Medical School in Australia

Today’s Medical Education Monday spotlight will be on a country I would absolutely love to visit someday – Australia! @sunlightandsnow is an extremely busy junior doctor in Australia who was nice enough to take some time out of her crazy schedule to help me out with this series. When she has some free-time she enjoys reading about politics and playing computer games. She just completed her medical degree at the end of last year, so she should be able to give us a great account of the medical education system “down under.” She mentioned that she was open to answer questions and clarify, so if you have a question feel free to tweet her or leave a comment here and we’ll make sure to get it answered!  

Griffith University School of Medicine in Queensland, Australia

Getting In
How old is one when they begin medical school?
It depends – Australians can study medicine as undergraduates or postgraduates. So they can start immediately after high school (usually around age 18), or can be quite significantly older when they begin. Sometimes they’ve done other university degrees first, often they have not. I was 19 when I started.
What exams does one have to take to get in?
There are always 2 and often 3 requirements to get into medical school. They are:
1. High school/university marks of a reasonable level to get in.
2. If applying for undergraduate, the completion of the UMAT – (university medical admissions test). This is an IQ like exam that takes place over a few hours. If applying for post graduate, the completion of the GAMSAT (similar, but probably harder test – I didn’t do this, as I did an undergraduate degree).
3. Interviews at the individual universities (varies from university to university about the requirements or whether they require interviews at all).
Is there any required pre-requisite coursework?
When I applied, no. This may have changed in the last six years.
Is it a competitive occupation?
Yes. I believe about one in eight applicants get accepted into medical school.
What are you called at this stage of training?
Medical student wannabe? 

Being In

How long is it?
Undergraduate is anything from 5-6 years. Postgraduate is 4 years.
How are the years broken down?
This varies significantly from school to school – most do at least 2 years of basic sciences (with clinical exposure thrown in), and then the remaining time is more clinical exposure. Obviously the length of the degree can make this vary significantly – six year degrees often have 3 years of basic sciences, 1 year of research and then 2 years of clinical training.
Describe your typical day.
In the early years, we’d usually have one morning of PBL (this is “problem based learning,” it is practiced at many medical schools in the US as well – but not at mine) where we “opened a learning problem” – a clinical scenario where we’d read through a patient scenario and realise how little we knew. We’d then come up with a list of things we didn’t know and needed to study. Usually the following few days would then be spent with lectures related to the scenario, teaching us the science behind it. We’d sometimes have an anatomy/histology lab based around this as well.We’d have a day of clinical exposure, and then we’d have a closing PBL towards the end of the week, where the tutorial group would get together and go over the areas we hadn’t understood before (and hopefully we would by then!)
In my final year, I’d spend probably ~30-40 hours a week at the hospital doing clinical exposure. We’d attend ward rounds, examine patients, take histories, and help the junior doctors. We’d have a few hours (2-4) of lectures/tutorials/week on top of that to make sure we were advancing, but mostly we were expected to self direct our learning (I guess using the skills we learnt in the early years, by identifying what we didn’t know).
If you choose a specialty, when do you have to decide by?
Not until after medical school – usually towards the end of internship (post grad year 1) or residency (post grad year 2).
What are you called at this stage of training?
Medical student.

Getting Out

What exams do you have to take?
Varies from university to university. I didn’t have any official “finishing exams” – it was more a continuous assessment type thing where I’d do a term in a speciality (like psych), and then at the end of that term do an exam in that speciality. There weren’t any big exams for me, but other schools often had big barrier exams.
Do most people graduate?
I think about 90% of the year I started with will eventually finish – some of them failed and are repeating, but mostly people get all the way through.
When are you finally considered a “doctor?”
Good question.
After my last day of university? (end of October)
When I’m registered with the medical board? (early January)
The day I started work? (mid January)
When I actually received my degree at the graduation ceremony? (April/May)
From my point of view, it was probably in mid-January when I actually started working as a doctor.
Do you have additional training or do you start working immediately?
We had a week’s worth of orientation and training at our individual hospitals, but we then start working. Internship, residency and specialty training are all considered training despite us working.
What’s the average debt for attendance?
In Australia you can have the government assist you with paying (known as a Commonwealth Supported Place [CSP]), and you owe them money through the Higher Education Contribution Scheme (HECS). In this situation they pay for a significant amount of your fees, but the cost depends on how long you take to do the degree (how many units of coursework you do). I went through this system and owe the government approximately $45,000.
You begin paying this debt off once you earn above a certain amount per year. I pay about $48/week…so that will take a LONG time to pay off! (This amount is taken out on top of the standard taxes that we pay. You have other options for paying it off, including paying up front as you go through the course, which comes with a lovely discount.)
There are also full fee paying places (FFP), in which case you don’t have the support of the government paying a large amount of it, although you are still able to borrow the money from the government and pay it back later. I did not have one of these places and so I’m not sure how much they cost, but I think it varies from about $100,000-$250,000 depending on the university.
What are you called at this stage of training?
Junior doctor/intern/resident.

Being Out

What’s the average salary?
Varies from state to state, and at what stage you are at.
Post graduate year 1 (PGY1) = Internship, PGY2 = Residency. Interns (which is what I am), are paid a varying base salary depending on the state. The lowest paid state is Victoria (~$50,000), the highest is Queensland (~$65,000). Many people can be paid more than this once you include overtime. Your pay goes up each year as you’re more experienced and progressing through the ranks. 
PGY3+ = Specialty Training (called “registrars” at this stage).
Specialty training takes anything from 3-6 years depending on the specialty (and whether you take time off, or take longer for various reasons). Once specialty training is complete, you are a specialist/consultant in that area. Dr Harris (@richharris2) could give you a better indication of how much specialists can earn! (Salary will vary depending on your specialty).
Is the job security good?
I feel like it is…
Can you switch specialties?
Yes. As internship and residency is a generalised teaching/experience, you aren’t even in a specialty at this stage. Even once you start training in a specialty, you can change.

Past Medical Education Monday Posts: