Cardiothoracic Surgeon Visa Pathway to Australia: Complete 2026 Guide
Updated: 13 May 2026
Australia classifies Cardiothoracic Surgeons under ANZSCO 253512. The Royal Australasian College of Surgeons (RACS) conducts the specialist assessment via its Cardiothoracic Surgery panel and the Medical Board of Australia (MedBA) handles registration. The occupation is on both the CSOL and MLTSSL, opening subclasses 189, 190, 491, 482 and 186. Typical 2026 salaries range AUD $335,000-$675,000 with senior consultants and private operators at the top.
Quick Facts: Cardiothoracic Surgeon Migration Pathway
| Detail | Information |
|---|---|
| ANZSCO Code | 253512 (Cardiothoracic Surgeon) |
| Skill Level | 1 (MBBS plus FRACS-equivalent cardiothoracic fellowship) |
| Skills Assessment | RACS (Royal Australasian College of Surgeons) + MedBA registration |
| Occupation List | CSOL and MLTSSL |
| Visa Options | 189, 190, 491, 482, 186 |
| Demand Level | Persistent specialist shortage; concentrated in 25-30 cardiac surgical units nationally |
| Salary Range | AUD $335,000-$675,000+ (SalaryExpert 2026; PayScale 2026) |
| Typical 189 Score | 80-95 points |
| Key Challenge | Narrow consultant market; new posts emerge through retirement or unit expansion |
What Cardiothoracic Surgery in Australia Looks Like
Cardiothoracic surgery covers adult cardiac (coronary bypass, valve repair and replacement, aortic root and arch, atrial fibrillation surgery, mechanical circulatory support, transplantation), thoracic (lung resection, oesophageal, mediastinal, tracheal and pleural surgery), and congenital cardiac work in dedicated paediatric centres. Australia's adult cardiothoracic services cluster around major tertiary hospitals: Royal Prince Alfred, St Vincent's Sydney, The Alfred, Royal Melbourne, The Prince Charles in Brisbane, Royal Adelaide, Sir Charles Gairdner, Fiona Stanley, and Royal Hobart. Paediatric and congenital cardiac surgery is concentrated in five centres: The Children's Hospital at Westmead, Royal Children's Melbourne, Queensland Children's, Women's and Children's Adelaide, and Perth Children's. Heart and lung transplant programs sit at St Vincent's Sydney, The Alfred and The Prince Charles.
The consultant market is narrow. Around 25-30 hospitals nationally run active cardiothoracic units, and Jobs and Skills Australia counts the workforce in the low hundreds. New positions emerge through retirement, transplant program expansion, or hybrid theatre and TAVI service growth. Despite the small footprint, demand is steady: ageing population, growing burden of valve disease, rising lung cancer surgical caseload, and persistent regional gaps mean cardiothoracic surgery continues to appear within the surgical-specialist shortage cluster. Migrant surgeons with strong subspecialty profiles (TAVI, minimally invasive valve, advanced lung resection, transplantation) tend to find pathways the easiest.
ANZSCO 253512 — Code Mapping
The official ANZSCO description covers medical practitioners who specialise in the diagnosis and surgical treatment of disorders of the heart, lungs, oesophagus and great vessels. The code applies to consultants holding FRACS (Cardiothoracic Surgery), the UK CCT in Cardiothoracic Surgery, the US ABTS, the European Board of Cardiothoracic Surgery, or recognised equivalents.
There is no separate ANZSCO code for adult cardiac, thoracic-only, congenital, or transplant subspecialty practice — all sit under 253512. Vascular surgery uses 253521 (Vascular Surgeon); general thoracic work performed by general surgeons uses 253511. For wider help, see how to find your ANZSCO code.
Skills Assessment
Two processes run in parallel: RACS comparability for college recognition, and MedBA specialist registration.
RACS Specialist Assessment
The Royal Australasian College of Surgeons assesses Specialist International Medical Graduates against an Australian-trained FRACS (Cardiothoracic Surgery).
Requirements:
- Recognised primary medical qualification (MBBS, MD or equivalent)
- Recognised specialist qualification in cardiothoracic surgery (FRCS Cth, CCT, ABTS, EBCTS or equivalent)
- Documented post-fellowship cardiothoracic experience (typically 5+ years for substantial comparability)
- English at IELTS Academic 7.0 / OET Grade B minimum
Process:
- Document-based assessment — RACS plus the Cardiothoracic Surgery specialty panel review qualifications and operative logbooks
- Interview with two assessors
- Comparability decision — substantially / partially / not comparable
- Workplace-based assessment for partially-comparable outcomes — typically 12-24 months under RACS supervision at an accredited Australian cardiothoracic unit
Indicative fees (RACS published schedule):
- Australian specialist assessment application fee: AUD $10,650
- 20% (AUD $2,130) refund if not comparable at document stage and the interview is not held
- Additional supervision and examination fees during workplace-based assessment
- See current RACS assessment fees
Processing: Document review 3-6 months; interview 2-4 months thereafter. Substantially-comparable outcomes can complete in 9-15 months. Partially-comparable outcomes routinely take 24-36 months total once workplace-based assessment is required.
Common rejection reasons: narrow operative scope (e.g. coronary-only with no valve or aortic work); insufficient independent primary-operator case numbers; gaps between training and current practice; references that fail to specify primary surgeon status; logbook gaps that suggest senior-fellow rather than consultant-level practice.
MedBA Specialist Registration
The Medical Board of Australia issues the registration that allows independent cardiothoracic practice.
- Application cost: approximately AUD $1,000-$1,400
- Annual renewal: approximately AUD $980
- Processing: 8-16 weeks after RACS comparability is issued
- English: OET (Medicine) Grade B or IELTS Academic 7.0 minimum
- Documents: AHPRA national police check, proof of identity, certificates of good standing for every jurisdiction worked over the past 10 years
AHPRA proof-of-identity should run in parallel with RACS.
Visa Pathways for Cardiothoracic Surgeons
253512 is on the MLTSSL and CSOL, so every skilled subclass is available. In practice, employer sponsorship dominates because the small number of consultant posts that open are filled through direct recruitment by tertiary hospitals.
Subclass 482 — Skills in Demand (Specialist Skills Stream)
Cardiothoracic consultant salaries clear the Specialist Skills Stream threshold by a wide margin.
- Visa fee: AUD $3,210 primary applicant
- Salary threshold: AUD $141,210 (rising to AUD $146,717 from 1 July 2026)
- Duration: up to 4 years
- Processing: median 7 days for Specialist Skills nominations; 90% inside 67 days
- Quirk: tertiary cardiac centres are practised sponsors and move quickly once a signed offer is in place
Subclass 186 — Employer Nomination Scheme
- Visa fee: AUD $4,910 primary applicant
- Nomination fee: AUD $540
- SAF levy (employer): AUD $3,000-$5,000
- Streams: Direct Entry (open for 253512) or Temporary Residence Transition (after 2+ years on 482)
- Processing: 6-12 months typical
Subclass 189 — Skilled Independent
- Visa fee: AUD $4,910 primary applicant
- Realistic invite score: 80-95 points
- Processing: 7-12 months from invitation
Subclass 190 — State Nominated
- Visa fee: AUD $4,910 primary applicant
- Points boost: +5
Subclass 491 — Skilled Work Regional
- Visa fee: AUD $4,910 primary applicant
- Points boost: +15
- Note: few true regional cardiothoracic posts exist outside major centres; this pathway works mainly where a regional unit (Townsville, Newcastle, Geelong) is expanding cardiac services
Points Test Strategy
| Points Factor | Points | Notes |
|---|---|---|
| Age 25-32 | 30 | Maximum |
| Age 33-39 | 25 | Common for new cardiothoracic fellows |
| Age 40-44 | 15 | |
| Bachelor's degree | 15 | MBBS |
| Doctorate | 20 | PhD / MD by research — common among academic cardiac surgeons |
| English Superior (8.0) | 20 | |
| English Proficient (7.0) | 10 | |
| Overseas experience 8+ years | 15 | |
| State nomination (190) | 5 | |
| Regional (491) | 15 | |
| Partner skills | 5-10 |
Realistic Scenarios
Scenario 1 — 37-year-old fellow, UK CCT cardiothoracic, IELTS 8.0, MD by research, 6 years post-CCT, applying 189: 25 (age) + 20 (doctorate) + 20 (English) + 15 (experience) = 80 points. Add 190 (Victoria or NSW) for 85. Strong invitation profile.
Scenario 2 — 46-year-old consultant with The Alfred or St Vincent's offer: Skip the points test. 482 Specialist Skills lodged inside 14 days of nomination; transition to 186 TRT after 2 years. Senior consultant base packages at major tertiary hospitals sit around AUD $450,000-$600,000 before private operating.
State Nomination
New South Wales
NSW nominates at unit group level so 253512 is captured under the surgical specialist cluster. Sydney holds the country's largest adult cardiothoracic workforce — Royal Prince Alfred, St Vincent's, Westmead, and Royal North Shore. Realistically, the practical path is a signed offer from one of these units with state nomination following.
Victoria
Victoria's 2025-26 program prioritises the health sector and captures cardiothoracic surgery through its broader surgical-specialist allocation. The Alfred runs the dominant cardiac and transplant service in the state; Royal Melbourne and Monash Heart cover the remainder. Royal Children's Melbourne offers congenital pathway entry points.
Queensland
The Prince Charles Hospital is the state's lead cardiothoracic centre, including transplant. Royal Brisbane, Princess Alexandra, and Gold Coast University Hospital all run thoracic services. Queensland's 2026 program has roughly 2,600 places and accepts surgical specialist nominations on a case-by-case basis with a signed offer.
South Australia, Western Australia, Tasmania
All three nominate cardiothoracic surgeons case-by-case where a state hospital offer exists. Royal Adelaide, Sir Charles Gairdner / Fiona Stanley in Perth, and Royal Hobart are the relevant employers. Regional 491 pathways are realistic primarily through expansion at Townsville University Hospital or Newcastle's John Hunter.
Salary and Employment Outlook
Typical 2026 Earnings
| Role | Range (AUD, total package) |
|---|---|
| New fellow (staff specialist) | $335,000-$420,000 |
| Senior staff specialist (5+ years post-fellowship) | $450,000-$600,000 |
| VMO private practice (established) | $550,000-$1,200,000 |
| Locum (daily rate) | $3,000-$4,000+/day |
| Subspecialty private (transplant, complex valve) | $700,000-$1,500,000 |
| Heart-lung transplant surgeon (senior) | $600,000-$900,000 (institutional + private) |
Sources: SalaryExpert 2026 (average $558,632; entry-level $335,846; senior 8+ years $675,918), PayScale 2026, Talent.com Australia, MedRecruit 2026. Gross before super (11.5%) and private billing. Total package figures include bonuses (typical $130,000-$150,000 senior level). Newly appointed post-fellowship earnings of AUD $300,000-$400,000 are common immediately after gaining FRACS; this scales sharply by year 5 with private operating rights.
Highest-Paying Settings
- Established private practice in Sydney, Melbourne or Brisbane — coronary, valve and minimally invasive cardiac rooms
- Senior staff specialist + private rights at major tertiary teaching hospitals
- Locum cover for tertiary units — rates routinely AUD $3,500+/day
- Heart-lung transplantation programs at St Vincent's Sydney, The Alfred, The Prince Charles — institutional and academic loading
- Medico-legal expert witness work as a senior consultant — significant supplementary income
Tips for a Successful Application
1. Document subspecialty breadth
A logbook that is 95% coronary work with no valve or aortic surgery will struggle to score "substantially comparable" against Australian-trained FRACS cardiothoracic surgeons, who train across the full adult scope. Where possible, document elective and emergency cases across coronary, valve, aortic, thoracic and minimally invasive techniques. The panel evaluates breadth as well as numbers.
2. Operative logbooks must be granular
RACS wants primary-operator case numbers by procedure type, with dates and supervision status. Anonymised case lists with this detail are routinely the make-or-break document. Start compiling 12 months before submission and have an Australian-trained cardiothoracic surgeon review the format.
3. Target the right unit first
There are roughly 25-30 hospitals in Australia with active cardiothoracic services. Identify the 5-8 that are actively recruiting (RACS public training position numbers and unit websites are the best signal). Most successful migrant cardiothoracic surgeons arrived with an offer from a known unit, not via SkillSelect alone.
4. Budget the full RACS fee upfront
The AUD $10,650 application fee is payable at submission. If not comparable at document stage and the interview is not held, AUD $2,130 (20%) is refunded. Plan for the gross amount and have it ready before lodging.
5. Use the points test as insurance
For cardiothoracic surgery, 189/190 EOIs typically take 12+ months from EOI to grant. A signed offer plus 482 Specialist Skills sponsorship is faster and gives certainty. Run the EOI in parallel as a backup.
Step-by-Step Migration Roadmap
- Confirm code — 253512 for any cardiothoracic fellowship holder
- Translate and notarise medical qualification, specialist fellowship, operative logbooks, certificates of good standing
- Sit IELTS Academic and OET (Medicine) — IELTS for points, OET for AHPRA
- Lodge RACS specialist assessment — pay the AUD $10,650 fee
- Lodge AHPRA proof-of-identity in parallel
- Approach Australian cardiothoracic units directly with CV, logbook summary and references
- Attend RACS interview with the Cardiothoracic Surgery specialty panel
- MedBA specialist registration once RACS comparability is issued
- Visa nomination and application — 482, 186, 189, 190 or 491
- Health and character checks
- Visa grant and relocate
- Complete any RACS-directed workplace-based assessment at the supervising Australian cardiothoracic unit to achieve FRACS
For wider context, see the skills assessment bodies guide and the 2026 SOL.
Frequently Asked Questions
Is the consultant market in cardiothoracic surgery realistic for migrants?
Yes, with eyes open. Around 25-30 hospitals nationally run active cardiothoracic services and the consultant workforce sits in the low hundreds. Vacancies open through retirement, transplant program expansion, and the growth of TAVI and minimally invasive valve services. Migrants with UK/Irish/US/Canadian credentials and subspecialty differentiation (transplant, minimally invasive, advanced aortic) regularly secure positions. Generalist coronary-only profiles can find the market tighter.
Will my UK FRCS Cardiothoracic be recognised?
UK CCT in cardiothoracic surgery is one of the qualifications RACS most frequently recognises as substantially comparable. The document assessment plus interview typically completes inside 9-12 months. Most UK CCT-holding cardiothoracic surgeons clear the process without workplace-based assessment, provided their operative logbook supports the application across coronary, valve and thoracic case mix.
How much does a senior cardiothoracic surgeon actually earn in Australia in 2026?
SalaryExpert 2026 reports an average gross salary of AUD $558,632 with senior (8+ years) at AUD $675,918. Entry-level fellows average AUD $335,846. Established private practice consultants in capital cities — particularly those running valve and minimally invasive rooms — routinely clear AUD $1,000,000+ in total income. Locum daily rates sit around AUD $3,000-$4,000.
Is heart and lung transplant surgery a realistic pathway?
Yes, but constrained. Three centres run transplant programs: St Vincent's Sydney, The Alfred Melbourne, and The Prince Charles Brisbane. Posts emerge through retirement or program expansion rather than routine recruitment. UK and US transplant fellows are well-regarded; a 12-month subspecialty fellowship at an Australian centre is the standard entry route.
What's the realistic timeline from RACS submission to landing in Australia?
UK CCT holder, substantially comparable outcome, employer-sponsored 482: 12-18 months total. Standard pathway with no top-up required: 18-24 months. Partially-comparable outcome with 12-24 month workplace-based assessment: 30-42 months. Plan funding for at least 18 months of process before consultant income starts.
Is paediatric cardiac surgery covered by 253512?
Yes. Congenital and paediatric cardiac surgery sits under 253512 alongside adult cardiothoracic. Five centres run congenital programs: The Children's Hospital at Westmead, Royal Children's Melbourne, Queensland Children's, Women's and Children's Adelaide, and Perth Children's. RACS assesses paediatric cardiothoracic credentials against the full adult-and-paediatric Australian training scope, with subspecialty fellowships often required for unit appointment.
