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Medical Administration Training Pathway

How to become a medical administrator in Australia — the RACMA pathway (FRACMA) you train through while employed in a real management job, in the only specialist college of medical administration in the world.

The bottleneck isn't an exam or a research race — it's finding an accredited training post that exists and is funded. RACMA doesn't run a national intake or place you; you must independently land a RACMA-accredited Medical Administration Registrar job (or get your employer's post accredited), and there's no published applicant-to-offer ratio. It's also a career change with real opportunity cost.

Why medical administration

You work office hours in a medical executive suite — Office of the Director/Executive Director of Medical Services, a Chief Medical Officer's office, or a health-department unit. Days are credentialing and scope-of-practice, medical workforce planning and rostering, clinical governance and incident/mortality review, complaints and medico-legal matters, policy, budgets, accreditation, and being the medical voice in management meetings. You are still a doctor — you sign off on clinical decisions, sit on credentialing and M&M committees, and are the bridge between executive and the wards — but you have largely left hands-on patient care. On-call, if any, is administrative (the on-call DMS for a hospital crisis), not clinical.

✓ Draws

Predictable, largely office-hours work with minimal or no clinical on-call — one of the best lifestyle profiles in medicine
You can enter years into your career; clinical and other-specialty experience is an asset, not wasted time
Train on the job in a paid management role rather than competing for a scarce single national intake
Clear executive ladder: Registrar to DMS to Executive Director of Medical Services / CMO / hospital CEO
Genuine system-level impact — you shape services, safety and workforce, not just one patient at a time
Skills travel: leadership, governance and health-system knowledge transfer across hospitals, government and the private sector

⚖ Trade-offs

You largely give up hands-on clinical work and procedural skills — a real loss for some
Getting in depends on a funded accredited post existing where you are; supply is thin and uneven
No published national selection rubric or applicant-to-offer ratio to optimise against — the market is opaque
You self-fund or negotiate Masters-level coursework, College fees, workshops and travel to Melbourne
Management carries political and medico-legal exposure — complaints, coronial matters, restructures land on your desk
Smaller, less visible specialty: fewer training posts, fewer peers, and a workforce skewed older

Subspecialties

Director / Executive Director of Medical Services (hospital or network)Chief Medical OfficerClinical governance, safety and qualityMedical workforce, credentialing and scope of practiceHealth-department / system policy and planningHospital or health-service executive leadership (up to CEO)

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

~6 years from internship (3 prevocational + 3 FTE training)

Structural floor if you go straight at it: minimum clinical experience, a post waiting, and no breaks.

Internship (PGY1)

General registration with the Medical Board of Australia.

Prevocational / clinical years

Build toward the minimum 3 years FTE clinical experience involving direct patient care that RACMA requires before Fellowship.

Secure an accredited Medical Administration Registrar post + RACMA candidacy

0 (concurrent)

You must independently land an accredited (or provisionally accredited) post and be assessed eligible for candidacy — this is the real gate, not an exam.

Foundation Phase

1.5

Min 18 months FTE in an accredited post; 15 workplace-based assessments; begin the 5 RACMA core Masters-level subjects.

Advanced Phase + MMP Oral Examination

1.5

Min 18 months FTE; 14 workplace-based assessments; pass the Medical Management Practice (MMP) Oral Examination in Melbourne.

FRACMA

Fellowship of RACMA — eligible for specialist DMS/CMO roles.

Realistic route

~8–12+ years from internship

Most people arrive later — often after substantial clinical years or a whole other specialty — and train part-time around a real job.

Internship + RMO years

3–6

Many do several years as an RMO/registrar, or fellow in another specialty (e.g. GP, emergency, physician), before pivoting.

Decide to pivot + find a funded post

0–2

The slow step: an accredited, funded Medical Administration Registrar job has to exist where you are and you have to win it. Specialists must also formally change scope of practice.

Foundation Phase (often part-time)

1.5–3

Training can run at a minimum 0.4 FTE around a substantive management role, stretching calendar time; complete the 5 core Masters subjects.

Advanced Phase + MMP Oral Examination

1.5–3

Up to 4 attempts allowed at the MMP Oral; two sittings per year in Melbourne.

FRACMA (max 10 calendar years from enrolment)

—

Candidates have a maximum of 10 calendar years to complete the program.

How competitive is it?

Medical Administration is not gated by a brutal national exam or a research-publication race the way the physician and surgical subspecialties are. The constraint is the number of funded, accredited training posts and whether one exists where you live and want to work. RACMA does not run a single national intake or publish an applicant-to-offer ratio, so the true success rate is not published. What the data does show is a small, ageing specialty: in 2016 there were about 277 medical administrators in the workforce (most recent Department of Health factsheet), with roughly 100–115 trainees and only ~12–28 new fellows admitted per year over 2013–15. Demand for medical leaders is steady and the lifestyle is attractive, so good posts attract strong fields — but the honest framing is "limited posts and a hidden job market," not "hundreds of applicants per training place."

Unaccredited time: Not applicable — there is no separate "unaccredited registrar" grind. The equivalent hurdle is securing an accredited (or provisionally accredited) Medical Administration Registrar post in the first place, since you train and earn in that post from day one.

Sources: Department of Health NHWDS — Medical Administration 2016 factsheet (277 in workforce; ~110 trainees; new-fellow counts), RACMA — Fellowship Training Program eligibility & post requirements, RACMA — Industry Vacancies (the de facto national job board for registrar posts).

Selection criteria & how to apply

There is no single national selection algorithm and no published points rubric for Medical Administration. Selection happens at the level of the individual health service (and, in some states, the state JMO/registrar campaign) that owns the funded post: they recruit and rank applicants for their Medical Administration Registrar job, and you must separately be assessed by RACMA as eligible for candidacy. In practice the binding requirements are RACMA's eligibility criteria plus whatever each employer weights at interview. The components below are therefore qualitative — assessed and weighted by employers, not scored against a published national percentage rubric.

Minimum clinical experienceEligibility

At least 3 years full-time-equivalent clinical experience involving direct patient care is a hard RACMA eligibility threshold before Fellowship — not points, a gate.

Medical registration & scope of practiceEligibility

General and/or specialist registration with the Medical Board of Australia (or MCNZ) with no limiting conditions; doctors holding only specialist registration must change their scope of practice to train. A gate, not a score.

Accredited training postEligibility

You must be appointed to (or about to commence in) a RACMA-accredited or provisionally accredited post. No post, no training — this is the real bottleneck.

Leadership & management aptitude / experienceAssessed

Demonstrated interest and experience in governance, quality, committees, projects or prior management roles is weighted heavily by employers at interview, but there is no published percentage weighting.

Curriculum vitae & refereesAssessed

CV and three nominated referees are required in the RACMA application; employers assess CV and references in their own recruitment, with no published national weighting.

Interview / multi-modal selectionAssessed

Prospective registrars participate in a multi-modal selection process run by the employer/state (Queensland, for example, runs a state-wide multi-modal selection panel); format and weighting are not nationally published.

Key documents: RACMA — Eligibility Requirements, RACMA — Applying for the Fellowship Training Program, RACMA — Fellowship Training Program Requirements Policy (PDF).

How training is organised in each state

Because RACMA does not run a national intake, the way you actually get in differs by state — some run a coordinated networked program or a central JMO/registrar campaign, others leave health services to advertise their own posts (most of which also appear on RACMA's Industry Vacancies board). "Not published" below means a per-state position count or formal ratio is not publicly reported.

NSW Not published as a single current state figure — positions are recruited by participating LHD sites each year (the network began in 2014 with 7 positions; an information night for the 2026 clinical year was held in July 2025).

Who runs selection: HETI (Health Education and Training Institute) runs a networked Medical Administration Training Program in partnership with RACMA, Local Health Districts and training providers; posts also appear in the annual NSW Health JMO recruitment campaign.

Where to apply: HETI — Medical Administration Training Program — application portal.

Positions: Not published as a single current state figure — positions are recruited by participating LHD sites each year (the network began in 2014 with 7 positions; an information night for the 2026 clinical year was held in July 2025).

Worth knowing: The most coordinated state model: HETI auspices a networked program with a trainee orientation guide and a partnered intake, rather than purely standalone health-service ads.

Links: HETI — Medical Administration Training Program, HETI — Medical Administration Training Program Orientation Guide (PDF).

VIC Not published as a state total — varies year to year by health service.

Who runs selection: Decentralised — individual Victorian health services (metro, regional and cross-border, e.g. Albury Wodonga Health, Bendigo Health, and Cabrini in the private sector) advertise and recruit their own RACMA-accredited registrar posts, listed on RACMA Industry Vacancies; positions are classified on the Victorian medical (AMA) award by experience.

Where to apply: RACMA Industry Vacancies (Victorian health-service ads) — application portal.

Positions: Not published as a state total — varies year to year by health service.

Worth knowing: No dedicated statewide RACMA computer match (unlike the physician PMCV match). Victoria includes private-sector training posts (e.g. Cabrini Health) and cross-border services such as Albury Wodonga Health.

Links: RACMA Industry Vacancies, Example — Medical Administration Registrar (RACMA Trainee), Albury Wodonga Health.

QLD Not published as a fixed annual number — distributed across HHSs and advertised through the RMO campaign.

Who runs selection: Queensland Health recruits accredited Medical Administration Registrars through its annual Resident Medical Officer (RMO) and Registrar campaign; posts sit in Hospital and Health Services (e.g. Metro North, West Moreton, Central Queensland, Cairns and Hinterland).

Where to apply: Queensland Health — RMO & Registrar campaign (Medical Administration) — application portal.

Positions: Not published as a fixed annual number — distributed across HHSs and advertised through the RMO campaign.

Worth knowing: Queensland frames medical administration as advanced training only, governed by the RACMA curriculum; you must be assessed eligible for RACMA candidacy before you can be employed as a registrar, and apply via the RMO campaign through a state-wide multi-modal selection panel. Strong rural/regional and Aboriginal & Torres Strait Islander health workforce focus in some posts.

Links: Queensland Health — Medical Administration (RMO & Registrar campaign), Queensland Health Careers — Medical Administration.

SA Not published as a state figure. SA had the lowest ratio of medical administrators per 100,000 population (0.8) in the 2016 workforce data, so posts are limited.

Who runs selection: South Australian Medical Education and Training (SA MET) coordinates trainee medical officer allocation and recruitment; RACMA-accredited Medical Administration Registrar posts sit in SA Health Local Health Networks (e.g. Limestone Coast) and are applied for via SA Health Careers / SA MET.

Where to apply: SA Health Careers — Trainee Medical Officer recruitment (SA MET) — application portal.

Positions: Not published as a state figure. SA had the lowest ratio of medical administrators per 100,000 population (0.8) in the 2016 workforce data, so posts are limited.

Worth knowing: Centralised TMO recruitment through SA MET, but the specific medical administration posts are network-based; rural networks recruit their own RACMA registrars.

Links: SA Health — South Australian Medical Education and Training (SA MET), SA Health Careers — Trainee Medical Officer recruitment.

WA Not published as a state total — posts spread across metro and rural WACHS sites.

Who runs selection: WA Health recruits through its annual RMO/Registrar campaign (MedCareersWA); RACMA-accredited posts sit in metropolitan and WA Country Health Service sites (e.g. Geraldton, Broome). The Postgraduate Medical Council of WA publishes medical administration career information.

Where to apply: MedCareersWA — Registrar training (WA Health) — application portal.

Positions: Not published as a state total — posts spread across metro and rural WACHS sites.

Worth knowing: WA stakeholders favour a one-on-one career conversation with prospective trainees (including advice on which Masters to do), and rural WACHS posts (Broome, Geraldton) are a recurring feature of supply.

Links: MedCareersWA — Registrar training, Postgraduate Medical Council of WA — Medical Administration.

TAS Not published as a fixed number — a small, statewide rotational program rather than a set of standing posts at named hospitals; vacancies are advertised on Tasmanian Government Jobs and RACMA Industry Vacancies.

Who runs selection: The Tasmanian Department of Health recruits Registrars in Medical Administration into a three-year rotational program run through the Office of the Chief Medical Officer / Executive Director Medical Services, rotating across Hospitals South and Hospitals North to prepare candidates for the RACMA Fellowship.

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

Positions: Not published as a fixed number — a small, statewide rotational program rather than a set of standing posts at named hospitals; vacancies are advertised on Tasmanian Government Jobs and RACMA Industry Vacancies.

Worth knowing: Small, defined statewide program structured around the CMO/EDMS office; the registrar rotates across the state's hospital regions rather than holding a single fixed post.

Links: Tasmanian Department of Health — Doctors in Training, Example — Registrar in Medical Administration, Royal Hobart Hospital / Dept of Health.

ACT Not published — small jurisdiction; posts recruited individually as they arise.

Who runs selection: Canberra Health Services recruits Medical Administration Registrar / trainee posts through its medical officer recruitment, typically working to the Deputy Director and Director of Medical Services; positions also appear on RACMA Industry Vacancies.

Where to apply: Canberra Health Services — Careers (medical officer recruitment) — application portal.

Positions: Not published — small jurisdiction; posts recruited individually as they arise.

Worth knowing: Single major employer (Canberra Health Services) means very few posts; trainees get broad exposure (workforce planning, recruitment, clinical governance, project and disaster planning) working directly under the DMS office.

Links: Canberra Health Services — Careers, Canberra Health Services — Junior Medical Officer careers.

NT Not published as a fixed number. The NT had the highest ratio of medical administrators per 100,000 population (2.0) in the 2016 workforce data, reflecting the management load of a small, dispersed system.

Who runs selection: NT Health (Department of Health) recruits Medical Administration Registrars at Royal Darwin Hospital and other NT sites; candidates must be enrolled or intending to enrol in the RACMA Fellowship Training Program. Posts appear on RACMA Industry Vacancies.

Where to apply: RACMA Industry Vacancies (NT Health posts) — application portal.

Positions: Not published as a fixed number. The NT had the highest ratio of medical administrators per 100,000 population (2.0) in the 2016 workforce data, reflecting the management load of a small, dispersed system.

Worth knowing: Strong remote/Aboriginal health and regional director-of-medical-services exposure; small workforce means individually advertised posts rather than a structured intake.

Links: Example — Medical Administration Registrar, Royal Darwin Hospital, RACMA Industry Vacancies.

How to optimise your application

The honest read: Unlike the physician or surgical pathways, there is no national exam cull and no research-publication arms race here. Almost everyone who lands an accredited post and does the work reaches Fellowship; the people who don't are mostly those who never find (or never create) a post. So your effort is best spent making yourself the obvious hire for a scarce job and engineering a post into existence where one doesn't yet exist.

Get the clinical years banked early (tied to Minimum 3 years FTE clinical experience, start From PGY1) — Don't drift — make sure you clearly clock the 3 years FTE of direct patient care RACMA requires, so eligibility is never the thing holding you up when a post appears.
Build a visible management track record before you apply (tied to Leadership & management aptitude (Assessed), start PGY1–3) — Sit on clinical governance, M&M, rostering, JMO and quality committees; run a real improvement or audit project; take JMO leadership roles. This is what employers actually weight at interview.
Work the hidden job market relentlessly (tied to Securing an accredited post (the bottleneck), start 12+ months before you want to start) — Watch RACMA Industry Vacancies and your state JMO/registrar campaign; cold-contact Directors of Medical Services; ask whether an existing role can be RACMA-accredited (employers apply to RACMA to accredit a post). Geographic flexibility — including rural and regional posts — dramatically widens your options.
Line up Masters-level coursework and RPL (tied to 5 RACMA core Masters subjects, start On or before enrolment) — Plan how you'll complete the five core subjects (Evidence Informed Decision Making, Financial Management in Health, Health Care Systems, Health Law and Ethics, Leadership) through an approved university program, and apply for Recognition of Prior Learning and Experience if you already have comparable postgraduate study.
Use part-time training to keep earning (tied to Minimum 0.4 FTE training rule, start At enrolment) — Training can run at a minimum 0.4 FTE around a substantive management role (at that minimum it must be in a single accredited post), so you can keep an income and a real job while progressing — useful given you've stepped away from clinical billings.
If you already hold another Fellowship, weigh AFRACMA (tied to Recognition of prior specialist training, start Mid-career) — Doctors who already hold specialist Fellowship in another college can pursue the one-year Associate Fellowship (AFRACMA) for formal medical-management recognition instead of the full FRACMA program — a faster route if you don't need full specialist registration in administration.

Key documents & official links

FAQ

Is Medical Administration hard to get into?

Not in the way physician or surgical training is — there's no national exam that culls most applicants and no research-publication arms race. The hard part is finding a funded, RACMA-accredited Medical Administration Registrar post, which depends on one existing where you live and want to work. RACMA doesn't run a single national intake or publish an applicant-to-offer ratio, so there's no national success rate to quote. It's a small, supply-limited, somewhat hidden job market rather than a high-volume competitive cull.

How long does it take?

The Fellowship Training Program is a minimum of 3 years full-time-equivalent — at least 18 months in the Foundation Phase and 18 months in the Advanced Phase — and you have a maximum of 10 calendar years to finish. Before you even start you generally need 3 years FTE of clinical experience involving direct patient care, so the structural floor is about 6 years from internship. Most people take longer because they enter mid-career and often train part-time around a real management job.

Do I have to do a Master's degree?

Not a full Master's. Candidates must satisfactorily complete five RACMA core subjects from an approved university Master's program — Evidence Informed Decision Making, Financial Management in Health, Health Care Systems, Health Law and Ethics, and Leadership — but since 2025 you don't need to complete the whole degree to meet the training requirements (you can if you want to). You can apply for Recognition of Prior Learning and Experience for comparable postgraduate study you've already done.

What's the exam?

The summative exam is the RACMA Medical Management Practice (MMP) Oral Examination, held face-to-face in Melbourne with two sittings per year. From 2024 candidates get up to four attempts, and the old compulsory College Trial Examination was removed. Alongside the oral you complete structured workplace-based assessments throughout training — 15 in the Foundation Phase and 14 in the Advanced Phase — plus mandatory workshops. There is no separate written barrier exam like the RACP Divisional Written.

Can I switch into this after training in another specialty?

Yes — that's one of the most common entry stories. Mid-career doctors, including those who've already fellowed in GP, emergency medicine or a physician specialty, regularly pivot into medical administration. If you hold specialist registration in another specialty you must formally change your scope of practice to undertake the program. If you already hold another college's Fellowship and want medical-management recognition without the full FRACMA, RACMA also offers a one-year Associate Fellowship (AFRACMA).

Does RACMA find me a job, or do I find my own?

You find your own. RACMA accredits posts and runs the training and exams, but it does not place candidates. You must independently land an accredited (or provisionally accredited) Medical Administration Registrar position — or get an employer to apply to have an existing role accredited — then enrol. Posts are advertised by individual health services, on RACMA's Industry Vacancies board, and through state JMO/registrar campaigns (HETI in NSW, the RMO campaign in Queensland and WA, SA MET in South Australia).

What does it pay?

There's no clean published earnings figure specific to specialist medical administrators. As a trainee you're paid as a registrar/senior registrar on your state's medical award (in Victoria, for example, posts are classified on the Victorian medical (AMA) award by experience). As a Fellow you move into executive medical roles — DMS, Executive Director of Medical Services, CMO, up to hospital CEO — paid on senior medical/executive contracts that vary by state, employer and seniority. Note the ATO's doctor income tables (which list specialties like cardiology and surgery) don't carry a medical-administration line, because the role sits under a managerial occupation code (ANZSCO 134211 "Medical Administrators") rather than a clinical-specialist code — so any single national salary number would be unreliable.

What's the lifestyle like?

Among the best in medicine for predictability. You work largely office hours in a medical executive role, with minimal or no clinical on-call once you've left the floor — any on-call is administrative (the on-call DMS for a hospital incident), not clinical. The trade-off is that you give up hands-on patient care and procedural skills, and you take on the political and medico-legal weight of management: complaints, coronial matters, restructures and accreditation all land on your desk.

Trained overseas? (IMG pathway)

How overseas-trained medical administration doctors get recognised

Overseas-trained medical administrators apply directly to RACMA under the specialist pathway for an assessment of comparability to an Australian/New Zealand-trained specialist medical administrator. You first register with the AMC, build a portfolio and complete primary source verification (via ECFMG/EPIC), then lodge RACMA's Application for Assessment of Comparability in Medical Administration. A RACMA SIMG Assessment Panel reviews your training and experience and may interview you to explore your management scope and identify gaps. Outcomes range from substantially comparable (a short path to Fellowship) to partially comparable (top-up training/assessment) to not comparable. Notably, the Department of Health recorded no overseas-trained new RACMA fellows across 2013–15, so this is an uncommon route in practice.

See the RACMA — Specialist International Medical Graduates and our IMG internship guide.

Public Health Medicine RACP (AFPHM)Occupational & Environmental Medicine RACP (AFOEM)General Practice RACGP / ACRRM Emergency Medicine ACEM Rural Generalist Medicine ACRRM / RACGP

Last reviewed 2026-06-01.