[Undergrad] Medical Rural Bonded Scholarship (MRBS) Explanation (inc. v. BMP)

Discussion in 'Medicine Entrance' started by rand, Feb 8, 2012.

  1. rand

    rand New Member

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    Hey all,

    Well I noticed a number of people seemed misinformed regarding the MRBS, so I thought I'd remedy this situation since I'm now something of an expert on it.


    Okay, so, the important facts:
    • The contract requires you to work for 20hrs/wk, for 9 months of every year, in RA2-RA5 regions, for 4-5.5 years depending on how remote you go, once you gain fellowship (i.e. once you have completed your specialisation).
    • You are allowed to work wherever you like during that required time (e.g. you can operate a private practice if you like), and you are allowed to move around geographically as much as you want.
    • As long as you meet those requirements, you can do whatever you like for the rest of the time (e.g. you could do your twenty hours in a rural area, then the rest of your time elsewhere).
    • You get about $25,000 a year (as of 2012), but this is indexed each year, and as such increases as time goes on.
    • There are essentially 2 consequences of breaching the contract (which is only possible once you commence the 2nd year of your degree):
      • You must return all the scholarship money paid to you, and this becomes due (and therefore begins earning interest – around 11% right now, I think) 6 years after you breach
      • You can't have a functioning Medicare Provider Number for 12 years after you gain fellowship – i.e. you can't work in private practice for 12 years after you are specialised
    • There is an interactive map which shows exactly where the borders of the Remoteness Areas are: DoctorConnect - Locator
    • This URL has all the latest information on the MRBS (be careful, I noticed people linking to contracts and information from 2009), including an updated information booklet, the latest draft contract, and information on scaling: Department of Health and Ageing - Medical Rural Bonded Scholarship (MRBS) Scheme

    I've not fully researched the Bonded Medical Places (BMP) Scheme, but I'm pretty sure that these are the major differences:
    • You don't get ~$25,000 per year, rather, you get nothing,
      • and if you breach:
        • you have to pay 75% of the Commonwealth Contribution Amount for each year of your uni schooling (i.e. 75% of ~$20000/year, probably increasing to ~25,000/yr by the time you finish, i.e. you'll owe the government ~$100,000),
        • but you get to keep your right to a Medicare Provider Number, and therefore can work in private practice all you like (unlike the MRBS).
    • You have to work in a District of Workforce Shortage (DWS), as opposed to specifically an RA2-RA5 area, although I believe that much of RA1 regions are not DWS regions.
    • 25% of CSP places are BMP places, while ~3% are MRBS.

    Also:
    • Unbonded, BMP, and MRBS places are technically all HECS and CSP places (i.e. in each case, the gov't contributes around ~$20000/yr, and you maximally contribute ~$10000/yr, which you are able to put on a HECS loan), but the people who run applications and such are sometimes not aware of this.
    • From what I could gather on MSO (I've just came off a gap year so I did all my applications over a year ago), most unis treat the MRBS as something you have to express interest in, and is offered to unbonded applicants in order of merit. However, the Adelaide offer system considers it to be below unbonded and above BMP places. If you're at Adelaide and aren't interested in the MRBS but haven't got an unbonded place, keep your hopes up (unless it's March and you still don't have unbonded), because there are probably only 5-10 of these places.

    I made this a thread so you guys can conveniently link to it.



    Hope that helps!
     
    Last edited: Feb 10, 2012
  2. JeremiahGreenspoon

    JeremiahGreenspoon Regular Member

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    Based on everything I've read in the past, and the contract I'm reading right now, it's 3-6 years. 6 years is the required return of service period, but an RA5 category achieves 50% scaling (RA4 40% and RA3 10%). Where did you get 4-5.5 years from?
     
  3. rand

    rand New Member

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    The key to not getting confused is knowing that scaling is applied regularly. It's actually applied monthly (by Medicare or the Department of Health and Ageing, depending on whether or not you're billing Medicare). The only way I can interpret the contract is that, e.g. if you work in an RA5 area for 1 month, then they calculate: 1 month * 50% = half a month, and deduct that from the end date of your Return of Service period. For the total RoS time to be 3 years, the RA5 rate would need to be 100%, and for it to be 6 years, the RA2 rate would need to be 0%. Also, not that the DHA says this anywhere, but the formula for how long your RoS period will be, assuming you stay in a particular remoteness category for the whole thing, is: y=6/(r+1).

    And btw it's RA2 10%, RA3 30%, RA4 40%, RA5 50%.
     
    Last edited: Feb 16, 2012
  4. muso94

    muso94 New Member

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    Also, it should be pointed out that the RSO obligation for MRBS is 6 years for anyone, while the BMP RSO is dependent on how many years of med school you did (4,5 or 6 years). That's an important diference to consider as a lot of Graduate entry Med students feel disadvantaged by this clause in the MRBS contract (since they get paid less money in the end, than the undergrad students but have to return the same amount of work). Meanwhile, the BPM RSO depends on how many years of medical school you did - so Graduate Entry students are only required to complete 4 years, while undergrads do 5 or 6 years.

    Also, there's a clause (5.7) in the MRBS contract that states that if you DO break the contract, the amount you must pay back HALVES if you are a country-resident medical student. You still lose the Medicare Bill number, which is the biggest catch of the entire contract, but you're not as heavily indebted.
     
  5. elixir

    elixir Regular Member

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    I am unbonded but would love to have MRBS!!!!
     
  6. pgawk

    pgawk Ekki múkk

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    This is probably a silly question but is the region you work in randomised or based on proximity to your area of residence? (I would assume the former since it would be difficult to equally distribute interns across DWS regions otherwise)
     
  7. Calem

    Calem Ol' Man River

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    You apply for positions in DWS areas/hospitals and you live where you get a position.
     
  8. muso94

    muso94 New Member

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    So yeah, the government doesn't choose your location. Of the places with your relevant position available, you choose one yourself. You're just restricted to work in a DWS for BMP, or a RA2-5 Area for MRBS.
     
  9. chinaski

    chinaski Regular Member

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    Not quite. You don't "choose"; it's not as easy as that - you go to where the work is. Your preference may be to work in Town X, but Town X may not have any need for your specialty, or have the capacity to support it.
     
  10. JeremiahGreenspoon

    JeremiahGreenspoon Regular Member

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    Well, I've decided to accept my MRBS offer, after weighing up the predictable pros and the unpredictable cons.
    I think it should be a very carefully considered decision for anyone, though for us it was mainly for personal implications rather than professional.

    Some additional things worth pointing out I guess........

    Financially, it's a bit more significant than $25,000/yr. In the end I had an actuary friend do some numbers, and over the five years the scholarship would be worth closer to $155,000 when the interest it saves us on the mortgage is taken into account, and that's assuming a very conservative 7% interest rate. A similar value could be arrived at for someone who avoids taking out another kind of loan because of the scholarship though. Oh yeh and if you've got kids, the MRBS isn't declarable income, so your family tax benefit is pretty hefty too.

    For what it's worth, there were a few things that made it seem less daunting (bearing in mind general practice is all I'm considering at the moment, subject to change but not likely):
    - Currently (obviously subject to change, but how much one can't predict) RA2 areas are within walking distance of UWS. If I want to stay living in the same home with my kids at the same school, it potentially could be not much larger a commute than I'd be doing to uni for the next good while. As long as there is the job there of course...
    - But then, so what if it is further to go? The obligation is only 20 hours a week for 9 months a year. That's effectively 2 working days a week. I know people doing that right now, driving 3 hours for two day shifts then going home. Things could be worse, though of course you have to find a clinic that needs someone just 2 days a week.

    Just better make sure I don't discover a passion for neurosurgery. Or something...
     
    Last edited: Feb 16, 2012
  11. Dr Worm

    Dr Worm Regular Member

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    Wow. Big News! You do travel a lot. And far as these things go, you're probably a good candidate.

    Decision made?

    *will support you whatever you decide*

    OK.

    Congratulations!.
     
  12. toolio

    toolio New Member

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    i am in a similar situation only thing which concerns me is whether i would be able to specialise(inc GP) by 16 years. What if i don't get a internship or residency position ? I don't mind working in RA5 area if I have to. Also if I opt to go to rural clinical schools as part of you Medical degree does it count towards the number of years?
     
  13. JeremiahGreenspoon

    JeremiahGreenspoon Regular Member

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    Yep, although Penny did ask if I had a crystal ball :p


    [MENTION=13425]toolio[/MENTION], that's something I considered also. The 16 years could be difficult for some specialties in particular. Eg. 6 year degree + 2 year PGY + 6 years training, only allows 2 years leeway. Having said that, the 16 years can be extended with approval and I'd imagine that there is likely to be an understanding of the tsunami and its implications for training times. If you've done your utmost to complete all training within that 16 years I can't imagine they'd be out to get you.
     
  14. Dr Worm

    Dr Worm Regular Member

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    Subtle, is Penny. I do <3 Penny.

    Passion for neurosurgery, huh? I think [MENTION=948]Kyle[/MENTION] wasn't struck with a passion for neurosurgery til 5th year, and [MENTION=814]Matt[/MENTION], who always entertained the idea of being a GP has gone off the idea now. However, if you're decided on it, I don't see how my naysaying will help, and accordingly, extend my blessings
    :)
     
  15. JeremiahGreenspoon

    JeremiahGreenspoon Regular Member

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    It's an interesting idea, because in reality, how in the world are we supposed to know what specialty we're going to be interested in? From watching Scrubs and visiting the GP? I did tinker with the idea that if one's dream became a specialty that simple wasn't tenable under the MRBS, you could always pursue it post-MRBS service.

    If you're thinking about it properly, it's a ridiculously tough decision to make. Pros and cons all over the place... and even harder, all the pros are in the very short term. I'd be interested to hear what guided Kyle and Matt to their specialties, because that's the only 'warning' that the Dept give with regards to the MRBS - think about your specialty carefully.
     
  16. chinaski

    chinaski Regular Member

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    Kyle and Matt are interns - they haven't started training yet (and heaven knows, things aren't certain until you have your fellowship - people change their mind, even in the midst of their training years).
     
  17. Matt

    Matt Emeritus MSO Staff Emeritus

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    Definitely. As far as specialty training stuff goes I'm very undecided and I'm in a position where that decision isn't yet pressing. I have ideas about what I think I'd like to do, but if it sounds like I'm decided it's only because I'm asked so often what you want to do as a specialty and it seems rude not to say you don't know (even if your ideas aren't very well formed yet).

    I don't actually spend much time thinking about specialty training (it might seem like I do because it's a common conversational topic), but at the moment there's so much more of the 'basics' to come to terms with it seems very premature to be thinking about what I'm interested re: specialty areas.
     
  18. JeremiahGreenspoon

    JeremiahGreenspoon Regular Member

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    Interesting, shows just how long the journey is. I was under the impression that people often tried to guide their PGY years towards what their specialty path was. Getting a bit off topic here anyway, but somewhat on topic I suppose.
     
  19. chinaski

    chinaski Regular Member

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    "PGY" only stands for "post graduate year" - so until you are a consultant, you are a PGYsomething. Pre-vocational doctors (ie interns and most residents) don't get a whole lot of choice as to what rotations they get; there's a lot of luck of the draw and what is needed by the roster, rather than personal wants of the JMO. Interns are also required to fulfill minimum requirements in order to gain full registration, meaning they must complete ED, surgical and medical terms - whether they want to or not.
     
  20. JeremiahGreenspoon

    JeremiahGreenspoon Regular Member

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    [offtopic]Thanks chinaski, getting a bit off topic here but still interesting...
    I was thinking of the PGY1/2 years, when I thought I recalled some saying that you could start training for some specialties as early as PGY2? I assume that involves a fair degree of luck as you said, and getting things to fall into the right place at the right time, but it still left me with the impression that some, at least, had their specialty path mapped out earlier on. [/offtopic]
     

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