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Basic Physician Training (Adult Medicine)

RACP. The gateway to every adult physician specialty. 3 years of broad internal medicine, two famous exams, then advanced training in your chosen field.

Medicine (physician)3 years BPT + 3–4 years Advanced TrainingCompetitiveness: moderate
Competition snapshot: Moderate   Entry is accessible at most hospitals (~1–2 applicants/post); big-name tertiary programs are oversubscribed. The real competition comes later, at Advanced Training selection for fields like cardiology and gastroenterology
Program length
3 years BPT + 3–4 years Advanced Training
Earliest entry
PGY2 (apply during internship)
Typical entry
PGY2–3 start
Annual intake
≈ 900–1,100 BPT1s per year nationally (indicative)
Trainees
RACP has 8,000+ trainees across all programs
Women (trainees)
≈ 55% of adult-medicine BPTs
Registrar pay
$95,000–150,000 + overtime (state award, rises with PGY)
Consultant (public)
$280,000–450,000 package (varies by state and specialty)
Consultant (private)
Depends entirely on the advanced specialty, see individual pages. ATO average for internal medicine specialists: $342,457 (2022–23)
Hours & lifestyle
Ward-based with after-hours cover; exam years are the crunch

Overview

Basic Physician Training is the trunk of the adult-medicine tree. You spend three years rotating through general medicine and subspecialty terms, pass the Divisional Written then Clinical examinations, and only then choose (and compete for) an Advanced Training program, cardiology, gastroenterology, geriatrics, endocrinology and a dozen others each have their own page on this site.

Strategically, BPT is the least locked-in of the big pathways: you commit to internal medicine, not to a subspecialty, and your options stay open until PGY4–5. The trade-off is that the competition you avoid at entry reappears at Advanced Training selection for the procedural specialties.

The pathway

  1. PGY1, internshipApply for BPT during internship through your state process (NSW: HETI-coordinated network match; VIC: hospital-by-hospital via PMCV; QLD: RMO campaign; others: health-service applications).
  2. BPT1–3 (PGY2–4)Accredited rotations: general medicine, subspecialties, ED/ICU exposure, a rural or secondment term in many networks. Work-based assessments throughout.
  3. Divisional Written → Clinical examsWritten usually attempted end of BPT2/BPT3; Clinical the following year. Passing both + completing rotations = eligible for Advanced Training.
  4. Advanced Training selection (PGY4–5)Competitive job applications to AT registrar posts in your chosen specialty; this is where cardiology/gastro bottlenecks bite. Research, referees and networks decide it.
  5. Advanced Training (3–4 years) → FRACPSpecialty-specific curriculum, projects and assessments; many add fellowship/PhD years before consultant posts.

Formal requirements

  • General AHPRA registration; completed PGY1.
  • Appointment to an accredited BPT position at a hospital/network; selection is employer-based, not a college exam.
  • Register with RACP once appointed (training fees apply annually).
  • Complete required rotations and work-based assessments; pass both Divisional exams to exit BPT.

Selection and points

How selection works

ComponentWhat it involves
Hospital/network job applicationCV + referees + interview, run through state recruitment systems (NSW networks match; VIC PMCV match; QLD campaign). No college exam or points system at entry.
InterviewUsually clinical-scenario and behavioural questions at hospital level; some networks interview centrally.

Points & scoring

  • No formal points matrix, ranking is CV + referees + interview at hospital level.
  • For Advanced Training later: research output, exam timing (passing the written early), and referee relationships at the hospitals that run AT posts are the real currency.
The unofficial view
  • Choose your BPT hospital with the endgame in mind: tertiary centres with big cardiology/gastro departments feed their own AT programs; smaller programs offer better support and less competition but fewer internal AT seats.
  • Passing the Written at first attempt, on the early schedule, is the strongest single signal for competitive AT selection; it frees your BPT3 for research and referee-building.
  • Your BPT3/PGY4 'pre-AT' year placement (e.g. a cardiology-heavy year) functions as an audition for AT jobs.
  • Dual-training (e.g. gen med + geriatrics, gen med + nephrology) is a respected, employable strategy and often less competitive to enter.

Competition & demographics

Competitiveness

  • Entry: most hospitals appoint the majority of reasonable local applicants; the famous tertiary programs (e.g. RPA, RMH, Alfred, PA) are oversubscribed and favour strong academic records and internal candidates.
  • Advanced Training is where ratios blow out: cardiology and gastroenterology AT posts at tertiary centres routinely attract several strong applicants per position; geriatrics, general medicine and rehabilitation-adjacent fields absorb nearly all comers.

Who's in the program

  • ≈ 55% of adult BPTs are women; subspecialty splits diverge sharply later (see individual pages).
  • Large IMG representation, particularly in regional BPT programs.

Exams

ExamWhenFormatCostPass rate
Divisional Written Examination (FRACP Part 1 written)
Most candidates start structured study 9–12 months out; question banks + group study are standard.		Usually end of BPT2 or during BPT3Two MCQ papers in one day, enormous breadth across internal medicine≈ $3,000–3,500≈ 65–75% per sitting (indicative)
Divisional Clinical Examination
Weekly practice cases with consultants for months beforehand is the norm; hospitals run mock exams.		The year after passing the writtenLong cases + short cases examined at the bedside≈ $4,000–4,600≈ 60–75% (indicative)

Fees and pass rates are indicative; check the college's current fee schedule and exam reports.

What training costs

  • RACP annual training fee ≈ $2,700–3,300 per year (basic and advanced).
  • Divisional Written ≈ $3,000–3,500; Clinical ≈ $4,000–4,600 per attempt.
  • Question banks, courses and mock exams commonly add $2,000–6,000 across BPT.

How to improve your chances at each stage

StageMedical student
  • Reference letters and rankings from medicine terms matter for intern allocation; treat final-year medicine rotations seriously.
  • Start one internal-medicine research project; even a case report teaches the machinery of publishing.
StageIntern (PGY1)
  • Apply for BPT through your state process mid-year; ask registrars which local programs actually support their trainees through exams.
  • Collect two strong physician referees from medical terms.
StageResident (PGY2–3)
  • BPT1–2: bank your mandatory rotations early; join a written-exam study group a full year before you sit.
  • Start research in your intended subspecialty now if you're aiming at cardiology/gastro. AT selection arrives fast.
StageRegistrar years & applications
  • BPT3/pre-AT: place yourself deliberately (department, hospital, project) for your target AT program; ask AT supervisors directly what their last successful applicant looked like.
  • If you fail an exam: remediate with structure (courses, coaching, different study group), repeated attempts are common and not fatal, but drifting is.
StageIf you don't get on (or change your mind)
  • BPT's backup options are built in. If cardiology doesn't happen, general medicine, geriatrics and nephrology dual pathways are excellent careers, and your FRACP transfers.
  • Exit ramps also exist to ICU (CICM recognises medicine time), palliative care, rehabilitation and medical administration.

See also the general strategy guide: universal CV, referee and interview advice that applies across specialties.

Job market & workforce outlook

Outlook: Excellent overall, physician demand is broad; individual subspecialty markets vary (see each page)
  • Physicians are in demand everywhere; general and acute-care medicine is the single most recruited specialty in regional Australia.
  • Consultant markets vary sharply by subspecialty, procedural fields concentrate metro; generalist fields hire everywhere.

Income

  • ATO 2022–23 average for internal medicine specialists: $342,457 (pooled across subspecialties).
  • Procedural subspecialists (cardiology, gastroenterology) earn far above that; clinic-based fields sit nearer $300,000–450,000. See individual pages.

Pre-tax, indicative, and highly variable with hours, setting and billing model. ATO figures are averages of taxable income by reported occupation.

Subspecialties & special interests

AreaNotes
See individual pagesCardiology, gastroenterology, respiratory, endocrinology, nephrology, neurology, haematology, medical oncology, infectious diseases, immunology, rheumatology, geriatrics, general medicine, clinical genetics, each has a page in this guide

International medical graduates

  • IMG physicians: RACP SIMG comparability assessment; the expedited pathway now covers general medicine (UK qualifications) for specialist registration (verified early 2026).

Full IMG pathways guide →

Community: questions and perspectives

CommunityAsk questions and share real-world experience below. Sign in with your email (button top right) to post. Your training stage and specialty interest appear beside your name so readers know the perspective, and the best posts are folded into the page at each annual review.

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🩺 Experiences, corrections & perspectives

If you've trained in basic physician training (adult medicine), or tried to, share what the page can't capture: what it's really like, what's changed, what you wish you'd known.

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Last reviewed July 2026. Details marked “verified” were checked against official/current sources at review; unmarked figures are indicative estimates from training data, college publications and community knowledge. Selection regulations change annually, always read the current-year official documents before acting.
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