This is a worked case study for a General Medical Practitioner migrating to Australia under ANZSCO 253111. Multiple pathways: Subclass 189, Subclass 190, Subclass 491 → 191, Subclass 186 Direct Entry, Subclass 494 → 191, and Subclass 482.
For visa-by-visa context, see the 253111 pathway guide and the AMC skills assessment guide.
The case profile (Specialist Pathway)
Anonymised composite. 36-year-old MRCGP-qualified GP, MBBS (UK approved school) + MRCGP (UK) + GMC unrestricted registration. 11 years professional career: 2 years foundation training (FY1/FY2), 3 years GP specialty training (ST1-3), 6 years GP partner / locum (UK / Ireland / NZ). OET B grade. Family: spouse + one child under 18.
Pathway A — Subclass 189 (Independent PR) — Specialist Pathway
Fees (primary + spouse + 1 child)
| Item | AUD |
|---|---|
| AMC + RACGP specialist assessment | 4,000-6,000 |
| 189 visa fees (family of 3) | 8,560 |
| Health, police, English | 1,050 |
| Total applicant-side | ~13,610 - 15,610 |
For Standard Pathway, AMC examinations add AUD 9,000-11,000 + 18-24 months prep + sits. PEP / Fellowship costs add AUD 5,000-15,000 over 2-4 years post-arrival.
Total wall-clock time: 12 to 24 months end-to-end (visa).
Pathway B — Subclass 190
| Item | AUD |
|---|---|
| AMC | 4,000-6,000 |
| 190 visa fees (family of 3) | 8,560 |
| State nomination fee | 200-800 |
| Health, police, English | 1,050 |
| Total applicant-side | ~13,810 - 16,410 |
Pathway C — Subclass 186 Direct Entry
| Item | AUD |
|---|---|
| AMC | 4,000-6,000 |
| 186 visa fees (family of 3) | 8,595 |
| Health, police, English | 1,050 |
| Total applicant-side | ~13,645 - 15,645 |
Employer SAF levy: AUD 5,000 (large business — Healius, IPN, Tristar) one-off, plus AUD 540 nomination fee. Total wall-clock time: 6 to 18 months.
Pathway D — Subclass 491 → 191 / 494 → 191 / 482
Critical regional / rural shortage — substantial 491 / 494 sponsorship in DWS / DPA areas. Total wall-clock time: ~60 months for 491/494; 30-36 months for 482 → 186 TRT.
Side-by-side
| Path | Applicant cost | Employer cost | Wall-clock to PR | AMC required |
|---|---|---|---|---|
| 189 (Independent) | AUD ~14,500 | AUD 0 | 12-24 months | Yes |
| 190 (state-nominated) | AUD ~15,000 | AUD 0 | 12-24 months | Yes |
| 186 Direct Entry | AUD ~14,500 | AUD 5,540 | 6-18 months | Yes |
| 491 → 191 | AUD ~16,000 | AUD 0 | ~60 months | Yes |
| 494 → 191 | AUD ~16,100 | AUD 6,000-25,540 | ~60 months | Yes |
| 482 → 186 TRT | AUD ~22,000 | AUD 9,000-25,000+ | 30-36 months | Yes |
Things that frequently surprise people
DWS / DPA restrictions for 10 years. Most overseas-trained GPs must work in Distribution Priority Areas for 10 years post first registration to bill Medicare freely.
RACGP / ACRRM Fellowship is essential. Without Fellowship, scope and earnings limited.
Healius (IPN), Tristar Medical, ForHealth. Major corporate GP chains — substantial international hire pipelines.
Aboriginal Community Controlled Health Services (ACCHS). Strong demand for GPs in Indigenous health — culturally appropriate care expected.
Code matters. ANZSCO 253111 = GP. 253112 = RMO (junior). 253211-253999 = specialist.
Health examinations expire after 12 months. If your visa takes longer than 12 months to grant, expect to redo them.
Tax residency starts on arrival. The Australian tax year runs 1 July to 30 June. See ATO residency rules before signing.
MARA registration is mandatory for paid migration assistance. Verify any agent at the MARA register.
Tools
- Visa fee calculator — model 189, 190, 491, 186, 494, or 482 fees
- Document checklist — AMC evidence pack
- ANZSCO search — confirm 253111 vs 253112 / specialist codes
- Eligibility wizard
- Invitation rounds tracker — for 189 / 190 round cut-offs
Where to verify the numbers
- Home Affairs visa pricing page
- AMC
- Medical Board of Australia
- RACGP | ACRRM
- DPA / MMM tool
- Office of MARA
- ATO
Next step
Want to model 189 vs 190 vs 491 vs 186 vs 494 vs 482 against your GP profile + Fellowship sequence? Book a 30-minute free strategy call.