Did You Know You Can Work in Private Psychiatry Under the 10-Year Moratorium?
Understand Section 19AB, where you may be eligible to work and why the 10-year moratorium doesn't necessarily rule out private psychiatry opportunities.
For many overseas-trained psychiatrists considering opportunities in Australia, the 10-year moratorium can feel like a major restriction on where you can work.
And one assumption comes up regularly:
“If I'm still under Section 19AB, I can't work in private psychiatry.”
That isn't necessarily the case.
Depending on your individual circumstances, the location of the position and the exemptions available to you, there may be pathways that allow you to work within private psychiatry while you are still subject to Section 19AB.
The important part is understanding how the rules apply to
your particular situation before ruling an opportunity in—or out.
What is Section 19AB and the 10-year moratorium?
Section 19AB of the Health Insurance Act 1973 places restrictions on access to Medicare benefits for certain overseas-trained doctors and foreign graduates of accredited medical schools.
For non-GP specialists such as psychiatrists, this generally means working in a location classified as a District of Workforce Shortage (DWS) to access Medicare benefits while subject to the moratorium.
The requirement is commonly known as the 10-year moratorium.
However, the term can be misleading if it creates the impression that you simply have to wait 10 years before other opportunities become available.
There are exemptions and workforce pathways that may allow eligible doctors to access Medicare benefits in circumstances that would otherwise be restricted under Section 19AB.
Can you work in a private hospital under Section 19AB?
Potentially, yes.
Being subject to the 10-year moratorium does not automatically mean you are excluded from every private psychiatry opportunity.
For psychiatrists, Medicare access is particularly important because practising and admitting patients within private hospitals can involve Medicare-billable services.
Whether you can take a particular position will depend on the circumstances of the role and the doctor, including:
- Whether the location is classified as a DWS for your specialty
- Your registration and Medicare eligibility
- Whether an appropriate Section 19AB exemption applies
- The structure and requirements of the position
- Your previous employment and exemption history
- Your individual circumstances
This is why two psychiatrists who appear to have similar backgrounds may not necessarily have the same options.
Section 19AB exemptions you should know about
The Australian Government provides several exemption pathways, each with its own eligibility requirements.
For overseas-trained psychiatrists, relevant pathways may include:
DWS positions
For non-GP specialists, working in a location classified as a District of Workforce Shortage for your specialty can provide a pathway to obtaining the required Medicare provider number and Section 19AB exemption.
Importantly, DWS status is assessed for specialist services and can vary by specialty and location.
Six-Month Locum Exemption
A six-month locum exemption can provide access to Medicare benefits in a location for up to six months while you arrange work in a DWS location.
This exemption cannot simply be extended or repeatedly used at the same location, so your previous exemption history matters.
Replacement Exemption
You may be eligible to work in a location that would otherwise be restricted if you are replacing another doctor who held an appropriate Section 19AB exemption and has left the practice and local area.
Spousal Exemption
Certain doctors may be eligible for an exemption based on their spouse's employment circumstances, including where the spouse is a medical practitioner or eligible skilled migrant
After-Hours Exemption
Section 19AB restrictions may also have an after-hours pathway.
The current rules define after-hours as
6pm to 8am Monday to Friday, plus any time on Saturdays, Sundays and public holidays.
Academic Exemption
An academic exemption may be available where a doctor holds an academic appointment with an Australian medical school and provides clinical services as part of that appointment.
This does
not simply apply to private practice without teaching responsibilities.
Discretionary Exemptions
In limited circumstances, discretionary exemptions may be considered for medical reasons or exceptional circumstances.
These exemptions have specific criteria and should not be assumed to apply without assessing the doctor's individual situation.
Don't assume a location is—or isn't—available to you
One of the most important things to understand about Section 19AB is that location matters.
DWS is calculated differently from the Distribution Priority Area system used for GPs, and specialist DWS classifications can be checked by specialty through the Australian Government's Health Workforce Locator.
That means a private psychiatry opportunity shouldn't necessarily be dismissed simply because you assume the location won't work under your moratorium.
Check first.
The combination of the position, location, DWS status and your individual exemption eligibility can make a significant difference.
Your moratorium may also be reduced through scaling
The “10-year” moratorium doesn't necessarily mean every doctor will spend the same amount of time working under geographic restrictions.
Eligible overseas-trained doctors working in regional and remote areas can accumulate scaling credits, with greater credits available for more remote locations.
Depending on the location and other eligibility requirements, this can reduce the period before a doctor can work outside DWS restrictions.
For some psychiatrists, the question therefore isn't simply:
“Where can I work today?”
It may also be:
“Which opportunity puts me in the best position for where I want to work next?”
Why generic advice can be risky
There is a huge amount of information online about the 10-year moratorium.
The problem is that Section 19AB is highly dependent on individual circumstances.
A general article—or an AI-generated answer—doesn't necessarily know your registration pathway, previous exemptions, Medicare status, employment history or the circumstances surrounding a particular vacancy.
And there is another important consideration: Section 19AB exemptions cannot be backdated.
You need the appropriate Medicare provider number and exemption before providing services that attract a Medicare rebate.
That makes it important to understand your position before commencing work.
Private psychiatry opportunities may be closer than you think
If you've assumed the 10-year moratorium means private psychiatry is completely unavailable to you, it may be worth taking another look.
Depending on your circumstances, there may be opportunities through:
- DWS locations →
- Locum exemptions →
- Replacement exemptions →
- After-hours work →
- Academic pathways →
- Other eligible exemptions
The right pathway isn't the same for every psychiatrist.
That's where specialist knowledge of both psychiatry recruitment and Section 19AB becomes particularly valuable.
Talk to someone who understands private psychiatry recruitment
Olga Kalenbach has specialised in psychiatry recruitment for more than 12 years, working with psychiatrists and hospitals across Australia.
One of the questions she receives most often from International Medical Graduates is:
“Can I actually work in this role under 19AB?”
Rather than assuming the answer is no, Olga can help you explore the circumstances surrounding the opportunity and determine what options may be worth investigating.
This can include helping you:
- Understand how Section 19AB may affect the roles you're considering
- Identify potentially suitable private psychiatry opportunities
- Explore locum positions where an exemption may be relevant
- Consider potential exemption pathways before applying
- Understand which locations may offer opportunities for your circumstances
- Navigate the recruitment process with greater clarity
Still under the 10-year moratorium? Don't rule out private psychiatry yet.
Your Section 19AB status doesn't necessarily tell you the whole story.
There may be private hospital, locum or other psychiatry opportunities available depending on your circumstances.
Speak with Olga and the CC Medical Psychiatry team about your situation and find out what opportunities may be worth exploring.
Information in this article is general in nature and should not be considered legal, Medicare or migration advice. Section 19AB eligibility and exemptions depend on individual circumstances and relevant government assessment. Always confirm your eligibility and Medicare provider number requirements before commencing a position.
