A guide to choosing between medical degrees

Discussion in 'Offers Forum' started by Mana, Jan 11, 2019.

  1. Mana

    Mana Registrar Administrar

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    As usual, I've had a few requests to answering this and while there is a very simplistic method to helping you choose between universities from the thread Choosing Between Universities - and with offers coming out this might be relevant to those with multiple offers.

    there are obviously many other factors to consider; one of them is the quality of the education there which I will cover in this article as best as I can.

    Now, before I get into discussions about universities and saying good or bad things about particular universities the disclaimer here is that I have not actually attended that many universities and the issues with comparing medical degrees and the quality of medical education generally occur from the fact that people tend very much NOT to attend more than one medical school to complete their medical degree.


    Okay so in order of what I think are the important factors to think about when choosing between multiple offers, here they are with some commentary:

    1. What is the cost of the medical degree that you are about to undertake?

    While this question may seem superficial at first, I'm not only talking about the cost in Australian dollarydoos; although this is not the only measure that is important. The costs include, but are not limited to:

    a) the cost in university fees and future repayments (CSP > BMP > FFP and obviously 5 years is better than 6 or 7 within those categories; if you happen to have already finished a degree then starting a 4 year grad entry degree is preferable to starting a 5 or 6 year undergrad degree)
    b) the cost in time to study the degree (we're talking 5 years v 6 years v 3+4 years for some provisional) and the loss of productivity that studying for those years would take (for example, you can't hold down full time work while you study)
    c) the cost in opportunity to spend time and maintain relationships (things like being able to live with your family or partner which may vary especially if time with particular people is very important - things like close family members with terminal illness for example make this cost very high)
    d) the cost in other lost opportunity (things like quitting a job that you have already invested significant time and effort into, or other future major life events such as getting married and having children)
    e) the cost of living in proximity to the university/locations where you will undertake your medical degree (for example, it's cheaper to live in Armidale than it is to live in Sydney if you're paying rent).
    f) any things that might offset the cost - things like those rare scholarships, or having other family or friends elsewhere who are happy to let you stay with them for discounted or no rent at all. Bear in mind that no scholarship will pay more than the income of an intern, which is what you get by graduating one year earlier.

    2. Do you already live in close proximity to one of the medical degrees such that you would not have to change your place of residence?
    While this might seem like it's pretty obvious, inevitably there will be someone every year who decides to uproot their entire life in the name of prestige of their medical school. Taking this into account, for example, this can decrease the hypothetical cost of living very significantly as per (1) given that if you already live at home and you're a school leaver and your family is happy to let you stay rent free (or with discounted rent) etc. you'll be saving a lot of time and money by not having to move and find accommodation etc.

    In this sense, unless there is some very obvious reason you should be uprooting (for example, things like toxic family environments which admittedly have come up in discussion many times on here) you should have as your first preference a university where you would be able to travel there every day from your own residence (all other factors being equal, like the CSP/FFP thing).

    3. What is the quality of the medical degree that you will be undertaking?
    This is a very difficult and arguably sensitive topic to discuss; here I will suggest some guidelines as to how I would determine the relative quality of medical degrees compared to one another. It's very difficult to quantify the quality without using subjective measures (especially since hardly anyone goes to multiple medical degrees at different universities), but I've put the more objective ones first and place more weight on them:

    a) Is the medical degree accredited by the Australian Medical Council and are they at risk of losing it or not being approved for it?
    As of the time of writing, all medical schools in Australia as far as I know have AMC accreditation for their existing years. However, as an example in the past Notre Dame in Sydney has lost its accreditation leaving a whole cohort of their medical students wondering whether their degrees would be recognised in the workforce (thankfully they regained their accreditation before this became a problem). This however can become a problem for new medical schools such as Curtin and Macquarie where for example the AMC may have granted accreditation provisionally for the first few years but not for the later years and THIS may become an issue later if you are a student there because your qualification is at risk if you are a medical student there during those years. As much as possible, I would stay away from very new medical courses in favour of those that have many years under their belt for this reason.

    b) How new is the medical degree?
    Other than the issue with potential accreditation, there are a lot of issues which can arise with newer medical degrees (Curtin, Macquarie, any others which started in the last decade) by measure of how long they have had to secure medical placements, how long they have had to change their course, how long they have had to recruit academic staff. Naturally, those with a longer history have had longer to sort out these issues and as a result it's less likely that this would be an issue for you in particular if you attend a medical degree where you aren't the (or one of the) guineapig cohort(s).

    c) What is the quality and number of the clinical placements that are offered?
    Clinical placements are a very significant cornerstone of medical education and there is vast variation in the quality of clinical placements. I would be looking for universities that have lots of placements in the major metropolitan centres (the more high level specialisation the better and the more specialty representation the better). Why? These are the placements which are harder for a university to get because these hospitals are already the ones that are saturated. You might notice that every new medical school on the horizon has a focus on rural health and rural placements and while they can be good places to learn good medicine, these are also the placements which are relatively easier for the medical school to create. Consequently, it is relatively easier for you to get a rural placement than a metro one (even though there are more metro placements overall). This is illustrated by the observation that every year in every medical cohort there is an oversupply of students that want to go metro and an undersupply of students that want to go rural. Without going into the discussion about which placement is better (rural placements vs metro placements each have their own place and you should do some amount of both), you don't want to be in a place where you don't have the option to go where you want to (or have a good chance to).

    As an example, and I will use this example as a relative comparison within this category only ignoring all others:

    Comparing UNSW's placements to UNDS (noting that UNSW has about 3x the cohort of UNDS):

    UNSW has these metropolitan sites:
    St. Vincent's
    St. George
    Prince of Wales (and associated Sydney Children's and Royal Women's)
    Liverpool Hospital
    Bankstown Hospital

    and a few rural sites with relative ease of getting in.

    UNDS has these metropolitan sites:
    St. Vincent's (shared with UNSW)
    Auburn Hospital
    Hawkesbury Hospital
    Mater Hospital
    Werribee Hospital (Melbourne)

    and a few rural sites, also with relative ease of getting in.

    If you look at the relative thoroughput of those hospitals and the relative specialty breadth of those hospitals and the relative acuity of patients managed in those hospitals then arguably UNSW has better quality placements than UNDS (based on locations alone, which may or may not be a fair comparison).

    Another example is to look at the number of relative clinical years or how early you get clinical exposure. For example, Melbourne University has 2.5 years of clinical placements (out of a 4 year degree) which scores it relatively highly in this regard, whereas many other 4 year degrees only have 2 years out of 4.

    d) What other resources does the university have or lack relative to others?
    This often ties in with the age and/or size of the university. For example, if you look at the older universities, these are the ones which have large anatomy labs with years and years of anatomical and pathological specimens. They are also the ones with large libraries and developed clinical schools and clinical facilities. Finally, they are also the ones which might have the other on-campus facilities, such as sporting or accommodation facilities, which while are not part of the quality of the medical degree per se they are part of the quality of the university experience, for which if you are going to be spending four or more years there, does make a difference.

    As asked below, there is the question of cohort size:
    Large or small cohort size per se is not a reason to go or not to go to a medical school; the issue is the relative availability of resources. For example, a medical school that is large however happens to have large enough anatomy labs and enough quality clinical placements for that large cohort makes the large cohort a non-issue. Similarly, a small cohort which doesn't have enough placements/resources etc is still less preferable in that regard.

    For example, and again I speak from personal experience - UNDS is a cohort of around 100 medical students (probably slightly more now) which is around 1/3 of the size of UNSW. However, UNDS happens to not even have an anatomy wetlab, meaning actually that the resources required for anatomy teaching are somewhat lacking there (they borrow the wetlab from UTS and even then the wetlab sessions are far less frequent). Even though the cohort was smaller, this resource in particular was even more limited in comparison to a larger cohort.

    4. Is there a reasonable guarantee of obtaining your medical degree at the end?
    There are multiple reasons why you would not make it through and a lot of these are personal (e.g. personal sickness, significant life events etc). However, barring these which I will assume would be similar wherever you went, there are a few things that might stop you from ever getting that medical degree once you start:

    a) Provisional degrees - as the adage goes, a bird in the hand is worth two in the bush. If you do a provisional degree and for whatever reason you're unable to make the minimum GPA (for example, you fell ill and you didn't get the marks because of this - and note that in pretty much all provisional degrees there is NO pathway for you to make this up other than being thrown into the GAMSAT pool with the remainder of non-provisional applicants) you're often out of luck, sorry. Going by this, you will want to be taking non-provisional medicine over medicine every time.
    b) Non-guaranteed pathways - this is like (a) but even worse and I'm looking at you, Melbourne Chancellor's Pathway with an interview in third year that you can fail
    c) Even less guaranteed pathways (like the UNSW Med Sci pathway or the UTas Med Res non-guaranteed pathway and many others) where your chances of getting in are very small (please see my articles elsewhere on MSO for my opinion on how crap these are - Common pitfalls to avoid for year 12 school leavers and other medicine applicants)
    d) A less common but significant issue being high fail rates and high attrition rates which was a problem up to very recently at the University of Adelaide (again, see my articles elsewhere on MSO for this Interesting data from the medical training review panel )

    5. What are your future career plans?

    This ties in with a lot of the other categories but there are a few things that I think are best mentioned here:

    a) Where do you want to practice? If you are wanting to practice in a certain state (e.g. in NSW) it makes sense to be doing your medical degree there because that's the state where you will be likely guaranteed an internship. It's possible of course to change between states at any point, however it tends to be harder for many reasons (nepotism of particular hospital networks being one of them).

    b) What do you want to practice? If you are wanting to do, say, paediatrics, then you'll be wanting to go to a university which has clinical placements in major paediatric centres. If you want to do neurosurgery, you'll be wanting to go to a university where you will get a clinical placement in neurosurgery (and this would generally be at major tertiary centres only). Essentially, if you want to be doing particular specialties you'll be wanting as much exposure to those as early as possible, because it will allow you to get experience (even if just observational) and networking within those as well as potential research opportunities.

    ----------------------------------------------------------------------------------------------------------------

    Taking these into account, here is my generalised rank list of medical degrees in order of which you should take them, assuming that you are a year 12 school leaver with no tertiary record (i.e. make a list of your current offers then start eliminating them based on this list until you have one choice left. Remember this list is preferred so you cross out the ones that AREN'T the description, starting at #1)
    (your list may be different depending on the above considerations)

    1. Whatever degree isn't full-fee paying (FFP)
    2. Whatever degree isn't provisional or non-guaranteed
    3. Whatever is the shortest degree in the city you already live in
    4. Whatever degree isn't bonded (BMP)
    5. Whatever is the shortest degree outside the city you already live in
    6. Whatever is the degree in the state you want to practice in
    7. Whatever degree happens to have offered you a scholarship
    8. Monash University (pi will enjoy this)
    9. University of Tasmania (NOT the guaranteed B.Med Res pathway)
    10-11.University of Newcastle/University of New England (supposedly there is equal possibility for clinical placements for both I am told)
    12. University of Western Sydney
    13. Curtin University
    14. University of New South Wales
    15. University of Adelaide
    16. James Cook University
    17. University of Western Australia provisional (6 years)
    18. Flinders provisional (6 years)
    19. Griffith provisional (6 years - NOT including the University of the Sunshine Coast 7 year pathway)
    20. La Trobe University/Melbourne University provisional (guaranteed pathway for regional students only) - Bachelor of Biomedical Science (Medical), Courses and degrees, La Trobe University
    21. University of Sydney provisional
    22. University of Queensland provisional
    23. University of the Sunshine Coast/Griffith provisional (7 years)
    24. University of Tasmania B. Med Res guaranteed pathway (8 years!)
    25. University of Melbourne Chancellor's Pathway (because it's not guaranteed)
    26. uh, Bond University ($$$$$$$$$$$$$$$$$)

    ----------------------------------------------------------------------------------------------------------------

    Similarly, here is a general list for those with a completed degree who are also applying through the GAMSAT pathway:

    1. Whatever degree isn't full-fee paying (FFP)
    2. Whatever degree isn't provisional or non-guaranteed (not that this is an option for graduates)
    3. Whatever is the shortest degree in the city you already live in
    4. Whatever degree isn't bonded (BMP)
    5. Whatever is the shortest degree outside the city you already live in
    6. Whatever is the degree in the state you want to practice in
    7. Whatever degree happens to have offered you a scholarship
    8. University of Melbourne (4 year grad) (because of the earlier clinical placements)
    9. University of New South Wales Lateral Entry (i.e. direct entry to year 3 if you are already B. Med Sci graduate from UNSW - note I don't recommend this pathway for year 12s)
    10-12 (aeq): University of Sydney (4 year grad)/University of Western Australia (4 year grad)/University of Queensland (4 year grad)
    13. Australian National University (4 year grad)
    14. Monash University (4 year grad)
    15. Flinders University (4 year grad)
    16-20 (aeq). Griffith/Wollongong/UNDS/UNDF/Deakin
    21. University of Tasmania (if you happen to be a UTas B. Med Res graduate - again I don't recommend this for year 12s)
    22-23. University of Newcastle/New England
    24. University of Western Sydney
    25. Curtin University
    26. University of New South Wales non-lateral entry
    27. University of Adelaide (there is a rural pathway that grads can use if rural)
    28. James Cook University
    29. uh, Macquarie University ($$$$$$ and the fact it's new and the fact that it couldn't get enough Australian clinical placements so it has to send its students to India... ಠ_ಠ wat)
    30. uh, Bond University ($$$$$$$$$$$$$$$$$)

    If there are other things that you think are important, please feel free to mention them here and I will be happy to edit the main article to talk about these. If you want a tl;dr - see the quote at the beginning of this post.

    Best of luck with your medical career, and welcome to medicine!
     
    Last edited: Jan 15, 2019
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  2. I'm curious why one of the factors wasn't cohort size? For example UQ has 385 first years whereas Curtin has 73. All else being the same (I know it's not) I would prefer to study in part of a larger cohort because it's more likely I'll meet friends that I get along with really well and you'd graduate with a bigger 'network' - is this a worthwhile consideration?

    ^^this is the main reason I'm considering Adelaide [173 first years] (if I get an offer) over UTas [120 first years] despite the extra year

    EDIT: I can't believe I didn't start my message with this, but thank you so much for writing this up!!!!!
     
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  3. Mana

    Mana Registrar Administrar

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    Large or small cohort size per se is not a reason to go or not to go to a medical school; the issue is the relative availability of resources. For example, a medical school that is large however happens to have large enough anatomy labs and enough quality clinical placements for that large cohort makes the large cohort a non-issue. Similarly, a small cohort which doesn't have enough placements/resources etc is still less preferable in that regard.

    For example, and again I speak from personal experience - UNDS is a cohort of around 100 medical students (probably slightly more now) which is around 1/3 of the size of UNSW. However, UNDS happens to not even have an anatomy wetlab, meaning actually that the resources required for anatomy teaching are somewhat lacking there (they borrow the wetlab from UTS and even then the wetlab sessions are far less frequent).

    I have edited this into the main post, thanks (and good question!)
     
    Last edited: Jan 11, 2019
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  4. 1234med

    1234med Regular Member

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    Hi Mana,

    My friend has deferred offers from Adelaide, UQ and JCU. Just got offered Curtin interviews in less than a week, so needs to decide ASAP. She's not sure if she would go to Curtin even if she got an offer.

    How did you conclude Curtin to be number 13. and above these other 3 universities? Why do you place more emphasis on 1 year shorter than the quality of the degree (qualifications at risk, lack of alumni and resources, etc.)?
     
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  5. Jenga118

    Jenga118 New Member

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    So my home state, WA, has Curtin (Is the medical degree accredited by the Australian Medical Council and are they at risk of losing it or not being approved for it?) and UWA (provisional) .

    Am I better off attending/prefering one of these universities, over Utas or Monash (In the event I do get in).
     
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  6. Mana

    Mana Registrar Administrar

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    Because finishing one year earlier means that you get to work full time as a doctor 1 year earlier which means a difference of around $65000 (pre-tax).
     
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  7. 1234med

    1234med Regular Member

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    But qualifications at risk might mean not being able to work at all? Probably will change but for 5., she wants to work in derm.
    By the way, on your list, could you explain why UoA is above JCU given the attrition rates you mentioned for UoA?
     
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  8. Mana

    Mana Registrar Administrar

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    There's a difference between having a university in your home state and actually living close enough to it that you can commute to it each day without having to move.

    Assuming you actually live within commutable distance to Curtin, I would be attending that rather than UWA (for the 5 vs 6 years) over UTas and Monash.

    Yes, the accreditation is new, but it has been approved by the AMC, so you should be safe for now.
     
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  9. Mana

    Mana Registrar Administrar

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  10. 1234med

    1234med Regular Member

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  11. Mana

    Mana Registrar Administrar

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    Derm placements are going to be hard to get anywhere, to be honest, so this is one of the times where I don't think it'll matter much at all.

    Re: Adelaide's attrition - there is a newer report I believe that has some updated numbers showing that Adelaide's attrition has come into line with the remainder of medical schools. It's also been around for 125+ years and has placements in all the major Adelaide metro hospitals.
     
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  12. Mana

    Mana Registrar Administrar

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    Yes, there could be, but the other universities go up for accreditation then as well. I wrote that there for posterity's sake because of that one event in the past, hoping that it won't be an issue in future but it could be.
     
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  13. 1234med

    1234med Regular Member

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    Makes sense makes sense, thanks a lot Mana for writing this all up and helping us all!
     
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  14. A1

    A1 Admissions Speculator Moderator

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    Flinders provisional is 2 accelerated + 4, shouldn't it be ranked next to Griffith rather than below USyd & UQ?
     
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  15. pi

    pi Junior doctor Administrar

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    I did enjoy that.
     
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  16. Mana

    Mana Registrar Administrar

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    fixed, thanks
     
  17. coolcool

    coolcool New Member

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    Hey so I have an offer from UON and Monash... I live in Newcastle so logically I should accept the UON offer. However I was wondering if there are any differences with regards to the course structure or content or clinical placement, anything that distinguishes the two unis? I am interested in doing honours if that helps
     
  18. Mana

    Mana Registrar Administrar

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    There are many differences, but both are well established, well resourced medical schools with good clinical placements of similar duration with the option of doing research years.

    Going by this they are similar enough that nothing at Monash should outweigh the convenience and support of living at home; UoN is the clear choice here in your situation.
     
  19. coolcool

    coolcool New Member

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    Thank you so much for the guide and your reply!! Do you there are real benefits (apart from financial obviously) with living with family? Is there a loss of social life with doing so? (sorry this is a little off topic)
     
  20. Mana

    Mana Registrar Administrar

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    Yes, you'll get meals made when you have to study for exams and you'll get washing done when you have to study for exams and you'll have food in the fridge that respawns by itself and you won't have to move.


    Seriously though, the support from living with parents is valuable if they maintain a good environment, and you always have the choice to move out later.
     
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