Medical Training Review Panel: fifteenth report

Medical Students

Page last updated: 15 March 2012

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 in Australia.

A number of these schools were established in the last five years. The first graduates emerged from Bond University in 2009. The University of Wollongong and University of Western Sydney (UWS) commenced teaching in 2007 and their first medical students graduated in 2010 and 2011 respectively. Medical students first commenced at Deakin University and the Sydney campus of Notre Dame University in 2008 and the first students graduated in 2011.

In the past most medical doctors gained their graduate qualification by completing a six-year Bachelor of Medicine and Bachelor of Surgery (MBBS). However, over the years an increasing number of five-year and four-year (graduate entry) programs have been introduced.

All these medical school programs result in a bachelor degree qualification, with the exception of the new Doctor of Medicine (MD) program, which leads to a masters level qualification.

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 from early in the course. Most significant clinical exposure, however, occurs in the last two years for graduate entry programs, or the last three and four years for undergraduate entry programs of five and six year’s duration respectively.

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 the student’s clinical skills to a level that is appropriate for commencing prevocational training as an intern.

Current Data

In 2011, there were 16,491 medical students studying in Australian universities (Table 2.1). Of these, 5,149 (31.2%) were undertaking a six-year course, 4,564 (27.7%) were undertaking a five-year course and 6,778 (41.1%) were undertaking a four-year course.

Table 2.1: Medical students in Australian universities, 2011

UG – undergraduate
PG – postgraduate
MD – Doctor of Medicine

(a) Undergraduate last intake in 2008. Current graduate program last intake in 2009. New graduate entry in masters program in 2011.
(b) These courses are slightly less than 5 years in duration - Bond 4.8 years, Melbourne PG 4.5 years and UWA PG 4.7 years.
(c) From 2009, Queensland data includes the Ochsner (USA) cohort (16 in 2009 and 36 in each of 2010 and 2011). This cohort is a 2+2 program with clinical training occurring in the USA. First graduates will be in 2012.

Source: Medical Deans Australia and New Zealand Inc

Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Total
6-year course
Adelaide
190
188
158
165
153
117
971
James Cook
195
220
163
150
99
90
917
Melbourne UG(a)
0
0
4
245
230
219
698
UNSW
275
271
281
279
264
233
1,603
UWA UG
171
166
171
151
138
163
960
Subtotal
831
845
777
990
884
822
5,149
5-year course
Bond(b)
87
83
87
73
82
412
Melbourne PG(a)(b)
0
0
95
84
105
284
Monash UG
305
310
301
341
242
1,499
Newcastle/UNE
198
216
202
192
90
898
Tasmania
121
123
122
123
96
585
UWA PG(b)
65
61
62
61
56
305
UWS
122
139
130
104
86
581
Subtotal
898
932
999
978
757
4,564
4-year course
ANU
94
94
100
79
367
Deakin
132
145
133
111
521
Flinders
167
125
142
129
563
Griffith
154
155
151
133
593
Melbourne MD(a)
331
0
0
0
331
Monash PG
89
80
83
46
298
Notre Dame Sydney
113
106
112
104
435
Notre Dame Fremantle
102
98
109
99
408
Queensland(c)
447
467
452
408
1,774
Sydney
327
282
292
263
1,164
Wollongong
85
83
79
77
324
Subtotal
2,041
1,635
1,653
1,449
6,778
Total
3,770
3,412
3,429
3,417
1,641
822
16,491

In 2011, 13,956 or 84.6% of all students were domestic students (Table 2.2). Of these, 4,214 (30.2%) were undertaking a six-year course, 3,910 (28.0%) were undertaking a five-year course and 5,832 (41.8%) were undertaking a four-year course.

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Table 2.2: Domestic medical students in Australian universities, 2011

UG – undergraduate
PG – postgraduate
MD – Doctor of Medicine

(a) Undergraduate last intake in 2008. Current graduate program last intake in 2009. New graduate entry in masters program 2011.
(b) These courses are slightly 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 Inc

Year 1Year 2Year 3Year 4Year 5Year 6Total
6-year course
Adelaide
175
171
137
136
122
95
836
JCU
182
186
142
146
95
88
839
Melbourne UG (a)
-
-
4
167
157
145
473
UNSW
206
210
219
218
213
195
1,261
UWA UG
146
146
145
115
117
136
805
Subtotal
709
713
647
782
704
659
4,214
5-year course
Bond(b)
85
83
86
73
81
408
Melbourne PG(a)(b)
-
-
81
73
88
242
Monash UG
249
258
244
276
175
1,202
Newcastle/UNE
179
187
172
156
70
764
Tasmania
100
99
99
106
68
472
UWA PG (b)
65
61
62
61
56
305
UWS
104
115
117
95
86
517
Subtotal
782
803
861
840
624
3,910
4-year course
ANU
92
92
91
75
350
Deakin
131
139
132
111
513
Flinders
142
113
123
110
488
Griffith
154
155
151
133
593
Melbourne MD(a)
305
0
0
0
305
Monash PG
67
74
76
41
258
Notre Dame Sydney
113
106
112
104
435
Notre Dame Fremantle
102
98
109
99
408
Queensland
305
315
310
298
1,228
Sydney
261
230
247
228
966
Wollongong
78
75
68
67
288
Subtotal
1,750
1,397
1,419
1,266
5,832
Total
3,241
2,913
2,927
2,888
1,328
659
13,956

Types of Student Places

A student undertaking medical studies in Australia may occupy either 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, or a full fee-paying place, funded entirely through the tuition fees paid by the student. In 2009 new full fee-paying places for domestic undergraduate medical students ceased to be available.

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), which commenced in 2004 and 2001 respectively.

Students participating in the BMPS 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. Up to half the return of service obligation, however, can be met while completing prevocational training and vocational training.

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

Three quarters of all places each year are supported by the Commonwealth. In 2011 this was slightly higher with 78.9% or 13,016 places being Commonwealth-supported places (Table 2.3).

The majority of students receiving Commonwealth support (9,435 or 72.5%) received HECS only. One-fifth (20.4%) of students are fee-paying, with three quarters (75.4%) of these coming from overseas.

Table 2.3 provides detailed information on the number and types of places available at each university in 2011.

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Table 2.3: Medical students by type of student place and university, 2011

UG – undergraduate
PG – postgraduate
MD – Doctor of Medicine

(a) Other includes medical students on state health department bonded medical scholarships.

Source: Medical Deans Australia and New Zealand Inc

Commonwealth
supported places
Fee Paying
Other(a)Total
DomesticInternational
Adelaide
830
6
135
0
971
ANU
350
0
17
0
367
Bond
0
408
4
0
412
Deakin
513
0
8
0
521
Flinders
436
7
75
45
563
Griffith
589
1
0
3
593
JCU
839
0
78
0
917
Melbourne MD
255
50
26
0
331
Melbourne PG
237
5
42
0
284
Melbourne UG
448
25
225
0
698
Monash PG
258
0
40
0
298
Monash UG
1,125
16
297
61
1,499
Newcastle/UNE
758
6
134
0
898
Notre Dame Sydney
299
136
0
0
435
Notre Dame Fremantle
370
38
0
0
408
Queensland
1,194
34
546
0
1,774
Sydney
920
44
198
2
1,164
Tasmania
472
0
113
0
585
UNSW
1,214
47
342
0
1,603
UWA PG
305
0
0
0
305
UWA UG
805
0
155
0
960
Western Sydney
511
6
64
0
581
Wollongong
288
0
36
0
324
Total
13,016
829
2,535
111
16,491

In 2011, seven years after the commencement of the scheme, there were 3,122 students in Bonded Medical Places Scheme places. This was 436 more students than in 2010, an increase of 1.5% but one and a half times (an increase of 57.6%) the number supported through this scheme in 2007 (Table 2.4).

In contrast, the number of students in the Medical Rural Bonded Scholarship Scheme remained relatively constant at between 480 and 490 from 2007 to 2010, decreasing slightly to 459 students in 2011. The number as a proportion of all student places, however, decreased significantly from 4.1% in 2007 to 2.8% in 2011.

Full fee-paying positions were first made available to Australian students in 2005 and ceased to be available for commencing undergraduate students at public universities from 2009. The proportion of domestic fee-paying students rose from 5.7% in 2007 to a peak of 7.0% of all students in 2008 and then down to 5.0% in 2011. Whereas the proportion of international fee-paying students decreased each year, ranging from 18.0% in 2007 to 15.4% of all medical students in 2011.

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Table 2.4: Medical students by type of student place: Number and proportion of places, 2007–2011

(a) ANU offers their research component part time in exceptional circumstances.
(b) International students are those studying as private or sponsored students who are not Australian citizens, permanent residents or New Zealand citizens.
(c) Other includes medical students on state health department bonded medical scholarships.

Source: Medical Deans Australia and New Zealand Inc

2007 2008 2009 2010 2011
Medical students
Commonwealth supported
9,017
9,878
10,938
(d)11,873
13,016
HECS only
7,317
7,642
(a)8,177.5
8,707
9,435
BMPS
1,212
1,747
2,279
2,686
3,122
MRBSS
488
489
(a)481.5
480
459
Fee-paying
2,831
3,241
3,373
3,356
3,364
Domestic
678
932
949
905
829
International(b)
2,153
2,309
2,424
2,451
2,535
Other(c)
101
218
210
231
111
Total
11,949
13,337
14,521
15,460
16,491
Proportion of places (%)
Commonwealth supported
75.4
74.1
75.3
76.8
78.9
HECS only
61.2
57.3
56.3
56.3
57.2
BMPS
10.1
13.1
15.7
17.4
18.9
MRBSS
4.1
3.7
3.3
3.1
2.8
Fee paying
23.7
24.3
23.2
21.7
20.4
Domestic
5.7
7
6.5
5.9
5.0
International(b)
18
17.3
16.7
15.9
15.4
Other(c)
0.8
1.6
1.4
1.5
0.7
Total
100.0
100.0
100.0
100.0
100.0

Scholarships

Students can receive scholarships through a variety of sources. Data was collected through the Medical Schools Outcomes Database (MSOD) Project from 3,115 medical students (82.6% of the total 3,770) commencing their studies in 2010. Of these, 435 (14%) stated that they received a scholarship to support them in their medical studies (Table 2.5).

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Table 2.5: Commencing medical students source of scholarships, 2010

Source: Medical Schools Outcomes Database

StudentsProportion (%)
Commonwealth scholarships
145
33.3
State scholarships
49
11.3
Scholarships provided by Australian universities
146
33.6
Scholarships provided by home country to international students
64
14.7
Scholarships provided by other institutions
21
4.8
Unknown
10
2.3
Total
435
100.0

Student Characteristics

Data from the MSOD provides insights into who is undertaking medical studies. Data is recorded for the 3,115 who completed the MSOD entry questionnaire in 2010.

Four-fifths (82.6%) of students commencing their medical studies in 2010 were under the age of 25 years (Table 2.6).

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Table 2.6: Commencing medical students by sex and age, 2010

Source: Medical Schools Outcomes Database

Age group Male Female Proportion
female (%)
Total Proportion
of total (%)
Less than 20 years
628
760
54.8
1,388
44.6
20-24 years
604
581
49.0
1,185
38.0
25-29 years
184
167
47.6
351
11.3
30-34 years
69
44
38.9
113
3.6
35-39 years
25
18
41.9
43
1.4
40 years and over
15
20
57.1
35
1.1
Total
1,525
1,590
51.0
3,115
100.0

Half (52.1%) of the medical students commencing in 2010 began their studies after finishing another degree, with 82.2%% of these having completed a tertiary degree in science, medical science and health and/or allied health (Table 2.7). Three quarters (73.6%) had bachelor degrees, 17.7% had completed honours or a graduate diploma or certificate and 9.4% of these students had a masters or doctorate (Table 2.8). The majority (93.3%) of these students entered a graduate program.

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Table 2.7: Commencing medical students discipline of highest tertiary qualification completed, 2010

(a) B.Sci; B Applied Sci (no or unclear major); Vet Sci; Liberal Arts; B Sci in Human Movement; biotechnology; human kinetics; exercise science; psychology.
(b) B.Sci; B Applied Sci (no or unclear major); Vet Sci; Liberal Arts; B Sci in Human Movement; biotechnology; human kinetics; exercise science; psychology.
(c) Radiography; nursing; optometry; podiatry; speech pathology; orthodontics; nutrition; public health and tropical medicine; occupational therapy; kinesiology; naturopathy; pharmacy; physiotherapy; dentistry; dental surgery; oral health; prosthetics and orthotics.
(d) B Eng; B Computer Science; architecture; urban planning, electronics; surveying; IT; mathematics

Source: Medical Schools Outcomes Database

Discipline of prior degreeUndergraduate entryGraduate entryTotal
Science(a)
28
612
640
Medical Science(b)
24
354
378
Health/Allied Health(c)
19
296
315
Humanities
7
96
103
Commerce/Business/Law
14
65
79
Physical sciences(d)
4
32
36
Other/Unknown
12
59
71
Total
108
1,514
1,622

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Table 2.8: Commencing medical students level of highest prior tertiary qualification by medical degree entry program(a), 2010

(a) Based on all individuals who reported previous qualifications.

Source: Medical Schools Outcomes Database

Level of prior degree Undergraduate entry Proportion undergraduate (%) Graduate entry Proportion postgraduate (%) Total
PhD
3
2.8
47
3.1
50
Masters
18
16.7
84
5.5
102
Graduate Diploma/Certificate
17
15.7
67
4.4
84
Honours
9
8.3
202
13.3
211
Bachelor
61
56.5
1,114
73.6
1,175
Total
108
100.0
1,514
100.0
1,622

In 2010 a total of 459 of the 3,115 medical students completing the MSOD entry questionnaire reported that they held temporary or other entry permits to Australia (Table 2.9). The highest numbers of international students came from Singapore (24.0%), Malaysia (20.9%) and Canada (19.8%).

Table 2.9: International commencing medical students holding temporary or ‘other’ entry permits by place of birth, 2010

(a) Based on all individuals who reported previous qualifications.

Source: Medical Schools Outcomes Database

Country of birth Students Proportion %)
Singapore
110
24.0
Malaysia
96
20.9
Canada
91
19.8
USA
35
7.6
Korea, Republic of (South)
21
4.6
Hong Kong (SAR of China)
18
3.9
India
12
2.6
China (excludes SARs and Taiwan Province)
11
2.4
All other (where n≤10)
65
14.2
Total
459
100.0

Aboriginal and/or Torres Strait Islander Students

Data on the Aboriginal and/or Torres Strait Islander status of medical students are available from two sources, Medical Deans Student Statistical Collection and the MSOD. Data from these two sources cannot be reconciled, so both are presented below as each provides different insights into the numbers of Aboriginal and/or Torres Strait Islanders studying medicine.

The number and proportion of medical students reporting that they are of Aboriginal and/or Torres Strait Islander origin when completing the MSOD entry questionnaire have risen slightly over the years from 34 or 1.3% of commencing students in 2007 to 47 or 1.5% in 2010 (Table 2.10).

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Table 2.10: Commencing medical students by Aboriginal and/or Torres Strait Islander status, 2010

Source: Medical Schools Outcomes Database

2007200820092010
Aboriginal and/or Torres Strait Islander students
34
37
38
47
Non Indigenous students
2,649
3,180
3,113
3,064
Unknown
14
18
10
4
Total
2,697
3,235
3,161
3,115
Proportion Indigenous (%)
1.3
1.2
1.2
1.5

Data from Medical Deans, shows that there have been significant increases each year in the overall numbers of Aboriginal and/or Torres Strait Islanders studying medicine. In 2011 there were a total of 218 medical students studying in Australian universities who reported being of Aboriginal and/or Torres Strait Islander origin (Table 2.11), an increase of 120.2% over the six years from 2006. These data suggest better retention of students in recent years. No actual data are available on the actual attrition rate, which is known to be dramatically higher than for non-Indigenous students, or on the numbers of Aboriginal and/or Torres Strait Islander students who go on to complete their medical degrees.

Table 2.11: Aboriginal and/or Torres Strait Islander medical students studying in Australian universities, 2006-2011

Source: Medical Deans Australia and New Zealand Inc

200620072008200920102011
Aboriginal and/or Torres Strait Islander students
99
125
129
137
161
218
Annual increase (%)
26.3
3.2
6.2
17.5
35.4

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 are collected by medical schools. In 2011, 765 or 23.6% of commencing domestic students reported that they had lived in a rural or remote area prior to commencing their medical studies (Table 2.12).

The proportion of domestic students with a rural background was roughly one quarter in each state and the Australian Capital Territory.

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Table 2.12: Commencing domestic medical students with a rural background(a) by state/territory, 2011

UG – undergraduate
PG – postgraduate
MD – Doctor of Medicine

(a) Based on Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA) classification in which Remoteness Areas 2 to 5 from the commencement of primary school are categorised as rural and remote areas.
(b) Rurality is not collected by this school.
(c) Data reported from Rural, Remote and Metropolitan Areas (RRMA) 3–7 (not consistent with other schools).

Source: Medical Deans Australia and New Zealand Inc

MalesFemalesTotalProportion domestic students (%)
New South Wales
Newcastle/UNE
32
31
63
35.2
Notre Dame Sydney
5
14
19
16.8
Sydney
20
17
37
14.2
UNSW (c )
20
33
53
25.7
UWS
3
0
3
..
Wollongong
25
21
46
59.0
Total NSW
105
116
221
23.5
Victoria
Deakin
17
24
41
31.3
Melbourne MD
13
17
30
21.1
Monash PG
12
10
22
32.8
Monash UG
25
43
68
27.3
Total Vic
67
94
161
21.4
Queensland
Bond (b)
na
na
na
na
Griffith
11
9
20
13.0
Queensland
24
11
35
11.5
James Cook
43
76
119
65.4
Total Qld
78
96
174
24.0
Western Australia
Notre Dame WA
11
15
26
25.5
UWA PG
7
11
18
27.7
UWA UG
15
21
36
24.7
Total WA
33
47
80
25.6
South Australia
Adelaide
9
6
15
8.6
Flinders
28
37
65
45.8
Total SA
37
43
80
25.2
Tasmania
Tasmania
10
18
28
28.0
Australian Capital Territory
ANU
11
10
21
22.8
Total
341
424
765
23.6

Trends

The number of commencing medical students has increased each year, rising by 25.8% overall from 2,996 in 2007 to 3,770 in 2011 (Table 2.13).

Over this same period, domestic commencing student numbers increased by 681 students or 26.6%, while international commencing student numbers increased relatively less by 93 students or 21.3%.

The proportion of female domestic students commencing medical studies has remained relatively stable over the last five years at just above half of all commencing medical students. Whereas the proportion of female international students was slightly less than half each year.

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Table 2.13: Commencing medical students: Domestic and international and proportion of females(a), 2007–2011

(a) Based on the commencing year of the 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 Inc

20072008200920102011
Domestic
2,560
2,934
2,955
2,940
3,241
Proportion female (%)
54.4
54.0
54.8
52.9
50.9
International(b)
436
499
487
529
529
Proportion female (%)
49.8
50.9
47.0
42.5
47.6
Total
2,996
3,433
3,442
3,469
3,770

Projections suggest that 3,645 medical students will commence their studies in Australian universities in 2012 (Table 2.14). Of these, 3,045 (83.5 %) are expected to be domestic students and 600 (16.5 %) international students. This is slightly less (by 125 medical students or 3.3%) than the actual number who commenced studies in 2011.

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Table 2.14: Commencing medical student projections(a), 2012

(a) These numbers are projections only and are subject to change.
(b) UWA will have no intake into its undergraduate program in 2012. Figures show postgraduate intake only.

Source: Medical Deans Australia and New Zealand Inc

UniversityDomesticInternational
Adelaide
145
25
ANU
95
10
Bond
85
0
Deakin
132
8
Flinders
135
25
Griffith
155
2
James Cook
185
15
Melbourne
305
30
Monash
325
71
Newcastle/UNE
170
24
Notre Dame Sydney
114
0
Notre Dame Fremantle
102
0
Queensland
325
190
Sydney
230
75
Tasmania
100
20
UNSW
208
68
UWA(b)
60
8
Western Sydney
100
17
Wollongong
74
12
Total
3,045
600

Between 2007 and 2011, there was an increase of 4,542 or 38.0% in the overall number of medical students studying in Australian universities (Table 2.15). Over this same period, the number of domestic students increased proportionally more than the number of international students, rising by 42.5% to 13,956 students in comparison with a 17.7% increase in international students to 2,535 international students in 2011.

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Table 2.15: Medical students: Domestic, international and proportions of females(a), 2007–2011

(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 Inc

20072008200920102011
Domestic
9,796
11,028
12,097
12,946
13,956
Proportion female (%)
55.8
55.3
54.6
54.2
53.0
Annual increase (%)
12.6
9.7
7.0
7.8
International(b)
2,153
2,309
2,424
2,451
2,535
Proportion female (%)
52.3
52.5
51.4
50.1
49.1
Annual increase (%)
7.2
5.0
1.1
3.4
Total
11,949
13,337
14,521
15,397
16,491
Annual increase
1,388
1,184
876
1,094
Annual increase (%)
11.6
8.9
6.0
7.1