A FEDERAL Government scheme which forces medical students to repay up to $110,000 in fees if they do not work in a rural or remote area once qualified is exploitative and will not solve the dire rural workforce shortage, doctors' groups say.
Since 2004, 600 students a year have gained entry to university by signing a deed of agreement to work in an area short on doctors for a period of time equal to the length of their degree. Bonded Medical Placements now make up 25 per cent of all federally supported (non-full-fee-paying) places at Australia's 18 medical schools.
The Australian Medical Students Association opposes the scheme, arguing it exploits the large gap between demand for entry to the prestigious degree and the limited number of university places available.
An association spokesman, Chris Mulligan, said students often did not realise the long-term implications of signing a legally binding agreement, particularly when they might not gain entry to university otherwise. "Kids sign on to these contracts when they are 17 or 18 but the return of service doesn't kick in until they have gained a fellowship in 10 or 15 years' time, which is around the same time when many are planning to start a family," he said.
There are 2416 students on bonded medical places in Australia, including 729 at universities in NSW. The students must finish their degrees within 10 years, gain a fellowship with a specialist college within 16 years and work for four to six years in a district of workforce shortage after attaining a fellowship.
Overall the student is locked in for between 11 and 20 years, depending on their choice of speciality. If they default on their obligations, they owe the Government about $18,000 for every year studied, on top of HECS payments.
The chief executive of the Rural Doctors Association of Australia, Steve Sant, said the bonded placements were "a necessary evil" in the face of chronic workforce shortages. However, it was too early to say if the scheme had been successful in building a permanent and skilled workforce in the bush.
Fewer than 5 per cent of medical graduates have taken up rural practice in the past 15 years.
Another 884 students are on more restrictive medical rural bonded scholarships, which require six consecutive years working in a rural area after attaining a fellowship. There is an added penalty of no Medicare provider number for up to 12 years on default.
A female GP registrar, who did not wish to be named, said she grew up in a poor family in rural NSW. At 18 she accepted the scholarship, worth $22,000 a year, to help pay relocation and living expenses at university.
But she said signing up was a "huge mistake" because it "imposes unnecessary sacrifices on a future family you don't know you'll have".
In the May budget, the Government announced students could reduce their return of service by working in more remote areas and could count up to half the time spent in specialist training towards their quota.
The Herald spoke to a number of students who said they planned to buy their way out of the rural placement once they were earning lucrative consultants' wages. But Mr Mulligan said the bonds were prohibitively expensive to break for all but the most well-off.
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