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Infectious Diseases Training Pathway

How to become an infectious diseases physician in Australia — RACP Basic Physician Training, the Divisional exams, the competitive jump onto ID Advanced Training, and why earnings sit largely on a public-hospital salary.

The bottleneck is the RACP funnel, not ID itself. The hard part is getting through Basic Physician Training and both Divisional exams; ID Advanced Training is competitive but not a bloodbath, with no national scored rubric or published applicant-to-offer ratio. The quieter catch is a thin private market — so the ATO doesn't even report ID separately, and your income is largely a public staff-specialist salary.

Why infectious diseases

The job is overwhelmingly cognitive and consultative. Most of your week is the consult service — ward-based teams across the hospital phone you about a patient with fever, a positive blood culture, an antibiotic-resistant organism, a prosthetic-joint infection or a possible infection in someone immunosuppressed, and you review, synthesise and advise. Woven through that is antimicrobial stewardship (approving restricted antibiotics, steering teams off the wrong drug), microbiology-lab liaison (interpreting cultures and molecular results with the scientists), outpatient clinics (HIV, viral hepatitis, tuberculosis, travel and post-travel illness, OPAT review, complex bone-and-joint infection) and OPAT/Hospital-in-the-Home rounds where patients get IV antibiotics at home. On-call exists and outbreaks and overnight sepsis advice happen, but you are rarely doing hands-on procedures at 3am — the work is diagnostic reasoning, not the cath lab.

Draws
  • Intellectually one of the broadest specialties — you touch every organ system and every ward in the hospital
  • Lifestyle is among the more controllable of the physician specialties: predominantly consultative, light procedural load, manageable on-call
  • Strong overlap with public health, global/tropical health, antimicrobial stewardship and research — easy to build a portfolio career
  • Getting onto ID Advanced Training is genuinely less cut-throat than the procedural physician specialties
  • The optional joint ID/Microbiology program lets you add a second fellowship (FRCPA) and a laboratory career
Trade-offs
  • Thin private market — earnings are largely a public staff-specialist salary, and the ATO publishes no standalone ID income line
  • You are an advisor, not the admitting/proceduralist team — if you want to 'own' patients and do procedures, ID will frustrate you
  • Consultative load can be relentless and you carry medico-legal weight on antibiotic decisions you don't directly control
  • Smaller workforce and fewer consultant posts than the big physician specialties, so geography can be limiting
  • Adding microbiology (joint program) means extra years and a second set of college exams

Subspecialties

HIV medicineAntimicrobial stewardshipTransplant / immunocompromised-host infectious diseasesOutpatient parenteral antimicrobial therapy (OPAT) and bone-and-joint infectionTropical and travel medicineTuberculosis and mycobacterial diseaseViral hepatitisInfection prevention and control / hospital epidemiologyClinical microbiology (via the joint ID/Microbiology program)Public health and outbreak response

The training pathway

The same fellowship, two very different timelines. The fast route assumes everything goes right; most people land on the realistic one.

Fastest route
9 years post-graduation (structural floor)
The theoretical minimum if nothing goes wrong: pass both Divisional exams first attempt, win an accredited ID post immediately, and complete the three core years without interruption. Very few people hit this exactly.
Internship (PGY1)
1 year
General registration with AHPRA. Not part of college training but a legal prerequisite.
Residency / RMO (PGY2)
1 year
Consolidate, build a competitive CV, secure a Basic Physician Training (BPT) network position.
Basic Physician Training (BPT)
3 years
RACP Adult Internal Medicine BPT. Sit the Divisional Written then Divisional Clinical exam — passing BOTH is the gate to Advanced Training.
Win an accredited ID Advanced Training post
Competitive, merit-based selection run by hospitals/states/matching services — NOT by the RACP. No national rubric. This is the real bottleneck.
Advanced Training in Infectious Diseases
3 years
24 months core ID + 6 months core microbiology + 6 months non-core, plus two research projects and work-based assessments. Leads to FRACP (Infectious Diseases).
Realistic route
10-12 years post-graduation (more if you do the joint ID/Micro program or take research time)
What it actually looks like for most people: an extra RMO/PHO year before BPT, at least one exam re-sit or a year that doesn't count, and often a research/PhD or fellowship year. The joint ID/Microbiology program adds two years on top.
Internship + RMO years (PGY1-2/3)
2-3 years
Most people do 2-3 prevocational years building a CV before landing a BPT spot.
Basic Physician Training
3-4 years
Three years if exams go smoothly; the Adult Medicine Divisional pass rates (mid-60s to low-80s%, all-attempts) mean re-sits and an extra year are common.
Securing an ID Advanced Training post
0-1 year
May take a year of acting-up, a non-accredited ID/general-medicine year, or a research year to become competitive and land a position.
Advanced Training (ID only)
3 years
24 months core ID + 6 months microbiology + 6 months non-core. FRACP (Infectious Diseases) on completion.
OR Joint ID & Microbiology
5 years
Instead of the 3-year ID program: 24 months clinical ID + 36 months laboratory microbiology, leading to dual FRACP + FRCPA. Adds the RCPA pathology exams.
Research / PhD or sub-specialty fellowship (optional)
1-3 years
Common in academic ID (HIV, transplant ID, stewardship research). Not mandatory but typical for tertiary-hospital consultant posts.

How competitive is it?

Honestly: getting INTO ID is moderate, not savage. The brutal filter in this pathway is Basic Physician Training and the two Divisional exams, which sit in front of every adult-medicine specialty — once you clear those, ID is competitive but not in the cardiology/gastroenterology league. The RACP publishes no national applicant-to-offer ratio for ID, and it states plainly that it is not involved in selection (run by hospitals, states and matching services), so there is no single success rate to quote. NSW workforce modelling (2019) found about 53 advanced trainees in the pipeline was sufficient to meet projected demand to 2035 with 'no requirement to increase advanced trainee numbers' — i.e. supply and demand are roughly balanced, not chronically oversubscribed. The catch is on the way out, not in: consultant posts are concentrated in public tertiary hospitals and the private market is thin.

Unaccredited time: No — ID has no 'service registrar' bottleneck like surgery. You don't need years of unaccredited posts; the real prerequisite is finishing BPT and passing both Divisional exams. That said, an unaccredited ID or general-medicine registrar year, or a research year, is a common way to become competitive for an accredited post.

Sources: RACP — Infectious Diseases Advanced Training (College not involved in selection; 3-year structure), NSW Health — Physician (Infectious Disease) workforce modelling: ~53 advanced trainees, adequate to 2035, RACP — Past Divisional Written Examination results, RACP — Past Divisional Clinical Examination results.

Selection criteria & how to apply

There is no national scored selection rubric for ID with published percentage weightings — the RACP sets standards but does not run selection, and each state/hospital/matching service assesses applicants on merit against its own criteria. What follows is qualitative: the things that are assessed, not a points formula. Anyone who tells you ID has a fixed national points table is wrong.

RACP Basic Physician Training completion + both Divisional examsEligibility
Hard prerequisite. You must have completed BPT and passed (or in some states be sitting/have passed) the Divisional Written and Clinical examinations before you can hold an accredited ID Advanced Training post. This is the real gate.
Current AHPRA general medical registrationEligibility
Required to be appointed. Citizens/permanent residents are generally prioritised over temporary-visa holders in state campaigns and the Victorian match.
Curriculum vitae, clinical experience & referencesAssessed
Prior ID/general-medicine experience, supervisor reports and structured referee reports are weighed heavily. The ACT post, for example, is assessed against four selection criteria (clinical proficiency, teaching, communication, safety/quality) — there is no published percentage weighting.
Research output, audit and quality-improvement workAssessed
ID is a research-friendly specialty and tertiary units value publications, conference presentations and stewardship/audit projects. Useful for ranking but not scored to a national formula.
Interview / panel assessmentAssessed
Most accredited posts and state campaigns involve a structured interview or panel. Weighting varies by employer and is not nationally published.
Demonstrated interest & fit (clinics, stewardship, global/public health)Assessed
Evidence of genuine commitment to ID — relevant electives, prior consult-team time, stewardship involvement — helps at competitive units. Qualitative.

Key documents: RACP — Infectious Diseases Advanced Training program requirements, RACP — Infectious Diseases Advanced Training Curriculum (PDF), RACP — Accredited settings for Advanced Training in Infectious Diseases (Australia, PDF), RACP/RCPA — Joint Infectious Diseases & Microbiology Advanced Training.

How ID training is organised state by state

Because the RACP doesn't run selection, you apply to whoever holds the accredited ID positions in your state — a central health-department campaign, a computer match, or individual hospitals. The structure, timing and portal differ in every jurisdiction. Position counts are rarely published as a single number; where a figure isn't public we say so.
NSW No single statewide ID advanced-trainee intake number is published. NSW workforce modelling (2019) counted ~53 ID advanced trainees in the pipeline, 93 specialists in clinical posts (118 headcount including non-clinical roles), and 3 new Fellows in 2018, with 32.5% trainee growth across 2015-2019.

Who runs selection: Accredited ID Advanced Training posts sit within Local Health Districts and specialty networks; the system is coordinated between the NSW Ministry of Health, HETI, the RACP and the LHDs. NSW is the largest ID training jurisdiction.

Where to apply: NSW Health JMO / Annual Medical Recruitment (advanced trainee positions advertised by LHDs) — application portal.

Positions: No single statewide ID advanced-trainee intake number is published. NSW workforce modelling (2019) counted ~53 ID advanced trainees in the pipeline, 93 specialists in clinical posts (118 headcount including non-clinical roles), and 3 new Fellows in 2018, with 32.5% trainee growth across 2015-2019.

Worth knowing: Largest network and the most ID posts in the country. Recruitment runs through the annual medical recruitment campaign (broadly July-October); you apply to LHD/network positions rather than to the RACP. Citizenship/residency is weighed in appointment.

Links: NSW Health — Junior Medical Officer recruitment, HETI — Basic Physician Training in NSW, NSW Health — Physician (Infectious Disease) workforce modelling, NSW Health — A career as an infectious diseases physician.

VIC Vacancy numbers are released each cycle in the PMCV Health Service Directory rather than as a fixed published figure; the match covers both new and continuing trainees and supports the standard 3-year / 24-month-core structure once you're in.

Who runs selection: Victoria runs a formal computer match for ID advanced training (the Victorian ID Training Program), administered by the Postgraduate Medical Council of Victoria's Advanced Trainee Selection and Matching service for the Victorian Department of Health.

Where to apply: PMCV Infectious Diseases Match — application portal.

Positions: Vacancy numbers are released each cycle in the PMCV Health Service Directory rather than as a fixed published figure; the match covers both new and continuing trainees and supports the standard 3-year / 24-month-core structure once you're in.

Worth knowing: A genuine algorithmic match: candidates and health services both rank preferences and the algorithm allocates. Citizens/PRs are offered positions before temporary-visa holders. For the 2026 cycle, applications opened 6 July and closed 30 July 2026, with results published 3 September 2026.

Links: PMCV — 2026 Infectious Diseases VIC Match, PMCV Pathways — Infectious Diseases, Austin Health — Infectious diseases & immunology training (example accredited unit).

QLD Not published as a single statewide ID number. You apply to the ID program via the RMO campaign; eligibility requires AHPRA general registration plus a pass in the RACP Written exam and a pass in (or imminent sitting of) the Clinical exam.

Who runs selection: Queensland runs a statewide Infectious Diseases Advanced Training Program; you apply through the centralised Resident Medical Officer (RMO) and Registrar campaign and are placed at accredited Hospital and Health Service sites.

Where to apply: Queensland Health RMO and Registrar Campaign — application portal.

Positions: Not published as a single statewide ID number. You apply to the ID program via the RMO campaign; eligibility requires AHPRA general registration plus a pass in the RACP Written exam and a pass in (or imminent sitting of) the Clinical exam.

Worth knowing: One centralised annual campaign for the whole state. For the 2027 clinical year the RMO campaign closed 29 June 2026 (3pm). Queensland is a strong tropical/melioidosis training environment (north Queensland in particular).

Links: Queensland Health — Infectious Diseases (Medicine Advanced Training), Queensland Health — RMO and Registrar campaign.

SA Not published as a fixed annual ID number. ID advanced-training posts are offered through the SA Health advanced trainee campaign and the relevant local health network (CALHN coordinates ID training in SA).

Who runs selection: Accredited ID posts are concentrated in the Central Adelaide Local Health Network (Royal Adelaide Hospital) and other metropolitan networks; SA Health recruits advanced trainees through a central campaign.

Where to apply: SA Health Advanced Trainee Recruitment — application portal.

Positions: Not published as a fixed annual ID number. ID advanced-training posts are offered through the SA Health advanced trainee campaign and the relevant local health network (CALHN coordinates ID training in SA).

Worth knowing: Smaller jurisdiction with a centralised advanced-trainee process; the Royal Adelaide Hospital is the principal accredited ID site and CALHN coordinates ID advanced training statewide.

Links: SA Health — Advanced Trainees recruitment, SA Health Careers — Advanced Trainee Recruitment campaign.

WA No published statewide ID advanced-trainee intake number. Posts are advertised through WA Health medical recruitment at the accredited Perth tertiary sites.

Who runs selection: Accredited ID training sits in the major Perth tertiary hospitals — Fiona Stanley Hospital, Royal Perth Hospital and Sir Charles Gairdner Hospital — with BPT delivered through three metropolitan WA Adult Internal Medicine networks (East, North and South Metropolitan Health Services) plus the WA Rural Physician Training Pathway.

Where to apply: MedCareersWA / WA Health medical recruitment (with PMCWA careers information) — application portal.

Positions: No published statewide ID advanced-trainee intake number. Posts are advertised through WA Health medical recruitment at the accredited Perth tertiary sites.

Worth knowing: Geographically isolated single-city tertiary system, so a small number of accredited units carry most ID training. Sir Charles Gairdner runs a prominent ID service; the WA Rural Physician Training Pathway adds rural-weighted internal-medicine training with metropolitan in-reach.

Links: MedCareersWA — Basic Physician Training, PMCWA Careers Portal — Infectious Diseases, Sir Charles Gairdner Hospital — Infectious Diseases service.

TAS Not published. ID advanced-training capacity in Tasmania is small; expect to combine local posts with interstate rotations to meet RACP core requirements.

Who runs selection: A small jurisdiction with limited accredited ID capacity; doctors-in-training are managed by the Tasmanian Department of Health, and many ID trainees rotate to or train interstate to complete accredited requirements.

Where to apply: Tasmanian Department of Health — Doctors in Training — application portal.

Positions: Not published. ID advanced-training capacity in Tasmania is small; expect to combine local posts with interstate rotations to meet RACP core requirements.

Worth knowing: Small two-hospital tertiary system; the Royal Hobart and Launceston General hospitals provide ID services, but the limited number of accredited posts means trainees often look interstate. Confirm accreditation of any specific post directly with the RACP.

Links: Tasmanian Department of Health — Doctors in Training, RACP — Accredited settings for Advanced Training in Infectious Diseases (Australia, PDF).

ACT The Canberra Hospital ID department comprises about nine ID physicians, three ID advanced trainees, one basic trainee, one intern and two microbiology registrars. ID advanced-trainee posts are advertised individually (typically 12 months, extendable).

Who runs selection: Centred on Canberra Health Services (The Canberra Hospital), whose Infectious Diseases Department runs the inpatient/consult service with close links to microbiology, infection prevention, antimicrobial stewardship, sexual health and the ANU Medical School.

Where to apply: Canberra Health Services — Junior Medical Officer / Advanced Trainee recruitment — application portal.

Positions: The Canberra Hospital ID department comprises about nine ID physicians, three ID advanced trainees, one basic trainee, one intern and two microbiology registrars. ID advanced-trainee posts are advertised individually (typically 12 months, extendable).

Worth knowing: Single tertiary centre. Posts require PGY4+ and success in BOTH parts of the FRACP (Divisional) examination, with applications assessed against four selection criteria (clinical proficiency, teaching, communication, safety/quality). Broad case mix including immunocompromised, tropical/travel and HIV.

Links: Canberra Health Services — Infectious Diseases Registrar (Advanced Trainee) PD.

NT Not published as a fixed ID number. The NT runs general-medicine advanced training at Royal Darwin and attracts ID-interested trainees nationally for tropical exposure; some accredited ID requirements are completed in combination with interstate rotations.

Who runs selection: Centred on Royal Darwin Hospital (Top End Health Service), which has a nationally distinctive ID service — tropical and remote medicine, melioidosis, strongyloidiasis, rheumatic heart disease and a heavy Indigenous-health and Southeast-Asian-region caseload.

Where to apply: NT Health / Health Jobs NT — Top End Health Service medical recruitment — application portal.

Positions: Not published as a fixed ID number. The NT runs general-medicine advanced training at Royal Darwin and attracts ID-interested trainees nationally for tropical exposure; some accredited ID requirements are completed in combination with interstate rotations.

Worth knowing: Unmatched tropical/remote ID experience and the reason many trainees from around the country (and overseas) rotate through Darwin. Small consultant workforce; confirm accredited ID core time directly with the RACP and the unit. Contact the Director of Physician Training for current posts.

Links: NT Health — Royal Darwin Hospital Medicine (Top End Health Service), Health Jobs NT — Medicine specialists.

How to optimise your application

The honest read: Every adult-medicine subspecialty sits behind the same wall: get into a BPT network, then pass the Divisional Written and Divisional Clinical examinations. Those exams, not the ID interview, are where most people lose a year or two. Once you hold both passes, ID is winnable — it is genuinely less competitive than the procedural physician specialties. So the highest-leverage move is to optimise the BPT-and-exams phase, then make yourself an obviously-fundable, obviously-keen ID candidate.
  • Secure a strong BPT network position early (tied to Curriculum vitae, clinical experience & references, start PGY1-2) — Land a BPT spot in a network with good ID exposure and exam support. Strong physician-training references and a clean prevocational record matter far more here than anything ID-specific.
  • Pass both Divisional exams as early and as cleanly as possible (tied to RACP BPT completion + both Divisional exams, start BPT years 2-3) — This is the gate. All-attempts Adult Medicine pass rates run mid-60s to low-80s%, so re-sits are normal — but a first-attempt pass frees you to compete for ID a year earlier. Treat the Written and Clinical as the main game of BPT.
  • Bank real ID consult-team and stewardship time (tied to Demonstrated interest & fit, start BPT / RMO years) — Do an ID term, get onto the consult service, involve yourself in antimicrobial stewardship and micro-lab meetings. Selection panels want evidence you actually like the consultative, advisory nature of the work.
  • Build a small but real research/audit portfolio (tied to Research output, audit and quality-improvement work, start BPT onward) — ID rewards a publication or two, a stewardship audit, or a conference abstract (ASID is the obvious venue). You don't need a PhD to get on, but a tangible project signals fit and helps ranking at tertiary units.
  • Decide early whether you want the joint ID/Microbiology track (tied to RACP/RCPA joint program eligibility, start Late BPT / early AT) — If a laboratory and dual-fellowship career appeals, plan for the 5-year joint program (24 months clinical ID + 36 months lab microbiology, dual FRACP+FRCPA) rather than discovering it late — it changes which posts and which units you target.

Key documents & official links

FAQ

How long does it take to become an infectious diseases physician in Australia?
The structural floor is about 9 years after graduation: internship, then a year or two as an RMO, then 3 years of Basic Physician Training (with both Divisional exams), then 3 years of ID Advanced Training (24 months core ID + 6 months microbiology + 6 months non-core), leading to FRACP. Realistically most people take 10-12 years once you allow for an extra prevocational year, an exam re-sit or a research year. The joint ID/Microbiology program is 5 years of advanced training instead of 3, so it adds two more years.
Is infectious diseases competitive to get into?
Moderately — and less so than people assume. The hard filter is Basic Physician Training and the two Divisional exams, which sit in front of every adult-medicine specialty. Once you've passed those, ID is competitive but nowhere near as cut-throat as cardiology or gastroenterology. The RACP doesn't publish a national applicant-to-offer ratio (it doesn't run selection — hospitals, states and matching services do), so there's no single success rate to quote. NSW workforce modelling found supply and demand roughly balanced, with no need to increase trainee numbers.
What exams do you have to pass?
The big ones are the RACP Divisional Written Examination and the Divisional Clinical Examination, both taken at the end of Basic Physician Training — passing both is the gate to Advanced Training. There is no separate ID exit exam; you complete Advanced Training through work-based assessments, two research projects and supervisor reports rather than a final written exam. If you do the joint ID/Microbiology program, you also sit the RCPA pathology examinations.
What are the RACP Divisional exam pass rates?
For Adult Medicine (all attempts): the Divisional Written was 81.1% in February 2024 and 68.2% in October 2024, then 73.9% in February 2025 (846 candidates) and 64.9% in October 2025 (259 candidates). The Divisional Clinical was 77.1% in 2023, 79.0% in 2024 and 84.0% in 2025 (938 candidates). These are overall figures across all attempts, not first-attempt-only, and they're for the whole Adult Medicine cohort rather than ID specifically.
How much does an infectious diseases physician earn in Australia?
Be careful with numbers here — the ATO does NOT publish a standalone income line for infectious diseases. ID is classified under ANZSCO 253399 'Specialist Physicians nec' (alongside geriatricians, immunologists and others) and reported by the ATO inside the broad 'Internal medicine specialist' occupation, which had an average TAXABLE INCOME of $342,457 in 2022-23 — the fourth-highest of any occupation that year. That is a single ATO average and a gross-income proxy (not a salary), and it blends ID in with several other non-coded physician specialties. Cardiology, by contrast, is reported by the ATO as its own occupation line at about $511,535 — and ID's thin private market means most ID income is a public staff-specialist salary, so real ID earnings tend to sit below that blended figure rather than at the procedural-specialty heights.
Does infectious diseases have a good lifestyle?
Comparatively, yes — it's one of the more controllable physician specialties. The work is overwhelmingly consultative and cognitive (consults, stewardship, clinics, lab liaison) with a light procedural load. On-call and overnight sepsis advice exist, and outbreaks happen, but you're rarely doing emergency procedures at 3am. The trade-off is a smaller private market and earnings that reflect a mostly-salaried public career.
What's the difference between ID and the joint ID/Microbiology program?
Straight ID Advanced Training is 3 years (24 months core clinical ID + 6 months microbiology + 6 months non-core) and gives you FRACP. The joint RACP/RCPA program is 5 years (24 months clinical ID + 36 months laboratory microbiology) and gives you BOTH FRACP and FRCPA, qualifying you as a clinical microbiologist as well. Choose the joint program if you want a laboratory career and dual fellowship; it costs you two extra years and a second set of college exams.
Can an overseas-trained ID specialist work in Australia?
Yes, without redoing training. You apply to the RACP for a specialist comparability assessment (Standard or, for recognised jurisdictions, the faster Accelerated Specialist Pathway), after AMC primary-source verification of your qualifications. You'll be rated substantially comparable (up to 12 months peer review), partially comparable (up to 24 months supervised practice, with any required top-up training) or not comparable. Completing the required peer review/supervised practice leads to Ahpra specialist registration and FRACP.

Trained overseas? (IMG pathway)

How overseas-trained infectious diseases doctors get recognised

Overseas-trained ID specialists do not re-do training. You apply to the RACP for a specialist comparability assessment: the College compares your training, experience and recent practice against the Australian ID program and rates you substantially comparable, partially comparable or not comparable. Substantially comparable doctors complete up to 12 months of peer review before full specialist registration and FRACP; partially comparable doctors complete up to 24 months of supervised practice, including any required top-up training and assessment. There is also a faster Accelerated Specialist Pathway for applicants holding a substantially comparable qualification and consultant experience from recognised jurisdictions (UK, Ireland, India, Hong Kong, Sri Lanka), plus an Area of Need route. Primary-source verification of your qualifications runs through the AMC first.

See the RACP Standard Specialist Assessment Pathway (IMGs) and our IMG internship guide.

Last reviewed 2026-06-01.

AussieClinicians is an independent Australian pay calculator built by Jacob Stretton (RN; final-year medical student). Estimates only — verify with your payslip, payroll, and the linked award/EBA + ATO sources. Not financial or tax advice.