In 2005, the College applied through the newly-established Australian Medical Council (AMC) process, for recognition of Rural and Remote Medicine as a medical specialty. The-then Commonwealth Minister for Health and Ageing, Hon Tony Abbott MP, determined that the application would not be accepted and that the College was to be supported to prepare its programs for accreditation within the specialty of general practice. The Commonwealth Government provided financial assistance to the College to further develop its programs to meet AMC accreditation standards.

In 2007, following a comprehensive assessment process, the College was awarded provisional AMC accreditation as a medical college within the discipline of general practice and recognised in Medicare legislation.

In 2011, after further extensive assessment, the College was awarded full AMC accreditation and in 2012 gained membership of the Australian Council of Presidents Medical Colleges.

ACRRM became the first Australian medical college to be fully assessed and accredited under the newly-established and substantively more rigorous AMC accreditation framework. It was also the first to be accredited as one of two colleges setting practice and education standards within the same specialty.

Since that time, the College has maintained its full AMC accreditation status.

In 1987, the Rural Doctors Association of New South Wales was formed.  Its national counterpart, the Rural Doctors Association of Australia (RDAA) was incorporated in 1991. In that year, RDAA was instrumental in convening the first National Rural Health Conference (NRHC) the recommendations from which, led to establishment of the original Rural Health Training Units, the National Rural Health Alliance (NRHA), and to Government support for a dedicated rural medical training program.

In 1992 the RDAA procured a Government grant to develop a rural medical training pathway to incorporate advanced curricula in the specialist fields of anaesthesia, surgery and obstetrics.

Following negotiations to secure a 'Faculty of Rural Medicine' and a 'Fellowship of the Faculty of Rural Medicine' within the RACGP, RDAA in a plebiscite, agreed to hand over its advanced skills curricula to the RACGP to form the basis for a discrete rural training pathway incorporating these skills.

A series of decisions by the RACGP Council however overturned this approach and resulted in the disillusionment and resignation of many rural RACGP members, eventually including eight of the ten RACGP Rural Faculty board members. In particular, the title, 'Faculty of Rural Medicine' was rejected in favour of 'Rural Faculty' and the proposed dedicated Rural Fellowship training pathway was replaced with a 'Graduate Diploma of Rural General Practice', a 12-month "add-on" qualification on top of the generic RACGP Fellowship.

In 1995 a second national plebiscite of rural medical practitioners voted by a ratio of 2:1 to establish a separate college to foster Rural and Remote Medicine as a distinct model of medical practice. The Australian College of Rural and Remote Medicine (ACRRM) was incorporated in March 1997.

The ACRRM Primary Curriculum in Rural and Remote Medicine (Edition 1) was published in 1998. Fellowship criteria were advertised to foundation members in 1998 and, in the same year, ACRRM's rural training pathways and the commencement of a continuing development program in Rural and Remote Medicine were established.