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Schmeag

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Thank you for your post.

My understanding is that there are three main differences between the two:

1) the MRBS obliges you to work in a rural area, as opposed to the bonded scheme where you can work in any "area of need", which can include outer metro. You actually have a lot more flexibility with just the bonded

2) if you breach the bonded scheme, you suffer a financial penalty (essentially become a DFEE student at a time when you're more able to pay it). If you breach your MRBS contract you can lose the ability to a provider number for up to 12 years - essentially meaning you cannot access medicare rebates for your services. This is extremely significant, and would essentially end your medical career. Given that virtually every medical service in Australia is subsidised, your options are to: a) open a clinic catering to the small portion of the population who are eligible for medicare and magically make enough to survive, b) practice an area of medicine which doesn't attract rebates (cosmetic medicine, or weird alternative therapies), c) use your medical degree to enter another field.

3) several of the more sub-specialised career paths will become unavailable, as they can only be practiced in locations which the MRBS would not cover.

Frankly I find the whole MRBS system to be extremely unfair. It exploits rural students who aren't from rich backgrounds and forces them into a career path when they have virtually no life experience. I would have no problem with them being required to pay back the scholarship and even suffering a large financial penalty on top of that (say $100k), but to remove their ability to make a living is appalling.
I am curious as to how it removes their ability to make a living - isn't rural medicine quite lucrative with all the subsidies?

Someone mentioned this had a slight negative tone, but I would say this is an objective account, although I feel there is room for variation within this experience. I am wondering if your feelings have now changed (I assume you are now RMO 3/4) - did you end up taking a year off?

To think that 7 years of university is not enough to guarantee a job, as a doctor, beyond 2 years duration... Such a gamble.
There aren't a lot of jobs that are guaranteed in general. Once you have completed your internship, finding a job is easy as a doctor. Finding a job that furthers your career might be difficult - you have to reapply for your job every year and the cards won't always fall the right way.
 

mayla

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Woah thanks for writing such a detailed post!! Makes me realise I have to start working my butt off and try out this 50 hour week...



I have a question about whether going overseas to look for a postgraduate specialisation course is a viable option. Is this at all possible and would this give a better chance of specialising sooner? Or would we need to be fully qualified i.e. already specialised if we want to try and practice overseas?


I know there are some tests that you have to take in order to practice medicine overseas but aside from that I have no knowledge about how it all works..


Thanks in advance!
 

Schmeag

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Woah thanks for writing such a detailed post!! Makes me realise I have to start working my butt off and try out this 50 hour week...



I have a question about whether going overseas to look for a postgraduate specialisation course is a viable option. Is this at all possible and would this give a better chance of specialising sooner? Or would we need to be fully qualified i.e. already specialised if we want to try and practice overseas?


I know there are some tests that you have to take in order to practice medicine overseas but aside from that I have no knowledge about how it all works..


Thanks in advance!
Specialisation overseas is viable. I have heard of doctors aiming to go to the UK and US. For the US, you need to take three exams before you are fully accepted into a training program. You do not need to be specialised when you do this. It may not necessarily be quicker and you would have to do some bridging training to return practice in Australia. Beyond that, I am not too sure.
 

Schmeag

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Do you have advice for paediatrician hopefuls?
While paeds is not my forte, I'll offer you some general starting tips:

Get some work experience if you can.
Pick med schools with placements at a large paediatric hospital for a more in-depth experience.
Don't fully commit until you've done a number of rotations in other parts of medicine.
 

tofusenpai

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While paeds is not my forte, I'll offer you some general starting tips:

Get some work experience if you can.
Pick med schools with placements at a large paediatric hospital for a more in-depth experience.
Don't fully commit until you've done a number of rotations in other parts of medicine.
Thank you very much ^^
 

tofusenpai

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Also for medicine do you need physics because I struggled in 5.3 maths and not sure if I should do physics but I'm definitely taking biochem so could I just take biochem only?
 

patpatpat

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I kind of find it hard to believe that the government would be happy letting people "pay off the bond", especially considering the very harsh medicare ban for breaking the MRBS contract.
One way of looking at it is that the bonded places are essentially DFEE positions (old scheme before your time) which the government is paying your part of on the condition that you are willing to go to an area of workplace shortage. If you fail to uphold your end of the agreement, then they fail to hold up theirs.

25% of med students are now bonded. Many of these will become GP's and have the ability to work in the outer metro (where good GP's are needed), and some will become specialists who cannot find jobs in the city, and have to go rural anyway. I daresay that many will simply work it out rather than pay it off.
 

patpatpat

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Thank you for your post.



I am curious as to how it removes their ability to make a living - isn't rural medicine quite lucrative with all the subsidies?

Someone mentioned this had a slight negative tone, but I would say this is an objective account, although I feel there is room for variation within this experience. I am wondering if your feelings have now changed (I assume you are now RMO 3/4) - did you end up taking a year off?


There aren't a lot of jobs that are guaranteed in general. Once you have completed your internship, finding a job is easy as a doctor. Finding a job that furthers your career might be difficult - you have to reapply for your job every year and the cards won't always fall the right way.
It removes their ability to make a living if they don't go to the country by removing their ability to access Medicare subsidies. A small portion may be able to score a salaried position, but this would be unfavourable to the hospital given billing structures for outpatients. And forget about working if you become a GP. In short, I would very, very strongly advise against this. If you can get a MRBS position, you are like competitive enough to get a normal bonded position.

I wouldn't say I was being negative, more realistic. Many people have a dream of medicine which is far from what it actually is, and seem to think that expensive UMAT coaching is absolutely essential. Despite the tone of the post, I really do enjoy being a junior doctor - it is an amazing journey where you will learn and discover new experiences every day. But some of those experiences unfortunately necessitate hating the job for a period of time or other people working (glares at medical admin). As for me, I ended up taking an SRMO position last year, and will be doing a bit of locuming for the next 6 months, before going for a reg job.

As for jobs... yes and no. I completely agree that there are always going to be jobs available, but the further up the pole you go the harder it is to find a position. Even if you got stuck and tried to fall back a level, it can be very difficult to find one (given pay structures necessitating higher wages, a loss of general medical knowledge etc). With the increasing number of doctors, the number of free positions (which would previously have been filled by IMG's) is falling rapidly, and a few people at my level have been unable to secure a job for the next clinical year.
 

patpatpat

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Woah thanks for writing such a detailed post!! Makes me realise I have to start working my butt off and try out this 50 hour week...



I have a question about whether going overseas to look for a postgraduate specialisation course is a viable option. Is this at all possible and would this give a better chance of specialising sooner? Or would we need to be fully qualified i.e. already specialised if we want to try and practice overseas?


I know there are some tests that you have to take in order to practice medicine overseas but aside from that I have no knowledge about how it all works..


Thanks in advance!
Thanks :)

Specialising overseas is an option, but it will be more difficult and more time consuming than staying in Australia, and you may not get recognised when you get home. To give two examples:

- the UK generally recognises all Australian doctors, and does not require additional entrance exams (not 100% sure how the scheme works). As a result there are a lot of Aussie doctors working in the UK and vice versa. You would be able to apply for a job and compete against UK applicants the same as a UK doctor (I think) and could then be accepted onto their training program. BUT you then need to work out visas/residency etc. If you came back to Australia, many colleges will recognise your training time but not your exam progress, so you would have to spend more time working as a registrar/fellow in Australia while studying for the exams. I am under the impression the same works in reverse for doctors who have finished their training in Austr

- the US recognises Australian qualifications, but would still require you to sit the USMLE (a difficult exam with multiple stages which is tailored for the US system), and upon passing that would then have to match into a program. But the US programs aren't recognised in Australia, so you would have to start all over again if you returned.

As I said I'm not an expert, but that it my understanding. From observation, most people will spend 6 months abroad and return to their home country, either in the UK or as a fellow in another country. It is difficult (but certainly not impossible) to train and practice in another country, but the lack of easy transferability of skills is something everyone should keep in mind.
 

patpatpat

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Do you have advice for paediatrician hopefuls?
1) get into a medicine program

2) try to get a rotation at a hospital with a good paeds department. If not possible, do your elective at one (in the city that you want to work in)

3) do some research into paediatrics while in med school, try to get published

4) try to score a paeds rotation in internship (if possible) or residency

5) understand that consultant jobs in paediatrics are harder to come by than other areas, and that every year a handful of fellows/advanced trainees will transfer to another program or change to GP land
 

Medman

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1) get into a medicine program

2) try to get a rotation at a hospital with a good paeds department. If not possible, do your elective at one (in the city that you want to work in)

3) do some research into paediatrics while in med school, try to get published

4) try to score a paeds rotation in internship (if possible) or residency

5) understand that consultant jobs in paediatrics are harder to come by than other areas, and that every year a handful of fellows/advanced trainees will transfer to another program or change to GP land
I believe consultant paediatricians in outer suburb hospitals are still lacking. Issue with this is that you will be working as a general paediatrician and not as a specialist paediatrician in your favoured area. If you're looking to work in a tertiary hospital where you can specialise and sub-specialise, in Westmead Childrens or Randwick Childrens those jobs are incredibly difficult to get (Overheard paediatricians being interviewed by the hospital for a job at Westmead Children's talk about how spending so many years in training still didn't guarantee them a job and they are now forced to do masters or PHDs just to put themselves ahead of the competition).
 

Futureunswmedstudent

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I believe consultant paediatricians in outer suburb hospitals are still lacking. Issue with this is that you will be working as a general paediatrician and not as a specialist paediatrician in your favoured area. If you're looking to work in a tertiary hospital where you can specialise and sub-specialise, in Westmead Childrens or Randwick Childrens those jobs are incredibly difficult to get (Overheard paediatricians being interviewed by the hospital for a job at Westmead Children's talk about how spending so many years in training still didn't guarantee them a job and they are now forced to do masters or PHDs just to put themselves ahead of the competition).
hi medman, my friend told me about you lol
is it true that you dont need 99.95 for undergrad med at usyd? o:
 

redjnr

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Not the almighty Medman but for the Provisional Entry MD (Usyd does not offer undergraduate medicine), interviews are usually only given to those who recieve 99.95 ATAR or equivalent in IB. However I've heard rumours that students have been given an interview with 99.90 in years where there was insufficient interest in the program.
 

Futureunswmedstudent

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Not the almighty Medman but for the Provisional Entry MD (Usyd does not offer undergraduate medicine), interviews are usually only given to those who recieve 99.95 ATAR or equivalent in IB. However I've heard rumours that students have been given an interview with 99.90 in years where there was insufficient interest in the program.
oh my god
can we pls swap lives, unswmedstudent *^*
 

redjnr

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Hahahahahaha no.

In all seriousness though - I know your username is probably just for fun but honestly be prepared to accept medicine anywhere. The UMAT is really a hit and miss - yet it is pivotal in determining who gets a medicine place. Having said that though, I'm sure someone who is already so determined to get into medicine will have no issues when the time comes. I hope to see you at UNSW in 2018 :)
 
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MiseryParade

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hi medman, my friend told me about you lol
is it true that you dont need 99.95 for undergrad med at usyd? o:
Also not Medman, but my careers advisor told me that if you apply for EAS at USyd with a high ATAR (she threw around the figures 99.7-9?) you might land a MD interview if demand isn't high enough that year. This is probably in line with what redjnr mentioned above - the EAS thing might be there just so that the university can keep up its "exclusive 99.95" reputation or something, lol.
 

bangladesh

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Also not Medman, but my careers advisor told me that if you apply for EAS at USyd with a high ATAR (she threw around the figures 99.7-9?) you might land a MD interview if demand isn't high enough that year. This is probably in line with what redjnr mentioned above - the EAS thing might be there just so that the university can keep up its "exclusive 99.95" reputation or something, lol.
Can confirm that this isn't true. It's not about demand, they only take .95ers full stop.
 

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