Student Income Support - Policy Document - Australian Medical Students ...

Policy Document
Student Income Support
Position Statement
AMSA believes that:
  1. Student income support programmes should ensure that financial, personal,
     social and geographical factors do not act as barriers to participation in higher
  2. Adequate financial support for medical students is required to ensure that:
         a. The wellbeing of students is not jeopardised;
         b. There is diversity in the medical workforce;
         c. Students are able to complete core requirements and progress in a
             timely manner;
  3. Adequate income support schemes should be available to support students
     from rural, regional and remote areas (RRR), Aboriginal and Torres Strait
     Islander students, First In Family (FiF), and low socioeconomic (SES)
  4. Rural placements should be financially accessible to students;
  5. Research should be conducted to ensure that financial initiatives are efficient,
     effective, and responsive to changing student needs.

AMSA calls upon:
  1. The Australian Government to:
          a. Provide accessible income support payments at least equal to the
             Henderson Poverty Line to medical students in need, particularly to:
                 i. Aboriginal and Torres Strait Islander students;
                ii. Students from low socioeconomic backgrounds;
               iii. FiF students;
               iv.  Students from rural and remote backgrounds;
          b. Ensure eligibility criteria for student income support programmes:
                 i. Are inclusive of medical students in need of financial support;
                ii. Effectively account for variations in personal and family
                    circumstances, rather than arbitrary measures such as age,
                    when assessing financial independence and eligibility for
          c. Address the unique challenges that Aboriginal and Torres Strait
             Islander students face by:
                 i. Improving access to pre-existing funding and scholarship
                ii. Monitoring and regulating existing financial support
                    programmes to enhance transparency and accountability;
               iii. Conducting appropriate research to foster more targeted
                    initiatives that address financial barriers.
  2. State and Territory governments to:
          a. Support the provision of public transport concessions to all tertiary
             students, including international and postgraduate students;
3. Universities to:
         a. Take into consideration personal circumstances when allocating and
             scheduling timetables for clinical activities, including but not limited to:
                 i.   Employment on which the student is financially dependent;
                ii.   Location of residence;
               iii.   Estimated duration of travel;
         b. Conduct research into:
                 i.   The nature of employment undertaken by medical students;
                ii.   The level of financial dependence on employment;
               iii.   The proportion of students accessing and relying upon
                      scholarships, government payments and other avenues of
                      financial aid;
               iv.    The efficacy of current financial initiatives in providing adequate
                      support for students;
                v.    The socioeconomic status of its medical students;
         c. Promote and educate students about financial services and supports,
             particularly for students who need to relocate in order to attend
             university and placements, or work alongside their medical degree;
         d. Provide adequate subsidies for all students undertaking rural clinical


The Australian Medical Students’ Association (AMSA) is the peak representative body
for medical students in Australia. Accordingly, AMSA is well-placed to advocate on
issues of relevance to medical student wellbeing, provide representation for medical
students from all backgrounds, and support the equitable and accessible provision of
financial support.

Financial burden of medical education
Medical course costs
Medical course costs in Australia are arranged into 2 main categories,
Commonwealth Supported Places (CSPs), and non-Commonwealth Supported
Places. Non-Commonwealth Supported Places are made up of Domestic Full Fee-
Paying Places (DFFP), and international full fee-paying places [1]. In 2019, CSPs
represented 76% of all medical student places. The remaining 24% were non-
Commonwealth Supported Places; 8% DFFPs and 16% international places [2].
Eligible students with CSPs are able to defer their student fees via the HECS-HELP
programme, and DFFP students are offered an alternative loan programme FEE-
HELP, which only partially covers the full fee of most medical courses [3, 4].
International students do not qualify for any fee support from the government. Issues
unique to international students are addressed in AMSA’s International Student

Additional costs
There are several additional costs associated with studying at university, for example,
textbooks, course-related equipment and certificates, study resources, and internet
access. This is compounded by a number of expenses unique to studying medicine

Transportation costs
Students are often expected to self-fund their transportation costs, which can be
considerably high when travelling to placements in rural and distant urban locations.
This serves as another financial burden which can detract from the student’s ability to
work or study.
There are currently discrepancies between states and territories in terms of which
students are eligible for concessional public transport fares. For example, in Victoria,
postgraduate students are excluded from transport concessions [5] and international
students are eligible for concession on yearly passes only [6]. In New South Wales,
only international students who are funded by approved Australian government
scholarships are eligible for concessional fares [7]. Currently all tertiary students have
access to concessions such as in Tasmania, Western Australia, South Australia and
the Northern Territory [8, 9, 10].

Students who elect to drive to placement are faced with the costs of operating and
maintaining their vehicle. The availability of free or concessional parking for students
varies greatly between clinical sites, with many students incurring steep parking fees
to access their placement site. For example, maximum daily fees for on-site public car
parks can vary on average between $30 - 50 per hospital site [11,12].

Rural placement costs
Rural placements can be financially inaccessible to students, as they require students
to physically relocate. Students who have jobs in metropolitan areas may need to
seek alternative employment, which can disrupt their financial income.

The Commonwealth government requires universities to ensure that at least 50% of
students with CSPs undertake a specified minimum amount of clinical training in a
rural area [13]. The Rural Health Multidisciplinary Training (RHMT) Program supports
students to undertake rural training [14]. In a recent evaluation of the RHMT program,
it was found that accomodation remains an unmet need in rural clinical education,
with many locations still lacking affordable accommodation that suit the varying
lengths of rural rotations [14]. As such, some universities offer subsidised
accommodation to students with CSPs, with exact supports provided dependent on
each medical program.

Non-CSP students are not required by the Commonwealth government to undertake
rural placements and do not qualify for RHMT funding. Due to this, there is less
financial support available to these students to undertake rural placements, where
they may be ineligible for subsidised accommodation, or financial support payments
[15,16]. Rural Clinical Schools are currently actively discouraged from spending
funding on international students [16]. However, reducing financial barriers to rural
health for all student groups regardless of fee status, improving support and
placement quality may have positive implications for future rural health retention [17].

Many students undertake paid employment as a necessary source of income to meet
the financial burden of studying at university. Many medical courses directly or
indirectly restrict students' participation in paid work.

There are limited statistics outlining the proportion of medical students in Australia
undertaking paid employment, the number of hours worked per week, and the types
of jobs completed. The Medical Schools Outcome Database 2019 National Report
found that 53% of final year medical students rely on paid employment to cover living
and/or education expenses, the third most common source of income after family
(73%) and government (62%) [18]. With more than half of respondents requiring paid
employment to help cover their cost of living during medical school, it is clear that the
accessibility of financial support for students must be optimised and that a greater
understanding of the nature of work undertaken by these students would help achieve

Additionally, the requirements that can make juggling employment simultaneously
more challenging include:

Course Requirements
No Australian medical school offers the opportunity to study medicine part-time or
with a reduced study load. Timetables are often dynamic and may not be completed
in advance, which can make scheduling paid employment difficult.

Clinical Placements
Medical students often spend additional contact hours attending unpaid clinical
placement, which can be highly variable in duration and nature. There can be at times
an expectation to attend placement outside of working hours, including overnight or
during weekends, which makes fixed or regular employment harder. Students may
also be allocated to numerous sites, both urban and rural, which can require
significant travel time.

Extra-curricular Activities
Extra-curricular and volunteer activities provide important opportunities for the
development of medical graduate capabilities that are essential for future practice,
regardless of whether they are being sought for a merit-based internship system or
out of personal interest. Moreover, for students in Victoria and Western Australia,
internship positions are allocated using a merit-based system compared to the ballot-
based system adopted in other Australian states [19]. This can result in further
pressure to partake in extra-curricular, volunteering and research endeavours, which
may inhibit students’ ability to seek or continue with paid employment or have
associated costs that contribute to the financial burden.

Financial support
A number of avenues are available to Australian citizens and permanent resident
students in accessing income support:
    ● Support payments through Centrelink (Youth Allowance, Austudy, ABSTUDY)
    ● Supplemental payments through Centrelink (Student Start-up Loan, Rent
    ● Scholarships provided at university, state and federal government levels
However, these programmes are sometimes inaccessible, with medical students
frequently ineligible or underserviced due to age or family circumstances. Students
may be considered dependent for a number of reasons, such as if they are under 22,
do not work full-time or live at home. The dependency status renders them: ineligible
for support, only eligible for payments at a reduced rate, or the payments are only
provided to their parents. Additionally, students may be excluded from these schemes
on the basis of the courses they study - only undergraduate and some masters
programs are supported.

Even where students do receive support, these schemes are often inadequate. There
is significant disparity between the income funding available to students and the
Henderson Poverty Line. In the March quarter of 2020, the Australian poverty line for
a single person not in the workforce was $445.40 per week [20]. However, the
standard payment from Youth Allowance and Austudy is only $231.25 per week [21,
22] and this is further reduced if the student can continue to live at home during their
study. Independence criteria are highly specific and limit accessibility of income
support payments.

                        Table 1: Centrelink payment schemes

  Payment Scheme         Eligibility (Basic    Maximum Weekly          Considerations
                         Requirements)*           Payment

                       Australian resident    $126.50 (single        Age
                       16-24 years old        student under the
Youth Allowance        Studying full time     age of 18 living at    Living
                        Completed year 12      home)                  circumstances
                                               $152.30 (single        Personal income
                                               student over the       test
                                               age of 18 living at    Partner and/or
                                               home)                  children
                                               $231.50 (single        Partner income test
                                               student living away    Parental means
                                               from home)             test (if the student
                                               $280.95 (single        is dependent)
                                               student on income
                                               support over the
                                               age of 22 living
                                               away from home)

                        Australian resident    $231.50 (single        Personal income
 Austudy                Older than 25 years    student)               test Partner and/or
                        old                    $280.95 (single        children
                        Studying full time     student on pre-        Partner income test
                                               existing income

                        1) The applicant is    $282.85 ABSTUDY        Living
                        of Aboriginal or       Living Allowance       circumstances
                        Torres Strait          (undergraduate         Personal income
                        Islander descent       student over the       test
                                               age of 22 living       Partner and/or
 ABSTUDY                2) They identify as    away from home)        children
                        an Australian                                 Partner income test
                        Aboriginal or Torres   $537.30 ABSTUDY        Parental means
                        Strait Islander        Living Allowance       test (if the student
                        person                 (masters/doctoral      is dependent)
                                               student living away    Course load (full or
                        3) They are            from home)             part time study)
                        accepted as such
                        by the community       An additional
                        in which they live     payment of up to
                                               $633.50 annually
                                               for course-related
                                               costs (ABSTUDY

*For a complete list of requirements and payment rates, see references
** Not including the Coronavirus Supplement that was paid during 2020

Centrelink Start-up Loan
Students who are eligible for Youth Allowance, Austudy or ABSTUDY and are
studying eligible courses are also eligible for the Centrelink Start-up Loan. This is a
loan of $1,094 per semester, which is added onto the students’ HECS debt [29].

Tertiary students are eligible for several scholarships from the government, tertiary
institutions and not-for-profit organisations. Equity scholarships are most important to
students requiring financial support. However, they are often only accessible to
students receiving Centrelink income support payments or those who can
demonstrate additional types of disadvantage (such as carer responsibilities or
     disability) [30]. This can be restrictive for students who do not meet the independence
     criteria for Centrelink payments and are not receiving parental support.

     Students who need to move from rural/regional areas in order to study, and already
     receive Youth Allowance or ABSTUDY, are also eligible for the Centrelink Relocation
     Scholarship. This provides the student with a sum of $4,626 for the first year of study,
     $2,314 for the following two years and $1,156 for each year after that [31].

     Populations facing additional barriers
     The Bradley Review of Higher Education identified that Aboriginal and Torres Strait
     Islander, lower socioeconomic status (SES), First-in-Family (FiF), and rural students
     face significant barriers to participating in tertiary education [32].

     Aboriginal and Torres Strait Islander students

     Aboriginal and Torres Strait Islander students are more likely than their non-
     Indigenous peers to face financial hardships which affect their ability to study. Just
     over 77% of Indigenous postgraduate coursework (PGCW) students received no
     financial support from family or partners compared to 60.3% of all domestic PGCW
     students. Fewer than half of Indigenous students reported having savings, with a
     higher percentage of Indigenous students having fewer assets (refer to Table 2) [33].

                     Table 2: Postgraduate coursework students’ savings and assets [29]

                                         Domestic Students                           Int.


                                   All                       Indigenous

                         All     Full-     Part-      All     Full-       Part-
                                 time      time               time        time

Have savings for use     64.0   59.5%     67.6%       40.4   35.8%     45.1%       53.3%
 in serious financial     %                            %

Used savings in 2017     43.0   54.6%     33.9%       40.0   50.5%     29.4%       39.8%
                          %                            %

         n              2876     1284      1592       149      72          77       1724

 Value of personal

   Under $10,000         31.8   47.7%     19.1%       37%    45.6%     28.2%       69.2%
$10,000- $20,000      14.7     17.0%     12.9%     17.8    23.6%      11.9%       14.8%
                        %                            %

$20,000 - $50,000      13.3     12.7%     13.8%     11.6     7.0%      16.2%        8.7%
                        %                            %

$50,000 - $ 100,000    7.6%     5.4%      9.4%      7.4%     6.3%      8.4%         2.5%

  Over $100,000        32.5     17.2%     44.7%     26.3    17.6%      35.2%        4.8%
                        %                            %

        n              2813     1267       1546      148      72         76         1599

    Financial pressures remain a strong barrier to course engagement and completion for
    Aboriginal and Torres Strait Islander students. A number of support programmes
    have been developed to minimise these financial pressures, such as the Aboriginal
    and Torres Strait Islander Support programme Funding [34]. Despite these
    programmes, a study conducted by Gore et al. (2017) demonstrated that Indigenous
    students still face difficulties arising, in part, from these financial pressures,
    suggesting that either more targeted or effective programmes are needed [35].

    Lower SES students

    A student is defined as being from a low SES background if their residential address
    is in the bottom 25% of ranked Australian Statistical Areas (typically smaller than a
    postcode, defined by the Australian Bureau of Statistics) [36]. It has been shown in
    the past that about two-thirds of Australian medical students come from affluent
    backgrounds. Fewer than one in ten come from low socioeconomic status
    backgrounds [37]; however there remains an inadequacy in research conducted into
    socioeconomic status. A higher proportion of low SES students (62.7%, compared to
    56.4% of non-low SES students) indicated that their financial situation was often a
    source of worry for them, and a larger proportion reported regularly going without food
    or necessities because they could not afford them (17.5% compared to 13.8% of non-
    low SES students) [38]. The financial requirements to complete tertiary education for
    low SES students were not met by the government-funded incentives alone and
    scholarships were required as a complementary financial resource. A major cost of
    tertiary education for students is the opportunity cost of foregone earnings in the
    years while their time is devoted to study. This cost is significantly higher for students
    with dependants and those from low-income households where current earnings are
    crucial to their families’ immediate well-being [39].

    FiF students
    The National Centre for Student Equity in Higher Education defines FiF as students
    who are the first member of their immediate family, including siblings, to attend
    university [40]. For FiF students, the constraints and costs of attending university are
    multifactorial [41]. Brosnan et al. revealed the gaps between the forms of capital
    valued in medical education and those accessible to FiF students. Alongside social
    and cultural capital, the study found FiF students lacked the economic capital; such
    as resources during the medical school application process and throughout the length
    of the course. And while the option exists for students to enrich their experiences
    through connections to prestigious institutions and opportunities, FiF students may
    not be afforded such opportunities [42].
Regional, Rural, and Remote students
RRR students are twice as likely as metropolitan students to move away from their
family home for higher education [43]. Nearly 60% of RRR students relocate to
metropolitan areas to study, with a further 12% moving to another RRR location [43].
Moving can as much as double the cost of undertaking a degree. RRR students often
defer their study to earn money to support their studies and/or to qualify for Youth
Allowance. The added financial stress of relocating can also contribute to RRR
students considering an early departure from their tertiary studies. For example,
30.8% of RRR students cite financial difficulties as the reason for considering early
departure, compared to 21.6% of metropolitan students [43]. Despite the extra
funding provided to such students through government financial schemes (such as
Youth Allowance), stakeholder feedback indicates that the financial cost of tertiary
education remains a significant issue and deterrent for RRR students. RRR students
could benefit from improved delivery of information about the available financial
support programmes and their eligibility criteria. It is possible that current
arrangements are not delivering the intended outcome of improving support for RRR
students. Stakeholder feedback captures a wide range of reasons why this might be
the case, including the timing of payments, the rate of payments, parental income cut-
offs and tapering rates, the criteria to become independent, and how payments are
targeted [43].


[1] Australian Government Department of Health and Ageing HWD. Medical Students
[Internet]. Australian Government Department of Health and Ageing; 2010 [cited 2020
Aug 20]. Available from:

[2] MDANZ. Medical Deans Australia and New Zealand Student Statistics Report:
2018-2019 [Internet]. [cited 2020 Aug 20]. Available from:

[3] University of Melbourne. Doctor of Medicine : Fees - The University of Melbourne
[Internet]. University of Melbourne: Fees & Scholarships. [cited 2020 Aug 20].
Available from:

[4] StudyAssist. FEE-HELP [Internet]. StudyAssist. StudyAssist; 2018 [cited 2020 Aug
20]. Available from:

[5] Tertiary students [Internet]. Public Transport Victoria. 2020 [cited 15 August 2020].
Available from:

[6] International students [Internet]. Public Transport Victoria. 2020 [cited 15 August
2020]. Available from:

[7] Tertiary or TAFE students [Internet]. NSW Government - Transport. 2020 [cited 15
August 2020]. Available from:

[8] Department of State Growth. Eligibility Requirements for Adult Concession Fares.
Tasmania: Tasmanian Government; 2020 p. 1-2.

[9] Adelaide Metro - Concession cards [Internet]. Adelaide Metro. 2020 [cited 15
August 2020]. Available from:
[10] Tap and Ride Card [Internet]. NT.GOV.AU. 2020 [cited 15 August 2020].
Available from:

[11] Visitor car parking | Monash Health [Internet]. Monash Health. 2020 [cited 17
September 2020]. Available from:

[12] Parking at St Vincent’s Hospital Sydney - St Vincent's Hospital Sydney [Internet]. 2020 [cited 17 September 2020]. Available from:

[13] Department of Health. Rural Health Multidisciplinary Training (RHMT) programme
Framework 2019-2020 [Internet]. [cited 2020 Aug 20]. Available from:

[14] Going Rural Health. Student Support Scheme [Internet]. Going Rural Health.
[cited 2020 Aug 20]. Available from:

[15] The Department of Health. Rural Health Multidisciplinary Training (RHMT)
Program Framework 2019-2020 - PDF version.pdf [Internet]. The Department of
Health. [cited 2020 Sep 17]. Available from:

[16] Deakin University. Rural Clinical Support Scheme (Medicine) [Internet]. Deakon
University Current Students. [cited 2020 Sep 17]. Available from:

[17] Going Rural Health. Student Support Scheme [Internet]. Going Rural Health.
[cited 2020 Aug 20]. Available from:

[18] Playford D, Ngo H, Gupta S, Puddey IB. Opting for rural practice: the influence of
medical student origin, intention and immersion experience. Medical Journal of
Australia. 2017 Aug;207(4):154–8.

[19] Playford D, Ngo H, Gupta S, Puddey IB. Opting for rural practice: the influence of
medical student origin, intention and immersion experience. Medical Journal of
Australia. 2017 Aug;207(4):154–8.

[20] Application Guide for 2021 Intern Positions [Internet]. Melbourne: Austin Hospital;
2020 [cited 15 August 2020]. Available from:

[21] National Data Report 2019: 2014 - 2018 Data from Final Year Medical Students
at Australian Medical Schools [Internet]. Sydney, New South Wales: Medical Deans
Australia and New Zealand; 2019. Available from:
[22] Melbourne Institute: Applied Economic & Social Research. Poverty Lines:
Australia | March Quarter 2020 [Internet]. Melbourne; 2020. Available from:

[23] Youth Allowance for students and Australian Apprentices [Internet]. Australian
Government: Services Australia. 2020 [cited 20 August 2020]. Available from:

[24] Austudy [Internet]. Australian Government: Services Australia. 2020 [cited 20
August 2020]. Available from:

[25] Youth Allowance for students and Australian Apprentices [Internet]. Australian
Government: Services Australia. 2020 [cited 20 August 2020]. Available from:

[26] Personal income test for Austudy and Youth Allowance [Internet]. Australian
Government: Services Australia. 2020 [cited 20 August 2020]. Available from:

[27] Austudy [Internet]. Australian Government: Services Australia. 2020 [cited 20
August 2020]. Available from:

[28] Payment Rates [Internet]. Australian Government: Services Australia. 2020 [cited
20 August 2020]. Available from:

[29] How much you can get [Internet]. Australian Government: Services Australia.
2020 [cited 20 August 2020]. Available from:

[30] Who can get it [Internet]. Australian Government: Services Australia. 2020 [cited
20 August 2020]. Available from:

[31] What it is [Internet]. Australian Government: Services Australia. 2020 [cited 20
August 2020]. Available from:

[32] Equity Scholarships [Internet]. Universities Admissions Centre. 2020 [cited 20
August 2020]. Available from:

[33] Relocation Scholarships [Internet]. Australian Government: Services Australia.
2020 [cited 16 September 2020]. Available from:

[34] Birrell B, Edwards D. The Bradley Review and Access to Higher Education in
Australia. Australian Universities' Review. 2009;51(1):4-13.
[35] 2017 Universities Australia Student Finances Survey [Internet]. Universities
Australia; 2018. Available from:

[36] National Centre for Student Equity in Higher Education. Low SES Students; 2020
[cited 17 September 2020]. Available from:

[37] Behrendt LY, Larkin S, Griew R, Kelly P. Review of higher education access and
outcomes for Aboriginal and Torres Strait Islander people [Internet]. 2012 [cited 20
August 2020]. Available from:

[38] Gore J, Patfield S, Fray L, Holmes K, Gruppetta M, Lloyd A, Smith M, Heath T.
The participation of Australian Indigenous students in higher education: a scoping
review of empirical research, 2000–2016. The Australian Educational Researcher.
2017 Jul 1;44(3):323-55.

[39] Dobson, Ian R. "Women's Access to Medical Training in Australia: An Equity
Issue?." Journal of Institutional Research in Australasia 6 (1997): 47-52.

[40] King S, Luzeckyj A, McCann B, Graham C. Exploring the experience of being
First in Family at university. Unpublished report. 2015 Aug 6.

[41] McCarron GP, Inkelas KK. The gap between educational aspirations and
attainment for first-generation college students and the role of parental involvement.
Journal of College Student Development. 2006;47(5):534-49.

[42] Brosnan C, Southgate E, Outram S, Lempp H, Wright S, Saxby T, Harris G,
Bennett A, Kelly B. Experiences of medical students who are first in family to attend
university. Medical education. 2016 Aug;50(8):842-51.

[43] National Regional, Rural and Remote Education Strategy [Internet].
Commonwealth of Australia. 2019 [cited 20 August 2020]. Available from:

Policy Details

Name:                 Student Income Support

Category:             C – Supporting Students

History:              Reviewed, Council 3, 2020
                            Keivan Davoodi, Keira Sanders, Sheneli Perera,
                            Hannah Rubinstein, Terra Sudarmana, Jessica Yu,
                            Travis Lines (National Policy Officer)
                      Reviewed, Council 1, 2018
                            Stephanie Davies, Damian Azzolini, David Barlow,
                            Kate Chiswell, Tristan Dale, Fergus Stafford
                            Celest Dines-Muntaner (Policy Officer)
                      Reviewed, Council 3, 2014
                      Adopted, Council 1, 2012
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