(Original article by user @JeremiahGreenspoon )
As the scheme is reasonably complicated, and is hotly debated in terms of its impacts on you as a professional later on, I’ve made notes on what I understand it to entail.
It would be great if folks that knew more about it posted their thoughts, and/or corrected my interpretation of the Scheme.
Those awarded the Scholarship are required to practice in a rural or remote area for six years continuously once qualified as a specialist (including general practice). The six years must each contain at least nine months of work at more than 20 hours per week, and at least three months of work in any six month period. The work commitment required may be reduced by working in more remote areas (via scaling), however if it is not honoured a debt must be paid back (proportional to the amount of rural and remote service not completed).
The not so obvious:
- Changes to rural area classifications in the 10 years approx between when you sign the contract and when you gain fellowship. The category that is valid is that valid at the time you gain fellowship (unlike the older MRBS contracts, which locked in the RA category at the time you signed)
- Could be a good thing? ‘slow death’ of smaller regional areas could mean these move up an RA category in that period – seeing as census data is used to determine RA categories, I assume population is one of the more significant contributors to an area’s RA classification. Then again, I’m not a demographer.
- Could be a scary thing. Hypothetically, what if the Govt decides they need to drastically increase the number of docs in remote areas, and fast. RA 5 becomes RA2 and suddenly you’re forced to work in Alice Springs for six years and put you and your family through that…
- At the moment RA Categories seem quite lenient (to me. EG you can work just about anywhere in Tassie, or could be all of Tassie as part of your return of service)
- Removal of medicare provider number only occurs in the case of breach of contract
- Scaling did not used to apply if you were working in a salaried position eg. ED of public hospital (i.e. to access scaling, you needed to be billing Medicare). From what I understand, this has now changed and scaling is applicable in public hospitals.
- Although your return of service is 20 hours per week, 9 months a year for 6 years, you can do research or work in public hospitals in a city for 3 months a year or the other 20 hours a week you might want to work, as long as you don’t directly bill (so, as a salaried employee, for example in a Public Hospital, run by a State/Territory Government). Having said that, with the federal govt looking to run state hospitals in the future, could this change?
- You may be restricted in terms of what you can specialise in, depending on what services are provided in the area you work in (the exact level of this restriction could be expanded on but I don’t know enough about it). Suffice to say that it’s unlikely you’ll know what you’d want to specialise in before you start med, so it would be disappointing to not be able to pursue a particular ‘calling’ because of the contract you have signed.