Why this matters in practice and in exams
Aboriginal and Torres Strait Islander peoples experience a higher burden of chronic disease, infection and earlier death than other Australians. The causes are rooted in colonisation, dispossession, racism and social determinants such as housing, income and access to care, not in individual choices or genetics alone.
For an IMG this has three practical consequences: you need to identify Aboriginal and Torres Strait Islander patients, you need to know the programs and earlier thresholds designed to close gaps in care, and you need to deliver care in a way the patient experiences as culturally safe. AMC, RACGP and college exams test all three.
Asking the identification question
Do not guess from appearance, name or where someone lives. Ask every patient, usually at registration and again if records are incomplete:
"Are you of Aboriginal or Torres Strait Islander origin?"
- Answer options are: no; yes, Aboriginal; yes, Torres Strait Islander; yes, both Aboriginal and Torres Strait Islander.
- Explain why you ask: so the patient can access health checks, programs and medicines support they are entitled to.
- Record the answer accurately. Identification is self-reported and is the patient's choice to share.
- Ask about children separately; a child's identification may differ from a parent's.
The annual health check (MBS item 715)
The Aboriginal and Torres Strait Islander health assessment, MBS item 715, is available to patients of any age and can be claimed once every 9 months. It covers physical, psychological and social wellbeing, and is a chance to catch problems early and plan care.
| Part of the check | What it involves |
|---|---|
| History and examination | Including social and emotional wellbeing, family history, smoking, alcohol, nutrition and activity |
| Age-appropriate checks | Growth and development in children; blood pressure, glucose, kidney function and CVD risk in adults |
| Overall assessment and plan | Recommended interventions, immunisation catch-up and screening due |
| Follow-up | Referral for up to 10 allied health follow-up services a year, and practice nurse or Aboriginal health worker follow-up |
| Written report | Offered to the patient, with the consent recorded |
A practice nurse, Aboriginal health worker or Aboriginal and Torres Strait Islander health practitioner can collect information under the GP's supervision, but the GP must personally attend the patient.
From Services Australia guidance on Aboriginal and Torres Strait Islander health assessments at the date above. Check MBS Online for current rules before claiming.
Where thresholds start earlier
| Area | What changes for Aboriginal and Torres Strait Islander patients |
|---|---|
| Cardiovascular risk | Assess absolute CVD risk from age 30, compared with 45 for the general population (2023 Australian guideline) |
| Diabetes | Screen earlier and more often; type 2 diabetes occurs at younger ages |
| Kidney disease | Check urine albumin-creatinine ratio and eGFR as part of the health check in adults |
| Immunisation | Additional funded vaccines, including annual influenza vaccine from 6 months and extra pneumococcal doses; some states fund further vaccines |
| Rheumatic heart disease | Treat sore throats and skin sores seriously in high-risk communities; give secondary prophylaxis after acute rheumatic fever |
| Ear and eye health | Watch for otitis media in children and trachoma or diabetic eye disease in some communities |
Immunisation entitlements follow the National Immunisation Program and state schedules, which change. Check the Australian Immunisation Handbook for current eligibility.
The RACGP and NACCHO National guide to preventive healthcare for Aboriginal and Torres Strait Islander people sets out age-specific recommendations and is the main reference for health checks.
Medicines: Closing the Gap prescriptions
The Closing the Gap (CTG) PBS Co-payment Program reduces or removes the PBS co-payment for eligible Aboriginal and Torres Strait Islander patients, including on 60-day prescriptions. Ask the patient whether they are registered and follow your prescribing software's CTG process.
Cost is a real barrier to filling scripts. If a patient has not started a medicine, ask whether cost, transport or understanding got in the way before assuming non-adherence. See our PBS prescribing guide for how co-payments work.
Working with community-controlled services
Aboriginal Community Controlled Health Organisations (ACCHOs) are primary care services run by local communities. Many patients prefer them, and they often provide transport, Aboriginal health workers and outreach that a mainstream practice cannot.
- Ask patients where they usually get care and share information with their consent.
- Involve Aboriginal health workers and liaison officers in hospital and community care; they are clinical colleagues, not interpreters only.
- Respect that decisions may involve family and community, and allow time for them.
- Offer an interpreter for patients whose first language is an Aboriginal language or Kriol.
How it appears in exams
- A question that hinges on starting CVD risk assessment at 30, not 45.
- A child with recurrent sore throats in a remote community where rheumatic fever must be considered.
- Choosing the culturally safe next step: involving family or an Aboriginal health worker, or offering an ACCHO.
- Recognising the 715 health check as the right vehicle for preventive care.
For the principles behind culturally safe care, see cultural safety in Australian medical practice.
Common questions
How do I ask if a patient is Aboriginal or Torres Strait Islander?
Ask every patient the standard question, "Are you of Aboriginal or Torres Strait Islander origin?", explain why you ask, and record the answer accurately. Never assume from appearance.
How often can a 715 health check be done?
MBS item 715 can be claimed once every 9 months for Aboriginal and Torres Strait Islander patients of any age.
At what age should CVD risk be assessed in First Nations patients?
The 2023 Australian guideline recommends absolute CVD risk assessment from age 30 for Aboriginal and Torres Strait Islander people, compared with 45 for the general population.
What is a CTG prescription?
A prescription under the Closing the Gap PBS Co-payment Program, which reduces or removes the PBS co-payment for eligible Aboriginal and Torres Strait Islander patients.