[2020 entry and beyond] Guide to Bonded Medical Places

[brownpanda69]

I contacted the Department of Health to ask about specialty training. I am considering specialising in neonatology as an option, however the 4 hospitals that have neonatologists are in metro Melbourne. The Department said I can't undertake this specialty under the scheme.
I'm close to accepting a bonded place anyway - my parents said they'll support me and that I can still start a family and settle and do that kind of stuff. I just don't know what my circumstances will be in the future.

 

[ucatboy]

I am considering specialising in neonatology as an option, however the 4 hospitals that have neonatologists are in metro Melbourne.

You're in year 12 and you're already deciding on a speciality to pursue post-graduation? My advice would be to not let a faraway decision like that affect your immediate decision of accepting a BMP or not - the latter takes precedence over the former.

 

[chinaski]

I contacted the Department of Health to ask about specialty training. I am considering specialising in neonatology as an option, however the 4 hospitals that have neonatologists are in metro Melbourne. The Department said I can't undertake this specialty under the scheme.
I'm close to accepting a bonded place anyway - my parents said they'll support me and that I can still start a family and settle and do that kind of stuff. I just don't know what my circumstances will be in the future.

Having a BMP should not necessitate having your parents support you financially, or see you miss out on having children or finding a life partner.

 

[garmonbozia]

I contacted the Department of Health to ask about specialty training. I am considering specialising in neonatology as an option, however the 4 hospitals that have neonatologists are in metro Melbourne. The Department said I can't undertake this specialty under the scheme.
I'm close to accepting a bonded place anyway - my parents said they'll support me and that I can still start a family and settle and do that kind of stuff. I just don't know what my circumstances will be in the future.

I think you need to step back and take a deep breath. The short answer is that you're in Year 10 -- considerations like what specialty you want to go into, how you're going to settle down and start a family and so on are way off in the future, so there's simply no point worrying about them now.

 

[chinaski]

I disagree. It's not ideal that kids in school are having to consider things so far off into the future, but essentially that's what's required if they're considering signing a contract which will directly affect their career and life a long way off into the future. Just telling them not to worry about it is akin to sticking your head in the sand. It's better that they be informed about what they're potentially signing up for.

 

[dotwingz]

You have to consider how much a decision would affect their life and career though.

Not taking a BMP because your chances of pursuing neonatology are reduced is really a non issue imo. As someone likely without meaningful experience in the field or alternative specialties, how are they meant to know whether neonatology is the breaking point for whether or not they apply to 30% of places across the country.

Similarly, not taking one because you dont know if you will settle down with a family etc is also a non issue.

 

[chinaski]

An awareness that broadly speaking, a BMP has potential to impede your specialty choice in the future is highly relevant information to know. Similarly, taking into account the potential impact that conscripted service to a rural setting will have on one's future relationships is also highly relevant. Just sweeping those issues under the rug because they're a long way off isn't helpful. Caveat emptor!

 

[brownpanda69]

Hey, thanks for all of your replies!

Having a BMP should not necessitate having your parents support you financially, or see you miss out on having children or finding a life partner.

Cheers.
It's more about the uncertainty of whether or not I'll find a job if I choose a niche sub-specialty, being away from family (and not being there if something happens). I've spoken to quite a few people about BMPs and the response has generally been to go for it. I guess I wouldn't be too far from my family if something were to happen (only a few hours drive), but it makes me terribly anxious. I know someone who accepted a BMP who has a partner and now is completing her RoS. Them and their partner had to pack up their lives and move, and whilst it was great for the doctor's job, their partner now has long commutes into work. From what I've seen, there are sacrifices to be made that have their implications for the future. I also know someone who got a BMP and failed their final year twice. They had to pay their BMP back plus undergrad and another postgrad course for a career switch as their uni didn't let them continue med.

I think you need to step back and take a deep breath. The short answer is that you're in Year 10 -- considerations like what specialty you want to go into, how you're going to settle down and start a family and so on are way off in the future, so there's simply no point worrying about them now.

I'm actually in Year 12 haha. Thanks for your advice. Yes, worrying and ruminating about the distant future isn't entirely helpful. I have to agree with what chinaski said below. While it is important to not worry about these kinds of things so early, I just would love a clearer picture of what my future would look like. Accepting a BMP involves signing a legally binding contract. I don't come from a rich family and I can't just rely on the "bank of my parents" to pay my way out. I've lived regionally for a brief period of time and having seen the inequalities that exist between regional and metro healthcare, I'm definitely down for working rurally to help do at least a little bit to tackle them, but the idea of not having flexibility in my career puts me off. I know this is selfish.

You have to consider how much a decision would affect their life and career though.

Not taking a BMP because your chances of pursuing neonatology are reduced is really a non issue imo. As someone likely without meaningful experience in the field or alternative specialties, how are they meant to know whether neonatology is the breaking point for whether or not they apply to 30% of places across the country.

Similarly, not taking one because you dont know if you will settle down with a family etc is also a non issue.

Thanks for sharing your perspective. I can definitely see where you're coming from here. I think I phrased my original post in the wrong way. I'm not set on neonatology or any specialty for that matter. I think it's really important to actually go to med school, do internship and be exposed to specialties before making such a big decision. It's not a neonatology or nothing situation.
I'd go to med school to become a doctor, because that's the ultimate goal. Although, it would be nice to have some reassurance that I can have some flexibility in my career path and that making a decision at 18/19 doesn't close me off to taking certain avenues in such a broad field.

Should I just be more spontaneous and go with the flow?

Sorry for being so annoying. I'm just so worried about my future (when I should be excited?).

 

[TKAO]

Should I just be more spontaneous and go with the flow?


Sorry for being so annoying. I'm just so worried about my future (when I should be excited?).

At this point, I'd reckon taking whatever offers or anything close to it that you can get. If your only option is a BMP or nothing, are you willing to take a gap year to try again? Many people would take anything they can get their hands on, and only a very select few people get multiple offers to choose from.

Also something to note is that you can pay off the BMP if you so choose. This is not the intention of the scheme nor am I recommending that you 'wave' off the bond with some money, but if it's between that or not picking the specialty you want because there are no positions in rural areas then perhaps its a price worth paying.

Being excited - when you finally get to flex the 'im doing med card' hahaha. People outside of med don't know what a BMP is so they won't know the difference either

 

[Crow]

Also something to note is that you can pay off the BMP if you so choose. This is not the intention of the scheme nor am I recommending that you 'wave' off the bond with some money, but if it's between that or not picking the specialty you want because there are no positions then perhaps its a price worth paying.

I really would love to see this "loop-hole" in the scheme to be closed off. Either that, or don't make BMPs available to high school leavers who, in my opinion, are not at an appropriate age to be making decisions like this that can have a big impact on their future.

 

[dotwingz]

Thanks for sharing your perspective. I can definitely see where you're coming from here. I think I phrased my original post in the wrong way. I'm not set on neonatology or any specialty for that matter. I think it's really important to actually go to med school, do internship and be exposed to specialties before making such a big decision. It's not a neonatology or nothing situation.
I'd go to med school to become a doctor, because that's the ultimate goal. Although, it would be nice to have some reassurance that I can have some flexibility in my career path and that making a decision at 18/19 doesn't close me off to taking certain avenues in such a broad field.

If being a doctor is the goal then take the BMP if given one. There are ways to satisfy your RoS agreement outside of giving up your specialty of choice.

Going off the top of my head without fact checking here so i might be talking bs but CMO Work through rural areas for short 3 months periods 6 times (assuming you did 18 months prior to specialisation) for example. Also, incredibly rural areas attract a bonus iirc (like 1.5x or something like that, i will have to look) so it could be even shorter.

Also many here may disagree in principle, but you can pay off your RoS if you dont complete it.

If your only option is a BMP or nothing, are you willing to take a gap year to try again

I appreciate the sentiment here but i would highly suggest not taking a gap year if you dont get a BMP, there is no guarentee that if you got in once you would get in again (let alone rank higher)

 

[TKAO]

I really would love to see this "loop-hole" in the scheme to be closed off. Either that, or don't make BMPs available to high school leavers who, in my opinion, are not at an appropriate age to be making decisions like this that can have a big impact on their future.

I feel like this isn't really a loophole but rather a high barrier of exit. I mean, in cases such as these paying off the bond is really the only option to do the specialty you want.

I totally agree with the point that it shouldn't be available to undergrads that don't totally understand the implications of what they are signing, but at the same time the other option is to either push more BMPs onto postgrads (not entirely fair on them) or give some fail rural Australia's medical requirements. At least this way this wall is high enough that only the most certain would pay it off.

Perhaps a better way of doing this is such that you are only able to pay off your BMP if you manage to successfully get acceptance into a training program that does not have ANY rural centres and show proof. That way you only allow those who are already deep into their training to skip out on it, while also preventing wealthier children with access to the bank of mum and dad to pay off their obligations.

Also many here may disagree in principle, but you can pay off your RoS if you dont complete it.

agree that it isn't good in principle. I don't think anyone here should really be encouraging it willy nilly.

 

[chinaski]

It's more about the uncertainty of whether or not I'll find a job if I choose a niche sub-specialty, being away from family (and not being there if something happens). I've spoken to quite a few people about BMPs and the response has generally been to go for it. I guess I wouldn't be too far from my family if something were to happen (only a few hours drive), but it makes me terribly anxious.

The situation for very niche-type jobs particularly is that you will likely need to move several times over to qualify in that area, and then move around again in order to land a job at a consultant level. Unfortunately the job market for many specialties is now very competitive, which does necessitate one to move away from one's home base a lot of the time. This is relevant for everyone to know, not just people considering a bonded place. The expectation that you'll be able to stay in one city or town for the majority of your training, and then stay there as a consultant is not realistic for many doctors.

 

[dotwingz]

Bonded Medical Places Scheme should be scrapped

The AMA has strongly opposed and questioned the Bonded Medical Places (BMP) Scheme since its inception.

ama.com.au

I think you’ll find it isn’t so much a “loophole” as it is a permanent design feature to account for the issues in rural training, changing life situations, and poor outcomes. The government is very aware on how many people break their contract, but yet decided to keep that clause when they rewrote the legislation for 2020 entry

 

[Crow]

Bonded Medical Places Scheme should be scrapped

The AMA has strongly opposed and questioned the Bonded Medical Places (BMP) Scheme since its inception.

ama.com.au

I think you’ll find it isn’t so much a “loophole” as it is a permanent design feature to account for the issues in rural training, changing life situations, and poor outcomes. The government is very aware on how many people break their contract, but yet decided to keep that clause when they rewrote the legislation for 2020 entry

That’s why I used “ “ . I am aware of the issues involved with rural training.

 

[chinaski]

At this point, I'd reckon taking whatever offers or anything close to it that you can get.

Would disagree with this view. It's up to every candidate to understand what their personal limits are. For some people, any bond or restriction on their career or living conditions would be personally unacceptable. For others on the other end of the spectrum, they might be willing to forgo a lot in order to follow their "dream". Either way, fostering a "take anything that's on offer" blanket advice isn't helpful as it doesn't take into consideration each person's hard limits.

Back in the day, I limited my chances and options of getting into med school by declining to be considered for the old (now defunct) rural bonded medical scholarships. By ticking that box, I would have had a greater chance of getting in, as well as a heckload of money that would have supported me throughout med school. However, the limitations associated with those places were a hard "no" for me, and so I gambled with just standard entry and resigned myself to living under the poverty line through med school instead.

 

[brownpanda69]

Thank you all so much for your input!

One of the reasons why I wanted to go into med was to make a difference in the world of neonatology and families with neonates in the NICU, but I can do this in so many specialties (e.g. paeds, cardiology, public health). Seeing as I haven't even been exposed to many specialties, I think I might accept a BMP and see where life takes me, should I receive one. Depends on what I get! Maybe I'll get a CSP who knows. Or maybe even ERC...

But really, is the bonded scheme actually making a difference in rural health outcomes? There aren't too many concrete incentives - one major one being you still have to pay off the CSP amount of HECS debt.

 

[dotwingz]

But really, is the bonded scheme actually making a difference in rural health outcomes? There aren't too many concrete incentives - one major one being you still have to pay off the CSP amount of HECS debt.

Exactly, the AMA letter up there shows us its pretty terrible at doing at what it set out to achieve.

 

[A1]

There aren't too many concrete incentives

The incentives are inherent in the offer, in the sense the BMP places didn't exist before then the federal gov invited med schools to increase their place quotas by 40% provided they were made bonded. IOW if you are only offered a BMP spot you wouldn't even get a med place if not for the BMP scheme.

(The BMP scheme's effectiveness is a different matter, I'm only touching on the incentives).

 

[energeon]

From when I checked UQ's website a while back, it seemed that I needed to put both a CSP and BMP in QTAC to be eligible for both compared to other universities where BMPs are automatically considered. However, I'm checking the website now and I don't seem to see such a requirement for eligibility to BMP. Was this changed? If not, could someone please provide a link that says I need to fill in both? Thanks