Why did I choose not to do Medicine as an international student in Australia?

OK, I am a domestic MD student in Australia now. However, I was an MBBS student back in Viet Nam, and the course’s length was 6 years in total. Before I could complete the course, I went to Australia to pursue a medical career in Australia. I started with a Bachelor degree of Biomedical Science as an international student. Then I worked in a lab for a while. I got my Australia Permanent Residency and got into an MD course afterwards.

So, you can read more about pathways for international students in my post here. But, why did I choose such a long route instead of doing MBBS or BSc/MD as an international student? And why I would highly recommend international students from non-English speaking (NESB) countries to think carefully before making any decision?

My answers were simple for me back in 2015. But for now, my answers have more factors for consideration. So, in 2021, if students from NESB countries consider doing Medicine in Australia, I will let them know that:

Firstly, an international medical student will not be guaranteed an internship in Australia after graduation!

The current fact

So, for those that are from NESB countries, if you don’t have an internship in Australia, it will be very hard for you to get back to Australia. And although you have an Australian medical degree, you’re not guaranteed an internship.

You might think you can do your best to apply for one as you are applying for a job. But it doesn’t work that way. In Australia, medical graduates will apply to the states’ organisations that run internship programs. Then they will be allocated to internship places in the states that they applied to. Australian states will have their own ways to allocate the graduates. But they mostly put domestic medical graduates in their first priority groups and international graduates in the next one.

The numbers

Now, I will run some numbers to demonstrate what I meant. For example, in South Australia where I study now, there are two medical programs, MD of Flinders and MBBS of Uni of Adelaide. The total number of 2021 medical students in both schools are more than 300. And in that cohort, domestic medical students of both schools are roughly 270 students. So, I will assume that those 270 students will become medical graduates in the next 4 years. And they will queue up for internship places.

However, the internship places that are offered by South Australia (SA) are also roughly 270 in 2021, and hopefully, in the best-case scenario, will increase by a bit, say 10 places, in 2025 when the 2021 cohort will graduate. So, in the best-case scenario, we have 280 internship places, which include 270 places provided to 270 domestic medical graduates of SA and 10 places left for firstly interstate domestic medical graduates and secondly international medical graduates. This situation does not only occur in SA but also in all Australian states (1). As a result, international students, in my opinion, might need to think very carefully about their post-graduation career before they make any decision.

Secondly, you will not be guaranteed a Permanent Residency!

You might be wondering why I am talking about Permanent Residency (PR) and why it is related to my decision. Let me explain to you in more detail.

So, if someone wants to work and live in Australia for the rest of their lives, they have to have PR. In Australia, after international students graduate, they will be granted a temporary visa. The visa will allow them to work and live in Australia for up to 2 years. But they will be granted that visa once in their lifetime. If they want to progress further in Australia, as I know, they either have to obtain a PR or a temporary visa sponsored by their employers.

And just like an internship, there is nothing like a guaranteed PR. It was easy to get PR in the past 2-3 years. But it is not the same story for 2021 and even for the future. There are many reasons for that. Most of them are due to changes in legislation and rules which would be very lengthy to discuss. So, I will write about how I got my PR and how you might want to prepare for it in another post. However, please bear in mind that it is really difficult for an international medical graduate to get a PR unless they can get an internship, which is also a challenge.

Thirdly, an international student with an Australian medical degree might still be required to work for 10 years in regional and rural areas.

In Australia, there is a “10-year moratorium” policy. This policy requires international medical graduates (IMGs) to work in regional areas namely Distribution Priority Area (DPA) and District of Workforce Shortage (DWS) for 10 years applied after they obtain Permanent Residency in Australia. This means that they can only access Medicare benefits (2) when they work in DPA and DWS in the first 10 years after they are registered as a Doctor.

So, you might be wondering if international students of an Australian medical school will be considered IMGs. Unfortunately, they will be.

International students graduating from Australian medical schools and from overseas medical schools are categorised as IMGs. Furthermore, if a student enrolled in an Australian medical course at the time they only have a temporary visa, they will be categorised as an IMG when they graduate even if they obtain their PR during their course.

I like working in regional areas. But there might be problems for some people to settle down and to find a post in those areas. Those problems might be relevant to the spouse’s career, kids’ education, lack of support network and difficult access to specialty training. Hence, living and working for 10 years in such areas are substantial factors that you might need to take into account.

And finally, the tuition fee is not so affordable.

For international students

For an international student, most medical schools will charge up to 70k to 80k AUD per year. So, the course will cost a student up to 300k AUD, as you can read more in my post about the pathways for international students/doctors here.

I have never been able to afford such tuition fees, let alone the addition of living expenses. I am only able to study Medicine now because I get supported by the Australian government. In Australia, education and public health are crucial sectors, so domestic medical students are supported to complete their medical degrees.

For domestic students

Particularly, domestic medical students are offered 3 types of places if they are successful with their medical application, namely Commonwealth supported places (CSPs), Bonded Medical Program places (BMPs) and full-fee paying places (FFPs)

With CSPs and BMPs, students need to pay around 10k to 12k AUD per year. Yes, only 10k to 12k AUD per year. And so, they are the most competitive places to get for medical schools’ applicants. For FFPs, students need to pay up to 60k to 70k, which is a bit less than international medical students’ fees. However, domestic students who have Australian citizenship can borrow from the Australian government up to 150k AUD to pay for their tuition fees. The loans will be interest-free and can be paid back via their taxes when the students start earning a salary above 50k AUD.

In conclusion, studying medicine is a big investment, especially for international medical students. Hence, I hope all the details above might help you make the best decisions for yourself!

(1) There are different lists of priorities in different states. But overall, IMGs are prioritised after domestic students and have limited chances to get internship places.

(2) Medicare benefits are payments of the Australian government to Doctors’ services. And they are the main income of most Australian doctors.