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Regional Visa Options for Doctors: 494, 191 and DAMA

Information current as at October 2026. Rules, fees and lists change often, so check your own circumstances with us before you act.

Regional and rural Australia has the greatest need for doctors, nurses and allied health professionals, and the visa system reflects that. Regional employers can sponsor you on the Skilled Employer Sponsored Regional visa (subclass 494), states and territories can nominate you for the Skilled Work Regional visa (subclass 491), and some regions have labour agreements called DAMAs with special concessions. Each of these can lead to permanent residence.

Working regionally also helps with Medicare access, because most regional locations are Distribution Priority Areas for general practice (see DPAs and Medicare provider numbers).

What counts as regional?

For the 494 and 491, designated regional areas cover all of Australia except Sydney, Melbourne and Brisbane. That means Perth, Adelaide, Hobart, Canberra, Darwin, the Gold Coast, Newcastle, Wollongong and Geelong all count, as well as rural and remote towns. Your employer’s location (for the 494) or where you live and work (for the 491) must be in a designated regional area.

Note that this definition is different from the Modified Monash Model used for Medicare and rural health incentives, and from the regional definitions used by individual DAMAs.

Compare the regional options

494 Employer Sponsored 491 State or Family Nominated DAMA (labour agreement)
Who sponsors A regional employer A state or territory government (or an eligible relative) An endorsed employer in the DAMA region
Visa length 5 years (provisional) 5 years (provisional) Depends on the visa used (482, 494 or 186)
Points test No Yes, at least 65 points No
Age Under 45 (limited exemptions) Under 45 Concessions often available
English Competent English (some exemptions) At least competent English Concessions often available
Skills assessment Yes (for doctors, usually based on Medical Board registration) Yes Depends on the agreement
Path to permanent residence 191 visa after 3 years 191 visa after 3 years 186 Labour Agreement stream or 191
Visa charge from 1 July 2026 $6,140 main applicant $6,140 main applicant As for the visa used

How each option works

  • A regional employer that is an approved sponsor nominates you for a full time position for at least five years.
  • Your occupation must be on the list that applies to the 494 employer sponsored stream. Most medical, nursing and allied health occupations qualify.
  • You need a positive skills assessment, at least three years of relevant work experience and competent English, unless an exemption applies.
  • The employer completes labour market testing (two advertisements in the four months before nomination, unless an alternative applies) and pays the $540 nomination fee and the one-off Skilling Australians Fund levy.
  • Your salary must meet the market salary rate and the applicable income threshold.
  • Healthcare 494 applications are in the highest priority group under Ministerial Direction 122.

More on the main site: 494 visa guide.

Planning a regional career move

  • Check registration for the role

    Regional and area of need positions are common starting points for doctors on limited or provisional registration. Make sure the Board can approve the position and supervision. See Ahpra registration pathways.

  • Check the Medicare position

    If the role includes Medicare billing, confirm the practice location has Distribution Priority Area status for your type of practice.

  • Choose the visa

    A 482 is often fastest to start work. A 494 gives a direct regional path to permanent residence. A DAMA helps where you or the role do not fit the standard criteria.

  • Count your time

    For the 186 regional medical practitioner age exemption, and for the 191, time in a designated regional area matters. Keep records of where you live and work.

  • Plan permanent residence

    Map out whether you will move to permanent residence through the 186 visa or the 191, and when.

Frequently asked questions

Yes. For the 494 and 491, all of Australia except Sydney, Melbourne and Brisbane is a designated regional area. This is a different test from the Modified Monash Model used for Medicare and rural incentives.

A 482 lets you start sooner and can lead to the 186 after two years. A 494 has stricter entry criteria (three years of experience, competent English, under 45) but leads to the 191. Many doctors aged 45 or over prefer the 482 and the regional medical practitioner exemption for the 186.

Not while you hold the 494. You must live and work in a designated regional area. Once you hold the 191 (permanent), you can live anywhere, subject to any Medicare location restrictions.

Some DAMAs offer higher age limits for permanent residence under the 186 Labour Agreement stream. The concession depends on the DAMA, the occupation and the endorsement.

Yes, scaling can reduce the moratorium for doctors who work in more rural and remote locations. See our page on DPAs and Medicare provider numbers.

Related pages

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