Bonded Medical School Places – 30 July 2003
Starting in 2004, the Federal Government plans to introduce 234 new bonded medical school places into Australian Universities. The students that sign this contract will have an ordinary medical school place that will attract no scholarship or any other benefit to distinguish them from ordinary places. The difference will be that they will be bonded to work in an Area of Need as designated by the government starting after the completion of all of their training and lasting for six years. This is therefore likely to be 10 to 15 years after signing the contract.If they are unable to fulfil the contract then they will be forced to repay $15000 per year of the contract not worked and possibly face a ban from Medicare for twice that length of time under Section ABA of the Health Insurance Act.
AMACDT and AMSA opposition:
The AMACDT and AMSA oppose conscription of doctors through bonding or any other coercive measure. We believe that this scheme is unfair to those forced into it at such a young age and is inequitable and restrictive for graduates. It is also unworkable and ineffective in the long term.This scheme is unfair to students who may be as young as 17 when they sign this contract. They are unlikely to be able to make informed choices about where they will work in 10 to 15 years in a career they have not yet begun to even train for. This scheme takes advantage of students who fail to meet the ordinary entry criteria and who are likely therefore to be desperate to get into medicine. This shifts the entry criteria away from merit towards a potential student’s level of desperation. It also creates a two-tiered medical system. This is likely to fragment the student body and create disillusioned graduates who will service communities that may therefore not be receiving the best healthcare.The option to “buy out” of the bond means that these positions may attract those students who possess the resources to buy out but who have no intention of working in Areas of Need. Those that do work off their bond in these areas will have built up their personal and professional relationships in the cities and are likely to move back to them after their return of service. We live in a nation with a strong social framework pushing us toward the cities. To push against this urbanisation requires creative thinking, foresight and planning, not reactionary policies directed at the most inexperienced and vulnerable of one profession.
This scheme fails to address any of the reasons behind the medical rural workforce shortage. These include: professional and social isolation, fewer services, poor employment and education opportunities for spouse and family, poor housing, inability to practice due to lack of demand, lack of technology and difficulties gaining access to local hospitals. Programs to attract doctors to these areas need to be incentive driven and take into account the personal, family and professional circumstances of the doctors involved.
Part of Speech by Dr Sally de Zwaan to Australian Doctors Fund (July 2003)
DIT Councillor AMA(NSW)
Mr Stephen Milgate – Australian Doctors Fund
30 July 2003