FAQ : Recognition of medical specialties

Recognition of a specialty or field of specialty practice means that the Council of Australian Governments (COAG) Health Council has made a decision under the National Law[1] to recognise a new or amended specialty or field of specialty practice and to amend the list of titles of specialties, fields of specialty practice and titles for the profession.

Only a medical practitioner with specialist registration can call themselves a ‘medical specialist’ and use the protected title associated with their recognised specialty. It is a breach of the National Law, attracting significant financial penalties, if practitioners call themselves a ‘medical specialist’ and/or use a protected specialist title if they do not have specialist registration in the relevant recognised specialty.

The Council of Australian Governments (COAG) Health Council decides whether to approve a new or amended medical specialty or field of specialty practice.

The Medical Board of Australia considers applications proposing a new or amended medical specialty and decides whether to recommend to the Council of Australian Governments (COAG) Health Council that a new or amended specialty be recognised.

The Australian Medical Council provides advice to the Medical Board of Australia (the Board) on any proposals for the recognition of a new or amended medical specialty. This includes assessing any applications proposing a new or amended medical specialty on behalf of the Board.

New or amended medical specialties are approved by the Council of Australian Governments (COAG) Health Council on the recommendation of the Medical Board of Australia (the Board).

The COAG Health Council has developed guidance for National Boards on the criteria and process for approval of specialties under the National Law. That guidance is published at https://www.ahpra.gov.au/About-AHPRA/Ministerial-Directives-and-Communiques.aspx.

The Board and the Australian Medical Council have published Guidelines for the Recognition of Medical Specialties and Fields of Specialty Practice under the Health Practitioner Regulation National Law (the Guidelines) detailing the process and assessment criteria that support the requirements of the COAG Health Council.

The COAG Health Council will only consider a recommendation for a new or amended speciality if a public benefit has been demonstrated. That is, applicants proposing a new or amended specialty must establish that there is a need for government intervention (regulation) in the interests of the public and that existing arrangements, or other regulation or non-regulatory options are unsatisfactory. For this reason, the application process involves a robust regulatory assessment, with extensive stakeholder consultation.

Proposals for regulatory change may also require a Regulation Impact Statement. The Office of Best Practice Regulation of the Department of the Prime Minister and Cabinet is responsible for scrutinising Regulation Impact Statements and will be consulted during the assessment process.

The Medical Board of Australia (the Board) and the Australian Medical Council (the AMC) have published Guidelines for the Recognition of Medical Specialties and Fields of Specialty Practice under the Health Practitioner Regulation National Law (the Guidelines). The Guidelines detail the process for applying for the recognition of a new or amended medical specialty by the COAG Health Council.

The process is a two stage process. Applications for a new or amended medical specialty do not proceed to Stage 2 (Detailed assessment) unless the Board decides that there may be a case for recognition. The Board receives applications and seeks the AMC’s advice in assessing them. The Board takes into consideration the advice of the AMC and any other information and decides whether or not to recommend the COAG Health Council approve the proposed new or amended specialty.

Stage 1: Initial assessment of proposal (application): The applicant submits a preliminary proposal to the Board, describing the objectives of the proposal in broad terms. The Board seeks the AMC’s advice. If the Board decides there is no case for recognition, the application does not proceed further.

Stage 2: Detailed assessment of proposal (application): During this stage, the AMC assesses the applicant’s detailed case for recognition of a new or amended specialty on behalf of the Board. The AMC sets up a review panel to complete the assessment. This stage is a rigorous assessment of the case, that includes a public consultation process. If necessary the Board may commission additional work by third parties (e.g. academics, health economists) and obtain independent expert opinion.

After considering the AMC’s advice, the Board will decide whether or not to recommend that the COAG Health Council approve the new or amended specialty.

The Guidelines for the Recognition of Medical Specialties and Fields of Specialty Practice under the Health Practitioner Regulation National Law (the Guidelines) detail the information to be provided by the applicant proposing a new or amended specialty.

Attachment A of the Guidelines describes the information required for the initial assessment (Stage 1).

Attachment B of the Guidelines describes the information required for the detailed assessment (Stage 2).

The Medical Board of Australia may ask for additional information if the applicant has not provided sufficient information for a detailed assessment.

The costs include the applicant’s costs to prepare their application, and the costs of assessing the application by the Australian Medical Council (the AMC) and the Medical Board of Australia (the Board).

In Stage 1 (initial assessment) the applicant pays a fee of $10,000 to the AMC.

If the application proceeds to Stage 2 (detailed assessment), the applicant will pay the direct cost of the assessment work including any reasonable administrative costs of the AMC and the Board. The costs will depend on the complexity of the assessment and the completeness of the information provided by the applicant, and whether or not the Board is required to commission additional work by third parties such as academics or health economists. The possible elements of the work include:

• preparing consultation papers based on the information provided by the applicant
• commissioning work by third parties such as academics or health economists
• developing a Regulation Impact Statement
• consulting stakeholders which may include interviews, site visits or forums and analysing their feedback
• discussing the application with the applicant
• preparing a report for the Medical Board of Australia about the outcome of the detailed assessment, and
• developing a Decision Regulation Impact Statement.

If an applicant proceeds to Stage 2 of the process, the AMC will provide an estimate of costs once the review panel has been established. All fees must be paid before the Board makes any recommendation to the Council of Australian Governments (COAG) Health Council.

The process for recognition of a new or amended medical specialty has a number of key steps and decision points. Each step takes time to complete and for the relevant organisation to make its recommendation or decision. Each step may result in a request or requests for additional information or clarification.

As this is a new process, the likely time has been estimated. These estimates do not take account of the time that may be required by the Office of Best Practice Regulation or the Council of Australian Governments (COAG) Health Council.

Stage 1 (initial assessment of proposal) is estimated to be six months.

Stage 2 (detailed assessment of proposal) is estimated to be between 12 and 18 months. Stage 2 requires public consultation on the proposal for a new or amended medical specialty. The consultation may also include developing a consultation Regulation Impact Statement (if required by the Office of Best Practice Regulation), interviewing the applicant and stakeholders, conducting clinical site visits, additional research, seeking expert opinion and conducting any other necessary inquiries or investigations.

The new or amended specialty becomes an approved specialty under the National Law and will be added to the approved List of specialties, fields of specialty practice and related specialist titles.

The Medical Board of Australia (the Board) then decides on the approved qualification in the new or amended specialty for the purposes of specialist registration.

Education providers with programs of study in the specialty can apply to the Australian Medical Council (the AMC) for accreditation. The AMC assesses programs of study in recognised specialties against the approved accreditation standards for specialist medical training programs. If the AMC accredits a program of study in a new or amended specialty, it provides a report to the Board and the Board will decide whether to approve the program of study as providing a qualification in the new or amended specialty for the purposes of specialist registration.

If the new or amended specialty is recognised under the National Law, medical practitioners awarded an approved qualification in the recognised specialty can apply for specialist registration. If a medical practitioner is granted specialist registration in the new or amended specialty, it will be recorded in the Register of Medical Practitioners and the practitioner can use the protected title associated with the specialty.

Yes, as long as you practise within the scope of your training, knowledge and skills and you do not use any protected titles for which you do not have specialist registration.

The list of approved specialties and associated protected titles are published in the document List of specialties, fields of specialty practice and related specialist titles.

The public can search your registration on the online national Register of Medical Practitioners. This will include that you have specialist registration.

The public register provides assurance that medical practitioners with specialist registration are qualified in the recognised specialty and that they have confirmed they have professional indemnity insurance and are complying with continuing professional development and recency of practice requirements.

The specialist recognition process is separate to other processes for Commonwealth benefit programs such as the Medicare Benefits Schedule or the Pharmaceutical Benefits Schedule. The Medical Board of Australia, the Australian Medical Council and the Australian Health Practitioner Regulation Agency are not responsible for determining access to these benefits.

Eligibility for such benefits is established under separate Commonwealth Government application and assessment processes.