Medical Training Review Panel: thirteenth report

Medical Students

Page last updated: April 2010

In Australia, initial medical education is provided by university medical schools accredited by the Australian Medical Council (AMC). There are 18 universities with accredited medical schools, of which 14 are currently producing graduates. Four universities have students enrolled in courses of various lengths, but are yet to produce graduates. The first medical students graduate from Bond University in 2009. The University of Wollongong and University of Western Sydney (UWS) commenced teaching in 2007, and Deakin and Notre Dame Sydney commenced in 2008. These universities are expecting their first medical graduates in 2010 and 2011 respectively.

In the past, most medical doctors gained their graduate qualification by completing a six-year Bachelor of Medicine and Bachelor of Surgery (MBBS). Over the years, an increasing number of 5 year and 4 year (graduate entry) programs have been introduced. Recently, some six-year programs have been replaced by five-year programs and a number of universities have introduced four-year graduate entry medical degrees for applicants with an existing degree. Some universities have both undergraduate and graduate entry programs.

In the past, university medical degrees usually had two stages:

  • pre-clinical, which was primarily lecture theatre and laboratory-based; and
  • clinical, which incorporated hospital ward and outpatient-based experiences.

Current programs integrate both components and incorporate clinical experience during the early years of the course.

Most significant clinical exposure occurs in the last two years for graduate entry programs, or the last three or four years for undergraduate entry programs of five or six year's duration.

Medical students are usually attached to a number of clinical teams, mostly in hospital settings. The student is part of the team and, under instruction from interns and registrars, learns in an apprenticeship manner how to undertake a range of clinical tasks. This approach aims to develop their clinical skills to a level that is appropriate for commencing prevocational training as an intern.

Current Data

In 2009, there were 14,521 medical students studying in Australian universities (Table 2.1). Of these, 5,306 (36.5%) were undertaking a six-year course, 3,926 (27.0%) were undertaking a five-year course and 5,289 (36.4%) were undertaking a four-year course.

Table 2.1: Medical students in Australian universities, 2009
Year 1Year 2Year 3Year 4Year 5Year 6Total

UG - undergraduate
PG - postgraduate

(a) UG last intake in 2008, current gradtuate program intake in 2009. Graduate entry in graduate program from 2011.
(b) Tasmania's six-year course last intake in 2005. Five-year course first intake in 2006.
(c) These courses are less than 5 years in duration - Bond 4.8 years, Melbourne PG 4.5 years and UWA PG 4.7 years.

Source: Medical Deans Australia and New Zealand

6-year course
Adelaide
179
166
145
122
138
123
873
James Cook
180
166
100
91
103
84
724
Melbourne UG(a)
-
248
224
221
220
213
1,126
UNSW
277
269
258
240
218
209
1,471
Tasmania(b)
-
-
-
-
53
96
149
UWA UG
173
144
124
152
187
183
963
Subtotal
809
993
851
826
919
908
5,306
5-year course
Bond(c)
91
83
80
75
59
388
Melbourne PG(a)(c)
85
77
107
87
83
439
Monash UG
301
294
295
279
233
1,402
Newcastle/UNE
196
192
105
127
107
727
Tasmania(b)
124
127
103
55
..
409
UWA PG(c)
64
58
60
33
15
230
UWS
133
110
88
..
..
331
Subtotal
994
941
838
656
497
3,926
4-year course
ANU
94
82
91
78
345
Deakin
136
112
..
..
248
Flinders
144
132
120
102
498
Griffith
156
142
149
119
566
Monash PG
73
57
..
..
130
Notre Dame Sydney
113
107
..
..
220
Notre Dame WA
109
106
90
80
385
Queensland
429
384
411
347
1,571
Sydney
299
261
264
261
1,085
Wollongong
86
81
74
..
241
Subtotal
1,639
1,464
1,199
987
5,289
Total
3,442
3,398
2,888
2,469
1,416
908
14,521

In 2009, 12,097 or 83.3% of all students were domestic students (Table 2.2). Of these, 4,230 (35.0%) were undertaking a six-year course, 3,268 (27.0%) were undertaking a five-year course and 4,599 (38.0%) were undertaking a four-year course.

Table 2.2: Domestic medical students in Australian universities, 2009
Year 1Year 2Year 3Year 4Year 5Year 6Total

UG - undergraduate
PG - postgraduate

(a) UG last intake in 2008, current gradtuate program intake in 2009. Graduate entry in graduate program from 2011.
(b) Tasmania's six-year course last intake in 2005. Five-year course first intake in 2006.
(c) These courses are less than 5 years in duration - Bond 4.8 years, Melbourne PG 4.5 years and UWA PG 4.7 years.

Source: Medical Deans Australia and New Zealand

6 year course
Adelaide
155
145
125
98
97
85
705
James Cook
162
162
96
88
100
82
690
Melbourne UG(a)
-
172
150
148
143
132
745
UNSW
210
209
206
200
162
169
1,156
Tasmania(b)
41
75
116
UWA UG
145
115
105
126
159
168
818
Subtotal
672
803
682
660
702
711
4,230
5 year course
Bond(c)
83
79
80
73
55
370
Melbourne PG(c)
79
72
88
69
68
376
Monash UG
247
228
221
182
159
1,037
Newcastle/UNE
172
166
80
104
85
607
Tasmania
99
109
81
47
..
336
UWA PG(c)
64
58
60
33
15
230
UWS
118
106
88
..
..
312
Subtotal
862
818
698
508
382
3,268
4 year course
ANU
86
78
85
72
321
Deakin
134
112
..
..
246
Flinders
125
114
106
74
419
Griffith
156
142
149
117
564
Monash PG
67
52
..
..
119
Notre Dame Sydney
113
107
..
..
220
Notre Dame WA
109
106
90
80
385
Queensland
306
300
328
272
1,206
Sydney
251
222
228
206
907
Wollongong
74
70
68
..
212
Subtotal
1,421
1,303
1,054
821
4,599
Total
2,955
2,924
2,434
1,989
1,084
711
12,097

Types of Student Places

A student undertaking medical studies in Australia may occupy either a full fee-paying undergraduate place, funded entirely through the tuition fees paid by the student, or a Commonwealth-supported university place where, through the Higher Education Contribution Scheme (HECS), the student is required to pay for only part of the cost of his or her degree.

Some medical students occupying Commonwealth-supported university places are participating in the Bonded Medical Places Scheme (BMPS) or have received scholarships through the Medical Rural Bonded Scholarship Scheme (MRBSS).

Students participating in the BMPS have a return of service obligation to work in an Area of Workforce Shortage, identified by the Commonwealth, for a period of time equal to the length of the medical degree. However, up to half the return of service obligation can be met while completing prevocational training and vocational training.

Recipients of the MRBSS scholarship are required to work for six continuous years in a rural or remote area of Australia. MRBSS doctors start their six-year commitment to work in rural Australia after completing their vocational training.

In 2009, three quarters of students (75.3%) were in Commonwealth Supported Places (Table 2.3). From 2009, new full fee-paying domestic undergraduate medical places were no longer available.

Table 2.3: Medical students by type of student place: Number and proportion of places, 2005-2009
20052006200720082009

(a) ANU offers their research component part time in exceptional circumstances.
(b) Other includes medical students on state health department bonded medical scholarships.

Source: Medical Deans Australia and New Zealand.

Number
Commonwealth supported
HECS(a)
6,983
7,144
7,317
7,642
8,177.5
BMPS
434
688
1,212
1,747
2,279
MRBSS
452
486
488
489
481.5
Fee paying
Domestic
160
415
678
932
949
International
1,919
2,081
2,153
2,309
2,424
Other(b)
na
35
101
218
210
Total
9,948
10,849
11,949
13,337
14,521
Proportion of places (%)
Commonwealth supported
HECS(a)
70.2
65.9
61.2
57.3
56.3
BMPS
4.4
6.3
10.1
13.1
15.7
MRBSS
4.5
4.5
4.1
3.7
3.3
Fee paying
Domestic
1.6
3.8
5.7
7.0
6.5
International
19.3
19.2
18
17.3
16.7
Other(b)
na
0.3
0.9
1.6
1.4
Total
100.0
100.0
100.0
100.0
100.0

In 2009, 8,178 students were in Higher Education Contribution Scheme (HECS) places. This was an increase of 1,195 (17.1%) places in total from 2005. However, HECS places significantly decreased as a proportion of all places from 70.2% in 2005 to 56.3% in 2009.

In 2009, there were 2,279 students in BMPS places, an increase of 1,845 (425.1%) from 2005, when there were only 434 students in BMPS places. The proportion of students in BMPS places also increased significantly between 2005 and 2009 from 4.4% to 15.7% of all places.

Over this same period, the proportion of students in MRBSS places decreased from 4.5% in 2005 to 3.3% in 2009.

Since full fee-paying positions were first made available to Australian students in 2005, the proportion of fee-paying domestic students has risen from 1.6% to 6.5% in 2009.The number of fee-paying international students decreased from 19.3% in 2005 to 16.7% in 2009.

Rural Exposure

Exposure to rural and remote settings, whether through living, being schooled and/or undertaking medical studies or training there, is considered to have a positive impact on the likelihood of medical professionals practising in rural and remote areas.

Data on students who have a rural background is collected by medical schools. In 2009, 20.7% of first-year domestic students reported that they had lived in a rural or remote area prior to commencing their medical studies (Table 2.4).

Table 2.4: First-year domestic students with a rural background(a), 2009
MalesFemalesTotalProportion domestic students (%)

UG - undergraduate

(a) Based on RRMA classification in which RRMAs 3-7 are categorised as rural and remote regions.

Source: Medical Deans Australia and New Zealand

Adelaide
6
5
11
7.1
ANU
7
9
16
18.6
Bond
na
na
na
na
Deakin
17
16
33
24.6
Flinders
12
23
35
28.0
Griffith
13
14
27
17.3
James Cook
18
38
56
34.6
Melbourne PG entry
5
13
18
22.8
Monash PG
6
13
19
28.4
Monash UG
30
31
61
24.7
Newcastle/UNE
21
42
63
36.6
Notre Dame Sydney
na
na
21
18.6
Notre Dame WA
na
na
32
29.4
UNSW
17
34
51
24.3
Queensland
23
21
44
14.4
Sydney
12
10
22
8.8
Tasmania
11
12
23
23.2
UWA PG
7
6
13
20.3
UWA UG
16
25
41
28.3
UWS
1
1
2
1.7
Wollongong
10
14
24
32.4
Total
232
327
612
20.7

No other data is currently available and the MTRP has identified this as an area in which it hopes to improve data in future years.

Trends

Between 2005 and 2009, the total number of first-year medical students increased by 47.7% (Table 2.5).

Over this same period, domestic first-year student numbers increased by 1,084 (57.9%), whilst international first-year student numbers increased by just 27 (5.9%).

The proportion of females in first-year medical studies has remained relatively stable over the last five years (Table 2.5).

Table 2.5: First-year medical students: Domestic and international and proportion of females(a), 2005-2009
20052006200720082009

(a) Based on commencing year of graduate course.
(b) International students are those studying as private or sponsored students who are not Australian citizens, permanent residents or New Zealand citizens.

Source: Medical Deans Australia and New Zealand.

Domestic
1,871
2,071
2,560
2,934
2,955
Proportion females (%)
55.2
55.1
54.4
54.0
54.8
International(b)
460
426
436.0
499
487
Proportion females (%)
57.2
53.1
49.8
50.9
47.0
Total
2,331
2,497
2,996
3,433
3,442

Between 2005 and 2009, there was an increase of 4,586 (46.2%) in the overall number of medical students studying in Australian universities (Table 2.6). Over this same period, the total number of domestic students increased by 4,071 (50.7%).

Table 2.6: Medical students: Domestic, international and proportions of females(a), 2005-2009
20052006200720082009

(a) Data covers all years of study.
(b) International students are those studying as private or sponsored students who are not Australian citizens, permanent residents or New Zealand citizens.

Source: Medical Deans Australia and New Zealand.

Domestic
8,026
8,768
9,796
11,028
12,097
Proportion female(%)
55.2
55.7
55.8
55.3
54.6
International(b)
1,909
2,081
2,153
2,309
2,424
Proportion females(%)
53.4
53.9
52.3
52.5
51.4
Total
9,935
10,849
11,949
13,337
14,521