Medical Training Review Panel 19th Report

University Medical Training

In Australia, professional entry level medical education is provided by university medical schools as four to six year bachelor degree or largely four year postgraduate master level degree courses. There are 18³ universities with accredited medical schools, and a number of these were established in the last ten years. The University of Melbourne was the first to commence a Doctor of Medicine (MD) program in 2011 and had the first cohort of postgraduate degree graduates in 2014.

In 2015, there were 16,959 medical students studying in Australian universities. This was an increase of less than one percent (122 or 0.7%) from 2014. Almost half (8,420 or 49.6%) of these students were undertaking a four-year course. This was slightly higher than in 2014 (8,132 or 48.3%).

Over three-quarters of all places in 2015 were Commonwealth-supported (13,364 or 78.8%). This is similar to previous years, with 79.3% of students receiving Commonwealth support in 2014 and 78.4% in 2013. Figure 1 shows that the majority of these students (9,692 or 72.5%) received support through the Higher Education Contribution Scheme - Higher Education Loan Program (HECS-HELP) only. The remaining students were in bonded places receiving assistance through the Bonded Medical Places (BMP) Scheme and the Medical Rural Bonded Scholarship (MRBS) Scheme.

Students participating in the BMP Scheme have a return of service obligation to work in a District of Workforce Shortage (DWS) as identified by the Commonwealth, for a period of time equal to the length of the medical degree. However, up to half of the return of service obligation can be met while completing prevocational and vocational training.

Recipients of the MRBS Scheme scholarship are required to work for six continuous years in locations within Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA) 2 to 5. MRBS Scheme doctors start their six year commitment to work in rural Australia after completing their vocational training.

In addition, medical students can be supported by scholarships through a variety of other sources, namely the state or territory, the university or other institutions and, for international students, their home country.

Overall, international students occupied 2,535 or 14.9% of places. These students were studying as private or sponsored students and were not Australian citizens, permanent residents or New Zealand citizens. A small proportion of Australian citizens (952 or 5.6% of medical students) also pay fees.

Figure 1: Medical students by type of student place: Number and proportion of places, 2015

Source: Medical Deans Australia and New Zealand Inc

In 2015, 265 medical students identified that they were of Aboriginal or Torres Strait Islander descent. This is over two-and-a-half times the number of students who identified themselves as Aboriginal and/or Torres Strait Islander people(s) in 2006 (99).

Of the total medical students, 3,777 were in the first year of their medical studies and 3,210 or 85% of these were domestic students. Most students were under the age of 25 years when they commenced their medical studies. Data from 2014 shows that about four-fifths (80.8%) of students were under 25 years (Figure 2). A further 13.4% were aged between 25 and 29 years and 5.8% were 30 years or older. Over half (60.8%) of the medical students commencing in 2014 began their studies after finishing another degree.

Figure 2: Commencing medical students by age groups, 2014

Source: Medical Schools Outcomes Database

Adult medicine/internal medicine, surgery and general practice were among the most preferred types of future medical practice for students in their final year of medical school.

Domestic students with a rural background comprised just over a quarter of all commencing domestic students (832 or 25.9%).

Over the last decade, the total number of commencing medical students has almost doubled, with the intake increasing by 1,446 or 62% from 2,331 in 2005 to 3,777 in 2015. This was primarily due to increases in the number of commencing domestic students, which rose by 71.6% compared with an increase of 23.3% for international students.

These increases are mirrored in the number of medical graduates each year. In 2014 there were 3,437 medical graduates, over double the 1,400 graduates in 1999 (Figure 3). This figure has stabilised since 2012, when there were 3,284 graduates.

The trend is somewhat different between graduating domestic and international students. International students constituted just 10.3% (or 144 of 1,400 graduates) in 1999, the first year this graduate data were published. Since then the number has more than trebled, rising to 469 graduating international students in 2014. The number has also increased as a proportion of all medical graduates, reaching a peak of 19.5% in 2009. Since 2009, the proportion of international medical graduates has seen a downward trend, decreasing to 13.6% of all medical graduates in 2014. The number of domestic students graduating each year increased from 1,256 in 1999 to 2,968 in 2014.

In 2014, 2,730 or 79.4% of medical graduates were Commonwealth-supported, with the majority of these in HECS-HELP only places. Almost two-thirds of fee-paying graduates were international students (67.1%).

Figure 3: Domestic and international medical graduates, 1999-2014

Source: Medical Deans Australia and New Zealand Inc

From 2013 to 2014, the actual number of graduates decreased slightly from 3,441 to 3,437. It is projected that there will be 3,715 medical graduates in 2016, with a small decrease anticipated in 2017 (to 3,698). This is then expected to reach 3,774 medical graduates by 2018 (Figure 4).

Figure 4: Projections of domestic and international medical graduates, 2014-2018

Source: Medical Deans Australia and New Zealand Inc