graduates of these programs of study are required to hold provisional registration and to satisfactorily complete 12 months of supervised practice as an intern before being eligible for general registration. whereby, general registration indicates that the practitioner has the skills, knowledge and experience to work as a safe entry level medical practitioner able to practise within the limits of their training. interns are required to perform satisfactorily under supervision in the following terms: at least 8 weeks that provides experience in emergency medical care at least 10 weeks that provides experience in medicine at least 10 weeks that provides experience in surgery a range of other approved terms to make up 12 months (minimum of 47 weeks full-time equivalent service). there are usually four or five terms in an internship (between 10 and 12 weeks duration). interns are required to complete three core terms in medicine, surgery and emergency care and other (non-core) rotations make up the balance of the intern year providing opportunities to explore additional areas of medicine and surgery, anaesthesia, psychiatry, paediatrics and less acute care such as rehabilitation medicine, palliative care, geriatrics and general practice. internships are positions facilitated and funded by both state governments and the commonwealth (federal) government. in 2016, there were 3314 state-funded intern positions and 100 commonwealth funded intern positions. with the increasing number of medical graduates, there have been concerns about the number of available internships. applications for internships are typically coordinated by the relevant state government's health department through an annual recruitment campaign. applicants have the opportunity to preference the district and/or hospital(s) they wish to be employed at, and are selected based on a combination of a ballot-based and merit-based system. the australian medical student association provides a yearly internship guide to help guide medical graduates in their application process, as well as providing general information about the different state and territory health systems and clinical opportunities available at the various hospitals. residency residency, for most doctors in australia, is typically a further one or two years following internship spent working in the hospital (or occasionally, in community health settings) to gain more clinical experience in a range of settings with increased levels of responsibility. in contrast to medical education following the united states system, internship and residency in australia are considered pre-vocational terms where doctors have yet to formally commence their training in a specific speciality. while some specialist medical colleges accept entrants after successful completion of internship or postgraduate year 1 (pgy-1), most prefer applicants to have completed at least a further 2 to 3 years (or more) of pre-vocational training at the level of a resident (pgy-2 to pgy-3 or more) in order to have gained sufficient additional clinical experience prior to applying for a specialist training program. clinical rotations and terms are at the preference of the resident (and dependent on the availability of the health service); there are no mandatory terms to fulfill; for example, if the resident has aspirations to pursue enrolment in surgical speciality training, they would preference and request more rotations in the various surgical specialties (for instance, neurosurgery, cardiothoracic, or urology), versus if the resident had interests to pursue emergency medicine, he or she would probably benefit from further rotations in the various critical care specialties (that is, intensive care medicine, emergency medicine, or anaesthetics). during residency, these clinicians are known by a variety of terms, including but not limited to: resident medical officer (rmo) or senior resident medical officer (srmo); junior house officer (jho) or senior house officer (sho) or principal house officer (pho); hospital medical officer (hmo); or, trainee medical officer (tmo). residents typically have general registration with the medical board of australia; that is, having successfully completed internship in australia. whilst the medical board no longer requires performance reports to be submitted directly to them, it mandates and delegates the responsibility to the relevant hospital administration, post-graduate medical councils and speciality colleges, to ensure the continual support, education and teaching of their residents (and registrars) as well as ensuring routine performance reviews and term reports from senior clinicians supervising their practice. applications for residency is similar to that of internship, and is coordinated by the relevant state government through an annual recruitment campaign. applicants have the opportunity to preference the district and/or hospital(s) they wish to be employed at, and are selected on a merit-based system which typically includes a review of the applicant's resume, interview, and referee reports. registrarship / speciality training programs registrars registrars are doctors formally enrolled and accredited into a speciality (also known as 'vocational') training program; hence, they are also known as "trainee specialists". after completing internship and one or more additional years as a resident and meeting the pre-requisites for the relevant speciality college, doctors can apply for admission to a recognised medical speciality training program. registrarship or vocational specialty training is akin to an apprenticeship or clerkship in other professions. it is a period of on-the-job training and assessments in order to qualify for fellowship of one of the recognised specialist medical colleges, which allows a doctor to practice medicine independently and unsupervised in that relevant speciality field, and with this access to an unrestricted medicare provider number and medical board specialist registration. selection into a speciality training programs are based upon merit and are highly competitive. nowadays, most colleges require applicants to have previous clinical supervisors submit referee reports, and fulfil a number of criteria in their curriculum vitae which typically involve scoring the candidate in four domains: demonstrated clinical experience at the level of a resident or unaccredited registrar relevant to the speciality applied for academic excellence in addition to the basic medical degree including research publications and higher educational degrees pre-requisite completion of recommended workshops or courses, and if any, entrance examinations or assessments extra-curricular activities and merits that demonstrate a well-rounded individual applicants with satisfactory cv are invited to partake in interviews or assessments that typically assess adequate medical knowledge to commence speciality training and explore psycho-socially if the candidate if suitable for the speciality. registrars pay an annual enrolment fee to be part of the speciality college (in addition to fees for exams and courses). in order to qualify for election to fellowship and specialist recognition, most specialist colleges have clinical, practical and exit exams, in conjunction with other assessments to assess the full range of skills and behaviours required as a doctor, such as communication and team work. specialist training programs and examinations are administered by the individual colleges and vary between three and seven full-time years to complete, depending upon the speciality you choose. part-time training is available to most specialities, and dual-speciality-training is optional and streamlined for some specialities. vocational training for most medical specialities is undertaken in a public teaching hospital, however it increasingly includes rotations in private hospitals, regional, rural and community health settings. the exception is general practice, where doctors undertake most of their training in designated private general practices in a community setting. registrars are nonetheless employed and remunerated by the hospital at which they work for; and thus, are still required to submit an application for a position through the recruitment campaigns coordinated by the relevant state government's ministry of health. that said, some colleges help allocate employment and allocation to various training sites and hospitals to streamline the traineeship and employment obligations, whereas some colleges leave this entirely to the discretion of the trainee. registrars are typically classified into : junior registrar; typically refers to trainees who are in the basic or primary phase of their specialty training; assessments are typically a requirement to progress to the advanced training phase senior registrar; typically refers to trainees who are in the advanced phase of their specialty training; assessments are typically a requirement to become eligible to complete training and attain fellowship fellow; typically refers to trainees who have successfully completed specialty training and eligible for specialty fellowship but are not yet formally employed as specialists time spent as a fellow is either a mandatory or optional requirement by some specialties in order to further develop sub-specialty skillsets and/or ensure and further prepare newly qualified specialists registrars are comparable to residents in the united states medical system; that is, at this stage of their medical career, both are undergoing specialty training. as aforementioned, residents in the australian medical system are doctors who have completed internship and undergoing additional years of general clinical rotations to gain further experience, prior to enrolling into a specialty training program. in the united states, choice of specialty is decided upon commencing internship, such that clinical rotations and specialty training requirements are streamlined early on and flows straight on to residency. there is no requirement in the united states for junior doctors to complete "pre-vocational/pre-specialist" training or experience general clinical rotations prior to specialty training enrolment; which is in contrast to australian and other commonwealth medical systems that choose to keep this traditional format in view that it ensures junior doctors receive holistic training and generalist exposure in various specialties of medicine before choosing a specialty to pursue. unaccredited registrars "unaccredited" registrars are doctors who are fulfilling the higher duties and role of a specialist registrar at a hospital, but do not receive accreditation for their time spent working in the role or the protected training benefits of an accredited training position. they typically come from the cadre of senior residents with adequately more experience and aspirations to pursue that specific specialty as a career, but have yet to meet the pre-requisites to formally enrol into the specialist training program and become an accredited specialist trainee; where typically time spent working and training as an unaccredited registrar does not usually count towards formal specialty training time. unaccredited registrars help fulfil shortages in hospital services where otherwise an accredited registrar is unable to be recruited; thus, they are sometimes also known as "service" registrars. doctors who choose to take up the role of an unaccredited registrar are typically those: needing to meet the pre-requisites to gain sufficient exposure and experience in that certain specialty at a more senior level of a registrar, and to acquire favourable referee reports from supervisors, in order to successfully enrol into the specialist training program thereafter becoming an accredited registrar (e.g. a senior resident who has applied to work as an unaccredited registrar in order to gain more experience so that he or she may enrol into a formal surgical specialist training program later on). having no intention of pursuing that specialty itself, but looking to gain more experience and training at a more senior level as a registrar in order to improve their overall clinical knowledge and competence (e.g. clinicians intending to work as a hospitalist or general practitioner rotating through intensive care to acquire more clinical skills in critical care). medical specialist colleges in australia, the australian medical council has recognised 16 medical speciality colleges responsible for the continued education, training, and accreditation standards of their respective specialities: medical specialist colleges of australia organisation speciality fellowship awarded years of training australasian college for emergency medicine emergency medicine fellowship of the australasian college for emergency medicine (facem) 5 years australasian college of dermatologists dermatology fellowship of the australasian college of dermatologists (facd) 4 years australasian college of sport and exercise physicians sports & exercise medicine fellowship of the australasian college of sport and exercise physicians (facsep) 4 years australian and new zealand college of anaesthetists anaesthesia pain medicine fellowship of the australian and new zealand college of anaesthetists (fanzca) fellowship of the faculty of pain medicine, australian and new zealand college of anaesthetists (ffpmanzca) 5 years 1 to 3 years australian college of rural and remote medicine general practice (rural generalist) fellowship of the australian college of rural and remote medicine (facrrm) 4 years college of intensive care medicine intensive care medicine (adult and/or paediatric) fellowship of the college of intensive care medicine of australia and new zealand (fcicm) 6 years royal australasian college of dental surgeons oral & maxillofacial surgery fellowship of the royal australasian college of dental surgeons (oral maxillofacial surgery) (fracds (oms)) 4 years royal australasian college of surgeons cardio-thoracic surgery general surgery neurosurgery orthopaedic surgery otolaryngology & head and neck surgery paediatric surgery plastic & reconstructive surgery urology vascular surgery fellowship of the