Does the Expedited Specialist Pathway lead to Fellowship?

At the time of writing, it still isn't clear how overseas-trained anaesthetists, psychiatrists, GPs, obstetricians, and gynaecologists who enter Australia via their respective Expedited Specialist Pathways (ESPs) can progress towards obtaining Fellowship in their specialties.

In late 2024, the Medical Board of Australia staggered the release of ESPs for GPs (October 2024), Psychiatry and Anaesthesia (December 2024), and then in January 2025, Obstetrics and Gynaecology. These ESPs provide a faster, easier, and more affordable way for UK- and Irish-trained specialists (only UK-trained for Psychiatry) to enter Australia and work as specialists from day one. These ESPs complement the existing specialist assessment pathways managed by the respective medical colleges. Essentially, the ESP removes the need for eligible specialists to be assessed by the relevant Australian medical college before starting work in Australia.

However, the medical college assessment process provides a clear pathway towards Fellowship in Australia—FRANZCP for Psychiatry, FANZCA for Anaesthesia, FRACGP, FRANZCOG, and so on. Taking Psychiatry as an example, a psychiatrist whose training was assessed by RANZCP as "substantially comparable" to that of an Australian-trained psychiatrist could start work as a specialist, be paid at the specialist level in the public sector, work for 12 months, complete three WBAs, submit patient reports to RANZCP, and then be awarded FRANZCP.

From what we know so far, the ESP does not replace this pathway towards Fellowship. The ESP requires you to work for six months under supervision but you are the specialist, and you get paid the same as an Australian specialist working in the public sector. We can only assume that if a specialist wants to gain Fellowship of the Australian college, they would still need to undertake the college's specialist assessment either alongside or after fulfilling the ESP requirements.

However, because the college's specialist assessment process often requires a period of supervision (sometimes longer than the ESP's six-month requirement, depending on the outcome of the assessment), an obvious question arises: would this supervision still be required if the ESP supervision requirement has already been completed?

The AHPRA (Australian Health Practitioner Regulation Agency / Medical Board) form now includes a section allowing an ESP applicant to provide permission for AHPRA to share their information with the relevant medical college.

This is the only public indication so far linking the ESP to the traditional pathway towards Fellowship. As such, until further information is released, we can only assume that a specialist taking advantage of the cheaper, faster, and easier ESP route to enter Australia will **still** need to complete the Australian college's specialist assessment in order to gain Fellowship.

Gotta love a medical bureaucracy!