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Sexual Health Medicine Training Pathway

How to become a sexual health physician in Australia — the RACP Chapter you can enter straight off Basic Training or laterally as a GP, O&G, dermatology, psychiatry or other Fellow, the outpatient no-on-call work, and a tiny workforce.

The bottleneck is jobs, not the gate. Entry is genuinely open — direct or lateral from several colleges, with no brutal national rubric — but this is one of the smallest specialties (about 114 specialists in 2016, ageing, NSW/VIC-concentrated). Training posts are few and almost all in public clinics, and consultant posts are fewer still, so you compete for scarcity at the consultant end.

Why sexual health medicine

Overwhelmingly outpatient clinic work in a public sexual health service: STI screening, diagnosis and treatment; HIV management and PrEP; contraception and reproductive/sexual health; genital dermatology; management of sexual dysfunction (vulval pain, vaginismus, anorgasmia, erectile dysfunction); and gender-affirming care. A large slice is communicable-disease and public-health work — partner notification, surveillance, outbreak response and health promotion — which is why the chapter frames the specialty as a blend of public health and clinical medicine. There is essentially no acute inpatient ward service and no overnight on-call, so the week is predictable.

Draws
  • Excellent lifestyle: outpatient-based, predictable hours, no acute on-call
  • Multiple entry routes — you do not have to do Basic Physician Training if you already hold an eligible fellowship
  • Broad, holistic scope spanning infectious diseases, public health, dermatology, reproductive and gender-affirming care
  • Meaningful work with under-served communities and a clear population-health impact
  • Short add-on training (3 years) relative to most physician subspecialties
Trade-offs
  • Very small workforce and few funded positions — both training posts and consultant jobs are scarce and have not grown in a decade
  • Predominantly public-sector and salaried (only ~28% of the workforce was in the private sector in 2016); limited procedural billing means a lower earning ceiling than most physician fields
  • Geographically concentrated (about half the workforce in NSW, ~85% in major cities) — limited choice of where to live
  • Ageing workforce and falling trainee numbers raise questions about long-term critical mass
  • Stigma and funding insecurity around sexual health services can make career stability feel precarious

Subspecialties

HIV medicineSexually transmitted infections / STI public healthReproductive and contraceptive healthGenital dermatology and HPV/anal dysplasia (high-resolution anoscopy)Sexual dysfunction (male and female)Transgender and gender-affirming careForensic / sexual assault medicine (elective)

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
~3 years (lateral entry as an existing Fellow)
The structural floor if you already hold an eligible fellowship (e.g. GP, rural generalist, O&G, dermatology, urology, psychiatry, pathology, public health) and walk straight into Advanced Training — no BPT, no Divisional exams.
Hold an eligible Fellowship (FRACGP/FRNZCGP, FACRRM, FRANZCOG, FACD, RACS urology, FRANZCP, FRCPA, FAFPHM, etc.) and current registration
Already done
This is the lateral on-ramp that makes Sexual Health Medicine unusual — your prior college fellowship satisfies the entry requirement.
Secure an accredited Advanced Training post
0 (the rate-limiting step)
You must be employed in an AChSHM-accredited sexual health position before the RACP will register your training — and accredited posts are few.
AChSHM Advanced Training (36 months FTE)
3
Core rotations: 6 months HIV medicine, 9 months female and 9 months male sexual health, plus reproductive/sexual health, an elective, formal coursework and an Advanced Training Research Project.
Pass the AChSHM Exit Assessment
In year 3
A viva (two 30-minute sessions, eight clinical questions, two examiners per session), offered once a year. You must have completed ≥24 months FTE certified training before you can sit it.
Admission to Fellowship (FAChSHM)
Recognised as a Sexual Health Medicine specialist in Australia and Aotearoa New Zealand.
Realistic route
~8-10 years from internship (the BPT route)
The common physician route: internship, then Basic Physician Training and the Divisional exams, then a scarce Advanced Training post — with time often lost waiting for a position to open.
Internship + residency (PGY1-2)
2
General medical and rotational experience; build exposure to sexual health, ID or general medicine where you can.
Basic Physician Training (BPT)
3
Accredited adult-medicine BPT; this is the standard physician on-ramp if you are not already a Fellow of another eligible college.
RACP Divisional Written + Clinical Examinations
End of BPT
The hard RACP hurdle. Pass both to progress to Advanced Training (this gate does not apply if you enter laterally as an existing Fellow).
Secure an accredited Sexual Health Medicine post
0-2+ wait
The real bottleneck. With so few accredited positions nationally, many trainees wait, relocate, or do unaccredited/locum sexual health work until a post opens.
AChSHM Advanced Training (36 months FTE)
3
Core HIV (6 months), female and male sexual health (9 months each) and reproductive-health rotations; an elective; coursework; and a research project.
Pass the AChSHM Exit Assessment + admission to FAChSHM
Year 3
Annual viva, sat after ≥24 months FTE certified training; then Fellowship. Consultant jobs are limited and overwhelmingly public, so the search for a substantive post can extend the timeline further.

How competitive is it?

Sexual Health Medicine inverts the usual physician picture. There is no national scored selection rubric and no fierce applicant-to-offer contest at the gate — entry is genuinely open, and you can come in laterally as a GP, rural generalist, O&G, dermatology, urology, psychiatry, pathology or public-health Fellow without doing Basic Physician Training at all. The competition is for scarcity at the other end: the workforce is one of the smallest in medicine (114 employed specialists at the 2016 national workforce survey), its average age was 55.1 with 60.4% intending to retire within a decade, total trainee numbers fell 35% between 2013 and 2016, and WA's training body states there has been no increase in full-time positions in ten years. The RACP does not publish a national applicant-to-offer ratio, and Queensland's facility-led recruitment figures are not reliably published per specialty — so there is no clean competitiveness number to quote. The honest read: getting in is not the hard part; finding an accredited training post, and then a substantive consultant job, is.

Unaccredited time: No formal unaccredited-registrar quota exists, but because accredited training and consultant posts are so few, many doctors do sexual health work in unaccredited, GP-clinic, family-planning or locum roles while waiting for an accredited position to open.

Sources: Sexual health medicine workforce — MWRAC fact sheet (Dept of Health, 2016 data), PMCWA — Sexual Health Medicine careers ("no increase in full-time positions in 10 years"), RACP — Sexual Health Medicine Advanced Training (entry requirements).

Selection criteria & how to apply

There is no centralised, points-scored national selection into Sexual Health Medicine. The RACP accredits training positions and approves your training, but you are selected by being employed into an accredited sexual health post — the recruiting service (a hospital or sexual health clinic) runs its own assessment and interview, and only then does the RACP register your Advanced Training. The components below are eligibility and assessed factors, not weighted percentages.

Entry eligibility (fellowship or completed BPT)Eligibility
You must either have completed RACP Basic Training including the Divisional Written and Clinical Examinations, OR hold Fellowship of an eligible college: AFPHM (public health), Australasian College of Dermatologists, ACRRM (rural and remote medicine), RACS (urology), RANZCOG (O&G), RANZCP (psychiatry), RACGP, RCPA (pathology) or RNZCGP. Other colleges are considered case-by-case. This is a hard gate, not a score.
An accredited training positionEligibility
Core training can only be done in an AChSHM-accredited setting. You must hold a job in one of these (the rate-limiting step), because the RACP will not register training in a non-accredited post except where an overseas setting is prospectively approved by the Training Committee.
Demonstrated interest/experience in sexual health and HIVAssessed
Advertised registrar posts (e.g. Melbourne Sexual Health Centre) list 'demonstrated interest or experience in sexual health and/or HIV medicine' as an essential criterion. Prior STI/HIV, ID, GP or community work helps, but there is no published numeric weighting.
Communication skills and suitabilityAssessed
Roles emphasise excellent, non-judgemental communication and the ability to work with marginalised populations and discuss sensitive topics. Assessed at interview by the employing service, not scored nationally.
Current medical registrationEligibility
Current general registration with AHPRA (Australia) or MCNZ (Aotearoa New Zealand) for the training period.

Key documents: RACP — Sexual Health Medicine Advanced Training (eligibility & requirements), RACP — Accredited Sites for Advanced Training, Sexual Health Medicine (PDF, Feb 2026), RACP — AChSHM Exit Assessment.

How training is organised in each state and territory

Sexual Health Medicine is a small, clinic-based specialty, so 'how it works' in each state really means 'which accredited sexual health services exist there and how you get employed by one.' The RACP runs the curriculum and the Exit Assessment nationally; the states and individual services run the jobs. Positions are heavily concentrated in NSW and Victoria. The site numbers below are taken from the RACP's February 2026 accredited-settings list (which includes a handful of provisionally-accredited sites).
NSW The deepest network in the country — about 16 accredited NSW settings on the Feb 2026 RACP list, including Sydney Sexual Health Centre (up to 5 trainees), Royal Prince Alfred, Western Sydney, Northern Sydney (Clinic 16, Royal North Shore), Kirketon Road and Albion Street centres, Liverpool, plus regional services at Illawarra (Port Kembla), Newcastle (Pacific Clinic), Lismore and Nepean/Blue Mountains, and reproductive-health placements at Family Planning NSW.

Who runs selection: By far the largest base for the specialty — about half the national sexual-health workforce practises in NSW. Training is via employment in an accredited sexual health service; positions sit across LHDs rather than in a single centralised match.

Where to apply: NSW Health JMO / service-level recruitment + RACP training registration — application portal.

Positions: The deepest network in the country — about 16 accredited NSW settings on the Feb 2026 RACP list, including Sydney Sexual Health Centre (up to 5 trainees), Royal Prince Alfred, Western Sydney, Northern Sydney (Clinic 16, Royal North Shore), Kirketon Road and Albion Street centres, Liverpool, plus regional services at Illawarra (Port Kembla), Newcastle (Pacific Clinic), Lismore and Nepean/Blue Mountains, and reproductive-health placements at Family Planning NSW.

Worth knowing: Sydney Sexual Health Centre is the oldest sexual health service in NSW and a major training and research hub. The spread of accredited regional posts (Illawarra, Newcastle, Lismore) gives NSW trainees the widest choice of where to base themselves.

Links: NSW Health MapMyCareer — Sexual Health Medicine, Sydney Sexual Health Centre — training.

VIC Six accredited Victorian settings on the Feb 2026 list: Melbourne Sexual Health Centre (up to 5 trainees), the Centre Clinic, Monash Medical Centre Clayton (HIV, part-time, provisional), Jean Hailes for Women's Health (reproductive health, provisional), and two Sexual Health Victoria reproductive-health placements (Melbourne Clinic / Box Hill).

Who runs selection: The second major centre, anchored by the Melbourne Sexual Health Centre (MSHC) — the state's main public sexual health service and an internationally recognised STI research centre. Training is via employment at an accredited Victorian service; the RACP then registers your Advanced Training.

Where to apply: Alfred Health / service-level recruitment + RACP — application portal.

Positions: Six accredited Victorian settings on the Feb 2026 list: Melbourne Sexual Health Centre (up to 5 trainees), the Centre Clinic, Monash Medical Centre Clayton (HIV, part-time, provisional), Jean Hailes for Women's Health (reproductive health, provisional), and two Sexual Health Victoria reproductive-health placements (Melbourne Clinic / Box Hill).

Worth knowing: MSHC registrar posts are advertised through Alfred Health and explicitly list 'demonstrated interest or experience in sexual health and/or HIV medicine' as essential. MSHC's research output makes Victoria a strong choice if you want an academic flavour.

Links: Alfred Health — MSHC Registrar in Sexual Health Medicine, RACP — accredited settings (PDF).

QLD Three accredited Queensland settings on the RACP list — Cairns Sexual Health Service, Gold Coast Sexual Health Clinic and Townsville University Hospital Sexual Health Service. Notably, although Brisbane's Princess Alexandra/Metro South service runs a clinical sexual health service, it is not on the RACP's accredited core-training list.

Who runs selection: Training runs through Queensland Health's annual RMO and Registrar campaign: you must first be employed at an accredited Queensland sexual health service, after which the RACP can register your Advanced Training. Recruiting facilities run their own assessment and interviews.

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

Positions: Three accredited Queensland settings on the RACP list — Cairns Sexual Health Service, Gold Coast Sexual Health Clinic and Townsville University Hospital Sexual Health Service. Notably, although Brisbane's Princess Alexandra/Metro South service runs a clinical sexual health service, it is not on the RACP's accredited core-training list.

Worth knowing: Queensland is striking for its regional weighting — the accredited training sites are in Cairns, the Gold Coast and Townsville rather than central Brisbane. Per-specialty applicant numbers are not reliably published, so treat any single figure with caution.

Links: Queensland Health — Sexual Health advanced training, Queensland Health Medi-Nav — Sexual Health Medicine.

SA Three accredited South Australian settings: Adelaide Sexual Health Centre (up to 2 trainees), SHINE SA (reproductive and sexual health) and O'Brien Street Practice.

Who runs selection: Centred on the Adelaide Sexual Health Centre, with training via SA Health advanced-trainee recruitment and employment at an accredited service.

Where to apply: SA Health advanced trainee recruitment + RACP — application portal.

Positions: Three accredited South Australian settings: Adelaide Sexual Health Centre (up to 2 trainees), SHINE SA (reproductive and sexual health) and O'Brien Street Practice.

Worth knowing: SHINE SA's inclusion reflects the reproductive-health and community side of the curriculum; a trainee can combine clinic-based STI/HIV work with reproductive-health exposure within the state.

Links: SA Health — Advanced Trainees recruitment, RACP — accredited settings (PDF).

WA Three accredited WA settings: Royal Perth Hospital Sexual Health Clinic, Sexual Health Quarters, and South Terrace Clinic (Fremantle Hospital / Fiona Stanley Hospital, provisional).

Who runs selection: Centred on Royal Perth Hospital's Sexual Health Clinic and the statewide service, with WA-specific scope including genital dermatology, high-resolution anoscopy and the statewide gender-affirming-care service. Training is via employment at an accredited WA service.

Where to apply: WA Health / service recruitment + RACP (info via PMCWA) — application portal.

Positions: Three accredited WA settings: Royal Perth Hospital Sexual Health Clinic, Sexual Health Quarters, and South Terrace Clinic (Fremantle Hospital / Fiona Stanley Hospital, provisional).

Worth knowing: WA's own careers body is unusually blunt about the job market: 'there has not been an increase in full-time positions in the last 10 years, career opportunities might be limited, particularly in the public field.' WA also offers a broader procedural skill set (CO2 laser, anoscopy) than some states.

Links: PMCWA — Sexual Health Medicine careers, RACP — accredited settings (PDF).

TAS Two accredited Tasmanian settings: Tasmanian Health Service — Clinic 60 and Clinic 34 (up to 2 trainees), and Family Planning Tasmania (reproductive health, up to 6 months).

Who runs selection: Delivered through the Tasmanian Health Service sexual health clinics (Clinic 60 and Clinic 34), with a smaller reproductive-health placement at Family Planning Tasmania.

Where to apply: Tasmanian Health Service recruitment + RACP — application portal.

Positions: Two accredited Tasmanian settings: Tasmanian Health Service — Clinic 60 and Clinic 34 (up to 2 trainees), and Family Planning Tasmania (reproductive health, up to 6 months).

Worth knowing: The RACP accredited-settings list explicitly notes Tasmanian trainees should ideally spend 6-12 months training outside Tasmania to gain exposure to a different clinical environment — so a Tasmanian-based training is expected to include an interstate rotation.

Links: Tasmanian Health Service — careers, RACP — accredited settings (PDF).

ACT One accredited ACT setting: Canberra Sexual Health Centre (up to 2 trainees, maximum 24 months core training).

Who runs selection: A single accredited service — the Canberra Sexual Health Centre — which can host the full core training program.

Where to apply: ACT Health / Canberra Health Services recruitment + RACP — application portal.

Positions: One accredited ACT setting: Canberra Sexual Health Centre (up to 2 trainees, maximum 24 months core training).

Worth knowing: Despite having only one accredited site, the ACT had the highest ratio of sexual health clinicians per head of population in Australia in the 2016 survey (1.0 per 100,000). A single well-resourced centre means a small, close-knit training environment.

Links: Canberra Health Services — careers, RACP — accredited settings (PDF).

NT One accredited NT setting: Clinic 34, Darwin (1 trainee, maximum 12 months). The 12-month cap means NT trainees must complete the remainder of core training interstate.

Who runs selection: A single accredited service — Clinic 34 in Darwin — which is capped at 12 months of core training, so you cannot complete the whole program in the NT alone.

Where to apply: NT Health recruitment + RACP — application portal.

Positions: One accredited NT setting: Clinic 34, Darwin (1 trainee, maximum 12 months). The 12-month cap means NT trainees must complete the remainder of core training interstate.

Worth knowing: The NT had the second-highest per-capita ratio of sexual health clinicians in the 2016 survey (0.8 per 100,000) and a high-need population (significant STI burden), making it valuable clinical experience — but it works as part of a training program, not a standalone one.

Links: NT Health — careers, RACP — accredited settings (PDF).

How to optimise your application

The honest read: Because there is no national scored selection, you cannot 'optimise points.' The leverage is entirely in positioning yourself to be the obvious hire when one of a small number of accredited posts opens, and in being geographically flexible enough to take it. The single highest-yield move for many doctors is recognising that you may not need BPT at all — a relevant existing fellowship is a faster, cheaper on-ramp.
  • Pick the cheapest legitimate entry route for your situation (tied to Entry eligibility, start Now) — If you already hold (or could realistically obtain) an eligible fellowship — GP, rural generalist, O&G, dermatology, urology, psychiatry, pathology, public health — you can enter Advanced Training laterally and skip BPT and the Divisional exams entirely. Map your shortest path before committing to a long physician route.
  • Build a genuine sexual-health/HIV track record early (tied to Demonstrated interest/experience, start PGY1-2 or during your current fellowship) — Rotate or locum through a sexual health service, do an STI/HIV clinic, get the ASHM HIV prescriber course, and contribute to sexual-health audit or research. Advertised posts make 'demonstrated interest/experience in sexual health and/or HIV' an essential criterion.
  • Be geographically flexible — go where the posts are (tied to An accredited training position, start When applying for posts) — About half the workforce and most accredited sites sit in NSW and Victoria (Sydney Sexual Health Centre and Melbourne Sexual Health Centre each take up to ~5 trainees). Being willing to move to where an accredited vacancy exists is often the difference between training now and waiting years.
  • Network directly with services and supervisors (tied to Demonstrated interest/suitability, start 12-24 months before you want a post) — This is a small, relationship-driven field. Email clinic directors, attend Australasian Sexual Health conferences, and make yourself known to FAChSHM supervisors — many posts are filled by people the service already knows.
  • Use waiting time productively in adjacent roles (tied to An accredited training position, start While waiting for an accredited post) — Family-planning clinics, high-caseload GP sexual-health practices, ID/HIV services and locums keep your skills current and your CV pointed at sexual health, so you are ready the moment an accredited position is advertised.

Key documents & official links

FAQ

Do I have to do Basic Physician Training to become a sexual health physician?
No — and that is what makes this specialty unusual. You can enter Advanced Training either by completing RACP Basic Training (including the Divisional Written and Clinical exams), OR by already holding Fellowship of an eligible college: general practice (RACGP/RNZCGP), rural and remote medicine (ACRRM), O&G (RANZCOG), dermatology (ACD), urology (RACS), psychiatry (RANZCP), pathology (RCPA) or public health (AFPHM). For doctors who already hold one of those fellowships, sexual health is a roughly 3-year add-on with no BPT and no Divisional exams.
Is Sexual Health Medicine competitive to get into?
Entry itself is not the hard part — there is no national scored selection rubric and no fierce applicant-to-offer contest, and the RACP does not publish a national applicant-to-offer ratio. The genuine difficulty is the number of jobs. This is one of the smallest specialties in the country (114 employed specialists at the 2016 national workforce survey), accredited training posts are few and concentrated in NSW and Victoria, and WA's own careers body notes there has been no increase in full-time positions in a decade. The competition is for scarce posts, not for marks.
What exams do I have to pass?
If you enter through Basic Physician Training, you must first pass the RACP Divisional Written and Clinical Examinations — the same demanding hurdle all physician trainees face. The specialty-specific exam is the AChSHM Exit Assessment, a viva taken in the third year of Advanced Training: two 30-minute oral sessions covering eight clinical questions (two examiners per session), offered once a year, sat after ≥24 months FTE certified training, with three attempts allowed for trainees who started from 2019 (five for those who started earlier). Lateral entrants who already hold another fellowship sit the Exit Assessment but not the Divisional exams.
What is the lifestyle like?
It is one of the better lifestyles in medicine. The work is overwhelmingly outpatient clinic-based with no acute inpatient service and no overnight on-call, so hours are predictable and family-friendly. The 2016 workforce data showed specialists working an average of about 27 hours a week. The trade-off is income and job security: it is a predominantly public, salaried field with limited private-billing or procedural revenue.
How much do sexual health physicians earn?
There is no sexual-health-specific income figure published. For tax and statistical purposes a sexual health physician falls under ANZSCO 253399, 'Specialist Physicians not elsewhere classified' — a blended code shared with infectious diseases, geriatric, palliative, rehabilitation, public health, sleep and several other physicians — so any ATO 'average taxable income' for that group is a broad proxy, not a sexual-health salary. In practice most sexual health physicians are paid public-hospital staff specialist or visiting medical officer (VMO) award rates, with little of the private or procedural income that lifts earnings in fields like cardiology or gastroenterology.
Where can I actually train?
Only in an AChSHM-accredited sexual health service, and you must be employed by one before the RACP will register your training. The accredited list is heavily concentrated: about 16 services in NSW (led by Sydney Sexual Health Centre) and six in Victoria (led by Melbourne Sexual Health Centre), with three each in Queensland, SA and WA, two in Tasmania, and a single accredited centre each in the ACT and NT. The NT site (Clinic 34, Darwin) is capped at 12 months, so you cannot complete the whole program there alone.
I'm an overseas-trained sexual health physician — how do I get recognised?
Through the RACP Standard Specialist Assessment Pathway, working with the Medical Board of Australia and AHPRA. Sexual Health Medicine is not on the Medical Board's Expedited Specialist pathway (which as of 2026 covers GP, anaesthetics, O&G, psychiatry, general medicine and general paediatrics), so there is no fast-track. A panel of Fellows rates you substantially, partially or not comparable to an Australian-trained FAChSHM; substantially comparable applicants do up to 12 months of peer review and partially comparable up to 24 months of supervised practice.

Trained overseas? (IMG pathway)

How overseas-trained sexual health medicine doctors get recognised

Overseas-trained sexual health physicians seek specialist recognition through the RACP, not a separate fast-track. Sexual Health Medicine is NOT one of the specialties on the Medical Board's Expedited Specialist pathway (which as of 2026 covers general practice, anaesthetics, obstetrics and gynaecology, psychiatry, general medicine and general paediatrics), so the route is the RACP Standard Specialist Assessment Pathway. A panel of Fellows assesses your training and consultant experience against an Australian-trained FAChSHM and rates you substantially comparable, partially comparable or not comparable; substantially comparable applicants do up to 12 months of peer review, partially comparable up to 24 months of supervised practice (which may include 6–12 months of top-up training).

See the RACP Standard Specialist Assessment Pathway 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.