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To all Med Hopefuls (1 Viewer)

patpatpat

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Hey guys,

I'm a RMO (PGY2 doctor) who used to work for a UMAT coaching college helping students to get into med. I was recently reminded about this site, and since it helped me a lot when I was doing HSC, I figured I could do my bit and provide some info on getting into medicine and things you should be aware of before becoming a doctor.

I'm sure a lot of this has been said many times over, but maybe there's something more I can add. If you have any questions, I'm happy to answer them :)

Why are you doing medicine/myths of medicine/other shit you should know

I enjoy my job, but I wouldn't rush to recommend it to other people. Medicine is a course and a career that you will fluctuate between absolutely loving, and absolutely hating. I'm not trying to discourage people from pursuing this path, but very few people in high school will have any idea about what this field is like.

If you don't love biology - you will find med challenging, not because you don't have the ability to learn, but because the interest isn't there. Physics and chem are very different to medicine, I found this out the hard way.


If you want to help people - don't do medicine solely for this reason. Many doctors are apathetic towards their patients, some just hate them. We all start off as caring individuals, but for so many reasons (being exposed to so many sad cases, lack of sleep, high work load, patients not caring about their health etc) we seem to give up. It's not bad, it acts as a defensive mechanism that protects us and ensures we are providing our patients with the best possible care. On the plus side, med school teaches you how to act like you care, and there will always be that patient who you truly feel for.

That's not to say you can't make a difference, a doctor who works hard and is a good communicator is better than one who is not. But if you're only desire is to help others, do science and find the cure for cancer, or commerce and work for a non-profit organisation. Don't do medicine, for your sake.


Medicine is like [insert TV show] - no, no and no. Most TV shows portray the lives of doctors so unrealistically that they're painful to watch. The only show which I have ever seen to come close was All Saints, and even that was horrendously wrong.


Hours - expect to work 50 hour weeks at a bare minimum. Most weeks I'm pulling 60 hours, and as a registrar you can expect to work 50-70 hour weeks (physician) or 70-90 hour weeks (surgery). The work itself is quite draining, you'll spend a lot of time walking around, thinking about stuff and getting yelled at. Many of these hours you won't get paid for, at the hospital I'm working at if a patient has a cardiac arrest at the end of my shift and I'm not rostered on for overtime, I don't get paid to save their life.

Many people don't realise just how draining this is, when I went to the interviews I said I'd have no problem working 80 hour weeks. But if you want to see if you're up for it, pick a week and each day spend 12 hours where you alternate between studying for an hour and digging a hole outside for an hour. You aren't allowed to take time off, must eat meals as quickly as you can etc. And for an hour before and after this "shift" hop on a bus and travel around your suburb to imitate getting home. Do this for six days.


Training - medicine doesn't stop when you graduate uni, in fact in many ways the learning is just beginning. Pretty much every doctor must complete post-graduate training, whether it be general practice or a specialty. Until you finish post-graduate training, you cannot work independently. This is a very big deal. If you decide you don't want to work for NSW Health or be involved in your GP training program, there is no alternative. If you get sent to a rural hospital for 6 months, you have to go.

The minimum amount of time it will take to finish training as a GP is 6 years from the time you finish med school. If you're a specialist, it will take 2-3 years working as a junior doctor to get onto a training program, then 5-6 years to finish (provided you pass everything first go, which most people don't). The entry onto the most lucrative programs is extremely competitive (and becoming moreso with more junior doctors), you will need to complete a masters and have a number of research papers published, many people will have a PhD. And when you're on the program the study is intense. A BPT will spend over two years doing nothing but study, one friend spend 12 hours a day when he wasn't working studying, and when he was working only took an hour to himself. His one day off a month was the only thing which kept him sane.


Job Security - it's true you'll not likely be out of work as a doctor, but only if you're willing to move to rural Australia. Funnily enough that's also true for most jobs. Essentially as a doctor when you finish your training, you lose your job, and you're not going to find a nice position in an ideally located hospital. Most specialists will spend the first 2-3 years working on the outskirts of a major city (if they have some good research under their belt) or in a regional hospital.

On the flipside, you're guaranteed a graduate position. That is a fucking awesome position to be in, particularly as graduates in other fields are struggling to find work. There is no other field where you are guaranteed work just for passing a degree (exception being international students!!!). However, you must consider:


Med Student Tsunami - for many years Australia didn't train enough doctors, resulting in a deficit which was filled by importing doctors from overseas. The government decided to correct this, but rather than gradually increase numbers and training positions, it decided to suddenly increase med student numbers and leave post-grad training untouched. This is resulting in a large number of people qualified to be junior doctors in the hospital system, but then a bottleneck into training positions. At first this seemed like a great strategy to force people to become GP's, but then this year there were only 1200 GP training positions for 2000+ applicants.

What this means is that while you are guaranteed a job on your first two years as a doctor, you may find yourself unemployed after that. Some of my friends are going to be entering their second year of unemployment next year despite applying to hospitals all over the country. Nobody knows exactly how this is going to work out, because this problem has never been encountered before, and our state and federal governments don't seem to consider it a big priority.


Money - if you're scientifically minded and more quietly spoken, medicine is the best way for you to make money. If you're business minded and quite social, then you will make a lot more in a commerce related field if you dedicated the same amount of time to it. About 60-70% of current medical students will become GP's and earn between $120k (metro bulk billing) to $250k (rural). Physician specialists will earn $200-$400k. Surgeons, anaesthesist and radiologists will often earn $500k+.

Those figures sound pretty good, but there are three downsides. Firstly, doctor pay is going to drop, especially for GP's. The marketplace is becoming increasingly flooded, and Medicare rebates are well below inflation. Secondly, you only get this after you spend years getting into and on training programs. Thirdly, you will work your ass off to become a specialist, and the hard work doesn't stop when you're qualified.


Prestige - it still exists, and it feels great to tell the family of your partner that you're a doctor. Unfortunately to do so means you'll have patients vomiting all over you at 2am on a Sunday morning. You'll also find that an increasing portion of the public has no respect for the healthcare workforce due to Dr Google, "natural medicine" and alcohol. I've been the victim of "common assault" twice in under two years, both times by intoxicated ED patients. Some doctors I know have suffered broken bones and concussions.


Medicine Courses

Which course do I choose?

The short answer is the one you can get into. There isn't a big difference between outcomes of the courses, they all produce doctors who satisfy the minimum requirements, and how much you learn comes down to how dedicated you are. Don't go chasing one course in the mistaken belief it will make you a better doctor.

If you are fortunate enough to get into multiple courses, go with the one in the city you want to live in (preferably the one where you have parents and can save money living at home). You aren't going to spend all your time studying, and living in a place which has things you enjoy doing will make it more bearable.

This brings us to UNSW vs UWS. Obviously I'm going to be biased, but if I had to choose again I would stick with UNSW. The benefits of UNSW are it's in the city, has a well engaged Medsoc, and has the ILP, a research year which can help you get a foot in the door of a specialty (or have a relaxing year where you can explore other interests). The benefits of UWS is that it arranges for more clinical placements, however my personal view though is that a motivated student would do this regardless, and a lot of the placements are geared towards GP.

The other difference is that UNSW has now adopted the MD, which is a masters level degree (the MBBS is a bachelor's). In the med world this means jack all, and many doctors will go on to get a masters anyway. But in other industries (applying for a job as a pharmaceutical rep, applying to study a different degree etc) it will make a big difference. Remember that not everyone sticks in the same career their entire life.


What is med school like?

The first two years are cruisey, essentially just rote learning and regurgitating (if you do well in the HSC you're likely already proficient at this). The last two years are very intense, I spend about 9 of my last 18 months on study mode (spending most of my free time studying), and about half of that time I shut myself off from the world outside medicine and did nothing but study.

One of the biggest problems with med school is that it is very subjective. In most uni subjects there is a single marker, or markers who work to stringent guidelines. In med a single student could get very different marks if he sat in the morning or afternoon session at a hospital. This is problematic as the only recognition of your hard work is whether you get honours (credit/distinction mean nothing), and that subjectivity can mean the difference between getting and not getting it.

Should I Go Bonded?

Bonded = yes, chances are you'll end up in a workplace shortage district to find a job, and can work it off. Even if you don't, at the time you break the contract you will be earning enough to pay it off without a significant hit.

Rural scholarship = hell no, even if you love the country don't take this. It leaves you with zero flexibility, if you want to train in a specialty only available in urban areas you can't, if you cannot move for family reasons then you will have to leave your family. Note that unlike the bonded scheme, if you break your contract you may lose your Medicare number (and cannot bulk bill).

HSC

Get tutoring! Pay for a good quality coaching centre, or if you have money to burn/are struggling in an area get a private tutor who got 93+ in the subject. Make sure you've got model answers for the common questions, know the way to approach the different questions in the exam ("describe" vs "evaluate" etc) and have your timing worked. Do as many past papers as you can and get feedback from your teachers/tutors - they are there for a reason.

This is going to sound very blunt, but it needs to be said. If you are motivated but cannot get an ATAR of 97+, then you need to reconsider whether medicine is the best career for you. Unlike other uni courses, medicine is all about rote learning and exam technique, similar to the HSC. About 10-15% of the cohort will fail or transfer to another degree, and in many cases this is because the course was too challenging. You don't want to spend years getting into med only to realise it isn't for you.


UMAT

Contrary to popular belief, you don't need coaching for the UMAT. I got 98th percentile without it, and I'd guesstimate that about half of my cohort did not do any UMAT prep. Coaching can produce small but significant gains, for instance increasing from the 90th to the 94th percentile. You need to weigh up the significant cost of the course with the possibility that this small gain may mean the difference between entry and non-entry. Many established centres have insanely good profit margins, pay their tutors very well, and market themselves based on the results of students who would have been successful without tutoring.

My recommendation would be to first buy the Acer booklets, then track down a "distance" or "home" or "resources" package, which lets you do the online tests and which provides written solutions to any questions you got wrong. They cost substantially less than the coaching packages, and let you gauge your performance. If you're not doing well, you can then get some coaching. It's important to make sure you finish every test paper, where I worked ~5% of people completed all the papers, and a majority of people completed 6 or less. When you're paying $30-$50/paper, that's a significant portion of your parent's money being wasted, and a lot of lost opportunities to practice.

As for which UMAT coaching is the best? Who knows? Ask around, try their online sample questions, ring them up and ask them about their results. Just don't get sucked into any offer about how you can receive help 24/7 etc, figure out what you need and go for it.


Interview

Get interview prep!!! Most of you will not have applied for jobs or done any interviews before, which means that potentially one of the most important interviews of your life will be the very first one you do. A guide will not be sufficient, practicing in person will help you to develop an approach to each station, and will build confidence that will translate into better performance on the day.

Make sure you have a rough idea about what medicine entails - learn the specifics about the course (which hospitals it is affiliated with, whether it has a research component), the role of a doctor and the various training programs. If you want some extra points, have a few stories about times when a doctor has inspired you (with a sick relative etc) and tell them you're interested in GP or psychiatry (because of a "friend's battle with depression/anorexia and how helpless it made you feel').

If you don't get in

and you have a good ATAR - take a gap year, have some fun, earn some money, and work on increasing your UMAT/interview score (ie go full out and get coaching etc). Do NOT start any university course, you will lock yourself out from many courses and your academic score will fall (uni is much harder to score good marks in than HSC).

and you don't have a good ATAR - prepare for GAMSAT. Don't do medical science unless you are genuinely interested in working in the field if you don't get into graduate med. Choose a degree that will give you a range of employment opportunities, and then work your ass off.


If you do get in

Take a gap year, either before or during your course. The biggest regret I have is finishing the shortest available time, you're only young once so live it up!
 
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Recondit

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Re: Too all Med Hopefuls

Very interesting +1
 

Medman

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Re: Too all Med Hopefuls

^Well said. Very similar advice to what I've been giving people on this forum but I seem to get a lot of resistance from younger med students in first year (Riproot), people who no longer do medicine (lawstu) or people who are in different fields of study. I'm glad a real doctor has the same perspective as myself being a final year medical student. Trust me everyone, I was not like this when I first started medicine but after so many years of training the power of hindsight is incredibly valuable.

Like I've been telling everyone GET INTERVIEW PREP if you are serious about medicine otherwise, take your chances. I am going to put post up regarding my interview preparation services. Private message me if you're interested.
 
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cadd1ct

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Re: Too all Med Hopefuls

Wow that was a good read, I sometimes wish other people will be just as detailed when answering my questions.
 

strawberrye

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Re: Too all Med Hopefuls

One of the best piece of advice-and a very detailed one as well, that I have ever read-thanks for the insight:)
 

iSplicer

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Re: Too all Med Hopefuls

Very candidly put - an excellent read. Definitely a lot of good information (I daresay I can't outright disagree with anything) but I think readers should be aware that the piece is definitely awash with a negative tone, even if it is slight. Nonetheless a very helpful reminder to hopefuls that medicine, like every other career in the world, has its downsides and those downsides are expected to get worse over the coming years.
 
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obliviousninja

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Re: Too all Med Hopefuls

Interesting read, even though I'm not looking towards med.
 

Medman

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Re: Too all Med Hopefuls

Just a side note. I have spoken to doctors who have finished their 2 year graduate positions at their relative hospitals. For the ones that didn't get onto training programs which is a significant amount only 50% were offered jobs to stay on as senior resident officers. Others were told to find a job at another hospital or take a year off. If you want to work in an urban hospital good luck because there are very limited positions.

As for GP training programs, this year there has been too many applicants compared to the number of training positions offered. This will only get worse with time. If you think becoming a GP is easy think again. Minimum time to graduate from GP is 4 years out of med school but this is looking grim now.
 

patpatpat

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Re: Too all Med Hopefuls

Shamelessly bumping my own post for the next generation

And realising I can't spell for shit after a long day... Any mods can change?
 

iStudent

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So minimum time to become a gp after uni is 6 (as pat said) or 4 years (quote medman)?

By the way, great read :)
Will take this on board if I get in!

Also, what do you mean by you won't take a significant hit if you buy your way out of bonded? Do you have a link or some figures just to give a better idea of what you mean? (because I'm trying to figure between UNSW bonded and going interstate).
 
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Kiraken

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So minimum time to become a gp after uni is 6 (as pat said) or 4 years (quote medman)?

By the way, great read :)
Will take this on board if I get in!

Also, what do you mean by you won't take a significant hit if you buy your way out of bonded? Do you have a link or some figures just to give a better idea of what you mean? (because I'm trying to figure between UNSW bonded and going interstate).
iirc it's 15k-20k u have to pay off for each year u break ur bond? (up to 5 years)
 

Bearman

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Interesting read, definitely worth a look if you're considering medicine!

Out of curiosity, which hospital were you at as a JMO/RMO? 60 hour working weeks isn't the norm from what I've heard (mainly heard of closer to 50 for interns) so I'm guessing you're at one of the bigger hospitals.

Also, where'd you get your figures for the current expected salary for a full time GP? I've heard of GP regs getting ~100k and fully trained GPs in urban settings being closer to ~200k but I'm not entirely sure how accurate these figures are.

Anyway, thanks for the post, definitely looks like you put a lot of effort in and you've covered a lot of ground.
 

patpatpat

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So minimum time to become a gp after uni is 6 (as pat said) or 4 years (quote medman)?

Also, what do you mean by you won't take a significant hit if you buy your way out of bonded? Do you have a link or some figures just to give a better idea of what you mean? (because I'm trying to figure between UNSW bonded and going interstate).
My apologies, it is minimum 4 years. Having said that, general practice can be one of the hardest jobs to do well, and extra experience from time on the wards will certainly help.

To buy out of bonded (not rural scholarship) is ~$100k ($16k/year of med school). That is a lot of money, but if you're willing to live a lesser lifestyle as a consultant for a few years then it's very manageable. If you consider the opportunity cost of entering med at a later stage and the income lost over a lifetime, then it becomes a lot more appealing.

I liked your post so much that I saved it to my disk. Thank you very much!
Thanks :)

Out of curiosity, which hospital were you at as a JMO/RMO? 60 hour working weeks isn't the norm from what I've heard (mainly heard of closer to 50 for interns) so I'm guessing you're at one of the bigger hospitals.

Also, where'd you get your figures for the current expected salary for a full time GP? I've heard of GP regs getting ~100k and fully trained GPs in urban settings being closer to ~200k but I'm not entirely sure how accurate these figures are.
One of the largest ones, and apparently less desirable (but not for me since I live close!). I chose terms which are best for learning, but these also tend to be some of the busiest (aged care, cardio, neuro, ortho etc), and we've had a bit of staff turnover which means the remaining JMO's have had to pick up extra overtime shifts. You can get away with 40-50 hour weeks on some of the less busy terms (mental health, rheum-a-holiday, some surgical terms) but you should always be ready for unpredictability. I'm on a very relaxed term at the moment, but a couple of weeks ago when I was ready to leave on time one of our patients became unwell and my reg and I were there for almost 3 hours trying to figure out what was happening, whether the patient needed to be escalated to ICU and reassuring the family.

General practice is a business, and the rates will vary depending on your billing structure (bulk billing vs private) and your practice structure. There are some GP's who would struggle to earn $80k net after paying staff, insurance etc, and others who have found a niche area who are making a mint. I don't know of any published figures, these are from friends and teachers who entering the world of GP:
- metro bulk billing (no private billing) = ~$120k
- metro mixed billing = $200k - $300k depending on structure
- metro corporate practice = ~$200k (less pleasent hours, eg 7am - 3pm, 2pm - 10pm, overnight shifts)
- rural add 25-50% on this, but work longer hours

As with anything, those earning higher amounts are going to be working longer hours. Also if you want a successful practice, you'll have to work evenings and on weekends.

As I mentioned in my previous post, the market is going to become increasingly flooded, reducing the ability of GP's to privately bill. Together with the cuts by Abbott the Liar to the medicate rebate this will push GP incomes down. It is possible that the ones listed above are the highest they will be.
 

louielouiee

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This was an incredible read, thank you. It's nice to hear from someone out there working and not still in university!

I found it interesting about what you said about bonded and MRBS positions- this is the situation for me (bonded) and my mate (MRBS) and I haven't really thought about it in that respect.

When you're offered such things people react with "oh you won't have flexibility as a bonded student AND you don't get paid extra for it" and with the MRBS "That's $25,000 a year so why not."

Considering the job options after uni with these schemes is not something I've read hugely about yet.
 

patpatpat

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When you're offered such things people react with "oh you won't have flexibility as a bonded student AND you don't get paid extra for it" and with the MRBS "That's $25,000 a year so why not."
My understanding is that there are three main differences between the two:

1) the MRBS obliges you to work in a rural area, as opposed to the bonded scheme where you can work in any "area of need", which can include outer metro. You actually have a lot more flexibility with just the bonded

2) if you breach the bonded scheme, you suffer a financial penalty (essentially become a DFEE student at a time when you're more able to pay it). If you breach your MRBS contract you can lose the ability to a provider number for up to 12 years - essentially meaning you cannot access medicare rebates for your services. This is extremely significant, and would essentially end your medical career. Given that virtually every medical service in Australia is subsidised, your options are to: a) open a clinic catering to the small portion of the population who are eligible for medicare and magically make enough to survive, b) practice an area of medicine which doesn't attract rebates (cosmetic medicine, or weird alternative therapies), c) use your medical degree to enter another field.

3) several of the more sub-specialised career paths will become unavailable, as they can only be practiced in locations which the MRBS would not cover.

Frankly I find the whole MRBS system to be extremely unfair. It exploits rural students who aren't from rich backgrounds and forces them into a career path when they have virtually no life experience. I would have no problem with them being required to pay back the scholarship and even suffering a large financial penalty on top of that (say $100k), but to remove their ability to make a living is appalling.
 

redjnr

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Hey firstly thanks for the VERY informative and well written post.

I just have a question about the bonded scheme: Does breaking your contract only incur a financial penalty? Will it cause any other unintended consequences e.g. hospitals / colleges become aware that this person did not fulfill his or her contract?

I kind of find it hard to believe that the government would be happy letting people "pay off the bond", especially considering the very harsh medicare ban for breaking the MRBS contract.
 

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