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wanabedoc
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|  | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #210 on Oct 12, 2009, 9:28pm » | |
I still don't quiet understand, just out of interest really, does the MRBS scholarship pay for your fees, or is the $23,000 a scholarship amount paid to the student yearly? I mean is the scholarship amount restricted on what you can spend it on?
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #211 on Oct 13, 2009, 2:17am » | |
Oct 12, 2009, 9:28pm, wanabedoc wrote:| I still don't quiet understand, just out of interest really, does the MRBS scholarship pay for your fees, or is the $23,000 a scholarship amount paid to the student yearly? I mean is the scholarship amount restricted on what you can spend it on? |
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From what I understand, you are paid the scholarship amount in ten monthly payments over the uni year and you do with it as you wish 
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treadwah
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #212 on Oct 13, 2009, 9:11am » | |
So, if you use it to pay for your uni-studies, I believe you are still eligible for the 20% up front discount. Making each year worth ~7K.
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MrBump
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #213 on Oct 13, 2009, 12:44pm » | |
Except that you get the money split up into 10 portions (every month for March-December), which would make it difficult to pay your fees up front.
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diver
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #214 on Oct 28, 2009, 8:04pm » | |
Has anyone seen the 'precise details' for the Scaling Initiative / new arrangements yet???
Dept of Health website still has "will be updated once all details are finalised"
My 2010 offer states that 2010 Contracts and details will be available on the website - but still only link to 2009 
Presumably they'll send me more info after I accept but I'd like to know beforehand... Not that I'm likely to decline Think I'll give them a call tomorrow.
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MrBump
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #215 on Oct 28, 2009, 8:14pm » | |
A phone call sounds like a good idea, diver. Let us know what they say!
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diver
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #216 on Oct 29, 2009, 10:07am » | |
Hi Guys, I just got off the phone to dept of Health:
Essentially it's a watch this space...
New contracts (2010) are still with legals for approval. They wouldn't say what the hold up was but I'm wondering if the governing legislation / amendments haven't past yet?? Does anyone know? I'll keep doing some research...
Intention from Dept of Health contact is that the RA classifications on the website below will be used. Also it appears that there is now no difference between GPs and other specialties - ie return of service will be anywhere RA 2-5 (anywhere outside of major metropolitan areas).
http://www.doctorconnect.gov.au/
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petesf
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #217 on Oct 30, 2009, 10:35am » | |
I'm not happy with this. I've just sent an email to the DH&A:
"The precise details of the new arrangements and how they will be applied to the Medical Rural Bonded Scholarship Scheme are currently being finalised and will be announced in the near future. The Website will be updated once all details are finalised."
When?
The 'near future' is passing us by. I'm uncomfortable that my place at UQ is conditional on my accepting an undefined contract, and I'm not sure of the legalities involved if the contract isn't acceptable.
If the terms of the contract are unacceptable, where does that leave me? As far as I can tell, my options are either to accept the contract as is, or to cancel my UQ enrolment (wasting a lot of time and effort, and jeopardising my future. I'm 37 with a family to support, and I don't have time to stuff about.) I was earlier under the impression that I could change to a CSP if the MRBS contract was unworkable, but that option does not seem to be available.
In the interests of transparency and fairness (and possibly under contract law), I believe that the Department of Health has an obligation to ensure either: i) that the terms of the contract are explicit before applicants are required to indicate their preference of MRBS over CSP, or ii) that applicants will not suffer undue hardship if they choose not to accept the contract.
Will advise what the reply is. Not that I'm expecting anything more than we already know.
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #218 on Oct 30, 2009, 10:55am » | |
Hi,
I have not been following this closely... so excuse me if my question is sillly. Do you have a contract to sign? or are there some ancillary documents that are not yet settled?
Frankly from a contract law point of view - there maybe a certain advantage to signing if the terms are uncertain. Later on... the validity of the contract could be disputed because what was actually agreed is unknown ie 'nasty bits' could be cut out because you did not agree to them. and particularly in this pressure scenario the principle of duress is relevant.
obviously better to agree to something all set out and which you understand fully.... but legally not necessarily the only strategy.
CP
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petesf
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #219 on Oct 30, 2009, 11:24am » | |
There is no contract yet. "The details are being finalised". I signed (was required to either sign or forfeit my place at UQ) a memorandum of understanding that I intend to sign an MRBS contract.
The MRBS page says:
The Scaling initiative was announced in the 2009-10 Budget as part of the Rural Health Workforce Strategy. It will provide a non-cash incentive for doctors from the Medical Rural Bonded Scholarship (MRBS) Scheme with a return of service obligation to work in more remote communities. In essence, the more remote an area the shorter the return of service obligation will be for students. The precise details of the new arrangements and how they will be applied to the Medical Rural Bonded Scholarship Scheme are currently being finalised and will be announced in the near future. The Website will be updated once all details are finalised.
It includes links to a sample 2009 contracts.
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countryphysician
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #220 on Oct 30, 2009, 11:47am » | |
Hi,
I will have a look at the sample contract. However, it seems to me that the the scaling initiative is simply a 'speed up' of return of service. There does not seem to be a change in concept.
So if you are happy in principle to take a MRBS - as I would be - then all you are getting is the 'new mechanism'. However no doubt there will be some wrinkles as to exactly where and how much extra time can be credited by practising ..... for 6 months on Christmas Island !
Again though - a person signing a contract subject to an unknown "x event" on day 1 can't legally be put in a worse position on day 25 by x occurring. Legally that part of the contract could be struck down ie is not enforceable - although some of us contract purists would argue that the entire contract was uncertain right from the start and voided ab initio if the "x" was a material clause. blah blah.
Anyway - easy though it is for me to say - I would not be terribly worried. The practical difficulties might be if you are committed to specific areas in country oz and that doesn't fit with new scaling initiative.
CP
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petesf
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #221 on Oct 30, 2009, 1:52pm » | |
Thanks CP,
I don't know how relevant the sample contracts will be.
I've just been speaking with Margaret Weir, the Assistant Director, Strategic Medical Education Section, Medical Education and Training Branch, Department of Health and Aging.
She said several things of interest:
Much of the contract terms have been finalised, but not the specifics of the sliding scale of return of service.
All details should be finalised and available by the end of next week! (But I'm allowing two, at least )
It is definite that all MRBS scholars will be able to do their return of service in RA 2 to 5 (including general practice).
The breach conditions for ceasing study before graduation have been made more lenient (but no, you can't switch to a CSP).
She stressed that I shouldn't hesitate to call her again, so I'm sure she would be happy to speak with other MRBS scholars. Call 1800 248720 (the MRBS freecall number) and ask for her by name, or PM me for her direct number or email address.
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treadwah
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #222 on Oct 30, 2009, 2:18pm » | |
Pete, you rock.
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petesf
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #223 on Oct 30, 2009, 2:38pm » | |
Thanks treadwah!
But kudos to the MRBS administrators.
I was really impressed by how quickly they responded. I have the impression that the people involved genuinely care about what they do and the students they support, which seems pretty novel for a government department!
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #224 on Oct 30, 2009, 3:02pm » | |
HI,
had a quick look at sample 09 contract. As you say they may change... but realistically unlikely to toss out and start again - too much work.
Two things that did raise an eyebrow...
First one of the breach events. A scholar cannot provide a professional service ie do something on the list of medicare items (whether claimed or not) outside the relevant 'rural/remote area' from fellowship to end of return of service (6 years).
Not one single one or you are in breach .... no exceptions for emergencies or voluteer stuff....
I hate contracts that set up inevitable breaches - such bad drafting.
Second - the release of personal info is not expressed to be subject to the Privacy Act which is odd. Under the contract, the scholar authorises release of all sorts of info from everone involved - ATO, supervisors... to dept. Dont like this black hole - if you dont have a right of access to the file to check it is correct etc.
If you speak to your new friend  again, think about asking about these issues. She may have some influence and there is no harm in asking before document is settled! I am a year or two off considering a MRBS myself - so if you'd like to sort it all out for me ahead of time that'd be great 
CP
ps the present draft does include an 'acknowledgement' that scholar has received independent legal advice.
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #225 on Oct 30, 2009, 3:38pm » | |
CP - we had been told previously that we should be able to do public hospital work in the city - I think because it's salaried and you're not billing under Medicare? That's a very good point and has scared the crap out of me - I was hoping to do some clinical research under that advice.
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petesf
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #226 on Oct 30, 2009, 9:43pm » | |
Thanks again CP. I'll send an email questioning those points.
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diver
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #227 on Oct 31, 2009, 4:28pm » | |
Thanks CP + petesf for the additional info.
Petesf - I'm in a similar position to yourself and also find it somewhat unfair that although I can consider the contract (when it is finally released) I don't really have a choice since it appears that the options at this stage are to accept the scholarship or NOT study medicine!
Considering it is a merit based scholarship I would have thought it reasonable to offer a CSP as a fall back option. Good thing I'm still keen on the scholarship... Though I'd sure like to know what's in it...
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petesf
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #228 on Nov 5, 2009, 11:03am » | |
Oct 30, 2009, 3:02pm, countryphysician wrote:HI
had a quick look at sample 09 contract. As you say they may change... but realistically unlikely to toss out and start again - too much work.
Two things that did raise an eyebrow... |
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I have a response from the department on those issues:
1. The new contract refers to a breach if a "Professional Service for which a Medicare benefit is payable" is renderered outside of an applicable area during the requisite period. There will be no breach if the rendering of the Professional Service does not attract a Medicare benefit. Thus voluntary work will not be a breach of the contract provided that nobody is entitled to receive a Medicare benefit in relation to the Professional Service either by right or by an assignment of rights.
Note that the work must be performed without charge by both the practitioner and the practice because, otherwise, a Medicare benefit may be payable if the practitioner volunteers his or her services but the practice still charges the patient for those services.
2. Despite not being mentioned in the contract, the Department must comply with any statutory obligations imposed upon it under the Privacy Act 1988 and other legislation with respect to personal information. MRBS scholars may exercise any statutory right available to them in relation to accessing their own personal information from the Department.
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countryphysician
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #229 on Nov 5, 2009, 11:32am » | |
Good work petesf!
On 1 - good to know what the dept thinks and good that volunteering is possible. However as I expected any salaried work (eg in a city public hospital) outside the zone is not okay. This does snooker the 'advice' given earlier to Miss G which is vexxing.
On 2. Expected this response but.... the dept should be expressly noting this issue imho - otherwise scholars might not appreciate thier administrative review rights.
good luck!!
CP
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #230 on Nov 5, 2009, 4:14pm » | |
That's interesting - I went back to the discussion forum that was held on the RRMEO website where a representative of DoHA, Margaret Weir, answered questions about the contract - here is her answer to one student, and then to me.
"Any 'medical work' undertaken outside a rural or remote area, before the return of service period is completed, can only be undertaken as a salaried employee, for example in a Public Hospital, run by a State/Territory Government. Public patients, in public hospitals, receive free medical and allied health/paramedical care from doctors nominated by the hospitals while in hospital. This is to ensure that there are no claims on Medicare.
MRBS doctors will be issued with a restricted Medicare Provider number that will not be able to be used outside Rural and Remote areas until their return of service is completed, ie 6 years. You would be able to work 20 hours per week in a rural/remote area and make claims on Medicare - however, if you were to spend the rest of the week in a metropolitan area you would only be able to work in a Public Hospital."
Here is her response to me:
Dear Miss-G- (name changed )
Letters from where you were working could be used to provide evidence of how long/where you were working. Medicare billing data can also be used to track when/where someone is working.
You are able to work in public hospitals in the city - as long as you don not directly bill - and you are able to do this for up to 3 months during your return of service period. As you will have a restricted provider number you would be unable to bill in city areas.
You would also be able to work in research during that 3 month period.
Margaret
I am thoroughly confused.
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countryphysician
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #231 on Nov 5, 2009, 5:12pm » | |
Yes it is thoroughly confusing.
However - thinking about the issue from general principles and not specifically to any one person; I would consider that if a person has a letter from a representative of the department saying that you can do the salaried work and not be in breach - then - (unless there are other contradictory bits and pieces ) it can be argued reasonably that the letter either varies the contract or gives the person a right to rely on it as an actionable representation.
As I have said, I think the agreement is uncertain and capable of different interpretations. And perhaps the dept doesnt appreciate that there is a strict interpretation which can knock out any salaried work (where a person's work causes someone/thing else to indirectly gains a medicare payment). And perhaps - evenif they do know - they dont care because they are happy to allow this sort of stop gap work to support the rural doctors. A person holding rights and obligations under an agreement does not have to enforce them. (subject to waiver principles - but blah blah).
So overall, as petesf's discovered - the dept reps were helpful and seeming to be committed to getting doctors into the country ( which they should be!!! per govt policy and NEED). So if there is a dispute, I would not expect all out warfare (like when dealing with say the ATO ![[image]](http://img230.imageshack.us/img230/452/smileypyrosk2.gif) ) over a matter of interpretation.
On the research - that doesn't seem so problematic because I would not think there is any medicare payment involved... but I dont actually know. Remember the whole thing turns on the definition of "Professional Services" which is linked to medicare payments.
End of day.... if I had a letter saying "x" and information saying "y" and I wanted the result to be "x", .... well I would be contacting the dept for a little chat and being quite determined about my "x" position and how I had relied on it/made arrangements around it. I would not wait until bells were ringing.
CP
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petesf
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #232 on Nov 5, 2009, 9:11pm » | |
Nov 5, 2009, 4:14pm, Mimieux wrote:That's interesting - I went back to the discussion forum that was held on the RRMEO website where a representative of DoHA, Margaret Weir, answered questions about the contract - here is her answer to one student, and then to me.
"Any 'medical work' undertaken outside a rural or remote area, before the return of service period is completed, can only be undertaken as a salaried employee, for example in a Public Hospital, run by a State/Territory Government. Public patients, in public hospitals, receive free medical and allied health/paramedical care from doctors nominated by the hospitals while in hospital. This is to ensure that there are no claims on Medicare. |
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That seems to gel with what Margaret said to me, quote din my previous post (yes, the same Margaret). I think the key phrase in that post is this:
There will be no breach if the rendering of the Professional Service does not attract a Medicare benefit.
Taking the two together, my reading is that metropolitan paid work is OK, as long as it's not billed to Medicare. I wasn't aware that public hospital services didn't go through Medicare, but that's what Margaret is saying, right?
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petesf
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #233 on Nov 6, 2009, 2:44pm » | |
The draft 2010 contract is now online: Department of Health and Ageing, MRBS Scheme 2010 contract
I haven't looked through it yet.
"Please be advised that this document is a draft of the 2010 contract for the Medical Rural Bonded Scholarship. The Commonwealth makes it available to you for information purposes only. The draft contract is subject to change and should not be regarded as the document that includes all the terms you will be asked to agree to. Rather, the purpose of releasing the draft contract is to advise you of proposed changes to the scholarship scheme. The Commonwealth has not yet adopted these proposed changes or any other term of the draft contact. By downloading or otherwise obtaining, this draft contract, you agree that the Commonwealth is not responsible for the outcome of any decisions that you make, which are based on the contents of the draft contract."
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kt308
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #234 on Dec 21, 2009, 9:07am » | |
I emailed the Department yesterday about the contracts, got this back....
Hi Katie
Thank you for your email regarding the Medical Rural Bonded Scholarship (MRBS) Scheme.
I can confirm for you I have received your paper work and all is in order, at this stage all MRBS contracts will not be sent out until the new year, late January to mid February so no cause for concern at this point.
Have a nice Christmas, and a happy new year.
Please do not hesitate to contact the Department if you require any additional information.
With kind regards, happy to discuss
Emma
MRB Scholarships
Strategic Medical Education
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Freecall 1800 248 720
www.health.gov.au/mrbscholarships
They were very prompt - I'm impressed! So now we can relax over Christmas, God willing.
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #235 on Dec 28, 2009, 7:36pm » | |
Thanks Katie - was about to e-mail away for that info.
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petesf
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #236 on Dec 29, 2009, 12:06am » | |
The Department ha a new page up (I don't know how new, exactly. It's not months old, but it could be weeks old):
The Scaling Initiative - Questions and Answers
The most interesting items are these:
6. How does scaling work?
Scaling will be applied monthly once you have attained Fellowship, commenced your return of service period, and meet a ‘threshold’ of the total schedule fee value of items claimed under the Medicare Benefits Schedule (MBS) for the month. The threshold is the same for general practitioners and specialists.
Scaling will be applied monthly at the following rates:
| ASGC-RA Category | Scaling Discount Rate % | | RA2 Inner Regional Australia | 10% | | RA3 Outer Regional Australia | 30% | | RA4 Remote Australia | 40% | | RA5 Very Remote Australia | 50% |
For example, if a MRBS doctor works for a month in an RA 5 location and meets the threshold, this will result in one month of actual time plus one month of credit toward the return of service period.
If you work in more than one location in a month then the scaling discount rate will be applied to the location where you have provided the highest value of schedule fee services.
7. Does scaling apply if I am in a salaried position?
To access scaling, you need to be billing Medicare. If you work in a salaried position, for example in a public hospital emergency department, your work will count towards meeting your return of service obligation however, scaling does not apply.
I'm boggled by the tying of scaling to billing Medicare. Why would they do that?
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #237 on Dec 29, 2009, 8:21am » | |
Dec 29, 2009, 12:06am, petesf wrote:| I'm boggled by the tying of scaling to billing Medicare. Why would they do that? |
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That IS really interesting.
Maybe it's a way of trying to encourage more scholarship holders to become GPs? With the new classifications, a fair amount of the larger areas that would have been OK for scholarship recipients under the RRMA scheme have been reclassified as RA1 and so are out of bounds. I'd imagine that since many rural and remote areas can't support lots of private specialists, people entering the scheme now have more incentive to go down the GP path.
Perhaps I'm misreading the situation, but I'm sure that would make the government very happy. They don't want country specialists, they've always been happy for people to travel to tertiary centres for specialised care, and with the amount of interest we're seeing at the moment in centralised care (like the cancer centre to go in at RPA) I don't see this changing any time soon. What they do want is people in R&R areas having more access to GPs. So limiting scaling to Medicare billable services could be an effective way of encouraging those who want to get their time done as quickly as possible to become GPs.
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petesf
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| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #238 on Dec 30, 2009, 4:47pm » | |
Dec 29, 2009, 8:21am, lorance wrote:| Perhaps I'm misreading the situation, but I'm sure that would make the government very happy. They don't want country specialists, they've always been happy for people to travel to tertiary centres for specialised care, and with the amount of interest we're seeing at the moment in centralised care (like the cancer centre to go in at RPA) I don't see this changing any time soon. What they do want is people in R&R areas having more access to GPs. So limiting scaling to Medicare billable services could be an effective way of encouraging those who want to get their time done as quickly as possible to become GPs. |
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Well, specialists in private practice bill Medicare, so the scaling initiative doesn't doesn't differentiate between GPs and specialists.
It does distinguish between doctors working for a hospital or clinic (no scaling for you), and doctors in private practice. I'm not sure what the situation is for doctors doing both (eg a salaried specialist with right of private practice). I've sent an email to ask, but the office is closed until the 4th.
The question of whether GPs are wanted in the bush rather than specialists is an interesting one that I'd like to address, but not in this thread. I'll post to the General Practice + Rural and Remote Medicine thread sometime soon.
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Location: Sydney, Australia
| | Re: MRBS: Medical Rural Bonded Scholarship Scheme
« Reply #239 on Dec 30, 2009, 5:59pm » | |
Dec 30, 2009, 4:47pm, petesf wrote:| The question of whether GPs are wanted in the bush rather than specialists is an interesting one that I'd like to address, but not in this thread. I'll post to the General Practice + Rural and Remote Medicine thread sometime soon. |
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I'll answer it here. Frankly, I'm mildly surprised that this is even being asked. To me it is obvious that the purpose of these schemes is to create rural GPs, not rural specialists.
Regards.
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Michael Tam (about me)
E-mail: m.tam(at)unsw.edu.au
The Medicine Box
vitualis' Medical Rants |
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