Emergency Medicine Training Pathway
How to become an emergency physician in Australia — the ACEM pathway, the two-step way selection actually works, and what FACEMs earn.
Entry is a two-step gate most guides blur together: first you have to land a registrar job at an ACEM-accredited emergency department (run by the states), and only then does ACEM enrol you in the training program nationally. Getting the job is the competitive part — the enrolment itself has no interview or entry exam.
Why emergency medicine
You're the first doctor for everyone who walks or is wheeled through the door — resus and trauma one minute, undifferentiated chest pain, paediatrics, mental health and minor injuries the next — making fast decisions with incomplete information and running the department's flow. It suits people who like acuity, variety and procedures, thrive on teamwork and shift work, and want defined shifts with no clinic or practice to run afterwards.
- Draws: Huge clinical variety and acuity, Shift work means clean handover — no take-home practice, Procedural and resuscitation-heavy, Works anywhere; strong locum market.
- Trade-offs: 24/7 rostering — nights, weekends, public holidays, Little private-billing income vs procedural specialties, Access block and overcrowding pressure, Exam-heavy training.
- Subspecialties: Paediatric emergency medicine, Pre-hospital & retrieval (with ACEM/ACRRM), Toxicology, Ultrasound, Trauma, Emergency medicine administration.
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?
Emergency medicine has no national match and no jurisdiction publishes EM-specific applicant, offer or position counts — so a clean state-by-state competitiveness table simply doesn't exist, and we won't invent one. The only hard national figure is ACEM's trainee headcount: 2,019 FACEM trainees were residing in Australia at 31 December 2024 (92% of all ACEM trainees). The real contest is securing an accredited-ED registrar job; once you have it, ACEM enrolment is standards-based with no interview or entry exam, so few who hold an accredited post and meet the requirements are turned away.
Unaccredited time: No unaccredited grade as such — but you must first land a registrar job at an accredited ED, and that hospital step (run by the states) is the genuine competitive gate.
Sources: ACEM — Demographic & Workforce Report (data to 31 Dec 2024), ACEM — How to apply (national selection).
Selection criteria & how to apply
Two gates, run by different people. The competitive one is landing a registrar job at an accredited ED — run by state health services or hospital networks (see your state below). The second, ACEM enrolment, is national and standards-based: no interview, no entry exam, no SJT. ACEM grades three things against its curriculum framework:
Key documents: ACEM — How to apply, ACEM — Where can I do my training? (accredited sites).
How to land the accredited ED job, state by state
NSW
Who runs selection: Decentralised — recruited network-by-network. EM is not one of NSW Health's centralised-panel specialties, so Local Health Districts, networks and individual hospitals run their own recruitment through the statewide JMO campaign.
Where to apply: NSW Health JMO recruitment campaign — application portal.
When: For the 2027 clinical year: early round applications open 4 May 2026 (close mid-May–18 June, offers from 2 June); main round opens 14 July 2026, closes 4 August 2026, offers late August–October.
Interviews: Set by each network or hospital — there's no single statewide EM format or weighting.
How they choose you: Assessed on your application, CV, interview and references against each site's criteria; numeric weightings aren't published and vary by network.
Worth knowing: Around 40 ACEM-accredited EDs statewide, so which network you target matters — you can apply to several. JMO support line 1300 566 321.
Links: NSW Health JMO recruitment, NSW Health JMO campaign dates.
VIC
Who runs selection: Decentralised — individual health services advertise EM registrar posts directly. Victoria's PMCV runs centralised matches for intern, PGY2, BPT and psychiatry, but emergency medicine is NOT a PMCV match, so there's no statewide EM match.
Where to apply: careers.vic.gov.au and the ACEM Jobs board — application portal.
When: Position-by-position (e.g. a Barwon/Geelong EM registrar role for Feb 2027 closed 5 July 2026). No single statewide EM timeline.
Interviews: Run per employer; format and criteria aren't published centrally.
How they choose you: Direct application — CV plus a cover letter tailored to each position description, assessed by the employing health service.
Worth knowing: The most decentralised big state: you chase individual job ads rather than lodge one application. The ACEM Jobs board is the best single place to see accredited vacancies.
QLD
Who runs selection: Statewide RMO & Registrar Campaign (Queensland Health) — one application portal, but recruiting hospitals contact applicants directly to interview and select on merit. Queensland Health's EM page spells out the 'get the accredited job first, then ACEM enrols you' sequence.
Where to apply: Queensland Health RMO & Registrar Campaign — application portal.
When: For 2027: applications close Monday 29 June 2026, 3 pm; registrars commence across 2–4 terms from 1 February 2027.
Interviews: Arranged and run by each recruiting hospital (e.g. RBWH assesses EM house officers with a joint Anaesthetics/ICU/EM panel). No published weightings.
How they choose you: One application via the campaign; use the position-search tool to preference sites. Selection complies with Queensland Health HR/EEO policy. Enquiries: RMO-Recruitment@health.qld.gov.au.
Worth knowing: The cleanest single-portal entry of any state, with a dedicated EM specialty page explaining the two-gate sequence.
Links: QLD Health — Emergency Medicine, QLD Health RMO & registrar campaign.
SA
Who runs selection: Centralised — the SA MET Unit runs a single PGY2+ Expression of Interest process on behalf of SA Health. EM is one of 35+ programs you can preference (up to four) in one EOI.
Where to apply: SA MET centralised PGY2+ EOI — application portal.
When: For the 2027 clinical year: EOI opens 10 June 2026, closes 1 July 2026 (referees by 8 July); interviews August; Round 1 offers 17 September 2026, further rounds to 8 October.
Interviews: The related acute/critical-care stream uses a Multiple Mini-Interview (MMI) — timed situational stations scored on the clarity and depth of your reasoning. Program-specific detail is in the SA MET information packs.
How they choose you: Centralised EOI with referee reports and MMI; exact EM weightings sit in the program information pack rather than being aggregated publicly.
Worth knowing: Genuinely coordinated and MMI-based — the closest to a single managed process among the smaller states.
Links: SA MET — PGY2+ recruitment, SA Health — careers in Emergency Medicine.
WA
Who runs selection: Centralised annual registrar intake through MedCareersWA (Department of Health WA), with country posts via the WA Country Health Service (WACHS) registrar pool.
Where to apply: MedCareersWA (metro) and WACHS pool (country) — application portal.
When: Annual intake plus mid-year/ad-hoc rounds; a 2027 EM trainee registrar intake is confirmed, though exact statewide EM dates aren't itemised on the public pages.
Interviews: Not published centrally — format and criteria aren't detailed on the public MedCareersWA pages.
How they choose you: Apply via MedCareersWA (and JobsWA); country applicants also go through the WACHS registrar pool.
Worth knowing: Metro and country run as somewhat separate streams, so decide early whether you're targeting Perth tertiary EDs or regional WACHS sites.
Links: MedCareersWA — registrars, WA Country Health Service.
TAS
Who runs selection: Statewide RMO recruitment (Tasmanian Department of Health), with emergency medicine running an aligned campaign across Royal Hobart, Launceston General and North West Regional.
Where to apply: Tasmanian Government Jobs + statewide RMO campaign — application portal.
When: Annual statewide RMO campaign (the 2027 campaign is advertised). ED-specific interview and selection dates aren't published — candidates are advised to contact the preferred hospital's Medical Staffing Unit.
Interviews: Not published; arranged through the hospital recruitment team.
How they choose you: Through the statewide RMO campaign with an ED-aligned process; direct hospital contact is expected.
Worth knowing: Small program — direct contact with the Medical Staffing Unit at your preferred site is the real route in.
Links: Tasmania — Doctors in Training, Tasmania — ED recruitment information.
ACT
Who runs selection: A single structured annual campaign run by Canberra Health Services (and North Canberra Hospital) — one employer, one process.
Where to apply: CHS Career Portal (Taleo) — application portal.
When: For a 2027 EM registrar post: advertising opens 1 June 2026, closes 28 June 2026; the clinical year commences 1 February 2027.
Interviews: Three stages — shortlisting, then interview plus referee checks, then offer; assessed against the published key selection criteria (no numeric weightings).
How they choose you: Application is a CV, written responses to the selection criteria and two referee reports (one from your current supervisor on the CHS template). EM registrar roles typically require PGY4+ by commencement.
Worth knowing: Single-employer territory: one campaign and one portal, but a limited number of posts.
Links: Canberra Health Services — JMO careers, CHS — EM Registrar position description.
NT
Who runs selection: Hospital-direct — no centralised NT-wide EM match. Top End Health Service (Royal Darwin & Palmerston, max 24 months ACEM-accredited) and Central Australia Health Service (Alice Springs, 18 months accredited) recruit separately.
Where to apply: NT Health Jobs plus direct email to the ED — application portal.
When: Not published — there are no fixed public dates; positions are advertised and filled through the year.
Interviews: Not published; arranged directly with the department.
How they choose you: Apply via NT Health Jobs or email the ED recruitment contact — Top End TEHSEMDocJobs.DoH@nt.gov.au; Alice Springs MedicalRecruitmentASH@nt.gov.au.
Worth knowing: The most informal entry: direct email to the ED is the real-world route. Drawcards include a high-trauma, high-sepsis casemix, strong paediatric logbook coverage, protected teaching and subsidised accommodation.
Links: NT Health — Emergency Medicine, NT registrar positions.
How to optimise your application
- ED + ICU + anaesthetics terms (tied to the job & CV, start PGY1–2) — The experience that wins an accredited-ED post and meets entry prerequisites.
- Strong references from ED consultants (tied to Selection & institutional references, start ongoing) — Work where the ED Director and senior staff will know you and rate you credibly.
- Target accredited EDs (tied to the job, start pre-application) — Apply to ACEM-accredited departments — only those let you enrol; check the ACEM accredited-sites list.
- Sit the Primary early (tied to progression, start PGY2–3) — Getting the Primary done early de-risks the timeline; it's not required to be selected.
Key documents & official links
- ACEM — how the FACEM Training Program works
- ACEM — examinations
- ACEM Jobs board (accredited ED vacancies)
FAQ
Is there an interview or entry exam to get onto ACEM training?
How long does it take?
How competitive is it?
What are the exams?
Do emergency physicians earn less than other specialists?
Trained overseas? (IMG pathway)
How overseas-trained emergency medicine doctors get recognised
Overseas-trained emergency physicians are assessed by ACEM (not the AMC) through the Specialist International Medical Graduate (SIMG) pathway — a paper-based comparability assessment against the ACEM curriculum, then a structured interview. Outcomes are substantially, partially or not comparable, with a period of supervised practice (and, if partially comparable, ACEM exams) before fellowship. About 45% of FACEMs gained their primary degree overseas.
See the ACEM SIMG assessment page and our IMG internship guide.
Related specialties
Last reviewed 2026-06-01.