Palliative Medicine Training Pathway
How to become a palliative medicine physician in Australia — the RACP Chapter pathway you can enter as a GP, emergency physician, anaesthetist or other Fellow without sitting the physician exams, the no-exit-exam training, and what the work and pay look like.
The catch isn't exams — Advanced Training has none — it's landing one of few accredited posts, recruited locally with no national rubric. The bigger fork is your entry route: through RACP Basic Training you still face the Divisional exams; as a Fellow of another college (GP, ACEM, ANZCA, RANZCP and more) you skip them entirely and train straight to FAChPM.
Why palliative medicine
Symptom control and goals-of-care for people with serious, progressive and life-limiting illness — cancer, end-stage heart and lung disease, neurodegenerative conditions, frailty. You split your time across an inpatient hospice or palliative care unit, a hospital consult service that the rest of the hospital leans on for pain, delirium, nausea and breathlessness, and community/home-based care. It is a talking-and-thinking specialty: pharmacology (opioids, anti-emetics, sedation), complex communication, family meetings, and coordinating a large multidisciplinary team of nurses, allied health and GPs. There are no scopes, no theatre lists and almost no overnight procedural emergencies.
- No exit examination in Advanced Training — assessment is entirely workplace-based (case-based discussions, mini-CEX, a case study and a research project)
- Multiple entry doors: enter as a Fellow of many other colleges (RACGP/RNZCGP, ACEM, ANZCA, the Faculty of Pain Medicine, CICM, ACRRM, RACS, RANZCOG, RANZCP, RANZCR) and skip the physician exams entirely
- Among the best lifestyles in physician medicine — predominantly daytime, light on-call, no procedural roster, strong part-time and flexible-training culture
- Workforce is in genuine undersupply and has grown ~5% per year for a decade, so jobs are findable and geographically flexible
- Deeply meaningful work with time to actually know patients and families
- Consultant earnings sit well below the proceduralists and high-billing physician subspecialties — there is little private-billing upside
- Emotionally heavy: constant exposure to death, grief and conflict carries a real burnout and compassion-fatigue load
- Accredited training posts are limited and recruited locally, so you may have to move states or wait for a spot rather than sit an exam to progress
- Low procedural content can feel deskilling if you came from a hands-on background
- Smaller specialist community and fewer departments means less choice of where to ultimately work
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?
Palliative medicine does not publish a national applicant-to-offer ratio, and the RACP is not the body that recruits trainees — hospitals, networks and state programs do. By the numbers it is more accessible than the high-prestige physician subspecialties: there is no Advanced Training exam to fail, and the workforce is in undersupply. The AIHW counted about 358 palliative medicine physicians / 335 FTE in 2023, roughly 1.3 FTE per 100,000 population (up from 0.8 in 2013) — growth of about 5.0% a year over the decade. (The AIHW reports the actual figure; it does not publish a target or benchmark FTE.) The real competition is for the limited number of accredited posts and, for physician-route entrants, surviving the BPT Divisional exams first. Coming in as a Fellow of another college removes that exam barrier entirely, which is why so many GPs, ED, ICU and psychiatry doctors take this route.
Unaccredited time: Not formally required, but an unaccredited or RMO palliative care term is the single most useful thing you can do — it builds the CV, gets you known to the consultants who sit on selection panels, and confirms the field suits you. In several states 'making yourself known' to local palliative physicians is explicitly how trainees get picked.
Sources: AIHW — Palliative care workforce (358 physicians, 335 FTE, 1.3 per 100,000 in 2023; up from 0.8 in 2013; +5.0% pa), RACP — Palliative Medicine Advanced Training (no exit exam; entry routes), National Health Workforce Dataset (Dept of Health & Aged Care).
Selection criteria & how to apply
There is no national scored selection rubric for palliative medicine and no published percentage weightings — selection is run locally by hospitals, state programs and networks, who assess a familiar bundle of CV, references, interview and demonstrated commitment to the field. Eligibility is the firmer part: you must either have completed RACP Basic Physician Training (including the Divisional Written and Clinical exams) or hold a Fellowship of an eligible college, plus current registration and an accredited post. The components below are qualitative, not point-scored.
Key documents: RACP — Palliative Medicine Advanced Training (eligibility & requirements), RACP — Accredited settings for Advanced Training, Australasian Chapter of Palliative Medicine (AChPM).
How training is organised state by state
NSW Not published as a single number; the most accredited sites of any state (about 31 on the RACP's April 2026 list).
Who runs selection: Largest training base in the country, but recruited locally rather than as a single match. Advanced trainee posts are advertised by individual hospitals and Local Health Districts; HETI coordinates the broader physician-training framework and runs the separate rural-generalist palliative care skills route with the GP colleges.
Where to apply: NSW Health career / I Work for NSW (individual LHD positions) — application portal.
Positions: Not published as a single number; the most accredited sites of any state (about 31 on the RACP's April 2026 list).
Worth knowing: No statewide match for palliative AT — you apply to specific hospitals/LHDs. Big metropolitan services (e.g. Calvary Mater Newcastle, Sacred Heart/St Vincent's, Western Sydney sites) anchor training. A distinct HETI rural-generalist pathway — billed as the first of its kind in Australia — lets GP registrars earn a 12-month advanced-skills qualification in palliative care.
Links: HETI — Medical focus area (NSW training), HETI — End of life and palliative care.
VIC Not published as a single number; about 21 accredited sites statewide (RACP April 2026 list).
Who runs selection: Coordinated through the Victorian Palliative Medicine Training Program (VPMTP), which places doctors into RACP-accredited services across the state for both Advanced Training and the 6-month Clinical Foundation.
Where to apply: VPMTP — application portal.
Positions: Not published as a single number; about 21 accredited sites statewide (RACP April 2026 list).
Worth knowing: Victoria runs a genuine statewide program rather than purely hospital-by-hospital recruitment — you apply through VPMTP, which is unusually organised for this specialty and a real advantage for trainees wanting a structured rotation across metro and regional sites. VPMTP also runs the 6-month Clinical Foundation registrar intake.
Links: VPMTP — Victorian Palliative Medicine Training Program, VPMTP — Six-month (Clinical Foundation) registrar.
QLD Not published as a single number; about 14 accredited sites statewide (RACP April 2026 list).
Who runs selection: Centrally coordinated by the Queensland Palliative Medicine Training Program — a statewide approach to recruitment and rotation across the Hospital and Health Services and private palliative services.
Where to apply: Queensland Health RMO/registrar campaign (Palliative Medicine) — application portal.
Positions: Not published as a single number; about 14 accredited sites statewide (RACP April 2026 list).
Worth knowing: A single statewide panel — with active involvement from all Queensland training sites — interviews shortlisted trainees and then allocates them to sites at an allocation meeting, with first-year positions ranked primarily on interview, CV, cover letter and (where possible) site preferences. Supported by a fortnightly statewide Queensland Palliative Medicine Education Program.
Links: Queensland Health — Palliative medicine advanced training, Queensland Health — Palliative Medicine Training Program process (PDF).
SA Not published as a single number; about 4 accredited sites (RACP April 2026 list), anchored by Southern Adelaide Palliative Services and the Women's and Children's (paediatric).
Who runs selection: RACP advanced trainee posts are filled through SA Health's centralised advanced trainee recruitment; the separate GP/rural-generalist palliative advanced-skills posts run through the SA MET centralised PGY3+ process.
Where to apply: SA Health Advanced Trainee Recruitment / SA MET — application portal.
Positions: Not published as a single number; about 4 accredited sites (RACP April 2026 list), anchored by Southern Adelaide Palliative Services and the Women's and Children's (paediatric).
Worth knowing: Two parallel doors: physician/post-Fellowship advanced trainees via SA Health AT recruitment, and rural-generalist palliative advanced-skills posts (e.g. Wirringka Palliative Care Unit at Modbury plus a rural GP site such as Clare) via SA MET. A relatively small specialist base concentrated in southern Adelaide.
Links: SA Health — Advanced trainee recruitment, SA MET — Palliative care advanced skills program.
WA Not published as a single number; about 11 accredited sites (RACP April 2026 list).
Who runs selection: No statewide match — trainees are recruited by the services themselves (metro tertiary, hospice, community and consult roles across sites such as Sir Charles Gairdner, Joondalup and SJOG Midland), with paediatric palliative posts at the Child and Adolescent Health Service.
Where to apply: WA Health medical recruitment / PMCWA careers portal — application portal.
Positions: Not published as a single number; about 11 accredited sites (RACP April 2026 list).
Worth knowing: Selection is notably relationship-driven — the senior Perth palliative physicians who sit on the selecting board are the people you should make yourself known to. There is also a WA rural generalist fellowship route that includes palliative care as an advanced skill.
Links: PMCWA — Palliative medicine career profile, WA Rural Generalist — Fellowship training.
TAS Not published as a single number; about 3 accredited sites (RACP April 2026 list).
Who runs selection: Small program centred on the Royal Hobart Hospital and the statewide Tasmanian specialist palliative care service; posts are recruited through the Tasmanian Department of Health.
Where to apply: Tasmanian Department of Health — Doctors in Training — application portal.
Positions: Not published as a single number; about 3 accredited sites (RACP April 2026 list).
Worth knowing: You cannot complete all three core terms at the Royal Hobart Hospital — at least one term must be done elsewhere (and Terms 1-3 must be completed across two or more sites with different supervisors), which in practice can mean a rotation interstate or to northern Tasmania.
Links: Tasmanian Department of Health — Doctors in Training, RACP — Accredited settings.
ACT Not published as a salaried-FTE figure; the RACP April 2026 list accredits Clare Holland House for up to 3 trainees (Inpatient/Hospice, Community and Clinical Foundation) and Canberra Hospital for up to 2 — 2 accredited ACT sites in total.
Who runs selection: Built around Clare Holland House (Canberra Health Services) — the territory's specialist hospice, community and hospital consult service — plus consultation/cancer-care terms at the Canberra Hospital, recruited through Canberra Health Services.
Where to apply: Canberra Health Services — Medical recruitment — application portal.
Positions: Not published as a salaried-FTE figure; the RACP April 2026 list accredits Clare Holland House for up to 3 trainees (Inpatient/Hospice, Community and Clinical Foundation) and Canberra Hospital for up to 2 — 2 accredited ACT sites in total.
Worth knowing: A single dominant hospice service means rotations across inpatient hospice, community and acute-hospital consult sit under one roof, and the same posts are also accredited for the Clinical Foundation. Small numbers, so timing matters.
Links: Canberra Health Services — Clare Holland House, Palliative Care ACT — Clare Holland House.
NT Not published; just 1 accredited site (Royal Darwin Hospital) on the RACP April 2026 list.
Who runs selection: Centred on Royal Darwin Hospital's palliative care service; recruited through NT Health. The smallest program in the country.
Where to apply: NT Health — Medical careers — application portal.
Positions: Not published; just 1 accredited site (Royal Darwin Hospital) on the RACP April 2026 list.
Worth knowing: With a single accredited site (accredited for a Teaching Hospital/Consultation term), completing the full three years entirely within the NT is not realistic — trainees will need rotations interstate to meet the multi-setting core requirements. Strong appeal for doctors wanting high-acuity, culturally complex and remote palliative care.
Links: NT Health — Medicine specialist careers, RACP — Accredited settings.
How to optimise your application
- Pick the cheapest entry door (tied to Eligibility, start As early as PGY1-2) — If you are heading for general practice, emergency, anaesthetics, psychiatry or rural generalism anyway, finishing that fellowship lets you enter palliative Advanced Training via the post-Fellowship (FAChPM) route and skip the RACP Divisional exams entirely. For many people this is a faster, lower-risk road than BPT.
- Do an unaccredited / RMO palliative term (tied to Demonstrated commitment to palliative care, start PGY2-4) — Get onto a palliative or hospice rotation, do it well, and collect a strong reference from the consultants. It test-drives the specialty and puts you in front of the exact people who sit on selection panels.
- Be geographically flexible (tied to Securing an accredited post, start When applying) — Posts cluster in NSW, Victoria and Queensland and are thin in TAS, ACT and the NT. Willingness to move (or to do a term interstate) materially increases your odds of starting on time.
- Get known to your local palliative community (tied to Being known to the local palliative community, start 1-2 years before applying) — Attend ANZSPM meetings, ask the local service for a term, and build relationships. In several states this is, candidly, how trainees get chosen.
- Bank the BPT exams if you take the physician route (tied to Eligibility (physician route), start During BPT) — Passing the Written and Clinical first time avoids the most common 12-month delay. There is no further exam after this, so clearing it cleanly is the whole physician-route game.
Key documents & official links
- RACP — Palliative Medicine Advanced Training
- RACP — Australasian Chapter of Palliative Medicine (AChPM)
- RACP — Clinical Foundation in Palliative Medicine (6-month, formerly the Clinical Diploma)
- RACP — Accredited Sites for Advanced Training: Palliative Medicine (PDF, updated April 2026)
- RACP — Standard Specialist Assessment Pathway (overseas-trained)
- RACGP — Palliative care curriculum & syllabus
- ACRRM — Advanced Specialised Training (AST) posts (GP/rural generalist)
- ANZSPM — Australian and New Zealand Society of Palliative Medicine (training resources)
- AIHW — Palliative care workforce
- Medical Board of Australia — Specialist recognition (IMGs)
- ATO — Taxation statistics 2021-22 (Individuals, occupation by income)
FAQ
Do I have to sit a palliative medicine exam?
Can I become a palliative medicine physician as a GP?
What's the difference between FRACP and FAChPM?
How competitive is palliative medicine?
How long does it take?
What does a palliative medicine physician earn?
Is the lifestyle really that good?
Trained overseas? (IMG pathway)
How overseas-trained palliative medicine doctors get recognised
Overseas-trained palliative medicine specialists are assessed by the RACP for comparability to an Australian-trained specialist, not by re-doing the whole training. You apply through the Medical Board / AHPRA Specialist Pathway, and the RACP runs the substantive assessment of your qualifications and consultant experience. Outcomes are 'substantially comparable' (peer review — minimum 6 and up to 12 months — then fellowship), 'partially comparable' (top-up training of around 6-12 months plus peer review, with comparability reachable within a maximum of 24 months FTE of supervised practice) or 'not comparable'. There is also an Accelerated Specialist Pathway for applicants from a defined list of comparable health systems. Successful completion leads to FRACP (or FAChPM) and AHPRA specialist registration in palliative medicine.
See the RACP Standard Specialist Assessment Pathway and our IMG internship guide.
Related specialties
Last reviewed 2026-06-01.