Direct Entry Stream vs Transition Stream

The Subclass 186 visa is the primary employer-sponsored permanent residency visa in Australia. For overseas doctors, it offers two main streams:

Transition Stream (TRT)

The Temporary Residence Transition stream is for doctors who have already been working in Australia on a Subclass 482 visa for at least three years with the same employer. This is the most common pathway for overseas doctors moving from temporary to permanent status.

  • You must have held a 482 visa (Medium-term stream) for at least three years
  • You must have worked for your nominating employer for at least three years on the 482 visa
  • Your employer must nominate you for the same occupation
  • You must still meet English language, health, and character requirements
  • No new skills assessment is required for the Transition stream

Direct Entry Stream

The Direct Entry stream allows doctors to apply for permanent residency without needing to have held a previous temporary visa. This stream is suitable if you are being offered a permanent position from the outset or if your employer wants to fast-track your permanent residency.

  • You need a positive skills assessment from the relevant assessing authority (typically the AMC)
  • You must be under 45 years of age at the time of application (exemptions may apply for certain high-salary positions)
  • You need at least three years of relevant post-qualification work experience
  • Your employer must nominate you and meet all sponsorship obligations
  • You must meet English language requirements (IELTS 6.0 in each band or equivalent, though higher may be required for medical registration)

Requirements and Application Process

Regardless of the stream you choose, both you and your employer must meet specific requirements:

Employer Requirements

  • The employer must be a lawfully operating Australian business
  • The nominated position must be a genuine, full-time role
  • The salary must meet the Temporary Skilled Migration Income Threshold (TSMIT) and be at or above the market rate for the position
  • The employer must demonstrate a commitment to employing local workers and training Australians

Your Requirements

  • Medical registration — You must be eligible for registration with AHPRA to practise medicine in Australia
  • English proficiency — Meet the English language requirements for both the visa and medical registration. See English requirements
  • Health and character — Undergo health examinations and provide police clearances from every country you have lived in for 12 months or more in the last 10 years
  • Age — Generally under 45 years of age for the Direct Entry stream (exemptions may apply)

Application Process

  1. Your employer submits a nomination application to the Department of Home Affairs
  2. You submit your visa application (this can be lodged at the same time as the nomination)
  3. Provide all supporting documents including skills assessment, English test results, health checks, and police clearances
  4. Wait for processing (times vary; check the Department of Home Affairs for current estimates)
  5. If approved, you are granted permanent residency in Australia

Benefits of Permanent Residency

Gaining permanent residency through the 186 visa provides significant advantages for overseas doctors:

  • Unrestricted work rights — Work for any employer in Australia without needing sponsorship
  • Medicare access — Full access to the Australian public healthcare system for you and your family
  • Education — Access to subsidised education for your children, including domestic university fees
  • Social security — Eligibility for certain government benefits after a waiting period
  • Travel — A five-year travel facility to enter and leave Australia
  • Pathway to citizenship — After living in Australia as a permanent resident for the required period, you can apply for Australian citizenship

For a comprehensive overview of all routes to permanent residency, including non-employer-sponsored options, visit our Permanent Residency Pathways page.

Strategic Considerations

When planning your pathway to permanent residency through the 186 visa, consider the following:

  • 482 to 186 transition — Starting on a 482 visa and transitioning to the 186 after three years is the most popular and well-established route. Plan your initial employer carefully, as you will need to stay with them for the full three years.
  • Regional alternatives — If you are open to regional work, the Subclass 494 visa provides an alternative employer-sponsored pathway with potential advantages in processing times and job availability.
  • Costs — Factor in visa application fees, skills assessment costs, English test fees, health examinations, and any migration agent fees. See our registration costs guide for a breakdown.
  • Family planning — Your spouse and dependent children can be included on your 186 visa application, granting them permanent residency as well. See bringing your family.

For guidance on finding an employer willing to sponsor you, see our job search guide and contracts guide.

Important Planning Note

This page is designed as practical guidance for overseas doctors and should be used alongside official requirements published by AHPRA, the AMC, relevant specialist colleges, and the Department of Home Affairs.

Rules, fees, and processing times can change. Before lodging any application, verify current criteria directly with official sources listed on our Resources page.