Junior Doctor Grades and Titles Explained: The Complete Guide for Australia

19/05/2025

Introduction

The medical career pathway in Australia features a structured progression of grades and titles that can seem bewildering to those unfamiliar with the system. Whether you're an Australian medical graduate, an international medical graduate (IMG) looking to work in Australia, or simply curious about the medical career structure, understanding these grades is essential.

This comprehensive guide explains the Australian junior doctor hierarchy, compares it with international systems (particularly the UK), and outlines what each position entails in terms of responsibilities, requirements, and career progression.

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Australian Junior Doctor Hierarchy: The Complete Overview

The Australian medical training pathway follows a clear progression, though terminology can vary slightly between states and territories. Here's a breakdown of the main grades:

1: Intern (PGY1)

An intern is a medical practitioner in their first postgraduate year (PGY1) after completing medical school. This position is equivalent to Foundation Year 1 (F1) in the UK system.

Key characteristics:

• Provisional registration with the Australian Health Practitioner Regulation Agency (AHPRA)
• Mandatory rotations in general medicine, general surgery, and emergency medicine
• Close supervision by more senior doctors
• Focus on developing core clinical skills
• Generally not deployed in subspecialties, paediatrics, or obstetrics/gynaecology
• Primarily available to Australian or New Zealand medical school graduates

Responsibilities include:

• Managing ward lists
• Writing ward round notes
• Completing discharge summaries
• Obtaining correspondence from GPs
• Performing basic ward-based procedures
• Working under direct supervision

Interns are generally well-supported with clear supervision structures. After successfully completing the internship year, doctors are eligible for general registration with AHPRA.

2: Resident Medical Officer (RMO) / PGY2

After completing their internship, doctors progress to become Resident Medical Officers (RMOs), equivalent to Foundation Year 2 (F2) in the UK. This is sometimes called the "residency year" and is the first year with general registration.

Also known as:

• Hospital Medical Officer (HMO) in Victoria
• Junior Medical Officer (JMO) in some hospitals
• PGY2

Key characteristics:

• Full general registration with AHPRA
• Usually a non-training position, especially for IMGs on provisional registration
• Can work across various specialties
• Forms the backbone of inpatient services

Responsibilities include:

• More independent patient assessment and management
• Attending to referrals from Emergency Department
• Participating in outpatient clinics (in some rotations)
• Supporting interns while taking on more complex tasks
• Writing notes and performing procedures
• Reviewing patients independently (with supervision available)

RMOs are present in almost every department, making these positions readily available across Australia's healthcare system.

3: Senior Resident Medical Officer (SRMO) / PGY3

The SRMO role typically refers to doctors in their third postgraduate year (PGY3), equivalent to FY3 in the UK. Despite the "Senior" title, responsibilities remain similar to those of RMOs.

Key characteristics:

• Non-training position
• May be given more responsibility based on previous experience
• Higher pay grade than RMO
• Often a stepping stone before speciality training

SRMOs are found in most departments and there's typically an abundance of positions available.

4: Principal House Officer (PHO) / PGY4+

The PHO grade refers to doctors in their fourth postgraduate year or beyond (PGY4+). This position offers substantially increased pay, though responsibilities can vary depending on the department.

Also known as:

• Medical Officer in Victoria's pay classifications
• Junior Registrar (in some contexts, particularly in Queensland)

Key characteristics:

• Significantly higher pay grade
• Can be seen as either the top of the Resident ladder or the first rung of the Registrar ladder
• May involve teaching and supervising more junior doctors
• Often filled by doctors taking time before entering specialty training

Responsibilities vary by specialty:

• In general medicine: May round independently with an intern assisting
• In emergency medicine: May work on the registrar rota for certain periods
• In subspecialties: May function more like an RMO with less independence

PHO positions are widely available across Australia and offer a good balance of responsibility and support.

5: Registrar Grades

Registrar is a broad term covering several sub-grades with increasing levels of responsibility and training status.

Junior Registrar / Unaccredited Registrar

Key characteristics:

• Usually requires PGY4+ experience
• Similar responsibilities to UK CT2/CT3 doctors
• Typically not in formal specialty training programs
• Well-supported by senior registrars and consultants
• Requires general registration with AHPRA

Responsibilities include:

• Taking referrals
• Performing consults
• Clerking patients
• Managing more complex cases
• Making more independent clinical decisions

Unaccredited Registrar

This term is more commonly used in surgical specialties and refers to positions with similar responsibilities to trainees but without formal college affiliation.

Key characteristics:

• Year-long positions similar to UK Trust Grade roles
• Not formally recognised for specialty training
• Often attractive roles as hospitals try to recruit strong candidates
• Generally require general registration (making them rare as first jobs for IMGs)

Advanced Trainee

Advanced Trainees are registrars enrolled in accredited specialty training programs recognized by Australian Royal Colleges.

Key characteristics:

• Equivalent to UK ST3/4+ in the respective specialty
• Formally recognised training position
• Usually only open to Australian permanent residents or citizens
• Higher level of autonomy and responsibility

🇦🇺 UK–Australia Medical Grade Equivalency Table

AHPRA Registration Types Explained

Understanding registration requirements is crucial for working in Australia:

Provisional Registration

• Required for first postgraduate year
• Similar to GMC's provisional registration for F1s
• Requires supervision
• Restricts from working outside nominated role (no locum work)
• Typical pathway for interns and first-time IMGs

General Registration

• Granted after one year of supervised practice
• Allows greater flexibility in employment
• Required for most registrar positions
• Permits locum work
• Similar to full GMC registration in the UK

Finding the Right Position Based on Your Experience

All roles will require a provisional year of registration prior to getting General Registration

For Post-F1 Doctors Moving to Australia

If you've completed F1 in the UK and are moving to Australia before F2, an RMO position would be most appropriate. Look for job descriptions specifying PGY2 requirements that match your F2-level experience.

For F3 Doctors with Limited Specialty Experience

An RMO position remains the best fit. You'll receive good support and have registrar supervision while you adjust to the Australian healthcare system. Your prior foundation training will give you an advantage in applications.

For F4+ Doctors with Locum or Fellowship Experience

PHO or Junior Registrar positions may be suitable, offering more responsibility and higher pay that reflects your additional experience. Consider initially "acting down" as you adjust to the Australian system.

For Specialty Trainees Looking to Continue Training

Advanced Trainee positions are restricted to doctors already in Australian training programs, typically requiring permanent residency. Consider Unaccredited Registrar positions as an alternative pathway.

State-by-State Variations

While the broad structure remains consistent across Australia, some terminology and specific arrangements vary between states:

New South Wales (NSW)

NSW follows the standard progression from Intern to RMO to Registrar, with recruitment occurring in multiple rounds:

• Early round (May): Limited specialties
• Main round (July-August): Most vacancies advertised
• Second round (October-January): Unfilled positions

Victoria

Victoria sometimes uses the term Hospital Medical Officer (HMO) instead of RMO, with similar grading structures but different pay classifications.

Queensland

Queensland uniquely considers the PHO grade as interchangeable with Junior Registrar, blurring the line between resident and registrar levels.

Salary Expectations Across Junior Doctor Grades

Salary progression is substantial as you advance through the grades:

Grade

Approximate Salary Range (AUD)

Intern (PGY1)

$73,000 - $86,000

RMO (PGY2)

$85,000 - $100,000

SRMO (PGY3)

$95,000 - $110,000

PHO (PGY4+)

$110,000 - $130,000

Registrar

$130,000 - $180,000+

Note: Figures vary by state, hospital, and overtime arrangements. These are base salaries before penalties and allowances.

FAQ: Common Questions About Doctor Grades in Australia

What is the doctor hierarchy in Australia?

The Australian medical hierarchy follows this progression: Intern (PGY1) → Resident Medical Officer (PGY2) → Senior Resident Medical Officer (PGY3) → Principal House Officer (PGY4+) → Registrar (Junior/Unaccredited/Advanced) → Consultant/Specialist.

What is a Junior Medical Officer in Australia?

Junior Medical Officer (JMO) is a broad term encompassing all non-consultant doctors in Australia, including interns, residents, and sometimes registrars. It's similar to the UK term "junior doctor."

What is the difference between SRMO and Registrar?

An SRMO is typically a PGY3 doctor without formal specialty training, while a Registrar is a more senior doctor (usually PGY4+) with increased clinical responsibility and often engaged in specialty training programs.

What is an ST1, ST2, ST3 doctor?

These are UK training grades (Specialty Trainee years 1, 2, and 3). In Australia, the equivalents would be:

• ST1-2: Junior/Unaccredited Registrar
• ST3+: Advanced Trainee

Are F1 and F2 junior doctors?

Yes, in the UK system, Foundation Year 1 (F1) and Foundation Year 2 (F2) doctors are junior doctors in their first two years after medical school. The Australian equivalents are Intern (PGY1) and Resident Medical Officer (PGY2).

What does F1 and F2 mean for doctors?

F1 and F2 refer to Foundation Years 1 and 2, the first two years of postgraduate training in the UK medical system. F1 is equivalent to Intern (PGY1) in Australia, while F2 is equivalent to Resident Medical Officer (PGY2).

What is a junior middle grade doctor?

"Middle grade" typically refers to doctors between junior resident and consultant levels, such as registrars in Australia or specialty trainees (ST1-7) in the UK.

What is an S12 doctor?

An S12 doctor refers to a doctor approved under Section 12 of the UK Mental Health Act to conduct mental health assessments. In Australia, similar roles are performed by psychiatrists or doctors with specific mental health training who are authorised under state mental health legislation.

What is the difference between ST1 and ST2?

ST1 and ST2 are the first and second years of specialty training in the UK. They represent progressive stages of training with increasing responsibility and expertise within a chosen specialty.

Is F1 or F2 better?

Neither is "better" - they are sequential stages of training. F2 offers more independence and responsibility than F1, with less direct supervision. In Australia, being a Resident Medical Officer (RMO/PGY2) similarly offers more autonomy than being an Intern (PGY1).

How old is an F2 doctor?

There is no specific age requirement for F2 doctors. Most are in their mid-to-late 20s, but this varies widely depending on when they entered medical school and whether they took time out during training.

What is a SAS doctor?

Staff Grade, Associate Specialist, and Specialty (SAS) doctors are UK non-training grade senior doctors who are not consultants. The Australian equivalent would be Career Medical Officers (CMOs) or Staff Specialists without fellowship qualifications.

Tips for International Medical Graduates Applying to Australian Positions

Understanding Clinical Year Dates

The Australian clinical year differs from the UK:

• Starts on the first Monday in February each year
• Most positions advertised between May and August for the following February start
• Different recruitment timelines from the UK system

Registration Requirements

• Apply for AHPRA registration at least 6 months before your intended start date
• Verify required documentation early (certificates, work experience, language tests)
• Understand which registration type you need (provisional vs. general)

Practical Advice for UK Doctors

1. Apply for positions matching your experience level, not just your years since graduation
2. Consider initially "under-applying" to allow adjustment to the Australian system
3. Clarify supervision arrangements during interviews
4. Ask about on-call commitments and support structures
5. Research state-specific terminology and requirements

Conclusion

Navigating the Australian junior doctor grades system requires understanding the different terminology and responsibilities associated with each position. Whether you're an IMG considering a move to Australia or an Australian graduate planning your career progression, knowing these distinctions will help you make informed decisions about your medical career pathway.

While terminology may vary between states and hospitals, the fundamental structure remains consistent: progression from closely supervised roles (Intern) through increasing levels of responsibility (RMO, SRMO, PHO) to more specialised training positions (Registrar levels).

By understanding this structure, you'll be better equipped to find positions that match your experience level and career aspirations in the Australian healthcare system.

This article was prepared by medlo.com.au to help doctors understand the Australian medical career structure. For specific advice on registration requirements or employment opportunities, always consult official sources like AHPRA or prospective employers.