What Supervision Level Will I Start At as a UK GP in Australia?
Most UK GPs with MRCGP and recent clinical experience start supervised practice at Level 3 — the most independent tier. Here is what that means in practice.
The four supervision levels
The Medical Board of Australia assigns a supervision level to every IMG on provisional registration. The levels reflect how closely your supervisor oversees your clinical work.
| Level | What it means | Typical for |
|---|---|---|
| Level 1 | Supervisor directly observes your consultations | Rarely used for experienced GPs |
| Level 2 | Supervisor in the building, available within minutes | Common for Standard AMC pathway doctors early in their supervision |
| Level 3 | Supervisor available for consultation but not on-site | Typical starting level for CA-pathway UK/IE GPs |
| Level 4 | Periodic review only, minimal direct oversight | Not used as a starting level — earned after a period at Level 3 |
What Level 3 looks like day-to-day
At Level 3 you practise independently. You:
- See patients on your own schedule
- Make your own clinical decisions
- Bill Medicare under your own provider number
- Manage your patient list and follow-ups
Your supervisor:
- Is available by phone or video for consultation
- Reviews a sample of your clinical records periodically
- Meets with you for structured supervision sessions (typically fortnightly or monthly)
- Submits progress reports to the Medical Board
You do not need the supervisor physically present. You do not need co-signatures on your clinical notes. You are not "shadowing" — you are working.
Why UK GPs typically get Level 3
The MBA considers your training background when setting the level. UK GPs with:
- Full GMC registration with no conditions
- MRCGP (Certificate of Completion of Training)
- Recent clinical practice (within 2 years)
- No adverse findings or complaints
...are assessed as having equivalent competence to Australian-trained GPs in the supervised phase. Level 3 reflects that: you are competent to practise, the supervision is a verification period rather than a training period.
What this means for after-hours work
Level 3 is the threshold for independent after-hours shifts. You can work evenings, weekends, and public holidays without the supervisor being present or available. This is the primary income stream for newly arrived UK GPs in Sydney — see our guide on after-hours earning from day one.
Can the level change?
Yes, in both directions:
- Upgrade: your supervisor can recommend reducing supervision (e.g. from Level 3 to Level 4) based on satisfactory progress reports. This typically happens 3–6 months in.
- Downgrade: if concerns arise during supervision, the MBA can tighten the level. This is rare for CA-pathway doctors with strong references.
How long does supervision last?
Typically 6–12 months for CA-pathway UK GPs. The duration depends on the MBA's assessment and your supervisor's recommendations. After completion with satisfactory reports, you apply for general registration and all supervision requirements end. See the full pathway timeline for how supervision fits into the overall process.
Source: MBA Supervision Guidelines