United push for prac payment parity

Medical students are relying on jobs and Centrelink payments to cover living expenses while working full-time hours in unpaid clinical placements, in a situation described by medical deans as unsustainable.
 
National data released by Medical Deans Australia and New Zealand shows a decade-long shift in how medical students are supporting themselves throughout their degrees.
 
Tracking income sources of Australian medical students since 2014, it shows they continue to be highly reliant on Centrelink support and paid employment as well as stacking multiple sources of income to get through their degree.
 
Almost two in three respondents draw on three or more separate income sources simultaneously, and 42.9% report needing both government income support and paid employment just to make ends meet, compared with fewer than one in four who need neither.
 
Medical Deans Vice President Professor Ruth Kearon describes the trend as a warning sign.
 
‘Medical students are not taking on more paid work because they have spare time. They are doing it to cover rent, food and placement costs during their training to become doctors.’
 
‘Full-time clinical placements leave little room for paid work, and many students are now trying to do both at once.
 
‘That is not a sustainable model, and it is not one that serves patients, students or the future health workforce.’
 
Medical students undertake on average 3000 hours of mandatory, unpaid clinical placement across their degree, often on a full-time basis.
 
Yet recent moves by the Australian Government to expand the Commonwealth Prac Payment (CPP) to 10 additional allied health disciplines from 1 July 2027 exclude medical students from the scheme.
 
Under the program, a means-tested payment of up to $338.60 per week is available to these health professionals during their clinical and professional placement periods.
 
When asked why medical students weren’t included in the announcement last month, Prime Minister Anthony Albanese said the scheme is currently focussed on targeted priority areas.
 
‘But there aren’t shortages of people who want to do medical degrees,’ he said.
 
‘In practical terms, there are shortages of our nurses, there are shortages of social workers, there’s shortages in areas like radiography and physiotherapy and OTs, speech pathology.
 
‘These are all areas where we need to encourage people to go into those professions. And that is why, at this stage, they’re the professions that we’re prioritising.
 
‘Of course, it’s important for people to do medical degrees and we have encouraged, through a range of other policies, that to occur, including the opening up of additional training.’
 
But Medical Deans emphasise medicine remains ‘the largest, most placement-intensive pre-registration health degree not covered by the scheme’.
 
It’s called on the Australian Government to urgently extend CPP eligibility to medical students, and to treat needs-based financial support during mandatory placement as a workforce sustainability measure.
 
‘We strongly welcome paid prac being extended to more allied health students, that is a genuine win for those students and for the workforce. But it leaves an increasingly hard-to-justify equity gap for medical students,’ Professor Kearon explained.
 
‘They face the longest and most demanding placement hours of any health discipline, and they are now the only major cohort of placement-heavy students without access to this support.
 
‘Evidence from our own student population tells us that rural, regional and first-in-family students are exactly the students we most need in the future medical workforce, are disproportionately affected by placement poverty.
 
‘If we are serious about a sustainable, well-distributed medical workforce, we cannot keep asking these students to shoulder the financial stress of their own training.’
 
Speaking at the time of the announcement, RACGP President Dr Michael Wright said unpaid training places a major financial burden on many medical students.
 
‘Out of all these courses the medical degree is the longest, and the impact of these placements on finances are greatest for future doctors, so excluding them from this, it just doesn’t make any sense,’ he said.
 
It’s a view supported by the New South Wales Doctor’s Union, with ASMOF NSW President Dr Nicholas Spooner saying the exclusion is fundamentally unfair and undermines efforts to build the medical workforce Australia needs at a critical time.
 
‘On any hospital ward, medical students are training alongside nursing, pharmacy and physiotherapy students who are eligible for paid prac,’ he said.
 
‘Yet the students completing the greatest number of mandatory unpaid placement hours are the only ones receiving absolutely nothing. It simply doesn’t make sense.
 
‘There appears to be an assumption that medical students do not need financial support, but that is absolutely not supported by the evidence.
 
‘The difficulty of simply trying to make ends meet while undertaking a punishing workload of study and training takes an enormous toll on medical students, which payment for prac time would help alleviate.’
 
Dr Spooner said ‘placement poverty restricts who can afford to finish medicine and ultimately reduces the number and diversity of doctors entering our health system’.
 
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