In Australia, the process of securing a place for medical school is not simply as straightforward as completing an application to the best medical schools and hoping to be selected. The university education system in Australia is heavily regulated and subsidized by the government.
This means that there is fixed funding that a GEMSAS medical school receives to run its course. Consequently, there are different tiers of payment contracts that a student can enter into with a medical school. In this article, we will run through the basics of the various fee structures that the GEMSAS medical schools offer. All students must consider the implications of subscribing to the various fee structures, as they have significant implications for your financial wellbeing, as well as your future student debt quantity.
CSP - Commonwealth Supported Place
This is the basic university course fee structure that is familiar to most students studying in Australia. This place is heavily subsidized by the government, meaning that most of your university course fees are covered by federal funding. It is important to note while the majority of your fees are covered, there is still an outstanding balance known as the ‘student contribution amount’ that university attendees are required to pay. A CSP is not the same as the HECS-HELP loan, which we will discuss later in this article.
First, we should clarify a candidate's eligibility criteria for a CSP. To qualify for a medical CSP position, one must be an Australian or New Zealand citizen. Alternatively, being a permanent visa holder is also acceptable. However, simply meeting these requirements is not a guarantee of receiving a CSP. When an aspiring medical student fills in their GEMSAS online application form, many Australian medical schools offer the option to apply for a CSP, BMP, and FFP.
As discussed later in this article, the latter two options (BMP, FFP) are often considered less desirable by students and will have a lower entry requirement. The reason for this is that universities have fixed numbers of each place type available. If a candidate does not meet the academic/interview requirements to receive a CSP, they may still be competitive in the significantly smaller pool of applicants for a BMP or FFP.
Much like the case with CSPs, medical schools never formally acknowledge the entry recommendations for any three-place types. This is why it is always best to apply to a medical school, even if you are uncertain of the competitiveness of your scores. After all, you may be overestimating the strength of your competition!
BMP - Bonded Medical Place
The bonded medical place is a university fee structure that is uniquely associated with medical school. In other words, this is not a fee type that is available for the undergraduate course that you will likely have completed before your GEMSAS application. In rudimentary terms, the BMP is a scheme that aims to improve healthcare in rural and remote areas by obligating junior doctors to spend time in a predefined ‘area of need’ following their graduation from medical school. It is important to understand that the nature of a BMP contract is dynamic. We mean by this that the terms of a BMP rural placement following graduation, including the duration and location of placement, are subject to change every year.
Once you have accepted a BMP position, the terms of your agreement are fixed. However, it would help if you considered what these terms entailed before accepting the bonded medical place. To give a practical example, in 2015, the ‘return of service’ obligation (i.e., duration spent working in a rural setting) was set at a maximum of three years.
This means that following graduation from medical school, a doctor that had accepted a BMP had to spend at least three years working in designated areas of need. Between 2016-2018 however, the duration of the ‘return of service’ period was only 12 months. A new bonded arrangement came into effect once again as of January 2020.
Beyond the employment obligation, a BMP is no different from a CSP from a financial point of view. These bonded positions have identical eligibility requirements as a CSP and are also subsidized to the same degree. Furthermore, both CSP and BMP places are eligible for HECS-HELP loads should the student require such assistance.
Understandably, the additional obligation of working rurally is a factor that makes a BMP less desirable than a CSP in the eyes of many medical applications. This means that the entry requirements may, in fact, be lower than for a CSP. It would help if you considered this in conjunction with the fact that given the challenges of specialty training, it is unlikely that you will stay in the same hospital throughout your early career.
In fact, rural placements offer junior doctors the benefits of training pathways and responsibilities that may be difficult to acquire in the inner city. This is why it is highly likely that you will spend at least a small portion of your medical career in the country regardless of whether you are fulfilling a contractual obligation for a BMP. This is why Fraser’s Interview advice is that it is probably most prudent to opt for both a CSP and a BMP at your given university of preference, especially in light of their equivalent fee structures.
FFP - Full Fee Paying Place
The final type of medical place offered by GEMSAS schools is an FFP or Full Fee Paying Place. As can be derived from the title of this offer, such a position offers no government rebate on university fees. This is the type of position offered to international students who are not eligible for CSP or BMP positions. The increase in cost associated with such a place is very significant. To illustrate this point, the University of Melbourne Medical School estimates that the approximate cost of a CSP/BMP Doctor of Medicine degree is ~$70,000. This is subject to changes in University of Melbourne course structures and governmental legislation each year.
An FFP, on the other hand, can reach a total cost of approximately ~$320,000.
While it is certainly important to consider the ‘price tag’ one may put on their dreams, especially in light of the reasonable future income of a medical professional, the FFP does present a significant disadvantage over a CSP or BMP. This disadvantage is that the cost of a full-fee-paying place at a GEMSAS medical school exceeds the maximum loan amount offered by HECS-HELP loans, which is approximately $150,000.
This means that while CSP and BMP places are costly, these positions allow for a deferment of tuition costs until you are meaningfully employed in your medical work. In an FFP, a domestic student must ultimately pay approximately half of the degree cost up-front. In practical terms, this means that your HECS-HELP limit will be reached by approximately the second year of your medical school training. The remaining two years cannot be deferred and must be debited to the university's commencement of the relevant academic year.
Understandably, this position is less desirable among domestic students relative to the BMP and CSP. Furthermore, it would help if you had a payment plan to opt for such a training route. However, the clear advantage is that (as is the case with the BMP) the reduced competition for FFP positions means that a lower GAMSAT/GPA/Interview combination may be accepted for such a position.
Other - Medical School Specific Places
Often, medical schools offer specific types of ‘specialty’ places. These are completely separate from the fee structure, and therefore do not impact admission. Nevertheless, it is important to consider these medical school places because the opt-in/opt-out question is embedded in the GEMSAS preference selection system.
An important example of such a special place is the University of Melbourne ERC, or ‘Extended Rural Cohort’ placement scheme. This placement structure essentially allows CSP, BMP, or FFP students to spend extended clinical placement periods in rural and remote areas. It is once again important to reiterate that this is purely a curriculum structure option and in no way impacts the fee structure associated with your application. If you are interested in learning about the specific details of various universities' fees and curriculum structures, make sure to check out our medical school-specific posts!