Nobody teaches you money at medical school. You emerge with a decade of pharmacology in your head, a HELP debt the size of a small mortgage, and a first hospital payslip that makes almost no sense. As medical accountants in Adelaide we work with doctors at every stage of their careers, and one thing is consistent: the habits set as an intern and registrar quietly decide how the consultant years go. Here’s what actually matters in those first years — written for interns, RMOs and registrars in the Adelaide hospital system.
Decode your payslip before you trust it
Your hospital withholds tax before you’re paid, which lulls most junior doctors into assuming everything is handled. Mostly it is — until you pick up overtime, penalties and extra shifts, and discover at tax time that withholding across multiple pay categories didn’t quite keep up. Check your payslip against your employment agreement early, understand what’s being withheld and why, and you’ll never be ambushed in October.
Use salary packaging — but understand what it does to your HELP debt
Public hospital employees have access to salary packaging arrangements that most private-sector workers would envy: a capped amount of everyday living expenses can be packaged from pre-tax salary. If you’re eligible and not using it, you’re leaving money on the table every fortnight.
The trap nobody mentions: packaged benefits are reportable, and reportable fringe benefits are added back when your HELP repayment income is calculated. Plenty of junior doctors package enthusiastically, then get a surprise at tax time when their student loan repayment is bigger than expected. Packaging is still usually worth it — but do the sums including the HELP effect, not just the headline tax saving.
Claim what the job actually costs you
Junior doctors reliably under-claim, partly from caution and partly from exhaustion. Deductions we see missed year after year: AHPRA registration, medical indemnity, college membership and training program fees, exam fees (which get eye-watering by fellowship), CPD courses and conferences, journals and clinical apps, equipment like stethoscopes, and laundering of hospital uniforms. Individually small; across the training years, thousands. Keep the receipts as you go — a folder in your email is fine — because reconstructing a year of expenses the night before lodgement is how claims get left behind.
Exam and course fees: expensive, and usually deductible
Fellowship exams and preparation courses can run into many thousands of dollars. Self-education costs are generally deductible when they connect to your current work — and for a doctor training within their field, they usually do. The year you sit an expensive exam is precisely the year to make sure your return is done properly, because the deduction is significant and the substantiation rules matter.
Don’t get an ABN just because someone asked you to
At some point a locum agency or private assisting arrangement will ask you to “just get an ABN.” Sometimes that’s right; often the arrangement is still, in substance, employment — and the tax law’s personal services income rules mean an ABN doesn’t magically change how your income is taxed anyway. What it can change is who’s responsible for your tax, your super and your insurance: you. Before you invoice anyone, it’s worth a short conversation with an accountant who deals with doctors — and if you do start earning untaxed income, put a slice of every payment aside from day one. We wrote about what happens to doctors who don’t in our guide to the tax mistakes Adelaide doctors make.
Super: boring now, enormous later
Between medical school jobs, internship and rotations, many junior doctors accumulate several super funds without noticing, each charging its own fees and insurance premiums. Consolidating early — after checking you won’t lose insurance you actually want — is a half-hour job that compounds for forty years. You don’t need to be a super expert at 26. You just need to not be paying four sets of fees.
Income protection while you’re young and healthy
Your biggest financial asset right now isn’t your car or your savings — it’s thirty-plus years of future earnings, and it’s worth protecting. Income protection is cheapest to establish when you’re young and healthy, premiums for policies held outside super are generally tax-deductible, and doctors have access to policy terms most occupations don’t. This is one to set up properly once, early, rather than perfectly, later.
When is it worth actually getting an accountant?
Honestly: not necessarily in your intern year, if your affairs are one payslip and a few deductions. The point where it changes is the first year anything gets layered — locum income, an ABN decision, serious exam costs, salary packaging plus HELP, a first investment. That’s when an hour with a medical accountant stops being a cost and starts being the cheapest advice of your career, because the structures you set up in your registrar years are the ones you’ll still be living with as a consultant.
Nitschke Nancarrow has looked after Adelaide’s medical profession for over twenty years, from interns to practice owners, from our office at Myrtle Bank. If you’re a doctor in training and want a sense-check on where you stand, get in touch or call 1300 059 670.
This article is general information only and doesn’t consider your personal circumstances. Get advice specific to your situation before acting on anything here.
