Medical Training Review Panel: sixteenth report

Medical Students

Page last updated: 09 April 2013

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, and a number of these were established in the last eight years. Most of these universities have now produced graduates, except the University of Melbourne’s Doctor of Medicine (MD) program which commenced in 2011, and is expected to have the first cohort of graduates in 2014.

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 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. However, the most significant clinical exposure occurs in the last two years for graduate entry programs, and in the last three and four years for undergraduate entry programs of five and six years 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 2012, there were 16,868 medical students studying in Australian universities (Table 2.1). Of these 4,927 (29.2%) were undertaking a six-year course, 4,583 (27.2%) were undertaking a five-year course and 7,358 (43.6%) were undertaking a four-year course.(a)

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Table 2.1: Medical students in Australian universities, 2012

UG – undergraduate
PG – postgraduate
MD – Doctor of Medicine

(a) Undergraduate program last intake in 2008. Graduate program last intake in 2009. Masters program commenced 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) The University of Queensland (UQ) has partnered with the Ochsner Health System in New Orleans to establish the University of Queensland-Ochsner Medical Program. This is a unique joint affiliation that provides US medical students with training experience and a global medical education. Students complete the first two years in Australia at UQ, and the final two years in the US, where they complete the clinical component at Ochsner in Louisiana. First graduates will be in 2012. These students have been separated from the UQ students as they do not form part of the medical workforce supply from a planning perspective, but have been included to maintain the trend analysis, as they have been included since 2009.

Source: Medical Deans Australia and New Zealand Inc

Year 1Year 2Year 3Year 4Year 5Year 6Total
6-year course
Adelaide2081761791871581361,044
James Cook192193204 16314598995
Melbourne UG(a)0000246232478
UNSW2632732822902572511,616
UWA UG0170174173156121794
Subtotal6638128398139628384,927
5-year course
Bond(b)9587838773-425
Melbourne PG(a)(b)0019383-177
Monash UG316300300289278-1,483
Newcastle/UNE204193221197175-990
Tasmania116110119123117-585
UWA PG(b)6962606162-314
UWS126125131127100-609
Subtotal926877915 977888-4,583
4-year course
ANU889598 97--378
Deakin139128142128--537
Flinders166149132132--579
Griffith154156154150--614
Melbourne MD(a)32832800--656
Monash PG87898082--338
Notre Dame Sydney115111106108--440
Notre Dame Fremantle1069597104--402
Queensland(c)444412452427--1,735
UQ Ochsner (USA)(c)83303112--156
Sydney302322281290--1,195
Wollongong85858078--328
Subtotal2,0972,0001,6531,608--7,358
Total3,6863,6893,4073,3981,85083816,868

In 2012, there were 14,177 or 84.0% of all students who were domestic students (Table 2.2). Of these 4,032 (28.4%) were undertaking a six-year course, 3,942 (27.8%) were undertaking a five-year course and 6,203 (43.8%) were undertaking a four-year course.

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Table 2.2: Domestic medical students in Australian universities, 2012

UG – undergraduate
PG – postgraduate
MD – Doctor of MedicineMD – Doctor of Medicine

(a) Undergraduate program last intake in 2008. Graduate program last intake in 2009. Masters program commenced 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.

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
178
160
163
151
129
111
892
James Cook
166
175
172
142
141
94
890
Melbourne UG(a)
-
-
-
-
171
159
330
UNSW
199
204
224
235
198
204
1,264
UWA UG
-
144
148
142
122
100
656
Subtotal
543
683
707
670
761
668
4,032
5-year course
Bond(b)
95
85
83
86
73
-
422
Melbourne PG(a)(b)
-
-
1
79
73
-
153
Monash UG
253
248
249
232
218
-
1,200
Newcastle/UNE
183
173
182
169
144
-
851
Tasmania
94
96
94
103
100
-
487
UWA PG(b)
60
62
60
61
62
-
305
UWS
103
110
106
114
91
-
524
Subtotal
788
774
775
844
761
-
3,942
4-year course
ANU
85
93
90
88
-
-
356
Deakin
130
127
136
127
-
-
520
Flinders
147
126
120
113
-
-
506
Griffith
154
156
154
150
-
-
614
Melbourne MD(a)
290
304
0
0
-
-
594
Monash PG
77
67
74
76
-
-
294
Notre Dame Sydney
115
111
106
108
-
-
440
Notre Dame Fremantle
106
95
97
104
-
-
402
Queensland
302
308
313
302
-
-
1,225
Sydney
223
259
231
247
-
-
960
Wollongong
75
78
72
67
-
-
292
Subtotal
1,704
1,724
1,393
1,382
-
-
6,203
Total
3,035
3,181
2,875
2,896
1,522
668
14,177

Types of Student Places

A student undertaking medical studies in Australia may occupy either:

  • a Commonwealth-supported university place, where, the student is required to pay for only part of the cost of his or her degree through the Higher Education Contribution Scheme (HECS); or
  • a full fee-paying place, which is funded entirely by the tuition fees paid by the student. In 2009 new full fee-paying undergraduate 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. However, up to half of the return of service obligation can be met while completing prevocational 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.

Over three quarters of all university places each year are Commonwealth-supported. In 2012, there were 13,289 Commonwealth-supported places or 78.8% of all places (Table 2.3).

The majority of Commonwealth-supported students occupy HECS only places (9,538 places or 71.8% of Commonwealth-supported places), whereas 3,574 or 28.2% of Commonwealth-supported students have a return of service obligation under either the MRBSS or BMPS, in addition to contributing to the cost of their education under HECS (Table 2.4).

Just over one-fifth (20.7%) of all medical students were fee-paying, with 77.1% of these coming from overseas.

Table 2.3 provides detailed information on the number and types of places available at each university in 2012. Table 2.4 provides further information on whether it was a Commonwealth-supported or fee-paying place.

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Table 2.3: Medical students by type of student place and university, 2012

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 placesOther(a)Total
DomesticInternational
Adelaide
886
6
152
0
1,044
ANU
356
0
22
0
378
Bond
0
422
3
0
425
Deakin
520
0
17
0
537
Flinders
446
0
73
60
579
Griffith
609
0
0
5
614
James Cook
890
0
105
0
995
Melbourne MD
505
89
62
0
656
Melbourne PG
130
2
24
21
177
Melbourne UG
317
13
148
0
478
Monash PG
294
0
44
0
338
Monash UG
1,191
9
283
0
1,483
Newcastle/UNE
847
4
139
0
990
Notre Dame Sydney
280
160
0
0
440
Notre Dame Fremantle
400
2
0
0
402
Queensland
1,203
22
510
0
1,891
UQ Ochsner (USA)
-
-
156
-
-
Sydney
937
22
235
1
1,195
Tasmania
487
0
98
0
585
UNSW
1,219
45
352
0
1,616
UWA PG
305
0
9
0
314
UWA UG
656
0
138
0
794
UWS
519
5
85
0
609
Wollongong
292
0
36
0
328
Total
13,289
801
2,691
87
16,868

In 2012, nine years after the commencement of the BMPS, there were 3,282 students in BMPS places. This was 160 more students than in 2011, an increase of 5.1%. However, from 2008 to 2012 the number of students supported through this scheme had increased by 1,535 places or 87.9% (Table 2.4).

In contrast, the number of students in the MRBSS remained relatively constant. This ranged between 489 students in 2008 and 459 students in 2011, and slightly increased to 469 students in 2012. However, the number of MRBSS students as a proportion of all student places decreased from 3.7% in 2008 to 2.8% in 2012, while the number of BMPS students as a proportion of all students increased from 13.1% in 2008 to 19.5% in 2012. Nevertheless, the proportion of MRBSS students to the total student places remained constant between 2011 and 2012.

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 University of Melbourne does have a cohort of domestic fee paying students in their new MD program.

The proportion of domestic fee-paying students was at its highest in 2008 at 7.0% of all students, but then continually decreased, reaching 4.7% in 2012. The absolute number of international fee-paying students has increased but the proportion has continually decreased each year, starting at 17.3% in 2008. By 2012, they comprised 16.0% of all medical students.

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Table 2.4: Medical students by type of student place: Number and proportion of places, 2008-2012

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

Source: Medical Deans Australia and New Zealand Inc

20082009201020112012
Medical students
Commonwealth-supported
9,878
10,938
11,873
13,016
13,289
HECS only
7,642
(c)8,177.5
8,707
9,435
9,538
BMPS
1,747
2,279
2,686
3,122
3,282
MRBSS
489
(c)481.5
480
459
469
Fee paying
3,241
3,373
3,356
3,364
3,492
Domestic
932
949
905
829
801
International(a)
2,309
2,424
2,451
2,535
2,691
Other(b)
218
210
231
111
87
Total
13,337
14,521
15,460
16,491
16,868
Proportion of places (%)
Commonwealth-supported
74.1
75.3
76.8
78.9
78.8
HECS only
57.3
56.3
56.3
57.2
56.5
BMPS
13.1
15.7
17.4
18.9
19.5
MRBSS
3.7
3.3
3.1
2.8
2.8
Fee paying
24.3
23.2
21.7
20.4
20.7
Domestic
7.0
6.5
5.9
5.0
4.7
International(a)
17.3
16.7
15.9
15.4
16.0
Other(b)
1.6
1.4
1.5
0.7
0.5
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 3,562 medical students (96.6% of the total 3,686) commencing their studies in 2011. Of these, 422 (11.8%) 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, 2011

Source: Medical Schools Outcomes Database

StudentsProportion (%)
Commonwealth scholarships
132
31.3
State scholarships
8
1.9
Scholarships provided by Australian universities
209
49.5
Scholarships provided by home country to international students
38
9.0
Scholarships provided by other institutions
31
7.3
Unnamed
4
1.0
Total
422
100.0

Student Characteristics

Data from MSOD provides insights into who is undertaking medical studies. Data are recorded for the 3,562 students who completed the MSOD entry requirements in 2011.

Just over four-fifths (81.6%) of students commencing their medical studies in 2011 were under the age of 25 years (Table 2.6).

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Table 2.6: Commencing medical students by sex and age, 2011

Source: Medical Schools Outcomes Database

Age groupMaleFemaleProportion female (%)TotalProportion of total (%)
Less than 20 years
630
790
55.6
1,420
39.9
20-24 years
769
716
48.2
1,485
41.7
25-29 years
241
225
48.3
466
13.1
30-34 years
67
51
43.2
118
3.3
35-39 years
20
13
39.4
33
0.9
40 years and over
22
18
45
40
1.1
Total
1,749
1,813
51
3,562
100.0

Just over half (52.3%) of the medical students commencing in 2011 began their studies after finishing another degree, with 81.9% of these having completed a tertiary qualification in science, medical science and health and/or allied health (Table 2.7).

The majority (94.7%) of these students entered a graduate program. Just over four-fifths (86.8%) had bachelor degrees, 4.4% had completed honours, graduate diploma or certificate and 8.8% of these students had a masters or doctorate (Table 2.8).

Table 2.7: Commencing medical students discipline of highest tertiary qualification completed, 2011

(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. Medical Science; pathology; biochemistry; microbiology; haematology; histopathology; cytology; immunology.
(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)
18
633
651
Medical Science(b)
20
487
507
Health/Allied Health(c)
33
420
453
Humanities
11
142
153
Commerce/Business/Law
8
85
93
Physical sciences(d)
5
73
78
Other/Unknown
9
23
32
Total
104
1,863
1,967

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Table 2.8: Commencing medical students level of highest prior tertiary qualification by medical degree entry program(a), 2011

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

Source: Medical Schools Outcomes Database

Level of prior degreeUndergraduate entryProportion undergraduate (%)
Graduate entry
Proportion postgraduate (%)Total
PhD
0
0.0
26
1.4
26
Masters
16
15.4
138
7.4
154
Graduate Diploma/Certificate
6
5.8
62
3.3
68
Honours
1
1.0
20
1.1
21
Bachelor
70
67.3
1,617
86.8
1,687
Other/Unknown
11
10.6
0
0.0
11
Total
104
100.0
1,863
100.0
1,967

In 2011, a total of 540 of the 3,562 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 (24.8%), Canada (18.5%) and Malaysia (15.2%).

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Table 2.9: International commencing medical students holding temporary or ‘other’ entry permits by place of birth, 2011

Source: Medical Schools Outcomes Database

Country of birth StudentsProportion %)
Singapore
134
24.8
Canada
100
18.5
Malaysia
82
15.2
USA
47
8.7
Korea, Republic of (South)
27
5.0
Hong Kong (SAR of China)
14
2.6
China (excludes SARs and Taiwan)
13
2.4
Indonesia
12
2.2
All other (where n≤10)
111
20.6
Total
540
100.0

Aboriginal and/or Torres Strait Islander Students

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

The number and proportion of medical students reporting that they are Aboriginal and/or Torres Strait Islander people(s)when completing the MSOD entry questionnaire have risen slightly over the years from 34 or 1.3% of commencing students in 2007, to 69 or 1.9% in 2011 (Table 2.10).

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Table 2.10: Commencing medical students by Aboriginal and/or Torres Strait Islander status, 2007-2011

Source: Medical Schools Outcomes Database

2007200820092010 2011
Aboriginal and/or Torres Strait Islander students
34
37
38
47
69
Non Aboriginal and/or Torres Strait Islander students
2,649
3,180
3,113
3,064
3,483
Unknown
14
18
10
4
10
Total
2,697
3,235
3,161
3,115
3,562
Proportion of Aboriginal and/or Torres Strait Islander students (%)
1.3
1.2
1.2
1.5
1.9

Data from the Medical Deans shows that there have been significant increases each year in the overall number of Aboriginal and/or Torres Strait Islander people(s) studying medicine. In 2012, there was a total of 226 medical students studying in Australian universities who reported being of Aboriginal and/or Torres Strait Islander origin (Table 2.11), an increase of 128.3% over the seven years from 2006. These data suggest better retention of students in recent years. No data are available for the actual attrition rate, which is known to be higher than for non Aboriginal and/or Torres Strait Islander students, or on the number of Aboriginal and/or Torres Strait Islander students who go on to complete their medical degrees.

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Table 2.11: Aboriginal and/or Torres Strait Islander medical students studying in Australian universities, 2006-2012

Source: Medical Deans Australia and New Zealand Inc

2006200720082009201020112012
Aboriginal and/or Torres Strait Islander students
99
125
129
137
161
218
226
Annual increase (%)
26.3
3.2
6.2
17.5
35.4
3.67

Rural Exposure

Exposure to rural and remote settings, whether through living, schooling 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 2012, 819 or 27.0% of commencing domestic students reported that they had lived in a rural or remote area prior to commencing their medical studies (Table 2.12). ). In 2011, 23.6% of commencing domestic students reported a rural background.

The proportion of domestic students with a rural background was roughly one quarter in each state and territory.

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Table 2.12: Commencing domestic students with a rural background(a) by state/territory, 2012

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) UNSW data based on Rural, Remote and Metropolitan Areas (RRMA) 3-7.
(c) Rurality is not collected by Bond.

Source: Medical Deans Australia and New Zealand Inc

MalesFemalesTotalProportion domestic students (%)
New South Wales
Newcastle/UNE
55
25
80
43.7
Notre Dame Sydney
11
23
34
29.6
Sydney
30
25
55
24.7
UNSW (b)
23
39
62
31.2
UWS
2
0
2
1.9
Wollongong
26
30
56
74.7
Total NSW
147
142
289
32.2
Victoria
Deakin
17
21
38
29.2
Melbourne MD
27
31
58
20.0
Monash PG
12
16
28
36.4
Monash UG
35
31
66
26.1
Total Vic
91
99
190
25.3
Queensland
Bond(c)
0
0
0
0.0
Griffith
4
3
7
4.5
Queensland
34
31
65
21.5
James Cook
52
59
111
66.9
Total Qld
90
93
183
25.5
Western Australia
Notre Dame WA
11
17
28
26.4
UWA PG
14
2
16
26.7
Total WA
25
19
44
26.5
South Australia
Adelaide
9
9
18
10.1
Flinders
17
25
42
28.6
Total SA
26
34
60
18.5
Tasmania
Tasmania
14
16
30
31.9
Australian Capital Territory
ANU
10
13
23
27.1
Total
403
416
819
27.0

Trends

The number of commencing medical students has increased each year, rising by 7.4% overall, from 3,433 in 2008 to 3,686 in 2012 (Table 2.13).

Over the same period, the number of domestic commencing students increased by 101 students or 3.4%, while the number of international commencing students increased by 152 students or 30.5%.

The proportion of female domestic students commencing medical studies remained relatively stable over the last five years – just above half of all commencing medical students. However, the proportion of female international students was slightly less than half of all commencing international students.

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Table 2.13: Commencing medical students: Domestic and international and proportion of females(a), 2008–2012

(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.
(c) From 2009, data includes the Ochsner (USA) cohort from UQ.

Source: Medical Deans Australia and New Zealand Inc

20082009201020112012
Domestic
2,934
2,955
2,940
3,241
3,035
Proportion female (%)
54.0
54.8
52.9
50.9
48.1
International(b)(c)
499
487
529
529
651
Proportion female (%)
50.9
47.0
42.5
47.6
47.5
Total
3,433
3,442
3,469
3,770
3,686

Projections suggest that 3,639 medical students will commence their studies in Australian universities in 2013 (Table 2.14). Of these 2,912 (80.0%) are expected to be domestic students and 727 (20%) international students. This is slightly less (by 47 students or 1.3%) than the actual number who commenced studies in 2012.

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Table 2.14: Commencing medical student projections(a) (b), 2013

(a) These numbers are projections only and are subject to change.
(b) UWA will have no intake into its undergraduate program in 2013 in preparation for commencing students into their MD program in 2014.

Source: Medical Deans Australia and New Zealand Inc

UniversityDomesticInternationalTotal
Adelaide
134
30
164
ANU
90
10
100
Bond
90
0
90
Deakin
130
10
140
Flinders
142
25
167
Griffith
155
12
167
James Cook
150
30
180
Melbourne
295
40
335
Monash
325
85
410
Newcastle/UNE
170
24
194
Notre Dame Sydney
113
0
113
Notre Dame Fremantle
104
0
104
Queensland
308
143
571
UQ Ochsner (USA)
-
120
-
Sydney
228
80
308
Tasmania
95
20
115
UNSW
208
68
276
UWA
0
0
0
Western Sydney
100
20
120
Wollongong
75
10
85
Total
2,912
727
3,639

Between 2008 and 2012, there was an increase of 3,531 students or 26.5% in the total 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 28.6% to 14,177 students. The number of international students increased by only 16.5% to 2,691.

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Table 2.15: Medical students: Domestic, international and proportion of females(a), 2008-2012

(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.
(c) From 2009, data includes the Ochsner (USA) cohort from UQ (refer to Table 2.1 for more information).

Source: Medical Deans Australia and New Zealand Inc

20082009201020112012
Domestic
11,028
12,097
12,946
13,956
14,177
Proportion female (%)
55.3
54.6
54.2
53.0
51.5
Annual increase (%)
12.6
9.7
7.0
7.8
1.6
International(b)(c)
2,309
2,424
2,451
2,535
2,691
Proportion female (%)
52.5
51.4
50.1
49.1
48.7
Annual increase (%)
7.2
5.0
1.1
3.4
6.2
Total
13,337
14,521
15,397
16,491
16,868
Annual increase
1,184
876
1,094
377
Annual increase (%)
8.9
6.0
7.1
2.3