “Registrar” posts. But again there are other titles and it can become just as confusing. I plan to write a post about this matter at a later date.

    In some cases you can enter specialty training as soon as PGY2 and of course you can also delay it to later into your training.

    If you see a position advertised as “Registrar” or “Trainee” it is generally a specialty training post. If you see the words “Unaccredited Trainee” this means that you will work at the level of a specialty trainee but won't receive any formal training. Unaccredited trainee positions can be exploited by hospitals as they are not subjected to College accreditation and standards.

    Question: How Much Does An Intern Get Paid?
    Answer.

    Generally somewhere between $68,000 and $79,000 AUD as a base salary.

    Question: Can I Negotiate My Pay & Conditions?
    Answer.

    Unlike some other countries, individual pay negotiation is unusual in Australia

    This is not to say that you cannot ask about certain things. But you have to bear in mind that the system is designed to be equal for everyone else at your same level, so employers will be reluctant to give you something that might give you an advantage over colleagues.

    Employers will also generally be limited to changing things according to how they are already covered in the Award or Enterprise Agreement (see above) or things that are not specifically covered by the Award or Enterprise Agreement.

    So examples of things you might be able to negotiate are:
    • Your commencement grade. Some employers will try to offer to employ you at the lowest grade possible, ignoring your past experience. You should always check on this as once you accept a certain pay grade its hard to negotiate to change it. Whilst you are in the “acceptance phase”, i.e. you have the contract you may be able to highlight to the employer that you have in fact worked more years as a doctor already and should be started as for example a Resident Year 4, rather than a Resident Year 2.
    • Where you are going to work. Often as a Resident you will be employed to a primary hospital which has secondments or even just a network of locations. You should always ask questions about the types of rotations and see if you can lock in where you will be working for the length of your contract. This may be particularly important if you need certain rotations to satisfy the Medical Board of Australia for registration purposes or you have specific personal or family arrangements. You probably won't be able to get out of a secondment but you might be able to choose where you go and when you go there.
    • Relocation expenses. Employers generally have some discretion to pay for relocation because this issue is generally not covered by the Award or EBA and its a once-off expense. It may depend on how desperate they are to have you. But it doesn't hurt to ask politely.
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