The Bonded Medical Places scheme was established in 2004. In return for the payment of the student contribution to the HECS fee, participants agreed to work in an area of medical workforce need for a specified period after they completed their Fellowship (which could be 10-15 years after commencing medical school). A 2017 audit found that of nearly 10,000 participants who receive free money from the Government since 2001, less than 1% had actually completed their return of service obligation to work in an area of workforce need. A Senate Inquiry recommended that the program be abolished. The Inquiry noted a submission from Rural and Remote Medical Services (now the Healthy Communities Foundation Australia) citing a previous review of the program in 2013 that many BMP recipients view the program as a “low cost or interest free loan that can relatively easily be repaid once fully qualified”. Ochre Recruitment stated to the Inquiry that some students react with incredulity when asked why they chose to go rural, Hamish Meldrum GP from Ochre Health said: “They laugh at me and say: ‘No. Nobody wants to go rural. We just put down that we want to be rurally bonded students so that we can get into medical school.”
Why is this useful for rural and remote people to read?
The Bonded Medical Places program is a salutary lesson for rural and remote people. Despite evidence over a decade that the Bonded Medical Places program was being exploited and was a failure, successive governments continued to tell rural and remote people it was a solution to rural doctor shortages. The Program was reviewed by Jenny Mason in 2013. Despite the finding by the Mason Review that the program was being used by predominantly city medical students as a ‘low interest loan scheme’, the then government decided to expand (not close) the program. Note: Students were not required to pay interest on the value of the bond they received from the government when they withdrew from the Program, and repayment of the bond often didn’t need to happen for up to 10-15 years after completing medical school when students were working as well-paid doctors. The Mason Review found that only 3 of some 7,000 medical students had actually completed their return of service obligation by 2013. By 2017, another Review found only 1% of 10,00 recipients had completed their obligation. It is a useful reminder that rural and remote people need to be cautious about inflated claims about rural and remote medical workforce programs, and must be ready to actively question governments. Over the last 2 decades the number of rural GPs has fallen dramatically, despite the expenditure of billions of dollars on rural medical workforce programs. Clearly these programs don’t work and never have - if they did, rural and remote towns would have more doctors. Rural and remote people need to hold governments accountable or the nation will continue to spend billions of dollars on programs that we know do not work. The article rightly says that medical students shouldn’t be held accountable for withdrawing from the program because they were not in a real position to make an informed decision when they are 18 years old.
RURAL HEALTH & MEDICAL WORKFORCE
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