How contractor GPs can successfully navigate the 186 visa pathway

For many General Practitioners considering a move to Australia, securing permanent residency is a priority from the outset.

A common misunderstanding is that GPs working as independent contractors can be nominated directly for permanent residency under the Direct Entry stream of the Subclass 186 visa, without first holding a temporary visa.
In practice, this is rarely possible under the current Migration Regulations 1994. Here’s why.

Direct Entry requires paid employment

At the core of the Direct Entry stream is a requirement that the nominated role must be a paid employee position within the nominating business, with the doctor working under the direct control of the employer.

This requirement comes from regulation 5.19, specifically regulation 5.19(9), which sets out additional criteria for Direct Entry nominations, including :

• the business needs to employ the doctor in the role under its direct control
• role must be genuine and ongoing
• the doctor must be employed full time for at least two years
• terms of employment must allow for extension beyond the initial period
• the business must have the capacity to employ and pay the doctor at the market salary rate
  

While the regulation does not define “direct control”, it clearly points to a genuine employment relationship rather than a contractor arrangement.

How GPs are typically engaged in Australia

Most GPs in Australia, particularly in private practice, work as independent contractors rather than employees. Under a typical arrangement:

• the GP bills patients directly, often through Medicare
• the clinic provides consulting rooms, staff and administrative support
• income is split between the clinic and the GP
• the GP is not paid a salary and is not on payroll

Legally, this is a services agreement, not an employment contract.

Why Direct Entry usually fails for contractor GPs

This distinction is critical for migration purposes. Where a GP is engaged as an independent contractor:

• there is no employer–employee relationship
• the GP is not under the clinic’s direct control in a legal sense
• role is not considered a position within the business
• arrangement may be viewed as self-employment or a business-to-business contract

Because of this, Direct Entry nominations for contractor GPs are unlikely to meet regulation 5.19(9) and carry a high risk of refusal.

The more practical pathway: Temporary Residence Transition

For most contractor GPs, the realistic pathway to permanent residency is:

• working in Australia on a Subclass 482 Temporary Skill Shortage or Skills in Demand visa
• transitioning to permanent residency through the Temporary Residence Transition stream of the Subclass 186 visa after two years
  
  

• whether the GP has worked for the sponsoring practice
• has the required two-year period been met
• does the work align with the nominated occupation

As this assessment is retrospective, there is greater flexibility in the medical sector, where contractor models are common. While the nature of the relationship is still relevant, the Department is generally more receptive to employment-like arrangements, even if they are not structured as traditional employment.

Practical options for GPs and medical practices

If Direct Entry is the preferred outcome, the engagement model must be restructured into a genuine employment arrangement. This would usually require:

• salary-based remuneration rather than percentage billings
• PAYG tax withholding
• superannuation contributions
• clear employer control over duties and working conditions

If that is not feasible, the more reliable option is to:

•  work on a Subclass 482 visa
• transition through the TRT stream after two years working in Australia as a contractor GP
• Independent skilled visa alternatives

In some cases, GPs may consider applying for permanent residency through independent skilled visas such as the Subclass 189 Skilled Independent or Subclass 190 Skilled Nominated visas.

These pathways are points tested and come with several challenges:

• a competitive points score is required
• an invitation to apply is not guaranteed
• processing depends on occupation ceilings and invitation rounds
• strict eligibility criteria apply, including age limits and registration requirements

Importantly, these visas require unrestricted AHPRA registration, meaning general or specialist registration without conditions.

Most internationally trained GPs enter Australia via supervision pathways such as the RACGP PEP or Expedited Specialist Pathway. This usually results in limited or provisional registration initially, making applicants ineligible for these visas for at least the first six months, and often longer.

Understanding the right visa pathway for contractor GPs

For contractor GPs, eligibility for the Subclass 186 visa depends on how employment is defined under Australian migration law.
The Direct Entry stream is limited to genuine paid employee roles under an employer’s direct control. Independent contractor arrangements, which are common in general practice, generally do not meet this requirement.

As a result, most contractor GPs will need to follow a temporary-to-permanent pathway, typically by working on a Subclass 482 visa and transitioning to permanent residency through the Temporary Residence Transition stream of the Subclass 186 visa after two years.

Seeking early, tailored migration advice can help ensure the chosen pathway aligns with both regulatory requirements and real-world practice structures.

For advice specific to your circumstances, speak with a registered migration agent. You can also contact our in-house migration agents for a personalised consultation at rms@wave.com.au.

Disclaimer: This article provides general information only and does not constitute migration advice. Immigration laws and policies change regularly, and outcomes depend on individual circumstances.