It can be a real challenge to get your head around the types of places available. Below you will find a breakdown of the types of places that are offered through GEMSAS.
CSP - Commonwealth Supported Place
Put simply, a Commonwealth supported non-bonded place (CSP) is a no strings attached medical place. The price is heavily subsidised by the Commonwealth government and there is no demand whatsoever to practice rurally unless you choose to do so. This is advantageous in that you are afforded freedoms early in your medical career. There is no reason why you should not rank CSP as your highest preference in your GEMSAS ranking. Having said this however, it is only natural that the limited number of CSP places would be the most sought after, and therefore the most competitive when it comes to GEMSAS medical school admission.
BMP - Bonded Medical Place
The BMP is essentially a modified CSP. This is the case as a BMP is the same cost as the CSP with the addition that you are expected to practice rurally for a predefined period. Currently the BMP Scheme requires the recipient to spend a minimum of 1 year in an area of workplace shortage. For the 2020 intake (and likely going forward), the bonded rural period will be 3 years with flexibility when and how that time is allocated. This means that you will not be required to undertake three years of consecutive work in a rural environment - you will likely be able to complete the three year commitment over a period time, through multiple extended rotations in areas of need.
Another important point to address is the definitions of rural or remote regions which satisfy BMP placement criteria are fluid. This means that regions of need may change, year to year, in response to healthcare workforce supply and demand in a given area. In practical terms, if you work for a year in a particular area of need, however this region is removed from the BMP list, then future work in this location will no longer count towards fulfillment of your BMP contract.
Finally, it has been previously possible to pay your way out of a BMP contract, once you are meaningfully employed. This means that you will pay a penalty fine, and subsequently be excused from your rural/remote employment obligation. While this can be liberating, you should consider the fact that penalty fees for breaking the BMP contract number in the tens of thousands of dollars (comparable to medical school full fees). Furthermore, the overwhelming majority of doctors, both CSP and BMP, will ultimately spend time in remote/rural regions as a necessary requirement of the training process. The bottom line means that the early career trajectory of both CSP and BMP doctors will not be greatly different in terms of placement at rural hospitals.
The purpose of a BMP is to encourage future doctors out into the country, the government can address the current and future workforce shortages that exist around rural and remote Australia. This means that a great deal of funding and support exists for work and training in rural areas. This should still be balanced however, with the fact that living away from your home region, as well as your friends and family, can be challenging. Especially in a career such as medicine, which is heavily reliant on social safety nets for psychological support.
Ultimately, BMP places are marginally less competitive than CSP places for the aforementioned associated obligations. Having said this, the advantage of securing an affordable medical place, in conjunction with the similar career trajectories of most junior medical staff, leads Fraser’s Interview to strongly recommend preferencing this type of place second, immediately after CSP.
Domestic Full Fee Place
The domestic full-fee place is the third major place offered to domestic applicants. It is not supported by the Commonwealth government financially but is identical to the CSP in that it is a no strings attached medical place. Costs for full-fee places vary between institutions, Notre Dame full-fee places cost around $35,000 per year, while full-fee places at Melbourne for the 2020 intake will cost an average of around $80,000 per year. The major application of such a high cost is that the fees exceed the limit of $155,448 afforded to students by the HECS-HELP loan. In practical terms, this means that by approximately the second year of standard postgraduate medical course, a student will no longer be able to delay medical school fee payment, and will be charged for tuition upfront. It is critically important to consider how such a payment will be secured prior to accepting, or even considering a full-fee placement at a medical school.
Given the significant expense of full-fee places, they are the least competitive when compared to CSP and BMP. This is not to say that such places are easy to secure, universities such as UniMelb offer guaranteed entry into full-fee places for any student with an ATAR of above 99 (given a successful MMI interview). Ultimately, Fraser’s Interview suggests a careful consideration of cost prior to preferencing a full-fee place. If the financial implications are not prohibitive, a student should consider ranking a full-fee place last, after CSP and BMP. There is no reason to prefer a full-fee place above a CSP or BMP as GEMSAS moves down the preferences list progressively checking eligibility for each preference.
Relevance to Internship:
A common myth is that a full-fee place will not be ranked equally to CSPs and BMPs for an internship. A full-fee place will NOT affect the way that you are ranked for an internship. At the moment, every domestic place offers the same opportunities with respect to your application for an internship. Until recently, Macquarie University did not have guaranteed internship positions available for their graduates. The university has indicated that now all Australian Citizen graduates of New South Wales medical schools will be given internships upon graduating.