🇦🇺 Australia — Two different standards apply

Austroads AFTD Assessing Fitness to Drive (2022) — applies to truck, bus, taxi, rideshare, and dangerous goods drivers. Any GP can assess. Frequency varies by state and licence class.

NTC Rail Standard National Standard for Health Assessment of Rail Safety Workers (2024) — applies to train drivers and rail safety workers. Only Authorised Health Professionals (AHPs) can assess. More comprehensive testing.

Jump to:
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Truck Driver (Heavy Vehicle)
MR, HR, HC, MC licence holders — Austroads AFTD

Who needs it: Anyone holding or applying for a Medium Rigid (MR), Heavy Rigid (HR), Heavy Combination (HC), or Multiple Combination (MC) licence. Also applies under NHVAS and TruckSafe accreditation. [Austroads — For commercial drivers]

How often (typical — varies by state)

AgeFrequency
Initial applicationRequired
21 – 39Every 10 years
40 – 59Every 5 years
60 – 69Every 2 years
70+Annually

Based on NSW MC requirements. [Austroads AFTD 2022, Appendix 1] Other states vary — QLD, VIC, SA, WA and TAS have different age thresholds. Always check with your state transport authority.

What the medical includes

👁️ Vision (acuity, fields, colour)
❤️ Cardiovascular (BP, heart)
👂 Hearing screen
🧠 Neurological assessment
🦴 Musculoskeletal screen
💊 Medication review
🩸 Diabetes check
😴 Sleep disorder screening
🧪 Drug/alcohol screen (if required by employer)
📋 Full medical history

Who can do it

Any registered medical practitioner (GP). Many employers use occupational health providers. The GP completes the Austroads Fitness to Drive Report form.

💡 Key point: You have a legal duty to report any medical condition that may affect your ability to drive safely to your state transport authority. This includes conditions diagnosed between scheduled medicals. Under the Heavy Vehicle National Law, you must notify within 7 days. [Austroads — For employers of commercial drivers]
🚆
Train Driver (Rail Safety Worker)
Category 1 Safety Critical Worker — NTC Rail Standard

Who needs it: Train drivers, shunters, and other rail safety workers who perform safety-critical tasks. Categorised as Category 1 (highest risk) under the National Standard for Health Assessment of Rail Safety Workers (2024 edition). [NTC Rail Standard 2024]

How often

AgeFrequency
Pre-employmentRequired
Under 40Every 5 years
40+Every 2 years
Any age"Triggered" assessment if health changes, incident, or returning from absence

Exact intervals may be adjusted by the rail transport operator based on their risk categorisation. [NTC Standard, Section 2.2.6] Some operators require more frequent assessments.

What the medical includes

Significantly more comprehensive than a truck driver medical: [Sonic HealthPlus — 2024 Rail Standard changes]

❤️ ECG (resting electrocardiograph)
🩸 Blood tests: lipids + HbA1c
👁️ Vision (acuity, fields, colour)
👂 Hearing (up to 8000 Hz)
😴 Sleep apnoea: STOP-Bang + Epworth
❤️‍🩹 CVD risk calculator (Australian data)
🧠 Mental health + neurodevelopmental screen
🧪 Drug and alcohol screen
💊 Full medication review
📋 Complete medical history + questionnaire

Who can do it

Only Authorised Health Professionals (AHPs) registered with the AHP Program. Your regular GP cannot do a rail medical unless they are AHP-registered. Your rail operator will direct you to an approved AHP. [NTC — AHP Program]

💡 Why so strict? A train driver who blacks out, has a seizure, or falls asleep can cause a catastrophic accident affecting hundreds of people. The rail standard requires ECG and blood tests because cardiovascular events and undiagnosed diabetes are leading causes of sudden incapacitation. The 2024 edition added STOP-Bang sleep apnoea screening and neurodevelopmental disorder assessment (ADHD, autism).
🚕
Taxi / Rideshare Driver
Uber, Didi, 13CABS, Ola, hire car — Austroads AFTD

Who needs it: Anyone who drives passengers for hire or reward — taxis, rideshare (Uber, Didi, Ola), hire cars, limousines, and community transport. Even though you drive a standard car, you are assessed against the commercial vehicle driver medical standards because you carry passengers. [Austroads AFTD — Medical standards for commercial drivers]

How often (typical — varies by state)

AgeFrequency
Initial applicationRequired (for driver authority / accreditation)
Under 50 (approx)Every 5 years (some states longer)
50 – 69Every 2-5 years (varies)
70+Annually (most states)

Requirements vary significantly by state. Some states (e.g. QLD) require a medical only on initial application and at age-based triggers. Others require periodic medicals throughout. Check your state's point-to-point transport authority.

What the medical includes

Same scope as a truck driver medical — vision, cardiovascular, hearing, neurological, diabetes, sleep, and medication review. Assessed against Austroads commercial vehicle driver standards.

Who can do it

Any registered medical practitioner (GP). Some rideshare platforms accept medicals from specific providers.

🚌
Bus Driver (Public Passenger Vehicle)
School bus, route bus, coach, charter — Austroads AFTD

Who needs it: Bus drivers carrying public passengers — route buses, school buses, coaches, charter buses. Assessed against Austroads commercial vehicle driver standards. [Austroads — For commercial drivers]

How often (typical — varies by state)

AgeFrequency
Initial applicationRequired
Under 40Every 10 years (some states every 5)
40 – 59Every 5 years
60 – 69Every 2 years
70+Annually

Bus drivers holding a heavy vehicle licence class (MR+) follow the same schedule as truck drivers. Those driving light buses on a car licence but carrying passengers for hire follow commercial standards. Check with your employer and state transport authority.

Who can do it

Any registered medical practitioner (GP).

☢️
Dangerous Goods Driver
ADG licence holders — Austroads AFTD

Who needs it: Drivers transporting dangerous goods in receptacles over 500 litres or 500 kg. Assessed against Austroads commercial vehicle driver standards regardless of vehicle size. [Austroads AFTD — Medical standards]

Medical frequency and content follow the same schedule as heavy vehicle drivers in your state. The key difference is that the commercial standards apply even if you drive a light vehicle — the dangerous goods component triggers the higher standard.

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Private Car Driver (C / R / LR licence)
Standard licence, motorcycle, light rigid — Austroads AFTD

No routine medical is required for standard car, motorcycle, or light rigid licence holders — unless:

• You have a medical condition that may affect driving (diabetes, epilepsy, heart disease, vision problems, sleep apnoea, psychiatric conditions) — you must report this to your state transport authority

• You are over 75 (some states require annual medicals — check your state)

• Your transport authority requests one (e.g. after a crash, medical report, or licence condition)

Private vehicle drivers are assessed against the lower (private) Austroads standards, which are less restrictive than commercial standards.

See our Driver Licence Medical guide for more detail.

📞 Check your state's requirements

Medical frequency varies by state. Contact your transport authority for exact requirements:

🏖️ QLD: TMR Queensland — 13 23 80
🌉 NSW: Transport for NSW — 13 22 13
🏙️ VIC: VicRoads — 13 11 71
🍷 SA: DIT South Australia — 13 10 84
🌿 WA: DoT Western Australia — 13 11 56
🏔️ TAS: Transport Tasmania — 1300 135 513
🐊 NT: MVR Northern Territory — 1300 654 628
🏛️ ACT: Access Canberra — 13 22 81

What happens if you don't meet the medical standards?

Failing a driver medical doesn't always mean losing your licence. Options include:

Conditional licence — you can keep driving with restrictions (e.g. corrective lenses, periodic review, no night driving, restricted area). This is the most common outcome for manageable conditions.

Temporarily unfit — you stop driving until a condition is treated or stabilised (e.g. after starting blood pressure medication, recovering from surgery, or treating sleep apnoea with CPAP).

Permanent unfitness — rare. Usually only for severe, untreatable conditions (e.g. advanced dementia, permanent severe vision loss, uncontrolled epilepsy).

Your GP or AHP will discuss the outcome and any restrictions. If you disagree, each state has an appeal process through the transport authority.

How much does a driver medical cost?

Commercial driver medical (truck, bus, taxi): Typically $80–$200 at a GP, $150–$350 at an occupational health provider. Not covered by Medicare — this is a private fee. Some employers cover the cost.

Rail medical (train driver): Typically $200–$500+ due to the ECG, blood tests, and specialised assessment. Usually paid for by the rail transport operator.

Private licence medical (when requested): $60–$150 at a GP. Not covered by Medicare.

Driver medicals are not bulk-billable because they are not clinically indicated — they are a licensing/occupational requirement. Ask your GP or provider about the fee before booking.

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