What Is the Standard Pathway?

The Standard Pathway is the primary registration route for international medical graduates (IMGs) who did not train in one of the countries covered by the Competent Authority Pathway — meaning the vast majority of overseas doctors applying for Australian registration. It is open to doctors from any country in the world, regardless of specialty, training background, or years of experience.

The pathway is administered by the Australian Medical Council (AMC) and requires passing two stages of examination — the AMC MCQ Examination and the AMC Clinical Examination — followed by an application to AHPRA for registration. The AMC examinations are specifically designed to assess whether an overseas-trained doctor's knowledge, clinical skills, and approach to patient care are equivalent to those of a graduate from an Australian medical school. Passing both examinations results in the AMC issuing a "Certificate of Completion," which forms the basis of your AHPRA registration application.

The total process from starting your AMC application to holding Australian registration typically takes 12–24 months, depending on how quickly EPIC credential verification is completed, how long you take to prepare for and pass the examinations, and how smoothly the AHPRA application is processed. Many doctors underestimate the time required, particularly for clinical exam preparation and travel logistics, so early planning is essential.

Before committing to the Standard Pathway, consider whether you might be eligible for the Specialist Pathway if you hold a recognised overseas specialist qualification, or whether Limited Registration could allow you to start working in Australia while you prepare for your AMC examinations.

Are you a specialist? If you hold a specialist fellowship, diploma, or board certification from your home country — such as MRCP, FRCS, FCPS, MMED, ABIM, or equivalent — you may qualify for the Specialist Pathway, which bypasses AMC examinations entirely. Check this before committing to the Standard Pathway.

Step 1 — EPIC Credential Verification

The very first action you should take when planning the Standard Pathway is to initiate credential verification through EPIC (ECFMG International Credentials Services). EPIC is a service provided by the Educational Commission for Foreign Medical Graduates (ECFMG) that verifies the authenticity of medical school degrees on behalf of the AMC. It is not optional — the AMC will not allow you to sit examinations until your credentials are verified.

How EPIC Works

You create an EPIC account online and submit details of your primary medical qualification (the degree that gave you the right to practise medicine). You pay the EPIC verification fee. EPIC then contacts your medical school directly — not you — to confirm that your degree is genuine and that you are a legitimate graduate of that institution. Once your medical school confirms your credentials, EPIC transmits the verification report to the AMC. The AMC then reviews your complete application, including the EPIC verification, before granting you access to sit the MCQ examination.

Timeline and Common Delays

EPIC verification typically takes 2–4 months, but can take considerably longer depending on your medical school's responsiveness. Schools in countries with slow administrative systems, schools that have merged or closed since your graduation, or schools with high volumes of EPIC requests can take 6 months or more to respond. Because you cannot sit the AMC MCQ until EPIC is complete, any delay here directly delays your entire pathway. This is why you must start EPIC immediately — not after you have passed the MCQ, not after you have your English test results, but as soon as you decide to pursue the Standard Pathway.

Practical Tips for EPIC

  • Begin EPIC the same day you register with the AMC — the two run in parallel, so there is no reason to delay one waiting for the other.
  • Contact your medical school registrar's office directly and tell them to expect a verification request from EPIC. Introduce yourself and provide your student ID or graduation year to help them locate your records quickly.
  • Follow up with EPIC every 4–6 weeks if you have not heard of progress — they do provide status updates online.
  • If you have changed your name since graduating (for example through marriage), ensure your documentation consistently reflects this with a supporting legal document such as a marriage certificate.
  • If your degree certificate is in a language other than English, have a certified translation prepared, as EPIC and the AMC will require one.
  • Keep copies of all correspondence in case you need to escalate or troubleshoot delays.

Step 2 — English Language Test

Before you can be granted AHPRA registration, you must demonstrate proficiency in English — unless you qualify for an exemption based on training and practice history. While the English test result is technically submitted at the AHPRA stage rather than the AMC stage, you should sit your test early in the process so that results do not expire before you are ready to apply to AHPRA.

Accepted Tests and Minimum Scores

  • IELTS Academic: minimum 7.0 in each of the four bands — Listening, Reading, Writing, and Speaking. A single band below 7.0 fails the requirement, regardless of the overall score. This is the most common test used by overseas doctors.
  • OET Medicine (Occupational English Test): minimum grade B in each of the four sub-tests — Listening, Reading, Writing, and Speaking. OET uses healthcare-specific clinical scenarios throughout the examination, which many doctors find more familiar and less stressful than IELTS. It is strongly recommended for doctors who are confident in clinical communication but less comfortable with academic English tasks.
  • PTE Academic (Pearson Test of English Academic): minimum score of 65 in each communicative skill section (Listening, Reading, Writing, Speaking). Computer-marked and with faster results than IELTS or OET.
  • TOEFL iBT: minimum scores apply across all four sections. Check the AHPRA website for the current TOEFL minimum requirements as they are updated periodically.

Test results are valid for two years from the date of the test. If your results expire before your AHPRA application is submitted and approved, you must resit. When planning your timeline, work backwards from your expected AHPRA application date to determine the latest date you can sit your English test while remaining within the two-year validity window.

Exemptions

You are typically exempt from English language testing if you have completed your primary medical degree at a medical school where English is the primary language of instruction, and have then practised medicine for a continuous period of at least five years in Australia, Canada, Ireland, New Zealand, the United Kingdom, or the United States. All five years must have been spent practising in English. See the English Language Requirements page for the complete exemption criteria and specific rules.

Step 3 — AMC MCQ Examination

The AMC MCQ Examination is a computer-adaptive test (CAT) that assesses the breadth and depth of your medical knowledge against the standard expected of Australian medical graduates. It tests all major clinical disciplines and is sat at Pearson VUE examination centres worldwide — you do not need to be in Australia to sit this examination.

Examination Format and Content

The examination consists of approximately 120–150 multiple-choice questions in a "single best answer" format — each question has five answer options and exactly one correct answer. The computer-adaptive element means the algorithm selects the next question based on your response to the previous one; questions are not fixed in advance. The total examination time is approximately 3.5 hours. You cannot skip questions and return to them later in the conventional sense, and there is no negative marking — always select an answer even if you are unsure.

Clinical disciplines covered include: internal medicine (cardiology, respiratory, gastroenterology, endocrinology, nephrology, haematology, rheumatology, neurology, dermatology), surgery (general, orthopaedic, urology, vascular), paediatrics, obstetrics and gynaecology, psychiatry and mental health, emergency medicine, general practice, and public health and epidemiology. Questions draw heavily on Australian clinical guidelines, Australian drug names (which may differ from those used in your home country), and the Australian healthcare system framework.

You receive a pass or fail result, together with a performance report indicating your relative performance across clinical domains. If you fail, there is a mandatory waiting period before you can resit, and there is a limit on the total number of attempts allowed.

Booking and Sitting the Examination

You book the AMC MCQ through the Pearson VUE website after you have been granted examination eligibility by the AMC (which requires EPIC verification to be complete). Pearson VUE has test centres in most countries worldwide, including India, Pakistan, the UAE, Egypt, Nigeria, South Africa, the Philippines, and many others. You can sit the MCQ in your home country before travelling to Australia. Examination dates are generally available throughout the year, but popular test centres can have limited availability — book well in advance.

Fees

The current AMC MCQ Examination fee is approximately AUD $2,880. This is the fee for a single examination attempt. Resit fees apply for subsequent attempts. Check the AMC website for the current fee schedule, as fees are updated periodically.

Preparation Strategy and Recommended Resources

Most doctors who pass the AMC MCQ on their first attempt spend between 3 and 12 months preparing, depending on how current their clinical knowledge is and how familiar they are with Australian clinical standards. The following resources are highly recommended:

  • AMC Question Book — the official AMC preparation resource, available from the AMC website. Provides sample questions in the AMC format and explanations of the standard expected.
  • AMC MCQ Banks — online question banks (several commercial providers offer AMC-specific banks). Doing a high volume of practice questions under timed conditions is the single most effective preparation strategy.
  • Therapeutic Guidelines (eTG Complete) — the gold-standard Australian clinical management guideline resource, available online by subscription. The AMC MCQ answers are frequently consistent with eTG recommendations. Particularly important for prescribing, infectious disease management, and antimicrobial stewardship questions.
  • MIMS Australia — for Australian drug names, formulations, and dosages. Australian drug names often differ from those in the UK, India, or other countries.
  • UpToDate / Harrison's Principles of Internal Medicine — for deeper reading on conditions where your knowledge is less confident.
  • Australian clinical guidelines — for conditions such as hypertension (National Heart Foundation), diabetes (Diabetes Australia), cancer screening (Cancer Australia), and immunisation (ATAGI). These are freely available online.
  • Join online study communities — Facebook groups and forums dedicated to AMC MCQ preparation provide access to shared resources, study schedules, and peer support from other candidates worldwide.

Step 4 — AMC Clinical Examination

Having passed the AMC MCQ, you are eligible to sit the AMC Clinical Examination — the most demanding and logistically complex stage of the Standard Pathway. This examination is held exclusively in Melbourne, Australia, and requires you to be physically present. If you are currently overseas, you will need to travel to Australia specifically for this examination.

Examination Format

The AMC Clinical Examination is a 16-station Objective Structured Clinical Examination (OSCE). Over approximately 2.5–3 hours, you rotate through 16 separate clinical stations. At each station (which lasts approximately 8–10 minutes), you encounter a different clinical scenario and are assessed by an examiner or a standardised patient. Station types include:

  • History-taking: taking a focused or comprehensive history from a standardised patient. Marks are awarded for clinical relevance, structure, empathy, and eliciting of relevant positives and negatives.
  • Physical examination: performing a structured examination of a system (cardiovascular, respiratory, abdominal, neurological, musculoskeletal, etc.) on a real patient or actor. Marks are for technique, structure, and communication during examination.
  • Communication and counselling: breaking bad news, obtaining informed consent for a procedure, counselling a patient about a diagnosis or medication, or addressing a patient's concerns. These stations assess communication skills, empathy, and the ability to use clear, jargon-free language.
  • Clinical management: interpreting investigation results (ECGs, blood tests, imaging), formulating a management plan, or making a diagnosis based on a clinical scenario.
  • Emergency scenarios: demonstrating appropriate initial management of an acutely unwell patient, including recognition of life-threatening conditions and application of resuscitation protocols.
  • Patient education: explaining a diagnosis, treatment plan, or lifestyle modification to a patient in understandable terms.

The examination is delivered using a combination of trained standardised patients (actors trained to simulate clinical presentations) and real patients. Australian clinical culture places strong emphasis on patient-centred communication, shared decision-making, and culturally competent practice — these are explicitly assessed in the examination.

Location and Practical Logistics

The examination is held at the AMC's National Test Centre in Melbourne, Victoria. It is offered multiple times per year — check the AMC website for current examination dates and registration windows, as places are limited and popular sessions fill quickly. If you are travelling from overseas, you will need:

  • A valid Australian visitor visa (subclass 600) or other appropriate visa for entry to Australia
  • Accommodation in Melbourne for at least 3–5 days (allowing time before the exam to acclimatise)
  • Return flights — factor in potential delays and book with flexibility where possible
  • Time off work or leave from your current position

Many candidates use the Melbourne trip as an opportunity to also visit hospitals, attend interviews, or meet with medical recruitment agencies.

Fees

The current AMC Clinical Examination fee is approximately AUD $3,700. When combined with travel, accommodation, and preparation costs, the total expenditure for the clinical examination can easily reach AUD $6,000–8,000. Budget conservatively and have resit funds available.

Preparation Strategy

Preparing for the AMC Clinical Examination requires a fundamentally different approach from MCQ preparation. This is a performance examination — you must demonstrate skills in real time, under observation, in a structured environment. The following strategies are effective:

  • Talley and O'Connor's Clinical Examination — the definitive Australian clinical examination textbook, structured around systematic approaches to each organ system. AMC examiners expect exactly the structured examination techniques described in this book. Memorise and internalise the system-by-system examination routines.
  • AMC Clinical Examination preparation courses: multiple commercial providers offer intensive 3–5 day OSCE preparation courses held in Australian cities, typically Melbourne or Sydney. These courses use trained standardised patients and experienced AMC examiners or tutors, and provide structured feedback. They are highly recommended, particularly if you have not practised clinically in Australia before and are not familiar with Australian clinical culture and communication norms.
  • OSCE practice with a partner: find other AMC Clinical Examination candidates and practise stations together. Use a timer (8–10 minutes per station), rotate roles between doctor and patient, and give each other structured feedback. Consistent, repeated practice is the most reliable preparation method.
  • Australian clinical culture: if you have not worked in Australia before, take time to understand Australian patient communication expectations — patients expect to be involved in decisions about their care, to receive clear information in plain language, and to be treated as partners rather than passive recipients of medical advice. Practise introducing yourself by first and last name, asking about the patient's understanding and preferences, and summarising your management plan clearly.
  • Emergency algorithms: be fluent in Australian resuscitation guidelines (ANZCOR — Australian and New Zealand Committee on Resuscitation) for cardiac arrest, choking, anaphylaxis, and other emergencies. These are tested in stations.

Step 5 — AHPRA Registration Application

After passing both AMC examinations, the AMC will issue your AMC Certificate of Completion. This is the pivotal document that confirms to AHPRA that you have met the AMC's assessment standard and are suitable for registration. Without this certificate, AHPRA cannot process your registration application.

Submitting Your AHPRA Application

You apply for registration through AHPRA's online application portal. The application requires the following:

  • AMC Certificate of Completion
  • Proof of identity (passport or equivalent government-issued photo ID)
  • English language test results or documentary evidence of exemption
  • Criminal history declaration and any relevant criminal history documents (police clearance certificates from countries you have lived in for 12 months or more since age 18)
  • Evidence of recency of practice (employment letters, contracts, or reference letters from employers confirming your clinical role, hours, and responsibilities)
  • Details of any current or past registration with any medical regulatory authority in any country
  • Disclosure of any past notifications, complaints, disciplinary actions, or conditions on your registration anywhere in the world
  • AHPRA registration fee (currently approximately AUD $885 for initial registration — check the AHPRA website for the current fee)

AHPRA's processing time is typically 4–12 weeks for complete applications. Incomplete applications or those requiring further investigation (for example, where criminal history or disciplinary matters need to be considered) may take longer.

Provisional vs General Registration

Most Standard Pathway applicants are initially granted provisional registration. Provisional registration is conditional on completing a period of supervised clinical practice — typically 12 months working in an approved supervised hospital position. During this period you work as a doctor under supervision, cannot practise independently, and must have an approved supervisor who provides regular assessment reports to AHPRA. After the supervised period is satisfactorily completed, you apply to AHPRA to convert to general registration.

General registration is the goal — it allows independent medical practice without supervision conditions and is what most employers expect for ongoing employment beyond a hospital training position.

Preparation Resources, Timeline, and Costs

Realistic Timeline

  • Month 1: AMC registration, initiate EPIC, book English test
  • Months 1–4: EPIC verification progresses; study for AMC MCQ begins; English test completed
  • Month 4–6: EPIC verification complete; AMC confirms examination eligibility
  • Months 6–12: AMC MCQ preparation and examination (6–12 months of study for most candidates)
  • Months 9–15: AMC Clinical Examination preparation, travel to Melbourne, sit exam
  • Months 14–18: AMC Certificate of Completion issued; AHPRA application submitted
  • Months 16–20: AHPRA registration granted (provisional)
  • Months 20–32: Supervised practice period (12 months in approved setting)
  • Month 32+: General registration granted

Doctors who prepare intensively and pass both AMC exams on first attempt can complete the pathway in 12–18 months. Requiring a resit of either examination adds 3–12 months. This is a realistic planning guide, not a guaranteed timeline.

Approximate Costs (First Attempt)

  • AMC application and administration fees: ~AUD $1,700–2,000
  • EPIC verification fee: ~USD $150–300
  • English language test (IELTS/OET): ~AUD $300–450
  • AMC MCQ Examination: ~AUD $2,880
  • AMC Clinical Examination: ~AUD $3,700
  • Clinical exam preparation course (optional but recommended): ~AUD $1,000–2,500
  • Travel and accommodation for clinical exam in Melbourne: ~AUD $1,000–3,500
  • Study materials and question banks: ~AUD $300–800
  • AHPRA registration fee: ~AUD $885
  • Total (first attempt, all exams passed): approximately AUD $12,000–18,000

Resitting either examination adds approximately AUD $2,880 (MCQ) or AUD $3,700 (clinical) plus associated preparation and travel costs. For a complete breakdown, see the Registration Costs page.

Consider Limited Registration while you prepare. Many Standard Pathway candidates also apply for Limited Registration, allowing them to work in a supervised position in regional Australia while studying for AMC exams. This significantly reduces the financial burden of the pathway and provides valuable Australian clinical experience that helps with clinical exam preparation.

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