Medical student body calls for urgent review of rural doctor placement scheme

Australia Broadcast Center

25-06-2025

The peak body for medical students says a government program mandating newly graduated doctors work in regional areas is flawed and in urgent need of review.
The Bonded Medical Program (BMP) offers Commonwealth-supported places in medical courses at Australian universities.
In return, participants must complete three years of service in eligible regional, rural or remote areas within 18 years of graduating, in a bid to ease staff shortages in locations that may otherwise struggle to attract doctors.
However, only 13 per cent of the nearly 17,000 participants have completed their return of service (ROS) obligation since the program began in 2001, despite the federal government investing more than $170 million over its first 20 years.
The Australian Medical Students' Association (AMSA) said changing life circumstances are prompting many participants to rescind their commitment, which requires them to pay out the cost of their course.
"We've had consultants come to us and express how challenging it is to fulfil their ROS obligation and are asking us to advocate on their behalf," advocacy officer Sparsh Tiwari said.
"We've had a couple of situations where the stress of the ROS obligations has been quite severe."
Griffith University medical student Taylor Cabassi may soon face that dilemma.
After years of hard work, the Townville local accepted a bonded place at a Sunshine Coast campus.
But two years later, she says personal changes have made it difficult for her to relocate, leaving her unsure whether she will be able to fulfil the obligation.
She also plans to specialise in forensic pathology, which has limited training and job opportunities outside of major cities.
"I'd only be able to work in Brisbane, Gold Coast or Townsville," Ms Cabassi said.
Ms Cabassi is one of many students concerned about completing the obligation too early in their careers.
"It was one of those things where I thought, 'Oh, I'll just figure it out,' but then that's also a lot of time for things to change," she said.
The concerns come as many regional, rural and remote areas struggle to recruit and retain doctors.
Competition is so severe that some towns have resorted to so-called "bidding wars", offering huge salary packages and, in some cases, free housing to attract doctors from cities.
The shortages are having consequences for health provision, with people living in the most under-served areas receiving about a third fewer specialist services than their peers in areas with better coverage, according to a report by the Grattan institute.
Rural Doctors Association of Australia CEO Peta Rutherford agreed the bonded program had potential but said it needed to better support students who commit before making serious career decisions.
"When you're looking at your return of service obligations, they're happening later in your training pathway or later in your career," Ms Rutherford said.
"That becomes really difficult when you've settled, you've got a partner who works, or you've got kids in school."
The scheme has had multiple revisions — including more time to complete the obligation and flexible work options — but the AMSA hopes to conduct research that will guide further evidence-based reform.
As it stands, Mr Tiwari questioned whether the program fostered long-term rural staff retention.
"Yes, you can push people for three years into a rural site but at the end of the day, to what extent does that solve the workforce shortages?" Mr Tiwari asked.
"We know that based on previous studies and audits there's been a low expression of interest in actually remaining and sustaining rural ties."
Federal Health Minister Mark Butler said rebuilding general practice is a top priority, with new incentives and payments introduced to support rural doctors.
"We're seeing a rush of new doctors joining the health system, with more doctors joining in the last two years than at any time in the past decade," he said.
Ms Rutherford said one cause of the recent decline in doctors choosing to work rurally was government changes to classifications that rank the remoteness of locations and their need for doctors.
However, the changes mean bonded graduates and internationally trained doctors or medical graduates can fulfil their obligation to work in areas of need that are much closer to metropolitan centres.
"We acknowledge that outer metropolitan areas have workplace pressures; they need GPs, particularly in bulk-billing services," Ms Rutherford said.
"That's OK, but only if the policies are being ramped up to incentivise people going to rural and remote locations.
"Because when all things are equal, it's really easy to stay in the city as a doctor."