Are you ready to be recognised for your rural and remote medical experience with a Fellowship of ACRRM? Submit your online application below. 

Please note: Unfortunately, you are unable to save the progress of your application. Please make sure you have all your supporting documents ready before you begin so that you do not lose your work.

If you have any issues or questions regarding your application please contact the REEF team at reef@acrrm.org.au

Section 1: Personal Information

(if applicable please use the same email address as on your ACRRM account, if you do not have an account please use this email address when creating your account for application fee)

Section 2: Advanced Skills (extended practice)

2.1 What is your area of advanced skills? *
2.3 Do you have a qualification relevant to this area of advanced skills, for example DRANZCOG Advanced? *
2.4 Do you have Clinical Privileges relevant to this area of advanced skills? *

Section 3: Attachments

Download REEF Pro Forma CV
3.1 You must attach the completed REEF Pro Forma CV *

If you have multiple files you can zip them together and upload them here.

3.2 Employment History *

Demonstrating at least 5 or more years of Rural Practice after specialist GP registration. Submission will need to be official signed letters of evidence from employers. If you have multiple files you can zip them together and upload them here.

3.3 Continuing Professional Development Program (CPD) *

Evidence of completion/progress of CPD current calendar year. If you have multiple files you can zip them together and upload them here.

3.4 Advanced Life Support (ALS) Certification *

Evidence of completion of the Advanced Life Support Course within the last 3 years. If you have multiple files you can zip them together and upload them here.

3.5 Certificates, Qualifications & Publications

Please supply any certificates and qualifications that you have achieved, including Clinical Privileges, and any notable publications. If you have multiple files you can zip them together and upload them here.

3.6 FACRRM References

A requirement of your application is that you provide letters of recommendation from two FACRRMs.

Send the link for the letter of recommendation to your two nominated FACRRMs for completion.

FACRRM References *

Section 4: Declarations

4.1 Investigations *

4.3 Indemnity

I acknowledge that the Australian College of Rural and Remote Medicine (ACRRM) will rely upon the accuracy and truth of the statements and information that I provide to assess my application. I hereby indemnify ACRRM and will keep ACRRM indemnified for any loss, cost or expense incurred by ACRRM as a result of any claim, action, demand or proceedings brought by any person in respect of loss or damage arising from any false, misleading, or inaccurate statement or information provided by me in this application. I also undertake to provide all details of any current or pending investigations, review, inquiry or sanction by the Australian Health Practitioner Regulation Agency, Professional Services Review Director, Medicare Australia or any similar body in relation to my professional practice or behaviour in Australia. I adhere to the College’s policies and understand the training requirements specified by the College which can be found on the ACRRM website.

4.3 Indemnity *

4.4 Privacy

I understand Australian College of Rural and Remote Medicine (‘the College’) collects, stores and discloses my personal information for the purposes of providing membership products and services, for training programs, for maintaining my membership records, for research or statistical purposes and to promote services which the College considers may be of interest to me. This information may be collected directly from me in my dealings with the College. To fulfil the purposes set out above, my personal information may also be collected from or passed onto external bodies which usually includes medical colleges, government organisations and associated training providers, or as otherwise permitted or required by law. Further information about the collection of personal information is available on the ACRRM website https://www.acrrm.org.au/privacy. The Privacy Policy contains information about how you may access and seek correction of your personal information and how you can complain about a breach of the Australian Privacy Principles.

4.4 Privacy *

4.5 Declaration

I declare that the information provided by me regarding this application is true and accurate. I acknowledge that ACRRM reserves the right at any stage to reverse any decision regarding this application made on the basis of incorrect or incomplete information.

4.5 Declaration *