The title "Royal" was conferred upon the College by His Majesty King George VI. The Inauguration Ceremony was held in the Great Hall of the University of Sydney on 14 December 1938. Prior to 1938, Australians and New Zealanders who wished to be regarded as physicians, sought membership of one of the colleges in the United Kingdom.

The College currently has 6,162 Fellows as well as additional 1,548 Fellows in its faculties: Australasian Faculty of Public Health Medicine (AFPHM), Australasian Faculty of Rehabilitation Medicine (AFRM), and the Australasian Faculty of Occupational Medicine (AFOM). Fellows are located predominantly in Australia and New Zealand with a number overseas.

The College has functioned from the outset as an educational institution by the training and assessment of future consultants, by sponsorship of scientific meetings and publications and through its extensive library. As well as the three faculties there are three chapters: the Australasian Chapter of Palliative Medicine, the Australasian Chapter of Addiction Medicine, and the Chapter in Community Child Health. The College also houses within its Sydney offices a number of special societies and associations and the College headquarters is located in a significant heritage building in Sydney, New South Wales with offices in Queensland, South Australia, Victoria and Western Australia. The New Zealand headquarters is located in Wellington.

The College is in the forefront of medical research, health education and health policy. It espouses the highest ethical standards in the care of individual patients. The College joins with other health bodies throughout the world, particularly in Asia and the Pacific region, and with government and other communities to advance the health of all people.

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