Medical Students

In Australia, professional entry level medical education is provided by university medical schools accredited by the Australian Medical Council. There are 18 universities with accredited medical schools in Australia, and a number of these were established in the last nine years. All of these universities have now produced graduates.

In the past, most medical doctors gained their professional entry level qualification by completing a five or six-year Bachelor of Medicine and Bachelor of Surgery (MBBS) degree. However, over the years an increasing number of four-year (graduate entry) programs have been introduced.

To date, these medical school programs resulted in a bachelor degree qualification. Most recently, a number of medical schools have moved to a Doctor of Medicine program, resulting in graduates with a master level qualification. The first of these is the University of Melbourne which commenced this program in 2011 and is expected to have the first cohort of master graduates in 2014.

Current programs integrate pre-clinical and clinical components throughout the program and incorporate clinical experience from early in the course. However, the most significant clinical exposure occurs in the latter years of the program.

Medical students gain clinical exposure in a range of clinical settings and via simulation. Throughout their professional entry level medical program they are provided with the skills, knowledge and attributes to move to the next phase of their training, which is the prevocational phase (prior to specialty training).

Current Data

In 2013, there were 16,994 medical students studying in Australian universities (Table 2.1). Of these 4,687 (27.6%) were undertaking a six-year course, 4,502 (26.5%) were undertaking a five-year course and 7,805 (45.9%) were undertaking a four-year course.

Table 2.1: Medical students in Australian universities, 2013

	Year 1	Year 2	Year 3	Year 4	Year 5	Year 6	Total
UG – undergraduate PG – postgraduate MD – Doctor of Medicine (a) Undergraduate program last intake in 2008. Graduate program last intake in 2009. Masters program commenced in 2011. (b) These courses are slightly less than 5 years in duration – Bond 4.8 years, Melbourne PG 4.5 years and UWA PG 4.7 years. (c) The University of Queensland has partnered with the Ochsner Health System in New Orleans to establish the University of Queensland-Ochsner Medical Program. This is a unique joint affiliation that provides US medical students with training experience and a global medical education. Students complete the first two years in Australia at UQ, and the final two years in the US, where they complete the clinical component at Ochsner in Louisiana. First graduates were in 2012. These students have been separated from the UQ students as they do not form part of the medical workforce supply from a planning perspective, but have been included to maintain the trend analysis, as they have been included since 2009. Source: Medical Deans Australia and New Zealand Inc
6-year course
Adelaide	159	189	172	171	189	152	1,032
James Cook	235	196	184	196	163	138	1,112
Melbourne UG(a)	0	0	0	7	0	239	246
UNSW	273	278	250	285	286	275	1,647
UWA UG	0	0	152	179	165	154	650
Subtotal	667	663	758	838	803	958	4,687
5-year course
Bond(b)	96	94	79	82	85	..	436
Melbourne PG(a)(b)	0	0	3	3	91	..	97
Monash UG	321	310	305	283	295	..	1,514
Newcastle/UNE	218	197	207	224	173	..	1,019
Tasmania	120	105	112	114	119	..	570
UWA PG(b)	0	67	60	58	58	..	243
UWS	120	130	122	137	114	..	623
Subtotal	875	903	888	901	935	..	4,502
4-year course
ANU	100	84	101	92	..	..	377
Deakin	136	138	133	149	..	..	556
Flinders	168	163	141	122	..	..	594
Griffith	158	149	147	153	..	..	607
Melbourne MD(a)	330	324	325	..	..	..	979
Monash PG	82	91	83	70	..	..	326
Notre Dame Sydney	121	115	107	108	..	..	451
Notre Dame Fremantle	111	98	96	98	..	..	403
Queensland(c)	421	440	428	439	..	..	1,728
UQ Ochsner (USA)(c)	105	76	36	24	..	..	241
Sydney	310	290	322	291	..	..	1,213
Wollongong	85	83	82	80	..	..	330
Subtotal	2,127	2,051	2,001	1,626	..	..	7,805
Total	3,669	3,617	3,647	3,365	1,738	958	16,994

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In 2013, 14,267 or 84.0% of all students were domestic students (Table 2.2). A domestic student is defined as being an Australian or New Zealand citizen, or an Australian permanent resident. Of these 3,857 (27.0%) were undertaking a six-year course, 3,872 (27.1%) were undertaking a five-year course and 6,538 (45.8%) were undertaking a four-year course.

Table 2.2: Domestic medical students in Australian universities, 2013

	Year 1	Year 2	Year 3	Year 4	Year 5	Year 6	Total
UG – undergraduate PG – postgraduate MD – Doctor of Medicine (a) Undergraduate program last intake in 2008. Graduate program last intake in 2009. Masters program commenced in 2011. (b) These courses are slightly less than 5 years in duration – Bond 4.8 years, Melbourne PG 4.5 years and UWA PG 4.7 years. Source: Medical Deans Australia and New Zealand Inc
6-year course
Adelaide	124	164	157	150	153	127	875
James Cook	201	173	167	169	141	136	987
Melbourne UG(a)	0	0	0	6	0	166	172
UNSW	214	216	187	225	232	212	1,286
UWA UG	0	0	130	147	134	126	537
Subtotal	539	553	641	697	660	767	3,857
5-year course
Bond(b)	95	94	77	80	83	..	429
Melbourne PG(a)(b)	0	0	3	3	77	..	83
Monash UG	263	247	252	235	237	..	1,234
Newcastle/UNE	192	179	178	186	151	..	886
Tasmania	100	85	89	88	105	..	467
UWA PG(b)	0	58	60	58	58	..	234
UWS	103	107	108	114	107	..	539
Subtotal	753	770	767	764	818	..	3,872
4-year course
ANU	98	81	92	84	..	..	355
Deakin	131	132	131	144	..	..	538
Flinders	143	143	121	111	..	..	518
Griffith	152	149	147	153	..	..	601
Melbourne MD(a)	294	288	302	0	..	..	884
Monash PG	75	82	68	64	..	..	289
Notre Dame Sydney	121	115	107	108	..	..	451
Notre Dame Fremantle	111	98	96	98	..	..	403
Queensland	308	308	320	313	..	..	1,249
Sydney	232	220	264	237	..	..	953
Wollongong	76	74	75	72	..	..	297
Subtotal	1,741	1,690	1,723	1,384	..	..	6,538
Total	3,033	3,013	3,131	2,845	1,478	767	14,267

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Types of Student Places

A student undertaking medical studies in Australia may occupy either:

• a Commonwealth-supported university place (CSP), where the student is required to pay for only part of the cost of his or her degree through HECS; or
• a full fee-paying place, which is funded entirely by the tuition fees paid by the student.

Some medical students occupying Commonwealth-supported university places are participating in the Bonded Medical Places Scheme (BMPS) or have received scholarships through the MRBSS, which commenced in 2004 and 2001 respectively.

Students participating in the BMPS have a return of service obligation to work in a DWS as identified by the Commonwealth, for a period of time equal to the length of the medical degree. However, up to half of the return of service obligation can be met while completing prevocational and vocational training.

Recipients of the Medical Rural Bonded Scholarship Scheme (MRBSS) scholarship are required to work for six continuous years in locations within Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA) 2 to 5. MRBSS doctors start their six year commitment to work in rural Australia after completing their vocational training.

Over three-quarters of all university places each year are Commonwealth-supported. In 2013, there were 13,315 Commonwealth-supported places or 78.4% of all places (Table 2.3). For commencing students the proportion is almost the same. Of the 3,669 commencing medical students in 2013, 2,792 students or 75.3% were in Commonwealth-supported places (Table 2.4).

Just over one-fifth (21.2%) of all medical students were fee-paying in 2013. Three-quarters of full fee-paying places are occupied by international students and this number is similar among commencing students (75.2%, Table 2.4) and all medical students (75.8%, Table 2.3).

Table 2.3 provides detailed information on the number and types of places available at each university in 2013, with Table 2.4 displaying this for commencing students. Table 2.5 provides further information on whether it was a Commonwealth-supported or fee-paying place.

Table 2.3: Medical students by type of student place and university, 2013

	Commonwealth-supported places	Fee-paying places		Other(a)	Total
		Domestic	International
UG – undergraduate PG – postgraduate MD – Doctor of Medicine (a) Includes medical students on state health department bonded medical scholarships. Source: Medical Deans Australia and New Zealand Inc
Adelaide	870	5	157	0	1,032
ANU	355	0	22	0	377
Bond	0	429	7	0	436
Deakin	538	0	18	0	556
Flinders	441	0	76	77	594
Griffith	598	0	6	3	607
James Cook	983	4	125	0	1,112
Melbourne MD	754	130	95	0	979
Melbourne PG	83	0	14	0	97
Melbourne UG	163	9	74	0	246
Monash PG	287	2	37	0	326
Monash UG	1,229	5	280	0	1,514
Newcastle/UNE	884	2	133	0	1,019
Notre Dame Sydney	260	191	0	0	451
Notre Dame Fremantle	399	4	0	0	403
Queensland	1,219	30	479	0	1,728
UQ Ochsner (USA)	..	..	241	..	241
Sydney	931	21	260	1	1,213
Tasmania	467	0	103	0	570
UNSW	1,256	30	361	0	1,647
UWA PG	234	0	9	0	243
UWA UG	537	0	113	0	650
UWS	530	9	84	0	623
Wollongong	297	0	33	0	330
Total	13,315	871	2,727	81	16,994

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Table 2.4: Commencing medical students by type of student place and university, 2013

	Commonwealth-supported places	Fee-paying places
		Domestic	International	Other(b)	Total
UG – undergraduate PG – postgraduate MD – Doctor of Medicine (a) The University of Western Australia is in the process of converting its medical degree from a 6 year undergraduate MBBS degree to a 4 year MD degree. First year enrolment for the MD program will commence in 2014. (b) Includes medical students on state health department bonded medical scholarships. Source: Medical Deans Australia and New Zealand Inc
Adelaide	124	0	35	0	159
ANU	98	0	2	0	100
Bond	0	95	1	0	96
Deakin	131	0	5	0	136
Flinders	112	0	25	31	168
Griffith	152	0	6	0	158
James Cook	201	0	34	0	235
Melbourne MD	253	41	36	0	330
Melbourne PG	0	0	0	0	0
Melbourne UG	0	0	0	0	0
Monash PG	75	0	7	0	82
Monash UG	263	0	58	0	321
Newcastle/UNE	192	0	26	0	218
Notre Dame Sydney	57	64	0	0	121
Notre Dame Fremantle	107	4	0	0	111
Queensland	305	3	218	0	526
Sydney	229	3	78	0	310
Tasmania	100	0	20	0	120
UNSW	214	0	59	0	273
UWA PG(a)	0	0	0	0	0
UWA UG(a)	0	0	0	0	0
Western Sydney	103	0	17	0	120
Wollongong	76	0	9	0	85
Total	2,792	210	636	31	3,669

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In 2013, the majority of Commonwealth-supported students occupied HECS only places (9,621 places or 72.3% of Commonwealth-supported places), whereas 3,694 or 27.7% of Commonwealth-supported students have a return of service obligation under either the MRBSS or BMPS, in addition to contributing to the cost of their education under HECS (Table 2.5).

Ten years after the commencement of the BMPS, there were 3,278 students in BMPS places. This was a slight decrease from 2012 (4 students). However, from 2009 to 2013 the number of students supported through this scheme had increased by 999 places or 43.8% (Table 2.5).

The number of students in the MRBSS also decreased from 2012 (53 students or 11.3%). However the number of students in MRBSS places remained relatively constant since 2009, ranging between 481.5 students in 2009 and 416 students in 2013. The number of MRBSS students as a proportion of all student places decreased from 3.3% in 2009 to 2.5% in 2013, while the number of BMPS students as a proportion of all students increased from 15.7% in 2009 to 19.3% in 2013.

The proportion of domestic fee-paying students has been in steady decline since 2009 (6.5% of all students in 2009, to 4.7% of all students in 2012). But the proportion of domestic fee-paying students increased in 2013 (5.1% of all students in 2013). The absolute number of international fee-paying students has increased but the proportion has fluctuated, starting at 16.7% in 2009. By 2013 (as in 2012), international fee-paying students comprised 16.0% of all medical students.

Table 2.5: Medical students by type of student place: Number and proportion of places, 2009–2013

	2009	2010	2011	2012	2013
(a) International students are those studying as private or sponsored students who are not Australian citizens, permanent residents or New Zealand citizens. (b) Includes medical students on state health department bonded medical scholarships. (c) ANU offers their research component part time in exceptional circumstances. Source: Medical Deans Australia and New Zealand Inc
Medical students
Commonwealth-supported	10,938	11,873	13,016	13,289	13,315
HECS only	(c)8,177.5	8,707	9,435	9,538	9,621
BMPS	2,279	2,686	3,122	3,282	3,278
MRBSS	(c)481.5	480	459	469	416
Fee-paying	3,373	3,356	3,364	3,492	3,598
Domestic	949	905	829	801	871
International(a)	2,424	2,451	2,535	2,691	2,727
Other(b)	210	231	111	87	81
Total	14,521	15,460	16,491	16,868	16,994
Proportion of places (%)
Commonwealth-supported	75.3	76.8	78.9	78.8	78.4
HECS only	56.3	56.3	57.2	56.5	56.6
BMPS	15.7	17.4	18.9	19.5	19.3
MRBSS	3.3	3.1	2.8	2.8	2.4
Fee-paying	23.2	21.7	20.4	20.7	21.2
Domestic	6.5	5.9	5.0	4.7	5.1
International(a)	16.7	15.9	15.4	16.0	16.0
Other(b)	1.4	1.5	0.7	0.5	0.5
Total	100.0	100.0	100.0	100.0	100.0

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Scholarships

Students can receive scholarships through a variety of sources. Data was collected through the MSOD project from 3,471 medical students (94.2% of the total 3,686) commencing their studies in 2012. Of these, 366 (10.5%) stated that they received a scholarship to support them in their medical studies (Table 2.6).

Table 2.6: Commencing medical students source of scholarships, 2012

	Students	Proportion (%)
Source: Medical Schools Outcomes Database
Commonwealth scholarships	124	33.9
State scholarships	11	3.0
Scholarships provided by Australian universities	180	49.2
Scholarships provided by home country to international students	37	10.1
Scholarships provided by other institutions	12	3.3
Unnamed	2	0.5
Total	366	100.0

Student Characteristics

Data from MSOD provides insights into who is undertaking medical studies. Data are recorded for the 3,471 students (94.2% of the total 3,686) who completed the MSOD entry requirements in 2012.

Just over four-fifths (81.1%) of students commencing their medical studies in 2012 were under the age of 25 years (Table 2.7).

Table 2.7: Commencing medical students by sex and age, 2012

Age group	Male	Female	Proportion female (%)	Total	Proportion of total (%)
Source: Medical Schools Outcomes Database
Less than 20 years	642	659	50.7	1,301	37.5
20-24 years	775	740	48.8	1,515	43.6
25-29 years	239	197	45.2	436	12.6
30-34 years	71	56	44.1	127	3.7
35-39 years	26	24	48.0	50	1.4
40 years and over	17	24	58.5	41	1.2
Unknown	1	0	0	1	0
Total	1,771	1,700	49.0	3,471	100.0

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Just over half (56.7%) of the medical students commencing in 2012 began their studies after finishing another degree, with 83.8% of these having completed a tertiary qualification in science, medical science and health and/or allied health (Table 2.8).

The majority (94.8%) of these students entered a graduate program. Just over three quarters (76.4%) had bachelor degrees, 14.4% had completed honours, graduate diploma or certificate and 9.2% of these students had a masters or doctorate (Table 2.9).

Table 2.8: Commencing medical students discipline of highest tertiary qualification completed, 2012

Discipline of prior degree	Undergraduate entry	Graduate entry	Total
(a) B.Sci, B Applied Sci (no or unclear major), Vet Sci, Liberal Arts, B Sci in Human Movement, biotechnology, human kinetics, exercise science and psychology. (b) B. Medical Science, pathology, biochemistry, microbiology, haematology, histopathology, cytology and immunology. (c) Radiography, nursing, optometry, podiatry, speech pathology, orthodontics, nutrition, public health and tropical medicine, occupational therapy, kinesiology, naturopathy, pharmacy, physiotherapy, dentistry, dental surgery, oral health, prosthetics and orthotics. (d) B Eng, B Computer Science, architecture, urban planning, electronics, surveying, IT and mathematics. Source: Medical Schools Outcomes Database
Science(a)	26	674	700
Medical Science(b)	14	527	541
Health/Allied Health(c)	34	363	397
Humanities	11	134	145
Commerce/Business/Law	7	79	86
Physical sciences(d)	7	64	71
Other/Unknown	3	26	29
Total	102	1,867	1,969

Table 2.9: Commencing medical students level of highest prior tertiary qualification by medical degree entry program^(a), 2012

Level of prior degree	Undergraduate entry	Proportion undergraduate (%)	Graduate entry	Proportion postgraduate (%)	Total
(a) Based on all individuals who reported previous qualifications. Source: Medical Schools Outcomes Database
PhD	0	0	44	2.4	44
Masters	17	16.7	128	6.9	145
Graduate Diploma/Certificate	9	8.8	55	2.9	64
Honours	7	6.9	213	11.4	220
Bachelor	65	63.7	1,426	76.4	1,491
Associate Degree	0	0	1	0.1	1
Other/unknown	4	3.9	0	0	4
Total	102	100.0	1,867	100.0	1,969

Table 2.10 and Table 2.11 provide information on the preferred type of medical practice as reported in the MSOD questionnaire by students in their final year of a medical degree and by PGY1 trainees. The same specialties ranked as the top three first-preference choices for each gender in both the final year of medical degree and the first postgraduate year.

The most popular preferred types of medical practice among males were surgery and adult medicine, followed by general practice (295, 205 and 127 respectively in final year of medical degree and 185, 173, and 107 in PGY1). Females noted general practice, adult medicine and paediatrics and child health most often as their first preference for type of medical practice (244, 240 and 187 respectively in final year of medical degree and 230, 189 and 114 in PGY1).

Table 2.10: Preferred type of medical practice in final year of medical degree by gender, 2012^(a)

Specialty	Preference 1		Preference 2		Preference 3
	Male	Female	Male	Female	Male	Female
(a) Data were collected from 2,519 medical students in their final year who answered the MSOD questionnaire. Source: Medical Schools Outcomes Database
Addiction medicine	3	3	3	4	2	7
Adult medicine/internal medicine	205	240	102	120	103	110
Anaesthesia	112	101	98	78	83	64
Dermatology	12	36	12	23	8	22
Emergency medicine	105	106	128	101	92	106
General practice	127	244	75	145	103	127
Indigenous health	1	6	2	5	4	18
Intensive care medicine	35	20	78	53	73	46
Medical administration (e.g. managing a hospital)	2	3	6	7	14	13
Non-specialist hospital practice (e.g. career as a medical officer in a hospital)	1	0	2	6	7	9
Obstetrics and gynaecology	32	138	24	97	25	54
Occupational and environmental medicine	0	0	1	0	1	0
Ophthalmology	26	25	20	17	9	13
Oral and maxillofacial surgery	9	1	2	4	4	4
Paediatrics and child health	69	187	66	100	37	76
Pain medicine	1	1	4	1	6	4
Palliative medicine	1	7	9	20	7	26
Pathology	7	7	4	8	7	11
Psychiatry	34	34	20	32	28	45
Public health medicine	0	5	8	7	11	21
Radiology	33	20	34	16	30	15
Rehabilitation medicine	0	1	1	4	3	7
Rural and remote medicine	19	37	18	26	24	32
Sexual health medicine	2	4	3	13	7	19
Surgery	295	141	77	43	60	35
Other	13	8	3	5	6	3

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Table 2.11: Preferred type of medical practice in postgraduate year 1 by gender, 2012^(a)

Specialty	Preference 1		Preference 2		Preference 3
	Male	Female	Male	Female	Male	Female
(a) Data collected from 2,519 medical students in their final year who answered the MSOD questionnaire. Source: Medical Schools Outcomes Database
Addiction medicine	0	1	1	3	2	2
Adult medicine/internal medicine	173	189	61	79	53	76
Anaesthesia	83	72	58	49	51	43
Dermatology	11	17	5	11	10	12
Emergency medicine	38	67	49	63	71	58
General practice	107	230	74	113	87	98
Indigenous health	0	2	2	5	2	10
Intensive care medicine	17	22	64	54	43	36
Medical administration (e.g. managing a hospital)	5	0	6	5	16	9
Non-specialist hospital practice (e.g. career as a medical officer in a hospital)	1	0	3	5	2	6
Obstetrics and gynaecology	14	71	8	44	7	33
Occupational and environmental medicine	2	0	0	1	1	2
Ophthalmology	25	18	6	5	7	2
Oral and maxillofacial surgery	6	1	7	2	2	1
Paediatrics and child health	30	114	17	45	11	39
Pain medicine	0	1	5	2	2	4
Palliative medicine	1	6	11	22	17	24
Pathology	5	11	6	7	3	5
Psychiatry	22	35	9	14	9	13
Public health medicine	1	9	7	9	6	23
Radiology	39	12	32	14	27	16
Rehabilitation medicine	2	3	4	6	2	6
Rural and remote medicine	22	29	11	19	12	23
Sexual health medicine	0	1	2	5	4	9
Surgery	185	92	50	28	21	22
Other	14	14	8	9	1	5

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In 2012, a total of 625 of the 3,471 medical students completing the MSOD entry questionnaire reported that they held temporary or other entry permits to Australia (Table 2.12). The highest numbers of international students came from Singapore (22.1%), Canada (19.7%), Malaysia (15.8%) and United States of America (13.6%).

Table 2.12: International commencing medical students holding temporary or ‘other’ entry permits by place of birth, 2012

Country of birth	Students	Proportion (%)
Source: Medical Schools Outcomes Database
Singapore	138	22.1
Canada	123	19.7
Malaysia	99	15.8
United States of America	85	13.6
Hong Kong (SAR of China)	24	3.8
China (excludes SARs and Taiwan)	19	3.0
Korea, Republic of (South)	19	3.0
Sri Lanka	15	2.4
Indonesia	12	1.9
All other (where n≤10)	91	14.6
Total	625	100.0

Aboriginal and/or Torres Strait Islander Students

Data on the Aboriginal and/or Torres Strait Islander people(s) status of medical students is available from two sources, MDANZ Student Statistical Collection and the MSOD. Data from these two sources cannot necessarily be reconciled, so both are presented below as each provides different insights into the number of Aboriginal and/or Torres Strait Islander people(s) studying medicine.

The number and proportion of medical students reporting that they are of Aboriginal and/or Torres Strait Islander origin when completing the MSOD entry questionnaire have risen slightly over the years from 37 or 1.2% of commencing students in 2008, to 48 or 1.4% in 2012 (Table 2.13).

Table 2.13: Commencing medical students by Aboriginal and/or Torres Strait Islander status, 2008–2012

	2008	2009	2010	2011	2012
Source: Medical Schools Outcomes Database
Aboriginal and/or Torres Strait Islander students	37	38	47	69	48
Non Aboriginal and/or Torres Strait Islander students	3,180	3,113	3,064	3,483	3,403
Unknown	18	10	4	10	20
Total	3,235	3,161	3,115	3,562	3,471
Proportion of Aboriginal and/or Torres Strait Islander students (%)	1.2	1.2	1.5	1.9	1.4

Data from the MDANZ shows that there have been significant increases each year in the overall number of Aboriginal and/or Torres Strait Islander people(s) studying medicine. In 2013, there was a total of 261 medical students studying in Australian universities who reported being of Aboriginal and/or Torres Strait Islander origin (Table 2.14), an increase of 163.6% over the eight years from 2006. No data are available for the actual attrition rate, which is known to be higher than for non Aboriginal and/or Torres Strait Islander students, or on the number of Aboriginal and/or Torres Strait Islander students who go on to complete their medical degrees.

Table 2.14: Aboriginal and/or Torres Strait Islander medical students studying in Australian universities, 2006–2013

	2006	2007	2008	2009	2010	2011	2012	2013
Source: Medical Deans Australia and New Zealand Inc
Aboriginal and/or Torres Strait Islander students	99	125	129	137	161	218	226	261
Annual increase (%)		26.3	3.2	6.2	17.5	35.4	3.7	15.5

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Rural Exposure

Exposure to rural and remote settings, whether through living, schooling and/or undertaking medical studies or training there, is shown to have a positive impact on the likelihood of medical professionals practising in rural and remote areas.

The Rural Clinical Training and Support (RCTS) program provides funding to participating universities for the establishment and support of medical student training in rural areas, and supports 17 rural clinical schools nationally. The RCTS program aims to improve the range of rural health care services and strengthen the health workforce in rural communities across Australia.

Participating Australian medical schools are required to meet a range of objectives set out in the program parameters, including:

• providing at least 4 weeks rural training for all medical students;
• having at least 25% of their medical students undertake at least one year of clinical training in a rural area;
• providing high-quality training of medical students in rural and remote areas;
• having at least 25% of their yearly student intake of rural origin;
• maintaining and enhancing measures to increase the number of Aboriginal and Torres Strait Islander medical student graduates; and
• facilitating an increase in rural health and workforce research, rural health advocacy and a raised awareness of rural and remote health issues.

The RCTS is a component initiative of the Rural Health Multidisciplinary Training (RHMT) program, which also supports 11 University Departments of Rural Health, six dental schools that offer rural dental placements and the John Flynn Placement Program.

Data on students who have a rural background are collected by medical schools. In 2013, 769 or 27.1% of commencing domestic students reported that they had lived in a rural or remote area prior to commencing their medical studies (this is in line with the proportion of 27% in 2012). A slightly higher proportion (29.9%) of students from universities participating in the Rural Clinical Training and Support Program reported a rural background compared to all commencing domestic students (Table 2.15).

The proportion of domestic students with a rural background was roughly one quarter in each state and territory.

Table 2.15: Commencing domestic students with a rural background^(a) by state/territory, 2013

University	Males	Females	Total	Proportion of all domestic students with a rural background (%)	Rural Clinical Training and Support Program(i): Proportion students with a rural background (%)
UG – undergraduate PG – postgraduate MD – Doctor of Medicine (a) Rural background is based on residency from the commencement of primary school in an area classified as RA2 to RA5 under the Australian Standard Geographical Classification - Remoteness Areas (ASGC-RA) system. (b) UNSW data based on RRMA 3-7. The Rural Clinical Training and Support (RCTS) program data based on an ASGC-RA 2-5 area. (c) This university is not subject to the RCTS rural origin target and does not collect data on rurality. (d) This university does not participate in the RCTS program and does not collect data on rurality. (e) This university does not participate in the RCTS program. (f) The University of Western Australia is in the process of converting its medical degree from a 6 year undergraduate MBBS degree to a 4 year MD degree. First year enrolment for the MD program will commence in 2014. (g) Excludes domestic students from UWS, UWA and Bond. (h) The total of 22 commencing students with a rural background reported for this school equates to 40% of CSPs for this school. (i) The Rural Clinical Training and Support (RCTS) program requires that a number of Australian medical students equal to at least 25% of the University's medical student CSP allocation must come from a rural background, defined as residency for at least five years since beginning primary school in an ASGC-RA 2-5 area. Universities may count full-fee paying students towards the 25% target. (j) The RCTS rural origin proportion for University of Notre Dame covers both NSW and WA campuses as they have one Agreement with the Department of Health. (k) Monash UG and Monash PG numbers are combined. Source: Australian Government Department of Health and Medical Deans Australia and New Zealand Inc
New South Wales
Newcastle/UNE	33	21	54	28.1	28.1
Notre Dame Sydney	8	14	22	(h)18.2	(j)29.6
Sydney	29	29	58	25.0	26.0
UNSW(b)	28	29	57	26.6	25.4
UWS(c)	..	..	..	..	..
Wollongong	23	28	51	67.1	67.1
Total NSW	121	121	242	29.0	30.6
Victoria
Deakin	15	21	36	27.5	27.5
Melbourne MD	31	36	67	22.8	27.3
Monash PG	8	13	21	28.0	..
Monash UG	34	39	73	27.8	(k)26.8
Total Vic	88	109	197	25.8	27.1
Queensland
Bond(d)	..	..	..	..	..
Griffith(e)	6	3	9	5.9	..
Queensland	39	37	76	24.7	24.4
James Cook	27	81	108	53.7	51.7
Total Qld	72	121	193	29.2	35.3
Western Australia
Notre Dame WA	8	20	28	25.2	..
UWA PG(f)	0	0	0	..	..
Total WA	8	20	28	25.2	..
South Australia
Adelaide	9	16	25	20.2	21.7
Flinders	12	19	31	21.7	28.8
Total SA	21	35	56	21.0	25.2
Tasmania
Tasmania	13	18	31	31.0	31.0
Australian Capital Territory
ANU	8	14	22	22.7	25.6
Total	331	438	(g)769	27.1	29.9

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Trends

The number of commencing medical students increased each year from 2009 to 2011 (328 more commencements in 2011 compared to 2009), but decreased in both 2012 (84 students) and 2013 (17 students). The zero intake for the University of Western Australia in 2012 affected the trend of commencing medical students, with 2012 the first year to show a decline in numbers, as the university transitions from a four-year program to a six-year program. Overall commencing medical students increased by 6.6% overall, from 3,442 in 2009 to 3,669 in 2013 (Table 2.16).

Over the same period, the number of domestic commencing students increased by 78 students or 2.6%, while the number of international commencing students increased by 149 students or 30.6%.

The proportion of female domestic students commencing medical studies remained relatively stable over the last five years – around half of all commencing medical students. However, the proportion of female international students was slightly less than half of all commencing international students.

Table 2.16: Commencing medical students: Domestic, international and proportion of females^(a), 2009–2013

	2009	2010	2011	2012	2013
(a) Based on the commencing year of the graduate course. (b) International students are those studying as private or sponsored students who are not Australian citizens, permanent residents or New Zealand citizens. (c) Includes the UQ Ochsner (USA) cohort. Source: Medical Deans Australia and New Zealand Inc
Domestic	2,955	2,940	3,241	3,035	3,033
Proportion female (%)	54.8	52.9	50.9	48.1	51.2
International(b)(c)	487	529	529	651	636
Proportion female (%)	47.0	42.5	47.6	47.5	45.6
Total	3,442	3,469	3,770	3,686	3,669

Projections suggest that 3,851 medical students will commence their studies in Australian universities in 2014 (Table 2.17). Of these 3,131 (81.3%) are expected to be domestic students and 720 (18.7%) international students. This is slightly more (by 182 students or 5.0%) than the actual number who commenced studies in 2013. It is worth noting that the University of Western Australia did not enrol any commencing students in 2013.

Table 2.17: Commencing medical student projections^(a), 2014

University	Domestic	International	Total
(a) These numbers are projections only and are subject to change. Source: Medical Deans Australia and New Zealand Inc
Adelaide	124	35	159
ANU	90	10	100
Bond	95	1	96
Deakin	130	12	142
Flinders	136	30	166
Griffith	154	8	162
James Cook	175	30	205
Melbourne	295	45	340
Monash	319	66	385
Newcastle/UNE	170	24	194
Notre Dame Sydney	120	-	120
Notre Dame Fremantle	106	-	106
Queensland	300	120	420
UQ Ochsner (USA)	..	110	110
Sydney	228	80	308
Tasmania	95	20	115
UNSW	208	67	275
UWA	209	30	239
Western Sydney	102	20	122
Wollongong	75	12	87
Total	3,131	720	3,851

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Between 2009 and 2013, there was an increase of 2,473 students or 17.0% of the total number of medical students studying in Australian universities (Table 2.18). Over the same period, the number of domestic students increased proportionally more than the number of international students, rising by 17.9% to 14,267 students. The number of international students increased by only 12.5% to 2,727.

Table 2.18: Medical students: Domestic, international and proportion of females^(a), 2009–2013

	2009	2010	2011	2012	2013
(a) Data covers all years of study. (b) International students are those studying as private or sponsored students who are not Australian citizens, permanent residents or New Zealand citizens. (c) Includes the UQ Ochsner (USA) cohort (refer to Table 2.1 for more information). Source: Medical Deans Australia and New Zealand Inc
Domestic	12,097	12,946	13,956	14,177	14,267
Proportion female (%)	54.6	54.2	53.0	51.5	51.2
Annual increase (%)	9.7	7.0	7.8	1.6	0.6
International(b)(c)	2,424	2,451	2,535	2,691	2,727
Proportion female (%)	51.4	50.1	49.1	48.7	47.3
Annual increase (%)	5.0	1.1	3.4	6.2	1.3
Total	14,521	15,397	16,491	16,868	16,994
Annual increase		876	1,094	377	126
Annual increase (%)		6.0	7.1	2.3	0.7