With medicine left out of the paid placement expansion, the Australian Medical Students Association says ‘the fair go stops at the doors of medical school’.
The federal government has extended Commonwealth prac payment scheme to another 10 “front line” health degrees – but medicine is not among them.
The Australian Medical Students Association has come out swinging, arguing that the exclusion will exacerbate Australia’s biggest health gaps.
At Labor’s National Conference in Adelaide today, Prime Minister Anthony Albanese said he was surprised paid prac hadn’t existed sooner, pointing to the $427.4 million four-year government investment that took effect on 1 July 2025.
“I’ve heard from students firsthand who had to go straight from their hospital placement to their part-time job just to pay the rent,” the PM said.
“Paid prac has changed their life, and today we build on its success,” he said.
The payments will now be extended to include students studying physiotherapy, occupational therapy, clinical psychology, pharmacy, podiatry, speech pathology, audiology, radiography, rehab therapies and paramedicine.
AMSA president Seniru Mudannayake celebrated the win for the association’s allied health colleagues, but said the association was devastated to have been left in the cold.
Mr Mudannayake argued the government wrongly assumes all medical students are privileged, claiming doctors will out-earn other health workers and practice payment costs would be substantially higher for medical students.
“I think it really reflects the stereotypes and misgivings the government has about medical students and doctors more generally, and I think it’s a real shame that serious policymaking is even being influenced by these misconceptions,” he said.
Medical students must complete between 2000 and 4000 hours of unpaid placement over two to four years, yet universities recommend they work no more than five to 10 hours per week.
Mr Mudannayake told The Medical Republic that professors had advised him to pursue medicine only if he had sufficient family support.
“This tells us that we [students from low socioeconomic backgrounds] don’t belong in medicine,” he said.
“By shutting out students from low-income First Nations and rural backgrounds, you’re shutting out future doctors who actually [are more likely to] serve the communities where we have a medical workforce shortage,” Mr Mudannayake said.
Rigorous placement without adequate financial support has contributed to attrition rates of up to 45% among First Nations medical students, AMSA said.
Indigenous students constitute 4.2% of medical students at entry, but only 2.3% at graduation.
“The healthcare gaps in low-income First Nations and rural communities will cost far more than what this prac payment does,” the AMSA president said.
“When it comes to financial distress and poverty, we know that it drives mental health deterioration,” he said.
Citing 2013 BeyondBlue data showing one in five medical students had contemplated suicide within 12 months of the survey, Mr Mudannayake estimated this is equivalent to 4000 medical students nationally today.
The AMSA president called it “obscene” that working-class medical students face poverty and mental health struggles during placements, such as skipping meals, drinking only morning ward round coffee, or adding Aldi Weet-Bix to soups to stay full.
“Students are sleeping in their cars, or commuting more than two hours each way to placement just to afford shelter or because they have dependent children,” he said.
Mr Mudannayake said AMSA would continue to lobby MPs and senators across the country and push for more research into financial stress among medical students.
Universal initiatives the government could pursue include raising youth allowance and rent assistance payments to help students who can’t sustain employment outside placements, he told TMR.
“Students deserve to be paid for their time, and this is important for them to be able to complete their degrees safely,” he said.
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The AMA said the government’s decision “makes no sense” given its workforce modelling, which highlights a dire need to attract doctors to underserved communities and specialties.
The AMA and AMSA urged the government to reconsider the decision.
“We welcome the inclusion of more health disciplines in the prac payment scheme, but the community deserves an explanation from the government about why medical students are once again being excluded from this payment scheme,” AMA president Dr Danielle McMullen said.
RACGP President Dr Michael Wright told TMR the financial toll of developing highly skilled GPs and doctors through extensive unpaid placements is a key barrier for some of the “brightest” doctors.
“Expanding this means-tested program to medical students just makes sense, and we’ll be calling on the government to do this,” Dr Wright said.
According to the Department of Health, Disability and Ageing’s own medical workforce report, by 2048, Australia will have a deficit of more than 12,800 full-time equivalent specialist doctors.
Rural areas have up to seven times fewer specialists than metropolitan areas.
