Employer Nomination Scheme (Subclass 186) Visa for Doctors
Information current as at October 2026. Rules, fees and lists change often, so check your own circumstances with us before you act.
The Employer Nomination Scheme visa (subclass 186) is a permanent visa. For most overseas doctors it is the step that turns a temporary job into a permanent future in Australia: permanent residence, Medicare for your family, and a path to citizenship. Your employer nominates you, and you apply either after working on a Skills in Demand (482) visa or directly from overseas.
This page explains the three streams, the rules that matter most for medical practitioners (age exemptions, registration and English), and what it costs.
The three 186 streams
Healthcare applications are in the highest priority group for processing under Ministerial Direction 122, which commenced on 19 September 2026.
- For 482 (or former TSS) holders who have worked in the nominated occupation for at least two of the last three years on that visa.
- From 29 November 2025, only time worked for an approved sponsor counts toward the two years, including for exempt occupations such as medical practitioners. Keep your visa and sponsorship continuous.
- You do not need a new skills assessment, and many doctors aged 45 or over can use the age exemptions below.
- Locum or contract work can count if it was for an approved sponsor under your visa.
Age exemptions for doctors aged 45 or over
The 186 has an age limit of under 45 at the time of application. Many specialists and experienced GPs are older than that, so the exemptions below are important. They are strict and are assessed on your visa history, so check them before you change jobs or visas.
| Exemption | Key requirements | Stream |
|---|---|---|
| Regional medical practitioner | The nominated position is in a designated regional area. In the three years before you apply, you held a 482 (or TSS) visa as a medical practitioner, with at least two of those years working in a designated regional area. | Temporary Residence Transition |
| High income | You worked for at least two years on a 482 (or TSS) and earned at least the Fair Work high income threshold (indexed each 1 July) in each of those years. | Temporary Residence Transition |
| Labour agreement or DAMA concession | The labour agreement allows an older age limit for your occupation. | Labour Agreement |
Other age exemptions exist (for example for some researchers and academics) but rarely apply to clinicians. If you are close to 45, talk to us early: the order in which you take visas can decide whether an exemption is available.
Requirements checklist
| Requirement | What you need |
|---|---|
| Nomination | An approved nomination from an employer that is actively and lawfully operating and can offer the position for at least two years. |
| Salary | At least the market salary rate and the Core Skills Income Threshold of $79,423 (from 1 July 2026). |
| Registration | Ahpra registration that allows you to perform the full duties of the role. Provisional or limited registration can be acceptable if it covers the position; training-only registration may not. |
| English | Competent English. Unlike the 482, Ahpra registration does not ordinarily satisfy this. You need an exempt passport (UK, Ireland, USA, Canada or New Zealand) or a test result from the last three years. |
| Health and character | Standard checks, with additional health examinations for people working in healthcare settings. |
| Medicare | Permanent residence does not remove section 19AB by itself. If you bill Medicare, the 10-year moratorium and Distribution Priority Area rules may still apply. See DPAs and Medicare provider numbers. |
How the 186 process works
Government charges
| Item | Charge from 1 July 2026 | Paid by |
|---|---|---|
| Visa, main applicant | $6,140 | Applicant |
| Visa, each additional applicant aged 18 or over | $3,070 | Applicant |
| Visa, each additional applicant under 18 | $1,535 | Applicant |
| Second instalment for an adult family member without functional English | $4,890 | Applicant |
| Nomination fee | $540 | Employer |
| Skilling Australians Fund levy (one off) | $3,000 or $5,000 | Employer |
Our costs and timeline page adds registration, AMC and relocation costs.
Frequently asked questions
I am 52 and on a 482 in a regional hospital. Can I get permanent residence?
Possibly, through the regional medical practitioner exemption in the TRT stream, if your nominated position is in a designated regional area and you have held a 482 or TSS as a medical practitioner for at least two of the last three years in a designated regional area. We recommend a review of your visa history before you lodge.
Do I need a skills assessment for the 186?
Not for TRT. For Direct Entry you need one, and for medical practitioners current Medical Board registration typically satisfies the requirement.
Does my Ahpra English test count for the 186?
The English requirement for the 186 is assessed separately. Ahpra registration does not ordinarily satisfy it, so you need an exempt passport or a valid test result from the last three years.
Can my GP practice sponsor me if I work as a contractor?
Direct Entry requires a genuine full time employee position. Contractor arrangements common in general practice need careful review. Our sponsor guide explains the options for practices.
Will I be able to bill Medicare anywhere once I am a permanent resident?
Not automatically. Section 19AB location restrictions usually continue until your 10-year moratorium ends (it can be reduced by scaling for rural work).
What happens if I leave my employer soon after the 186 is granted?
Your visa is permanent, but you should genuinely intend to stay in the role for at least two years. Leaving very early can raise questions about whether the nomination was genuine, so get advice first.
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