The Pathway to Becoming a Consultant Doctor in Australia: A Comprehensive Guide
Becoming a doctor isn't easy.
On average, to become a consultant it can take between 10-20 years, depending on the speciality that you choose to pursue.
It's also one of the more difficult careers to pivot from because there is a strong expectation by those both within and outside the field, that once you graduate from medical school you will work as a doctor.
Thus, choosing a career in Medicine isn't a decision that should be made lightly.
I'm hoping that this blog post, along with my below YouTube video, will help you make a more informed decision about whether you want to become a doctor by showing you what the process may look like.
Disclaimer
#1 If you don't know who I am, my name is Kajanan and I'm a final year medical student (I'm not a doctor ... yet) studying at the University of Newcastle.
#2 If you're an International Medical Graduate (IMG) or an international student and looking for some information on this process, unfortunately it's not something I've got experience in and thus I've not covered here. If you do fall into this category, I'd highly recommend checking out Advance Med, a blog by Dr Llewellyn, as well as his YouTube channel, Career Doctor. Across these two platforms, there is a wealth of information on this topic that hopefully can answer any questions you may have.
#3 This is now the second time that I'm writing some of this (somehow Ghost failed to autosave my work), so forgive me if by the time you get up to this stage, the article is not complete.
Should you even try to apply for Medicine?
Maybe ... maybe not.
I don't know what's right for you.
What I can say is that when it comes to approaching any major decision, there are four main frameworks that I use:
- Pros vs Cons
- The Deathbed Mentality
- Don't fear discomfort
- Pivotability
Pros vs Cons
When it comes to the pros and cons, writing a simple list of all the perceived pros and cons of a career in Medicine is a good place to start. Then, because you likely won't have the most well-rounded opinions unless you've worked in healthcare before, you should go out and consume information by other doctors about what working as a doctor is like and what the documented pros and cons are. I'll link two videos here that touch on this topic. First, I talk about my journey through Medicine and try to guide you through answering the question of "why do I want to be a doctor?" Secondly, I interview my sister, Kathiyajani, who is a PGY3 doctor working in Sydney about her experiences working as a junior doctor over the past few years.
The Deathbed Mentality
This is a simple concept (that I've stolen from Robin Sharma from his book The Monk Who Sold His Ferrari).
If I was on my deathbed, would I regret not choosing this course of action? (i.e. would I regret not choosing to become a doctor?)
Why do I ask myself this?
It's well documented that people often regret the things they didn't do more than the things that they did do.
For me personally, I would have regretted giving up on trying to get into Medicine. There would've always been a part of me that thought, "what if?" And so, irrespective of whether the cons outweighed the pros (not that they did at the time) I knew I had to continue trying to study Medicine to find out if it was everthing that I had dreamt of.
Don't fear discomfort
I strongly believe that humans are wired to avoid discomfort.
Recognising this is powerful, it means that every time you make a decision, you can check as to whether it's being made out of avoidance of discomfort or not.
Whenever you identify that a decision is made out of fear or in an attempt to avoid discomfort, that's great. It doesn't mean that you need to do the opposite and always run towards discomfort. So long as it's a conscious decision, there's nothing wrong with choosing comfort.
But don't disillusion yourself. If you want to grow as a person, you cannot always take the easy path.
Pivotability
I think of pivotability as the difficulty associated with pivoting out of Medicine and into another career pathway.
For me personally, Medicine is quite unpivotable, for a number of reasons:
- It's a large part of my identity
- All my family and friends I know I went to medical school and if I didn't work as a doctor, I think they would be disappointed
- The sunk cost fallacy, which is that I've spent so much time working towards this goal that I would feel like it would be a waste to let it all go now.
I acknowledge that most of these are self-imposed barriers that could easily be overcome by simply quitting. However, because I've framed a large part of my identity around being someone who wants to become a doctor, someone who's studying to become a doctor and (soon) someone who's working as a doctor, it would be difficult to release that part of me.
Ultimately, I am happy that I chose to do Medicine and I 100% don't have any regrets about where I am today. However, I do acknowledge that I wasn't particularly informed when making that initial decision to get into Medicine and so if I had been more informed, perhaps I wouldn't have chosen this pathway. But in saying that, I don't think that a lot of what I know now is something that I personally would've internalised if I'd heard it from a conversation with someone or from reading an article or two. Sometimes I think we really need to experience the highs and the lows of something to help us decide if we're on the right pathway.
Getting Into Medicine
Medicine is competitive.
I should know—it took me three attempts to get in.
It's kind've weird that this is the case considering that there's an Australia-wide shortage of medical practitioners.
Regardless, the number of applicants for medical school are far greater than the number of positions, so let's look at some of the stats so that you've got a realistic expectation of the odds of getting into med school.
What are the different types of medical school applicants?
There are two main categories:
- Domestic applicants
- International applicants.
This is pretty self-explanatory.
You are a domestic student if you are:
- An Australian citizen
- An Australian Permanent Resident
- A New Zealand citizen.[1]
You are an international student if you are:
- A Temporary Resident of Australia
- A Permanent Resident of New Zealand
- A Resident or Citizen of another country.[1]
What types of places exist?
There are two main types of places when it comes to financial structure. These are:
- Commonwealth Supported Places (CSPs) – these are places that are financially subsidised by the federal government
- Full Fee-Paying Places (FFPs) – these are places that you must fully fund yourself.
The cost of these vary between universities, but here are an example of each.
From my personal experiences, the cost of a CSP at the University of Newcastle is $11,392 per year.
From the Macquarie University website, an FFP position in the Doctor of Medicine program costs around $70,800 per year.
There is also a Bonded Medical Program but how it differs is in that they have an employment requirement associated with them. In exchange for being offered a CSP in a medical school, participants are required to work for a specified period in an eligible regional, rural or remote area (Modified Monash Model locations 2-7). This is known as your 'return of service obligation' (RoSO). From 2020 onwards, the RoSO involved a commitment to work in a rural area for three years at any time within 18 years of graduation from medical school, though half must be completed prior to your fellowship and half after your fellowship.[2]
The two older versions of the Bonded Medical Program were the Medical Rural Bonded Scholarship Scheme (2001-2014),[3] and the Bonded Medical Places Scheme (2015-2019).[4] These differ in terms of RoSO requirements, so refer to the linked resources if you fall under those program categories.
Are there any differences between FFPs and CSPs?
There is likely less competition for FFPs compared to CSPs, as many people simply cannot afford to pay the associated fees.
That is the only difference.
There are no differences in terms of priority ranking for internship positions.[5]
How many places are available?
3,533 domestic students commenced in 2021. Of these, 3,165 were CSPs and 368 were FFPs.[6]
How likely are you to get a place in medical school?
This is a difficult question to answer, but I'll try to give you my best estimate.
I've read some resources out there which provide an estimate of 5%. [7, 8] However, they use a single university's application numbers and extrapolate this to the entire country. For example, UNSW apparently had 3500 applicants for 198 places. This number of applicants is likely overinflated, because in reality I'm sure many applicants would've applied for multiple medical schools. If 1000 students all applied for five different medical schools (which, if you do want to study Medicine, I highly advocate for applying to all universities), then this would be counted as 5,000 applications, despite the fact that each of these students could only ever accept a single position.
Let's just say that you're applying for 2023 entry and theoretically you're able to apply for all 3,500 positions that exist for domestic students.
Now, there is no information out there that provides us with the real number of medical school applicants in a given year. So let's conservatively assume that there are around 35,000 applicants.
This means there is an ≅10% chance for a particular student to get in.
This is lower than the number I provided in the video because I am erring more on the conservative side here.
This means that your chance of NOT getting in is ≅90%.
After performing some basic maths, we can estimate our 5- and 10-year likelihoods for entering Medicine:
5-year likelihood = 1 - (0.9 ^ 5) = 1 - 0.59 = 0.41
10-year likelihood = 1 - (0.9 ^ 10) = 1 - 0.35 = 0.65
As you can see, even after 10 years, there is a significant chance that you may not get in, though it's rare to see someone continuously apply for this extended period of time.
Remember, stats apply to populations, not to individuals, so if you're a particularly emotionally intelligent, well-communicating or hard-working student, your likelihood of getting into med school is probably higher than this.
Additionally, I've pulled these numbers out of my backside, so the true likelihood of getting in may be higher or lower. In my opinion, thinking about this isn't very useful though as all you can do is create the best application that you possibly can and beyond that it's out of your control.
One of the flaws of the system I think is that there are dedicated students out there who would make great doctors but who simply haven't been given the opportunity to prove themselves. Sometimes I think that universities should have less stringent entry criteria so that there are more medical students, especially in the early years of med school, and they should slowly be filtered out by the examinations, written and clinical, that we perform throughout medical school. But that's a discussion for another day.
How many medical schools are there?
This is a list of accredited medical schools in Australia.[9]
- Australian National University
- Bond University
- Curtin University
- Deakin University
- Flinders University
- Griffith University
- James Cook University
- Macquarie University
- Monash University
- University of Adelaide
- University of Auckland (NZ)
- University of Melbourne
- University of Newcastle/University of New England
- University of New South Wales
- University of Notre Dame Australia (Fremantle)
- University of Notre Dame Australia (Sydney)
- University of Queensland
- University of Sydney
- University of Western Australia
- University of Otago (NZ)
- University of Tasmania
- University of Wollongong
- Western Sydney University
- Charles Sturt University and Western Sydney University
What are the pathways into medical school?
There are two main pathways into medical school. There's the undergraduate pathway (bolded in the list above) and the graduate entry (postgraduate; underlined in the list above) pathway. As you can see, there are 11 undergraduate medical programs and 13 graduate entry medical programs.[2-4]
If you're a high school leaver, then you can choose to directly enter Medicine through an undergraduate pathway OR complete a degree and try to enter into the postgraduate pathway.
If you've started a university degree, then you may still be able to apply for some undergraduate medical programs, but you will have to check with each university for their specific requirements. For example, after I started my Biomedical Science degree, I was able to apply to the Joint Medical Program between the University of Newcastle and the University of New England, but I was unable to apply for the medical program at the University of Adelaide.
If you've started a different university degree and you're in the penultimate year of your program, you should also consider sitting the GAMSAT exam. This GradReady article details a logical approach to sitting the GAMSAT as a current undergraduate student.
If you've completed an undergraduate degree, then the quickest pathway would be to complete a graduate entry program since these are four years in duration. However, it is still possible to enter through the undergraduate pathway. I have many friends studying with me at The University of Newcastle who have already completed a degree.
Getting Through Medical School
Medical school is tough.
There's definitely lots of positives. Meeting likeminded people. Learning about how the body works and solving diagnostic problems. Free coffee (sometimes).
But it also comes with its fair share of negatives too. Lots of people really struggle with medical school too. There's immense amounts of content which requires and endless amount of studying, there's stressful exams, there're not-so-nice supervisors, there's the impostor syndrome and there's the fact that you're dealing with real people who are dying in front of you.
I guess that's what you expect when you sign up for med school.
There's a lot I could say about how I got through medical school and the tips and tricks that I used. If that's something you'd be interested in, please get in touch by tweeting at me (@kajanan_n) or commenting on any of my YouTube videos and I'd be happy to dedicate an entire blog post to that.
Working as a Junior Doctor (PGY1 and PGY2)
Before we actually talk about what working as a junior doctor is like (and I'm relying on anecdotes from my sister and other doctor friends for this) let's talk a little bit about some of the confusing terminology when it comes to the hierarchy in Medicine.
Terminology
PGY1 (Internship)
So as I mentioned in the title, I was planning this to be a comprehensive guide and include all the relevant information here. However, when it comes to information about internship, there is already an extremely comprehensive guide developed by the Australian Medical Students' Association (AMSA) which is updated each year and contains all the information that you need to know about completing an internship in Australia.
I will leave that linked here for your reference.
Subsequently, I will not go into any further details about internship, and I'll instead move on to residency.
PGY2 (Residency)
References
This does not include direct links that appear in text above.
[1] https://medicaldeans.org.au/md/2021/11/MDANZ-Student-Statistics-Report-2021.pdf
[3] https://www.studymedicine.com.au/chance-of-acceptance-into-medicine
[4] https://medprepschool.com.au/medicine-harder-than-ever/
[3] https://gradready.com.au/medical-school-entry-requirements
[4] https://www.flinders.edu.au/study/courses/bachelor-clinical-sciences-doctor-medicine