royal australasian college of surgeons (fracs) 5 to 7 years (varies by speciality) royal australasian college of medical administrators medical administration fellowship of the royal australasian college of medical administrators (fracma) 3 years royal australasian college of physicians cardiology clinical pharmacology endocrinology gastroenterology general medicine geriatric medicine haematology immunology and allergy infectious diseases medical oncology nephrology neurology nuclear medicine respiratory and sleep medicine rheumatology clinical genetics community child health general paediatrics neonatal and perinatal medicine paediatric cardiology paediatric clinical pharmacology paediatric emergency medicine paediatric endocrinology paediatric gastroenterology and hepatology paediatric haematology paediatric immunology and allergy paediatric infectious diseases paediatric medical oncology paediatric nephrology paediatric neurology paediatric nuclear medicine paediatric palliative medicine paediatric rehabilitation medicine paediatric respiratory and sleep medicine paediatric rheumatology fellowship of the royal australasian college of physicians (fracp) 6 years addiction medicine fellowship of the australasian chapter of addiction medicine (facham) 3 years palliative care fellowship of the australasian chapter of palliative medicine (fachpm) 3 years sexual health medicine fellowship of the australasian chapter of sexual health medicine (fachshm) 3 years rehabilitation medicine fellowship of the australasian faculty of rehabilitation medicine (fafrm) 4 years occupational and environmental medicine fellowship of the australasian faculty of occupational and environmental medicine (fafoem) 4 years public health medicine fellowship of the australasian faculty of public health medicine (fafphm) 3 years royal australian and new zealand college of obstetricians and gynaecologists obstetrics & gynaecology gynaecological oncology maternal-fetal medicine obstetrics and gynaecological ultrasound reproductive endocrinology and infertility urogynaecology fellowship of the royal australian and new zealand college of obstetricians and gynaecologists (franzcog) 6 years royal australian and new zealand college of ophthalmologists ophthalmology fellowship of the royal australian and new zealand college of ophthalmologists (franzco) 5 years royal australian and new zealand college of psychiatrists psychiatry fellowship of the royal australian and new zealand college of psychiatrists (franzcp) 5 years royal australian and new zealand college of radiologists diagnostic radiology diagnostic ultrasound radiation oncology nuclear medicine fellowship of the royal australian and new zealand college of radiologists (franzcr) 5 years royal australian college of general practitioners general practice general practice (rural generalist) fellowship of the royal australian college of general practitioners (fracgp) rural generalist fellowship of the royal australian college of general practiitoners (fracgp-rg) 3 years 4 years royal college of pathologists of australasia anatomical pathology chemical pathology forensic pathology general pathology haematology immunology microbiology fellowship of the royal college of pathologists of australasia (frcpa) 5 years other non-specialist medical practitioners (hospitalists) in australia, 'other medical practitioners' typically include hospitalists who are career hospital doctors; they are experienced generalist medical practitioners whose principal focus is the provision of clinical care to patients in hospitals or the community; they are typically beyond the internship-residency phase of their career, but have decidedly chosen as a conscious career choice not to partake in vocational-specialist training to acquire fellowship specialist qualification. whilst not specialists, these clinicians are nonetheless senior in their years of medical practice, and depending on their scope of practice and experience, they typically work with a reasonable degree of independence and autonomy under the auspices of their specialist colleagues and supervisors. hospitalists form a demographically small but important workforce of doctors in hospitals across australia where on-site specialist (or registrar) coverage is otherwise unavailable. the commonest pathway in medicine, is to complete medical school, then internship and residency, before finally completing a specialty training program as a registrar thereby becoming a specialist medical practitioner. hospitalists typically come from clinicians who have completed their internship-residency, and usually some further formal or informal rotations as a registrar, but have decided not to, or have yet not, complete their vocational specialty training. the reasons for why hospitalists choose their career track are varied, some of which include: doctors who do not have any intentions of specialising as a conscious career choice and prefer working as a non-specialist hospitalist clinician; doctors who practice in a specialised area of medicine with seniority and experience but this specialised area of medicine is not formally recognised as a specialty (such as a medical practitioner working as a clinical forensic medicine or aviation medicine with a qualification or fellowship in this area of medicine from a specialty college that is not recognised or accredited by amc and ahpra); doctors who practice in a specialised area of medicine with seniority and experience but have not been formally recognised as a specialist medical practitioner (such as a medical practitioner who is an international medical graduate with specialist qualifications of a cardiologist in his home country that is not recognised by the relevant accredited specialty college, amc and ahpra); doctors who do not or did not meet the requirements for specialty training; doctors who are intending to specialise in the future but not at this moment; doctors who have completed specialty training in a field but have decided to seek (primary or secondary) employment as a non-specialist hospital clinician (such as a fellowship qualified general practitioner working part-time as a career medical officer in the emergency department or as a surgical assistant); doctors who are concurrently in the process of specialising but are taking temporary leave from their specialty training and/or additionally working as a non-specialist clinician elsewhere usually in the capacity of a temporary locum tenens (such as a resident or registrar at a public teaching hospital working part-time or casually as a career medical officer at a private hospital). these clinicians are also known by a variety of terms, including but not limited to: career medical officer (cmo) senior medical officer (smo) multi-skilled medical officer (mmo) hospitalists or career hospital doctor hospitalists are typically employed in a variety of public and private hospital settings on a contractual or salaried basis. traditionally, career medical officers or hospitalists are employed as permanent full-time or part-time staff, but more commonly in recent times, due to a significant workforce of clinicians been in-flux with their specialty training and insufficient staffing of middle-grade clinicians at hospitals, there has been an increase supply and demand for hospitalists on a locum tenens or casual basis. dependent on their place of employment and duties, the responsibilities and remuneration of non-specialist hospitalists are usually comparable to somewhere between registrars and consultants. despite the common trend for clinicians to specialise nowadays, non-specialist hospitalist clinicians have an important role in fulfilling shortages in the medical workforce, especially when specialist (or registrar) coverage and accessibility is unavailable, where there is an area-of-need, and after-hours or on-site medical care is required. these clinicians and employed across australia in a variety of clinical environments which include medical & surgical wards, mental health units, intensive care units and emergency departments. nonetheless, these clinicians work closely and continually consult with the relevant attending specialists on-call; that is, final responsibility and care for the patient ultimately still rests with the attending specialist. general practice is formally a speciality of its own with formal vocational specialist training. that is, those wishing to practice as a non-vocationally registered general practitioner (non-vr gp) without specialist registration can only do so in designated areas-of-need (such as that of rural townships) and at the compromise of only been able to invoice for limited medicare rebates. the exception to this are those who were 'grandfathered' as already working as gps for at least 5 years prior to 1996. non-specialist doctors are issued a restricted medicare provider number that allows them to initiate referrals and request pathology and radiology investigations, but not access full medicare billings. the australian medical association (ama), australasian society of career medical officers (ascmo) and australian salaried medical officers federation (amsof) are organisations that represent this group of medical practitioners. despite being non-vocational and non-specialist clinicians, they are still required to meet continuing professional development requirements and frequently attend courses facilitated by these organisations and the hospitals to keep their practice and skillsets up-to-date alongside their vocationally-trained specialist colleagues. specialist medical practitioners (general practitioners & consultants) upon completion of the prescribed specialty training program by the relevant medical specialty college, medical practitioners are awarded a fellowship of that college and eligible to register and be recognised as a specialist by their medical specialty college, australian health practitioners regulatory agency and the medical board of australia, which is annually renewed. specialist medical practitioners are considered to have satisfied all the necessary education and training requirements and recognised as vocationally qualified to practise competently and safely for that medical speciality. medical practitioners with specialist registration are allowed to practice independently and unsupervised within their scope of practice, which in effect allows them to pursue private practice outside of public teaching hospitals. specialist medical practitioners are eligible for an unrestricted medicare provider number that allows clinicians to bill rebates from medicare for services delivered to patients, privileges for hospital admissions and private health fund billings, where most patients in australia are a mixture of publicly covered medicare and privately insured through a health fund. whilst most specialist medical practitioners take the opportunity to pursue private practice, many of them (with the exception of a majority of gps) continue to work at least part-time as salaried employees in the state public hospitals. there is also an opportunity for specialists partake in hospital administration to take-up committee or managerial positions, such as director of their department or the hospital or health service, as well as being actively involved in the education and supervised training of their junior colleagues. specialist medical practitioners are typically recognised by their specialty profession name; for example, general practitioner, cardiologist, radiologist, pathologist, haematologist, nephrologist, neurologist, neurosurgeon, et cetera. physician broadly refers to those who specialise in any of the adult or child non-surgical medical sub-specialities. surgeon broadly refers to those who specialise in any of the surgical sub-specialities. medical practitioners which have completed their specialist training are known by a variety of other terminology, including but not limited to: staff specialist attending medical officer (amo) visiting medical officer (vmo) senior medical officer (smo) specialist medical practitioners are required, as part of mainting their specialist registration and fellow status, to partake in activities throughout the year ensuring their continued professional development (cpd) which is monitored and facilitated by their respective specialty medical college. additionally, while there is no requirement to do so, some clinicians at this stage of their career may consider further education (that is, if they have already not done so): higher research or education degrees (such as masters or phd) or co-joint academic position at a university fellowship placements (such as a neurosurgeon spending a year as a fellow in paediatric neurosurgery) sub-specialisation (such as an emergency physician sub-specialising in toxicology) second specialty qualification (such as an anaesthetist attaining a second-qualification to become an intensivist) furthermore, specialist medical practitioners may pursue executive, administrative or advisory roles, including but not limited to: medical director chief medical officer board or committee membership executive of hospital or health service ministerial or political appointments general practice from 1995, general practice in australia became recognised as a specialist field of medicine with an accredited specialty training program; that is, similar to their non-gp specialist colleagues, vocationally registered or fellowship qualified general practitioners are recognised as specialist medical practitioners by the australian health practitioners regulatory agency and medical board of australia as per the health practitioner regulation national law. its specialised role in health care is providing general medical care to the community; it is comparable to the scope of practice of family physicians in the united states and canada. a properly trained and qualified general practitioner (gp) should be able to independently assess, diagnose and treat a wide variety and range of illnesses within their scope of practice prior to referral to their non-gp specialist colleagues. most urban gps work in community-based clinics and deliver predominantly primary care, with a subset of regional or rural gps additionally working in public hospitals to deliver emergency or secondary care where there is a shortfall of non-gp specialist medical practitioners. it is not uncommon for gps to also complete extended skills training to broaden their clinical scope of practice; insofar that it is encouraged and typical for gps to proceed to attain formal accreditation in advanced areas of clinical practice (such as a gp who has postgraduate diplomas and accreditation to provide anaesthesiology or obstetric services) and/or formally complete additional fellowship in another specialty field of medicine (such as