Subclass 186 visa requirements for hospitals and health services

Overview

Hospitals and health services use the subclass 186 visa to stabilise critical roles and reduce turnover. Employer Nomination Scheme 186 planning works best when the nomination file tells one consistent story. The role must be genuine and ongoing. The occupation must match the actual duties. The salary and conditions must be clear. The evidence must line up across the position description, contract, organisational chart, and work location details.

Where hospital nominations go wrong is predictable. Internal job titles do not always align neatly to ANZSCO. Roles shift across wards, clinics, and campuses. Enterprise agreement classifications, loadings, and allowances can muddy the salary narrative. This guide sets out the subclass 186 nomination requirements for hospitals, with a focus on evidence quality and the risk points that delay decisions.

Which 186 stream fits hospitals and health services

Temporary Residence Transition stream(TRT):

This stream suits a hospital sponsoring a current employee under the TRT pathway, subject to the TRT stream criteria on the Home Affairs page.

Direct Entry stream:

This stream suits hospitals recruiting from offshore or selecting an onshore candidate under the Direct Entry pathway, subject to the Direct Entry criteria on the Home Affairs page.

Labour Agreement stream:

This stream fits where the nominating employer is party to a labour agreement and the nominee meets the agreement based criteria described by Home Affairs.

The nomination basics. What Home Affairs tests

Nomination requirements sit in migration law. Regulation 5.19 deals with approval of nominations for prescribed employer sponsored visas, including the Employer Nomination Scheme framework.

In practice, nomination strength comes down to a clear position story. Genuine role. Full-time role. Clean terms and conditions. Clear salary narrative. Evidence that the role exists as an ongoing position in the organisation, not a paper role built for the application.

Hospital reality check. Role design decides the outcome

Hospitals use internal titles that do not map neatly to ANZSCO. Rotations across wards, clinics, and campuses also blur duties. Home Affairs looks for one consistent story across:

• Position description
• Employment contract
• Organisational chart
• Work location details
• Salary and classification evidence

Roles and occupation alignment

Home Affairs expects the nominated occupation to align with the tasks and responsibilities of the position, using ANZSCO as the reference point. That alignment should be obvious from the position description, contract, and organisational chart.

In the nomination file:

• Describe duties that match the nominated occupation, with enough detail to show level and scope.
• Show the reporting line and who supervises the role, so the position sits clearly within the hospital structure.
• If the role spans wards, clinics, or campuses, keep the core duties stable and describe rotations as context, not a different role.

Work locations

Hospitals often operate across multiple sites. A nomination benefits from clean location detail. List:

• Primary site
• Secondary sites where regular work occurs
• Rotation patterns, if applicable
• Outreach clinic arrangements, if applicable
• Contract clauses that match the real operating model

Salary and classification

Hospitals pay under enterprise agreements, with loadings and allowances. Home Affairs still expects clarity. Provide:

• Base salary
• Classification level and enterprise agreement reference
• Ordinary hours
• Allowances and loadings, with a one line explanation per item
• Superannuation and standard entitlements

Evidence that strengthens a hospital nomination

• Workforce plan or recruitment plan for the service line
• Vacancy history and recruitment attempts
• Roster data showing persistent gaps
• Service demand drivers and coverage requirements
• Org chart showing clinical governance and reporting

After approval

Hospitals change rosters, teams, and service models. Track changes and keep records for:

• Duties
• Work location
• Entity employing the worker
• Hours and salary
• Manager and reporting line

What the employee must meet

Home Affairs sets the core visa requirements, including skills for the job, nomination by an employer, and health and character. Stream-specific requirements apply under TRT, Direct Entry, and Labour Agreement streams on the relevant Home Affairs pages. Hospitals should also plan for registration and credentialing timing where relevant.

Hospitals perform best on 186 when the nomination tells one story end to end. Role design, occupation alignment, location detail, and salary clarity drive speed and outcome.

Roam Migration Law supports HR and workforce teams with occupation alignment, nomination evidence, and audit ready files.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.