Medical Practice Regulations 2004
S.R. No. 104/2004
table of provisions
RegulationPage
RegulationPage
1.Objective
2.Authorising provision
3.Revocation
4.Definition
5.Form of application for registration
6.Form of application for endorsement of registration
7.The register
8.Certificate of registration
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SCHEDULES
SCHEDULE 1—Application for Registration under the Medical PracticeAct 1994
SCHEDULE 2—Application for Registration/Renewal of Registration asa Medical Student under the Medical Practice Act1994
SCHEDULE 3—Application for Endorsement of Registration under Section 9B of the Medical Practice Act1994
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ENDNOTES
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S.R. No. 104/2004
Medical Practice Regulations 2004
statutory rules 2004
S.R. No. 104/2004
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S.R. No. 104/2004
Medical Practice Regulations 2004
Medical Practice Act 1994
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S.R. No. 104/2004
Medical Practice Regulations 2004
Medical Practice Regulations 2004
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S.R. No. 104/2004
Medical Practice Regulations 2004
The Lieutenant-Governor as the Governor's Deputy with the advice of the Executive Council makes the following Regulations:
Dated: 3 August 2004
Responsible Minister:
BRONWYN PIKE
Minister for Health
DIane Casey
Clerk of the Executive Council
1.Objective
The objective of these Regulations is to prescribe the following matters for the purposes of the Medical Practice Act 1994—
(a)the forms for applications relating to registration and endorsement of registration of medical practitioners; and
(b)the forms for applications relating to registration of medical students; and
(c)the particulars to be included in the register and certificates of registration.
2.Authorising provision
These Regulations are made under section 98 of the Medical Practice Act 1994.
3.Revocation
The Medical Practice Regulations 1994[1] and the Medical Practice (Amendment) Regulations 2001[2] are revoked.
4.Definition
s. 3
In these Regulations "the Act" means the MedicalPractice Act 1994.
5.Form of application for registration
(1)For the purposes of section 5(2)(a) of the Act, the prescribed form is set out in Schedule 1.
(2)For the purposes of section 9A(2) of the Act, the prescribed form is set out in Schedule 2.
6.Form of application for endorsement of registration
For the purposes of section 9B(6)(a) of the Act, the prescribed form is set out in Schedule 3.
7.The register
For the purposes of section 17(3)(c) of the Act, the following information is the prescribed information—
(a)the address of the medical practitioner;
(b)his or her professional qualifications;
(c)the date of his or her initial registration;
(d)his or her registration number;
(e)details of any cancellation of registration.
8.Certificate of registration
r. 8
For the purposes of section 18(2)(b) of the Act, the following information is the prescribed information—
(a)the name of the person registered;
(b)his or her qualifications;
(c)the date the certificate was issued.
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SCHEDULES
SCHEDULE 1
Sch. 1
Regulation 5(1)
Medical Practice Regulations 2004
Application for Registration under the MedicalPractice Act 1994
To the Medical Practitioners Board of Victoria
I apply for registration under the Medical Practice Act 1994.
PERSONAL DETAILS
Title and name: (Title) (Given Names) (Family Name)
Any other names: (e.g. previous family name)
Address:
Telephone Number:
Date of Birth:
PROFESSIONAL QUALIFICATIONS
Name of institution where study of medicine and surgery undertaken:
Date course commenced:
Date course completed:
Length of course:
Internship completed at: (complete if applicable)
Current position:
If previously registered as a medical practitioner—
(a)date and place of initial registration:
(b)date and places of any other registrations:
I enclose—
Sch. 1
(a)evidence of the qualifications which entitle me to be registered; and
(b)the fee of $
Signature of applicant:
Date:
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SCHEDULE 2
Sch. 2
Regulation 5(2)
Medical Practice Regulations 2004
Application for Registration/Renewal of Registration* as a Medical Student under the Medical Practice Act 1994
To the Medical Practitioners Board of Victoria
I apply for registration/renewal of registration* as a medical student under the Medical Practice Act 1994.
SECTION 1—ALL APPLICANTS
PERSONAL DETAILS
Title: (Mr/Ms/Mrs/Miss/Dr/other)
Family Name:
Given names:
Any other names: (e.g. previous family name)
Residential address:
Postal address: (if different from residential address)
Date of birth:
SECTION 2—ALL APPLICANTS
PRELIMINARY
Is this your first application for registration as a medical student? Yes/No
If not, what is your Medical Student Registration Number?
SECTION 3—UNIVERSITY STUDENTS ONLY
UNIVERSITY DETAILS
Name of medical school accredited by the Australian Medical Council where the course of study is undertaken:
Name of clinical school where the course of study is being undertaken (if applicable):
Year course commenced:
Length of course:
Year of course:
University student number:
SECTION 4—AMC CANDIDATES ONLY
Sch. 2
AUSTRALIAN MEDICAL COUNCIL EXAMINATIONS
AMC Candidate number:
Medical qualification:
University at which degree obtained: Year:
Have you sat the multiple choice questions component of the AMC examinations? Yes/No
If you have sat the multiple choice questions component, did you pass? Yes/No
Have you sat the clinical component of the AMC examinations? Yes/No
If you have sat the clinical component, did you pass? Yes/No
Institution at which you are undertaking or completing a course of study for an AMC examination:
Name of responsible supervisors:
SECTION 5—ALL APPLICANTS
Signature of applicant:
Date:
* Delete if inapplicable.
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SCHEDULE 3
Sch. 3
Regulation 6
Medical Practice Regulations 2004
Application for Endorsement of Registration under Section 9B of the Medical Practice Act1994
To the Medical Practitioners Board of Victoria
I apply for endorsement of registration under section 9B of the Medical Practice Act 1994—
*to be exempt from certain provisions of the Chinese Medicine Registration Act 2000 in order to practise Chinese medicine.
*to obtain, have in my possession and to use, sell or supply Schedule 1 poisons within the meaning of the Drugs, Poisons and Controlled Substances Act 1981.
*I am a registered medical practitioner under the Medical Practice Act 1994.
*I enclose a separate application for registration as a medical practitioner under the Medical Practice Act 1994.
PERSONAL DETAILS
Title and name: (Title) (Given Names) (Family Name)
Any other names: (e.g. previous family name)
Address:
Telephone number:
Date of birth:
COURSE OF STUDY OR TRAINING
I enclose the details of the course of study or training that I have completed which I submit—
*qualifies me to practise Chinese medicine.
*qualifies me to obtain and have in my possession and to use, sell or supply Schedule 1 poisons within the meaning of the Drugs, Poisons andControlled Substances Act 1981.
I enclose the fee of $
Sch. 3
Signature of applicant:
Date:
* Delete if inapplicable.
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Medical Practice Regulations 2004
ENDNOTES
Endnotes
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[1] Reg. 3: S.R. No. 116/1994.
[2] Reg. 3: S.R. No. 139/2001.