Entrance Information

Medical Rural Bonded Scheme

(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.

The obvious:

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.
Just wanting to clarify a point as per my interpretation...<br />
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The service debt cannot be paid back if someone fails to complete the ROS, the Dr will then not be able to access Medicare payments for a period of 10 years which can be restrictive of practice and career.<br />
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Perhaps I'm wrong, but that was my interpretation from memory.
    From what i gather:<br />
    <br />
    You have to work in a rural area for how ever many years you were receiving the scholarship + 1. This can be 5, 6 or 7 years depending what uni you go to (i.e. UNSW is a 6 year degree, or postgrad is 4 years..)<br />
    Also not sure if this is true but i heard that you can work off those years at any stage in your career? I.e. so it wont be 'career suicide' if you want to be a heart surgeon in a city.<br />
    Also you would be surprised what rural is. I.e. RA2 is byron bay (where i am from) and to be honest i would like to go back there eventually so the scholarship wouldnt matter to me.<br />
    <br />
    But all your other points seem verry correct and need some serious thought ..
      No, you are required to perform your return of service once you have your fellowship - you're not allowed to have a glittering career in the city and return to do your ROS just before you retire, for instance.<br />
      <br />
      I would underline what is said in the article RE the changing of RA classifications. Popular places fill up first, so you won't have been the first person to think that working in Byron Bay would be a nice gig. As such, it doesn't remain an area of need in the Government's eyes for long. These classifications have already changed significantly since the inception of the MRBS (first intake was in 2001) - so beware.
        <blockquote>No, you are required to perform your return of service once you have your fellowship - you're not allowed to have a glittering career in the city and return to do your ROS just before you retire, for instance.<br />
        <br />
        I would underline what is said in the article RE the changing of RA classifications. Popular places fill up first, so you won't have been the first person to think that working in Byron Bay would be a nice gig. As such, it doesn't remain an area of need in the Government's eyes for long. These classifications have already changed significantly since the inception of the MRBS (first intake was in 2001) - so beware.</blockquote><br />
        <br />
        Ouch. That is all.
          I've got one of these, so I like to keep up to date.<br />
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          A couple of corrections: If you breach the contract, you have to pay back the scholarship, plus interest AND you lose your medicare provider number for 12 years.<br />
          <br />
          Also: you have to do 6 years RoS, regardless of the length of your course. It's different to the BMP, where RoS depends on your course length. I'm doing a 4 year course and I definitely have to do 6 years RoS (less scaling).<br />
          <br />
          Also worth noting is that you breach the contract if you don't get an appropriate job within 12 months of getting your fellowship (as well as 16 years since you started med school). That provides an additional pressure to choose a specialty with lots of jobs, i.e. General Practice. There's no time to hang around waiting for the perfect job to become available if you don't want to move interstate, or there's a lack of jobs in your field or whatever.<br />
          <br />
          Something a lot of people don't consider is that you don't get the HECS discount that others can for working rurally, while you are doing RoS for the MRBS- this reduces the 'value' of the scholarship.<br />
          <br />
          When I signed my contract, there was a specific provision about not being able to access scaling if you worked for the Flying Doctors. Not sure if this has changed. Only mentioning it because some people have this romantic idea they'll take an MRBS and then join the Flying Doctors and do their RoS super-fast with full scaling.
          <blockquote><br />
          Also worth noting is that you breach the contract<span style="font-weight:bold;">if you don't get an appropriate job within 12 months of getting your fellowship (as well as 16 years since you started med school)</span>. That provides an additional pressure to choose a specialty with lots of jobs, i.e. General Practice. There's no time to hang around waiting for the perfect job to become available if you don't want to move interstate, or there's a lack of jobs in your field or whatever.</blockquote><br />
          <br />
          Probably worth bearing in mind, in regards to the "must pay back within 16 years of starting med school" bit: you're going to be pushed to a) get onto a training program rapidly and b) not spend too much time as a trainee. As such, the pressure will be on if you're looking at a more competitive specialty (each year you miss out on an accredited position counts), as well as to pass your exams and fulfil all training requirements in the minimum amount of time (which is something you can't really absolutely guarantee).
          <blockquote>If you breach the contract, you have to pay back the scholarship, plus interest <span style="font-weight:bold;">AND you lose your medicare provider number for 12 years</span>.</blockquote><br />
          <br />
          Is this the case for the BMP as well?
          <blockquote>Is this the case for the BMP as well?</blockquote><br />
          <br />
          No. The loss of Medicare provider number only applies if you break the MRBS contract.
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