Addiction Medicine Training Pathway
How to become an addiction medicine specialist in Australia — the RACP Chapter (AChAM) you can reach as a physician or laterally as a GP, psychiatrist, emergency or other specialist, with no addiction-specific exam, and a tiny, ageing workforce.
The catch isn't getting in — it's finding a job to train in. There's no competitive national selection and no exam of its own, so eligibility is rarely the problem. The problem is supply: about 150 specialists nationally (nearly half aged 60+), with scarce, often part-time accredited posts clustered in metro drug-and-alcohol services — and you need an AChAM supervisor and accredited setting, sometimes only one or two per state.
Why addiction medicine
Mostly ambulatory and consultative. The RACP program is built around 36 months of certified training — at least 18 months of core training in accredited settings under an AChAM-Fellow supervisor, and up to 18 months of non-core — but the College specifies the work as themed learning rather than a fixed rotation timetable. In practice the clinical scope means assessing and managing alcohol, opioid, stimulant, benzodiazepine, tobacco and pharmaceutical dependence; running and titrating opioid pharmacotherapy (methadone/buprenorphine) programs; managing withdrawal and intoxication in community, inpatient and residential settings; doing consultation-liaison on the wards and in ED for intoxicated, withdrawing or dependent inpatients; and untangling the heavy overlap with psychiatric and chronic-pain comorbidity. It is procedure-light and almost entirely cognitive — history, risk assessment, pharmacotherapy, harm-minimisation and care coordination across a multidisciplinary team.
- Multiple open entry pathways — you can qualify as a physician (via RACP Basic Training + both Divisional exams) or via Fellowship from GP, psychiatry, emergency, anaesthetics, pain medicine, intensive care, rural & remote, public health, rehabilitation, occupational, palliative or sexual health medicine; other colleges are considered case-by-case.
- No addiction-medicine exam: progression is by supervised, work-based assessment over 36 months rather than a high-stakes written/clinical barrier.
- Lifestyle-friendly — largely outpatient and consult-based with little to no acute overnight on-call and very few procedures.
- Genuine, well-documented workforce shortage and an ageing cohort, so qualified Fellows are in demand and the job market is favourable.
- Deeply meaningful work with measurable impact on a high-need, under-served population, plus a real public-health and advocacy dimension.
- Tiny specialty (~150 specialists nationally at the last census) with scarce, often part-time/sessional accredited training posts concentrated in metropolitan services — geography can dictate whether you can train at all.
- You generally must already hold (or be completing) a primary fellowship, or have finished RACP Basic Training including both Divisional exams, before you start — so it's a long-game add-on rather than a direct run from internship.
- Lower private-practice earning ceiling than procedural physician subspecialties; most work is salaried public drug-and-alcohol services.
- Heavy load of chronic relapsing illness, stigma, medico-legal and prescribing scrutiny (Schedule 8 / opioid authorities), and complex psychiatric comorbidity.
- No dedicated ATO/ANZSCO occupation code and thin per-state training infrastructure make it harder to research and plan than mainstream specialties.
Subspecialties
The training pathway
The same fellowship, two very different timelines. The fast route assumes everything goes right; most people land on the realistic one.
How competitive is it?
Addiction Medicine isn't competitive in the way cardiology or the surgical SET programs are. There's no national scored selection rubric, no centralised match, and no addiction-specific exam — and the College deliberately keeps multiple feeder pathways open (physician, GP, psychiatry, emergency, anaesthetics, pain medicine, intensive care and others). No national applicant-to-offer ratio is published, and frankly the concept barely applies, because selection is local: individual hospitals and drug-and-alcohol services advertise individual training posts. The real scarcity is on the supply side. National workforce data (NHWDS, 2016) recorded only about 150 addiction medicine specialists employed in Australia, with 47.7% aged 60 or over and 67.5% intending to retire within 10 years, and accredited training settings (with an AChAM-Fellow supervisor) are few and unevenly spread. So the honest framing is: easy to be eligible, harder to find a funded accredited job to train in, and very employable once you finish.
Unaccredited time: Not applicable in the surgical sense — there is no unaccredited-registrar 'service year' gauntlet. What you do need first is a qualifying fellowship or completed RACP Basic Training (with both Divisional exams), and then an accredited, supervised Advanced Training post, which is the genuinely scarce ingredient.
Sources: RACP — Addiction Medicine Advanced Training (entry pathways, requirements), NHWDS Addiction Medicine workforce factsheet (2016 data): 150 specialists, 47.7% aged 60+, 67.5% intend to retire within 10 years, Queensland Health Medi-Nav — Addiction Medicine (workforce distribution & demand).
Selection criteria & how to apply
There is no national points-scored selection system for Addiction Medicine and no centralised match. The RACP sets the eligibility rules and curriculum; the actual selection happens when a hospital or drug-and-alcohol service recruits to a specific, individually-advertised training post. To be eligible you must hold (or be completing) one of the recognised qualifications and then secure an appointment to an accredited Advanced Training position under an AChAM-Fellow supervisor. The components below are assessed for eligibility and progression — none carry a published percentage weighting.
Key documents: RACP — Addiction Medicine Advanced Training (entry pathways & requirements), RACP — Addiction Medicine Advanced Training Curriculum (PDF; thematic, work-based assessment — 2013 edition, superseded by the 2024 renewed program), RACP — Addiction Medicine curriculum renewal (current program, implemented from 2024), RACP — Addiction Medicine accredited training settings (PDF).
How training is organised in each state
NSW Not published — positions are advertised individually by services as they arise. At the 2016 census NSW held the largest single share of the national addiction medicine workforce (39.8% of clinicians).
Who runs selection: No selection network or match. Accredited posts sit within Local Health District (LHD) and Specialty Health Network drug-and-alcohol services — including Justice Health & Forensic Mental Health Network — plus hospital consultation-liaison units. NSW has the largest concentration of addiction medicine clinicians in the country.
Where to apply: NSW Health jobs (individual positions advertised by LHDs/services) — application portal.
Positions: Not published — positions are advertised individually by services as they arise. At the 2016 census NSW held the largest single share of the national addiction medicine workforce (39.8% of clinicians).
Worth knowing: Best-developed network of AOD services and supervisors in Australia, so generally the widest choice of accredited posts. Justice Health and forensic settings are a notable NSW feature. An addiction psychiatry route via the RANZCP Certificate of Advanced Training also exists for psychiatry trainees.
Links: NSW Health — Alcohol and other drugs career pathways (FAChAM), NSW Health job search.
VIC Not published. Eastern Health/Turning Point advertises full-time addiction medicine advanced-trainee positions (based primarily at Box Hill).
Who runs selection: No match. Training is anchored by Turning Point (the statewide addiction service) at Eastern Health, which is Monash University–affiliated, alongside other metro health services. Posts are advertised by the employing health service.
Where to apply: Health service careers pages / Victorian Government Health jobs — application portal.
Positions: Not published. Eastern Health/Turning Point advertises full-time addiction medicine advanced-trainee positions (based primarily at Box Hill).
Worth knowing: Turning Point is the flagship training environment, offering community/inpatient/residential withdrawal, opioid pharmacotherapy clinics, hospital consultation-liaison and pain-clinic exposure (via the Eastern Health Pain Service), with protected teaching (a statewide online session, a monthly addiction journal club and grand rounds). The Hamilton Centre and DACAS support statewide AOD–mental-health consultation. Strong academic/research links via Monash. Open to GP Fellows and RACP Basic-Training-completed trainees.
Links: Eastern Health / Turning Point — Addiction Medicine Advanced Trainee position description (PD), Victoria — The Hamilton Centre (statewide AOD–mental health).
QLD Not published. Queensland Health's Medi-Nav reports the local workforce is heavily metro-concentrated (about 92.9% in major cities, 14.3% regional, none remote) and that around 50% of the 2023 workforce intend to retire by 2034.
Who runs selection: No match. Advanced Training is via Hospital and Health Service alcohol-and-other-drug services; the pathway is profiled on Queensland Health's Medi-Nav careers resource. Posts are individually recruited.
Where to apply: Queensland Health careers (Medi-Nav) — application portal.
Positions: Not published. Queensland Health's Medi-Nav reports the local workforce is heavily metro-concentrated (about 92.9% in major cities, 14.3% regional, none remote) and that around 50% of the 2023 workforce intend to retire by 2034.
Worth knowing: Queensland Health frames the physician route as ~6 years (3 Basic Training + 3 advanced), but Fellows of other colleges can also enter. Pronounced metro concentration and an imminent retirement wave make qualified Fellows highly employable.
Links: Queensland Health Medi-Nav — Addiction Medicine (pathway, workforce, demand).
SA Not published — small number of posts centred on DASSA.
Who runs selection: No match. Drug and Alcohol Services South Australia (DASSA) is the statewide service and the principal training and employment base; posts are advertised through SA Health.
Where to apply: I Work for SA / SA Health — application portal.
Positions: Not published — small number of posts centred on DASSA.
Worth knowing: Training is concentrated in the single statewide DASSA service, so supervisor and post availability is narrow and largely Adelaide-based. SA Health publishes a dedicated addiction medicine training page.
Links: SA Health — Addiction medicine training, SA Health — Drug and Alcohol Services (DASSA), I Work for SA (SA Health vacancies).
WA Not published. WA had the lowest specialist-to-population ratio in the country at the 2016 census (about 0.3 per 100,000), and the first public-hospital consultant positions only began relatively recently.
Who runs selection: No match. Most addiction medicine specialists work at Next Step Specialist Drug and Alcohol Services (Royal Perth/East Metropolitan Health Service), with public-hospital consultant posts more recently established; Fiona Stanley Hospital holds an accredited advanced-training post.
Where to apply: WA Health careers / Postgraduate Medical Council of WA — application portal.
Positions: Not published. WA had the lowest specialist-to-population ratio in the country at the 2016 census (about 0.3 per 100,000), and the first public-hospital consultant positions only began relatively recently.
Worth knowing: PMCWA describes the program as comparatively accessible, with a supportive Next Step environment and good consultant access, plus exposure to toxicology, public health, pain and obstetric AOD care. Growing recognition and a very small, ageing base mean strong future demand.
Links: PMCWA — Addiction Medicine (WA training, Next Step, Fiona Stanley), Royal Perth Hospital — Next Step Drug and Alcohol Services.
TAS Not published — very small service; expect few or intermittently available posts.
Who runs selection: No match. Advanced Training is through the Tasmanian Alcohol and Drug Service; entry is via the same RACP pathways. Posts are very limited.
Where to apply: Tasmanian Department of Health careers — application portal.
Positions: Not published — very small service; expect few or intermittently available posts.
Worth knowing: Tasmania recorded one of the highest clinician-to-population ratios at the 2016 census (about 1.0 per 100,000) off a tiny base. Training includes opioid pharmacotherapy prescriber authorisation and statewide assessment work.
Links: Tasmanian Department of Health — Alcohol and Drug Service careers.
ACT Not published — very small number of posts.
Who runs selection: No match. Posts sit within Canberra Health Services' alcohol and drug service; recruited individually through ACT Health.
Where to apply: ACT Health / Canberra Health Services careers — application portal.
Positions: Not published — very small number of posts.
Worth knowing: The ACT recorded one of the highest clinician-to-population ratios (about 1.0 per 100,000) at the 2016 census, but off a very small absolute base, so accredited training opportunities are limited and centred on Canberra.
Links: ACT Health — Careers.
NT Not published — minimal local capacity; expect to arrange non-core or partial training and to look interstate for core requirements/supervision.
Who runs selection: No formal training network. The NT has the thinnest addiction medicine infrastructure of any jurisdiction; accredited posts and resident AChAM supervisors are scarce, and training is typically arranged with NT Health and/or in partnership with interstate services.
Where to apply: NT Health careers — application portal.
Positions: Not published — minimal local capacity; expect to arrange non-core or partial training and to look interstate for core requirements/supervision.
Worth knowing: High AOD-related burden and significant Aboriginal and Torres Strait Islander health need, but very few specialists and limited accredited settings. Most aspirants will need to combine NT experience with accredited core training elsewhere.
Links: NT Health — Careers.
How to optimise your application
- Pick the fastest legitimate feeder pathway for you (tied to Qualifying fellowship / Basic Training, start Early — before you commit to a primary training program) — If your goal is FAChAM and you're not wedded to general physicianship, a GP (FRACGP/FRNZCGP) or psychiatry (FRANZCP) fellowship is often a faster, more flexible route in than full RACP Basic Training plus both Divisional exams. Map your endpoint before choosing your primary college.
- Embed yourself in a drug-and-alcohol service early (tied to Appointment to an accredited post, start PGY1–3 / during your primary training) — Do D&A, consultation-liaison, psychiatry and ED rotations; locum or take a non-accredited registrar role at a service that holds accredited posts (e.g. a metro AOD service). Being known and useful to the team is how these jobs get filled.
- Find your supervisor first, then build the post (tied to AChAM-Fellow supervisor, start 12–18 months before you want to start Advanced Training) — There may be only one or two AChAM Fellows in your city. Identify them, ask about supervision capacity, and work with them and the service to confirm (or create) an accredited, funded position — sometimes assembled from sessions across services.
- Be geographically flexible (tied to Accredited training settings, start When planning Advanced Training) — Posts cluster in particular metro services and some states have very few. Willingness to relocate (or to combine core training in one centre with non-core elsewhere) dramatically widens your options.
- Use non-core time deliberately (tied to Work-based assessment / research project, start Once on the program) — Up to 18 months can be research (counting toward an MD/PhD/Masters) or approved medical/psychiatric/public-health work. Plan it to strengthen your CV and complete the required research output rather than treating it as filler.
Key documents & official links
- RACP — Australasian Chapter of Addiction Medicine (AChAM) overview
- RACP — Addiction Medicine Advanced Training (entry pathways & requirements)
- RACP — Addiction Medicine Advanced Training Curriculum (PDF, 2013 ed.; superseded by 2024 renewal)
- RACP — Addiction Medicine curriculum renewal (current program from 2024)
- RACP — Addiction Medicine accredited training settings (PDF)
- RACP — Standard Specialist Assessment Pathway (overseas-trained physicians)
- RACP — Accelerated Specialist Pathway (UK/Ireland/India/HK/Sri Lanka SIMGs)
- NHWDS — Addiction medicine workforce factsheet (2016 data)
- Queensland Health Medi-Nav — Addiction Medicine (workforce & demand)
- NSW Health — Staff Specialists (State) Award 2022 (salary schedule)
FAQ
Is Addiction Medicine hard to get into?
Do I have to do Basic Physician Training first?
Is there an exam?
How long does it take?
What's the lifestyle and on-call like?
What do addiction medicine specialists earn?
Is there a job at the end?
Can I come from overseas?
Trained overseas? (IMG pathway)
How overseas-trained addiction medicine doctors get recognised
Overseas-trained addiction medicine specialists seek specialist recognition through the RACP, which assesses your overseas qualifications and consultant experience against the FAChAM standard. A favourable outcome is then forwarded to AHPRA / the Medical Board of Australia for specialist registration. Because addiction medicine is a Chapter qualification, the assessment is run by the RACP through its standard physician (SIMG) processes rather than a separate addiction-only stream.
See the RACP Standard Specialist Assessment Pathway (overseas-trained physicians) and our IMG internship guide.
Related specialties
Last reviewed 2026-06-01.