Judge Felicity Hampel said she faced a "dilemma to reconcile the irreconcilable" in sentencing 31-year-old John Murray Van Remmen.

"It is one of those tragic cases where an otherwise good person... brings about the death of another good person," Judge Hampel said.

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Van Remmen fronted the County Court on Tuesday after he last week pleaded guilty to dangerous driving causing death following the fatal crash on September 5 last year.

The court heard Van Remmen had been driving along the Calder Freeway towards Melbourne when he left the freeway at the Malmsbury exit.

Van Remmen drove on the incorrect side along the overpass and around a right-hand bend onto Mollison Street, before he crashed head-on with the car of 64-year-old victim, Colleen Plowman.

Van Remmen helped Mrs Plowman out of the vehicle, but she collapsed to the ground. Witnesses performed CPR until paramedics arrived.

Mrs Plowman was flown to the Alfred Hospital with multiple chest injuries. She died that evening shortly after arriving in hospital.

The court heard Van Remmen was not injured in the crash. He told multiple witnesses he had been looking for a rest stop because he was dozing off.

Van Remmen had no drugs or alcohol in his system, but CCTV footage showed the 31-year-old drove on the wrong side of the road for about 1.3km before the collision.

Judge Hampel said it was clear that Van Remmen ignored and failed to heed multiple warning signs.

"The level of inattention was protracted and high," the judge said. "You knew you were tired, yet you kept driving and looking for a place to stop instead of just pulling over."

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Judge Hampel said Van Remmen's actions left behind a "stricken and still grieving family".

"I know that this hearing cannot undo what happened," the judge told Mrs Plowman's family. "But I hope you felt heard and listened to."

Judge Hampel said in sentencing, she needed to take into account Van Remmen's personal circumstances.

The judge noted Van Remmen was a United States citizen who had been recruited to Australia in 2018 for his "highly valued" skills as a clinician for children with complex autism presentations.

Judge Hampel said it was clear Van Remmen had a profound effect on all of the children, families, and colleagues he came into contact with at the Irabina Autism Services.

The judge also noted that if Van Remmen was jailed for 12 months or longer, his Australian visa would be cancelled and he would likely face deportation.

Judge Hampel said she took into account Van Remmen had entered a very early guilty plea and showed remorse through both his plea and a letter of apology to Mrs Plowman's family.

But the judge said the only available sentence was a term of imprisonment given the seriousness of the crime.

Van Remmen was convicted and jailed for 10 months. His licence was cancelled and he was disqualified from driving for 18 months.

If he did not plead guilty, Van Remmen would have been jailed for two years with a non-parole period of 12 months.

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