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[2020 entry and beyond] Guide to Bonded Medical Places

dotwingz

Google Enthusiast
Moderator
Why do you think you won't enjoy it once you get to clinical years? or rather, be any more likely than anyone else?

Ultimately to ease your nerves a little bit, getting a CSP offer wouldn't put you in too much of a different position. If you frame it in terms of opportunity cost, every year you spend doing medicine costs ~70k/year (Aus median income, you would likely earn higher) you could earn working a job elsewhere, while the CSP payback is ~30k/year.

Realistically no one actually knows what they're getting into absolutely, and kind of have to pull the trigger of blind faith wether or not they actually like doing medicine. Its hard to really know until you get somewhat deep into your degree unfortunately.

Either way, theres something for everybody in medicine. You might hate seeing patients, thought about pathology?

EDIT: It almost kinda looks like youre looking for a rational excuse not to medicine. Which is fair enough if you're not into it.
 

NR1

Member
Why do you think you won't enjoy it once you get to clinical years? or rather, be any more likely than anyone else?
Realistically no one actually knows what they're getting into absolutely, and kind of have to pull the trigger of blind faith wether or not they actually like doing medicine. Its hard to really know until you get somewhat deep into your degree unfortunately.
You're right on not being any more likely than anyone else. I don't have anything that would make me thing I would dislike clinical years. If anything I would probably enjoy them. It's just more so the possibility that it could happen which as you mentioned is just the fact of life and something I seemingly can't shake at the moment probably because the repercussions of navigating this uncertainty have been low for me so far (i.e. just HECS after 1 year of a degree I found I didn't quite gel with).

EDIT: It almost kinda looks like youre looking for a rational excuse not to medicine. Which is fair enough if you're not into it.
Yeah I think you're right. Rationally my head is thinking about the money. I had a friend recently finish up 2nd year of an allied health degree who's swapping out after finding during placements it's not for them. In their case they were able to just leave with HECS debt that will eventually be paid off. Had it been an unbonded offer my posts wouldn't have existed. The financial concerns of potentially leaving are the only thing honestly holding me back from taking my offer. I can't lie it's also because it would have to largely come out the pockets of my parents and I'd feel incredibly bad.

Ultimately to ease your nerves a little bit, getting a CSP offer wouldn't put you in too much of a different position. If you frame it in terms of opportunity cost, every year you spend doing medicine costs ~70k/year (Aus median income, you would likely earn higher) you could earn working a job elsewhere, while the CSP payback is ~30k/year.
I guess this is fair but I think in my situation probably not too applicable (correct me if I'm wrong though). My current backup plan at the moment is a 4 year degree I'm starting this year so I think I would still be financially negative on the calculations right? ~70k from one year work v.s. ~ -150k if I were to pay out at the end of 5 years. The gap only widens financially with saving on rent and being able to work more.

I think my head's just all wrapped up in the financial aspect so I'm all frozen not wanting to do it which means I guess I have my answer. My head's definitely in a sort of logic loop (I want to do it --> but if it doesn't work out you have to pay --> thus don't do it and repeat) right now which I don't really know how to break.

Either way, theres something for everybody in medicine. You might hate seeing patients, thought about pathology?
Sure have! I want to do GP but path, public health and psych were on my radar as well.

Sorry for this. I'm sure it must be kind of frustrating reading this but I appreciate you commenting
 

A1

Rookie Doc
Moderator
I guess it comes down to whether you consider a med degree worth ~150-180k and I don’t think any degree is worth that but maybe I’m wrong.
I don't have a full solution to offer you, only a few bits & pieces.

- It may not be worth to you but from the cost perspective it costs the uni typically $320k to teach a med student, not including an additional $180k worth of teaching provided by doctors/teachers not paid by the university. Total $500k.

So your dilemma is either do the BMP potentially quit after 5yrs lose $150k, or discard the offer potentially lose a $500k opportunity.

- If you withdraw before starting 2nd year you don't have to pay back the one year of BMP. You can do the 1st year, resit UCAT apply to JMP to hopefully get a CSP offer next year. If not successful at least it gives you a year to think about continuing medicine or not.

Ref > The hidden cost of medical student education: an exploratory study
(Back in 2010 a USyd med student cost $56k/year + $34k/year unpaid teaching x 4yrs = $360k per graduate, CPI indexed to $500k now).
 

dotwingz

Google Enthusiast
Moderator
2nd year of an allied health degree who's swapping out after finding during placements it's not for them.
What I say might be grossly incorrect, but in my eyes the diversity within a single AH occupation is really a completely different ball game vs medicine. Sure theres different types of nursing or physio, but it really does not compare to how drastically different medical specialties can be (which is represented in the training durations post medical school). From the outside in, while they can be diverse, they definitely appear more heterogenous.

My current backup plan at the moment is a 4 year degree I'm starting this year so I think I would still be financially negative on the calculations right?
Fair enough. My calculations don't quite stack up in that case. Either way your taking a $280,000 gamble on that degree too (which you don't know if you will complete), ontop of the $80,000 (70k earnings + 10k hecs) you cost yourself with the IT degree.

Im obviously wary that lost earnings are very different to financial liabilities, just putting a new perspective on it

Sure have! I want to do GP but path, public health and psych were on my radar as well.
These are three very different specialties. What makes you feel drawn to these specialties? I think you will find you have a better chance of enjoying the degree based off walking into Medicine with a diverse set of interests, and would be more likely to 'find your niche' based on mixing and matching aspects of those specialties, compared to the hundreds of grammar school'd myopic future orthopaedic surgeons who start medicine each year.

EDIT: Just adding im not here to convince you to do medicine, if your heart is not in it then your heart is not in it. I just wouldn't feel spooked away by not knowing the security of what you will be or enjoy. Realistically having these doubts means you are probably a better candidate than a lot of the undergraduate students who walk in with delusions of grandeur and very narrow viewed specialty goals. With little thought given to the 'alternative'
 

chinaski

Regular Member
As an aside, I would suggest that the dollar amount of unpaid teaching/time cost is grossly underestimated there, particularly in schools which farm their students out to clinical settings, full time, for a substantial fraction of the degree itself.
 

NR1

Member
- If you withdraw before starting 2nd year you don't have to pay back the one year of BMP. You can do the 1st year, resit UCAT apply to JMP to hopefully get a CSP offer next year. If not successful at least it gives you a year to think about continuing medicine or not.
This was something I considered but I'll have to confirm with JMP tomorrow since I know doing this essentially rules you out from WSU since wanting an unbonded offer wouldn't exactly be a compelling reason to transfer.

"Are you are an Australian citizen, Australian permanent resident or New Zealand citizen who is currently (or has previously been) enrolled in a Doctor of Medicine (MD) or equivalent program, including combined medical degrees within Australia or New Zealand? If yes, you must submit a Transfer Request directly to the School of Medicine.

You are not eligible to apply via any other pathway. If such an applicant is found to have gained a place in the MD Joint Program in Medicine via any other pathway, the place will be rescinded. "


Fair enough. My calculations don't quite stack up in that case. Either way your taking a $280,000 gamble on that degree too (which you don't know if you will complete), ontop of the $80,000 (70k earnings + 10k hecs) you cost yourself with the IT degree.

Im obviously wary that lost earnings are very different to financial liabilities, just putting a new perspective on it
Point taken. It is very possible I don't complete the 4 year degree either but at least there aren't any financial liabilities. On an unrelated note what's your perspective on 'degree hopping'? Of course I'm not doing intentionally and I feel I'm at least learning about myself and picking up some degree specific knowledge along the journey. I can't deny however it feels a bit bad and like you said does add up in lost earnings.

These are three very different specialties. What makes you feel drawn to these specialties? I think you will find you have a better chance of enjoying the degree based off walking into Medicine with a diverse set of interests, and would be more likely to 'find your niche' based on mixing and matching aspects of those specialties, compared to the hundreds of grammar school'd myopic future orthopaedic surgeons who start medicine each year.
Super super happy to be corrected here if I have anything wrong especially since Chinsaki's here.

I was originally in the dental camp just based off WLB and shorter training periods but found out through spending time with some dentists and reading online that I think I preferred the consulting style diagnostic work and problem solving over procedural work. Whilst there is a balance of both in dentistry, it seemed to skew more towards the latter so I turned towards medicine. Shame since to be frank I'm not super career oriented and I think dentistry is a perfect values match in terms of autonomy and lifestyle but I don't think I'd be happy with the bread and butter of mostly procedural work.

I know medicine isn't exactly conductive to being lifestyle friendly and that the hard work never ends even after becoming a consultant but you'll notice the specialties I've leaned towards tend to be on the more lifestyle friendly side of medicine. It's just lucky I guess that I happen to at least find some of them interesting.

I originally wanted to go down the physician route for Immunology and Allergy but consultant positions seem basically non-existent. That's in part why I wanted to do GP and go down the GP with special interest route to scratch that itch and more (e.g. mental health). Massive variety, friendlier WLB and shorter training, the ability to build long term patient relationships and autonomy in how you practice since you're a contractor. My plan was to do something like 3 days clinical work and 1 day teaching or something like that.

(Disclaimer: The following is probably wrong in all sorts of ways)

The other specialties I mentioned are more currently 'oh that seems interesting. I'd like to find out more' so it's all based off impressions right now. Public health from what I've gathered seems to be consulting, policy and advisory style work in health prevention, promotion, etc which sounds interesting. Path from the small anecdotes online looks to be a lot of diagnostic, deduction and problem solving work. As for psych, mental health as an area is interesting to me. The work that draws me here I think is probably mostly outpatient work: the whole talking and listening, doing assessments, counselling style work, building long term patient relationships and watching that journey of getting better, etc . I think pursuing psychology would probably be a better fit here. In all honesty though I have an open mind. Those specialties were just the ones that jumped out immediately. Being a CMO also doesn't sound bad although I assume it's not at all sustainable in the long term.

Now, I also understand some of the reasons for X specialty aren't particularly unique to medicine. Part of the reason I did IT was because I thought it would be more WLB friendly than medicine, give me variety on a similar scale to GP if not more, scratch the problem-solving itch and have the ability to angle into healthcare through med-tech, digital health or consulting. Too bad I didn't actually like the work. I imagine nursing and some-wider scoping allied health's like OT would be able to more or less fulfil my wants though on a smaller scale and with far friendlier work life balance. In terms of consulting-esque work itself consulting in the business world or process improvement type gigs would probably fit the bill.

I'm not a med or dead person however so if you have any other suggestions for fields or careers I'm open. One of the main reasons I applied to medicine was because I didn't have any particularly strong feelings towards another path and thought it would more or less combine everything I was looking for in a health and patient centred context without the limitations (advancement, scope and income) of allied health.
 

dotwingz

Google Enthusiast
Moderator
On an unrelated note what's your perspective on 'degree hopping'? Of course I'm not doing intentionally and I feel I'm at least learning about myself and picking up some degree specific knowledge along the journey. I can't deny however it feels a bit bad and like you said does add up in lost earnings.

Nothing wrong with that. A couple years finding a degree and career that suits you is better than shoehorning you into a degree which you don't like. In some cases makes you a bit of a more well rounded individual and gives you insights into your passions. It does eventually hit a point where you need to knuckle down and start working towards a career, you as a 20 year old are ages from that point however.


I know medicine isn't exactly conductive to being lifestyle friendly and that the hard work never ends even after becoming a consultant
Its not in the context of leaving work on Friday and not having to think about it until Monday morning, but nothing professional is. My housemate (and sister) are lawyers and put in the same amount of out of hours work as I do, and the same moving across the country for the best job prospects as I will have to do in medicine. Same with my BIL engineer, and software friends.

There are certainly lifestyle specialties which will be on par with other professional careers. You won't be at that stage until later in your life however.


Massive variety, friendlier WLB and shorter training, the ability to build long term patient relationships and autonomy in how you practice since you're a contractor. My plan was to do something like 3 days clinical work and 1 day teaching or something like that.

Like I said in my previous comment, you seem to have a very balanced and open mind re: what you want to get out of medicine. I don't think you will get into later years and hate all of it to the point where you will quit medicine. You seem to be passionate about the bread and butter of medicine at the very least.


Realistically, based of what you said I don't think you have any real reason to think you wouldn't enjoy medicine more than the next person.
 
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NR1

Member
It does eventually hit a point where you need to knuckle down and start working towards a career, you as a 20 year old are ages from that point however.
Out of curiosity when would that point be? I assume mid 20s ish?

Like I said in my previous comment, you seem to have a very balanced and open mind re: what you want to get out of medicine. I don't think you will get into later years and hate all of it to the point where you will quit medicine. You seem to be passionate about the bread and butter of medicine at the very least.


Realistically, based of what you said I don't think you have any real reason to think you wouldn't enjoy medicine more than the next person.
EDIT: Just adding im not here to convince you to do medicine, if your heart is not in it then your heart is not in it. I just wouldn't feel spooked away by not knowing the security of what you will be or enjoy. Realistically having these doubts means you are probably a better candidate than a lot of the undergraduate students who walk in with delusions of grandeur and very narrow viewed specialty goals. With little thought given to the 'alternative'
I appreciate the reassurance and don't view your input as trying to convince me in any way.

To be honest, I don't know if my heart is in it or not. I tell myself it is and that I want to do it but how true that is I'm not actually sure. For e.g. if I had an unbonded offer it would be an easy decision but it would be easy probably because the financial consequences aren't as extreme so I guess it'd be a head over heart sort of decision? Is there a way to tell? Probably not because the answer is internal and feeling based rather than something I can logic my way through.

Medicine is the only near 'certain' option I have currently in the sense that I don't have anything else I feel strongly which is also why I'm not really sure if my heart's in it because the alternative is ?? and picking it would immediately quell the anxiety or if it's something I really want to do. Like I said I think I do but this isn't something I can think. My backup 4 year degree is just me chasing things that sound interesting currently in the same way I initially chose my IT degree and like we talked about before has the chance to spit me out in the exact same position a year from now.

I've always been a bit risk averse - the type when they were a kid to resist change and had to be pushed to undergo that change but settle in quite quickly after and be a bit embarrassed at the over reaction. I think that part of me still lingers a lot and wants to play it safe, buy time, minimise loss and reapply but I'll sit on this for a bit longer and provide closure in a day or two.
 

dotwingz

Google Enthusiast
Moderator
Out of curiosity when would that point be? I assume mid 20s ish?

Highly dependent. All I was saying is that you don't need to shoot directly for a career and make it work. Its not a bad idea to find yourself a bit when your a teen/young adult... but at the same time being wary of spending too much time with not much to show for it.


I think that part of me still lingers a lot and wants to play it safe, buy time, minimise loss and reapply but I'll sit on this for a bit longer and provide closure in a day or two.
Yeah honestly just sit on it. Worst case scenario do a year and then decide then.
 

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