Bonded medical graduate programs – 2018 Budget Changes

These changes follow extensive lobbying by the AMA Council of Doctors in Training (AMACDT) and the AMA and will effectively standardise conditions for bonded medical graduates, moving away from the current contract-based arrangements.

The reformed arrangements will apply to all new participants from January 2020.

In addition, existing BMP and MRBS participants will be able to opt in to the new arrangements once they are in place, including in circumstances where they are already part way through meeting their current Return of Service (ROS) obligations.

For MRBS recipients and those BMP participants who signed up in 2015 or earlier, the Government has agreed to substantial changes that offer more certainty and flexibility in how ROS obligations can be satisfied. From discussions with the Department of Health (DoH), we understand the changes include:

• The introduction of a standard three-year return of service;
• ROS eligible locations to include Modified Monash Classification areas 2 – 7 and outer metropolitan Districts of Workforce Shortage;
• Up to 50 percent of prevocational and vocational training in ROS eligible locations can count towards ROS obligations, with the remaining 50 per cent required post Fellowship;
• Where Fellowship is not achieved within 10 years of internship, the remaining balance of ROS can be completed in a non-specialist role;
• ROS can be served in three-month blocks, including in the post Fellowship years;
• Scaling of ROS according to rurality will continue;
• Compliance with ROS requirements will be managed through a web-based portal, avoiding some of the administrative problems currently encountered; and
• Bonded graduates will have more options to work in ‘ineligible’ areas during their ROS period.

Existing bonded graduates who opt in to the new arrangements may find that they have completed the new reduced length of ROS. In these circumstances, they will be able to apply to complete their obligation and exit the program.

BMP participants who signed a contract from 2016 onwards will also be able to opt in to the new arrangements if they want, while still keeping their 12-month ROS obligation.

The current 12 year 'Medicare ban' for MRBS recipients will be cut back to 6 years although, with the additional flexibility announced in the Budget, it is hoped that MRBS recipients will not find themselves in the position of having to face this situation.

The Government has also agreed to establish a more transparent process for assessing requests for special consideration due to a medical condition.

The AMA has formed a Bonded Medical Graduate Working Group, which has provided strong input and advice in guiding the AMACDT’s policy approach and the AMA’s negotiations with the DoH over several months to arrive at the package of changes outlined above.

With the finer detail of these changes to be finalised over coming months, the AMACDT and AMA will continue to draw on the advice of this Working Group to inform our ongoing discussions with the DoH.

The DoH has also re-instated its telephone contact lines for bonded medical graduates to provide better assistance and more timely advice to participants. These numbers are:

• BMP enquiries phone line on: 1800 987 104 (available Monday to Friday 8:30am-5pm AEST).
• MRBS enquires phone line on: 1800 248 720 (available Monday to Friday 8.30am - 5pm AEST)

While the AMA pushed strongly for an earlier commencement date for these reforms, DoH advised that it was not in position to achieve this due to a range of considerations including the challenge of implementing a broader package of rural health workforce reforms. This means that during the interim period, bonded graduates will continue to have to comply with their current contract arrangements.