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Russ

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Medicine FAQ / So You Want To Be A Doctor
« on: July 06, 2012, 06:11:53 pm »
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In the interests of not letting the law students one-up us, this is a FAQ with respect to medicine. It's also to stop the same questions getting reposted and messaged to members, so hopefully people can see them here, in one place.



If you have questions that you'd like answered, go ahead and post. If you'd like to tell me that I'm wrong and something needs to be changed, send me a PM with a link to the correct information. If you'd like something added, write it up and PM/email it to me and I'll add it with accreditation to you :)

If you ask a question that is covered in here, I will probably be snippy and refuse to answer it. I wrote this thing, at least you can read it.

Why should I study medicine?

I became a doctor for the same four reasons as everybody else; chicks, money, power, chicks.

No, but seriously...

Because you like biology and chemistry and that sort of "book learning". Because you also like interacting with people and have some sort of charisma or ability to get on with them. Because you find the idea of understanding disease interesting. There are a bunch of reasons, those are just a few.

Why shouldn't I become a doctor?



Because your social life will turn into this:




The working life of a doctor is generally considered on objective metrics to be not particularly great. The answer to the question, 'Should I do medicine?' is almost certainly 'no'. Becoming a consultant doesn't really save you from this, so it's a long commitment you're making. Young people rarely listen, however, but do try to investigate the downsides of the job rather than just pretending they won't affect you.

And there's also this gem I found on another forum (not completely true but the point holds)

Quote
Did you know that doctors in Australia can claim virtually ANY personal spending as tax deductible? Food, vacations, whatever. It's crazy. I'm friends with an anesthesiologist and she explained why.

It's because the doctor life cycle is Wake up > 16 hour shift > Get home > Sleep. Every so often some money shows up in their bank account, but in general this doesn't change the routine.

This basically makes them economic black holes. Vast piles of money pour into their bank accounts and then never comes out because they're all too busy to spend it. So the government does whatever the fuck it can to get them to actually spend their income rather than have it just leave economic circulation forever. She told me she could have claimed her wedding as tax deductible if she wanted to but felt that was kinda pushing it.

Where am I going to study this degree?

If you're a high school student and you live in Victoria, you get to go to Monash or go interstate. With Melbourne redesigning their course structure as the Melbourne Model, their medicine degree is now not available to high school leavers. If you want to go interstate, there's a lot of universities in the country that will accept your application, but they come with the fairly obvious downside of requiring you to move there.

What do I need to study in VCE to get in?

Chemistry is a prereq for Monash. Beyond that check each uni individually, but I'd strongly recommend doing it anyway since it's important. Biology typically isn't a prereq but again, medicine is really just applied biology. Get a head start on understanding it now. Other than that, pick what you enjoy and you can do well in.

How am I going to get in?

Get a good ATAR. Like a really good one. There's all sorts of examples of people getting in with lower scores and whatnot, but aim for 99+. That's high but everyone else is aiming there as well. It does, unfortunately, get worse. Monash (and most other medical schools) like to also rank students based on other skills, so that you can't just ace all your subjects and get in that way. There's an entrance exam. It's called the UMAT. If you don't know what that is, go and google it and then read the UMAT subforum here. The score you get in that exam will be compared to your ATAR and they'll be used together to decide whether or not you get...an interview.

Medical schools also want to find out if you're good at talking to people and not just good at taking tests. At most schools, you'll be put in a corridor with several rooms opening off it and you'll enter the rooms one at a time. In each room there will be a different interviewer with a different question/questions for you. Your marks across all the rooms will be combined etc. and based on the ATAR/UMAT/Interview results they decide whether you get a place.

What about all these prep companies?

There is an industry that revolves around selling preparation materials to students for medicine entrance exams and interviews. You may benefit from purchasing these services but ultimately they aren't a substitute for hard work. They are a tool you can use to do well but are inadequate in the absence of a willingness to study and prepare. My honest opinion is that there is minimal difference between the products in the market, so you should predominantly base your decision on price. My exception to this is MedEntry, who I would never personally purchase product from.

Disclosure: I've previously been financially compensated for interview preparation. I've never been directly compensated for producing exam preparation material.

I didn't get in and now I'm going to have to do the graduate medicine thing. Help!

Okay. So things are slightly different. Instead of the UMAT you get to sit the GAMSAT, which is 8 hours of fun! Go read the GAMSAT forum for information on this. Instead of an ATAR you'll get a GPA based on your undergraduate marks (go read the GPA sticky on this). Other than that, the application process is similar (ie academic marks + entrance exam + interview). In terms of marks, all universities differ but at UoM (where most people here will be interested in), the typical successful application would have some combination of 6.5+ GPA and 65+ GAMSAT. Go read the relevant threads about them!

What's the difference between Science and Biomedicine and Biomedical Science? I heard if I don't do Biomedicine, I can't do medicine afterwards?!

The difference between the courses is mostly one of structure. Science encompasses many areas (maths, geology, chemistry etc.) and as such, is very broad. If you do a BSc, you can take classes that focus on human health, biology etc. but you can also take classes that don't. Biomedicine and Biomedical Science are designed to focus on these things throughout the degree and don't have the same amount of flexibility that a BSc does. The advantage, however, is that they may be better organized for a prospective medical student, may offer classes not available to science students etc. It depends on the course and the university.

You can apply to study medicine with any degree. There is no advantage or disadvantage if you have a law degree, science degree, biomedicine degree etc. As of writing this, the University of Melbourne requires you to have studied 2nd year level subjects (anatomy, physiology, biochemistry) and thus it is easier to apply there if you did a science/biomedicine undergraduate degree. There may well be a shift in coming years towards requiring previous study in the field, as more universities transition to a graduate education model, but currently it does not matter what your undergraduate degree is, in terms of applications.

I don't want to talk to people/I'm bad at it, what does this mean for the interview?

There are one or two universities in the country who have decided that the cost of the interviews isn't worth it in selecting their students, so they've abolished it. Subsequently, the entrance cutoffs have gone up substantially. Look into them if you really don't want to sit an interview.

The interview itself is trending towards an MMI (Multiple Mini Interview), rather than the older panel system. Instead of 45 minutes talking to three people who might ask you anything, you now spend 8 minutes talking to 8 different people in 8 different rooms, with predetermined questions. A discussion of interview theory is probably beyond the scope of this but you can do some googling if you really want to know about the reliability and so forth. In general, the MMI allows you to answer specific questions with specific answers, so you don't need to be good at thinking on your feet and be able to dazzle them with flair (it certainly helps though).

I heard that not all medical school places are the same..

Correct. There are different types of places, depending on what you apply for and how good your marks are. Broadly speaking:

Commonwealth Supported Place (CSP): The government pays a large amount of your fees, leaving you the rest to pay yourself (roughly 10k a year). They also offer you the ability to take on a debt for that 10k and pay them back through the tax system once you're earning actual money.

Full Fee Place (FFP): If you're an international student / don't have ANZ citizenship then you can't get a CSP and have to take one of these. It's expensive (roughly 60k a year) so work out where that money's coming from before you start.

Bonded Medical Place (BMP): Turns out doctors like money and city comforts and don't want to work rurally, leading to a whole lot of rural health problems. To address this, the government has introduced a scheme where 25% of medical school places are "bonded". Before you start you sign a contract and you'll have to work rurally for a year.

If you want more information on the BMP, I strongly (STRONGLY) recommend you google the government website and read the contract and your obligations etc. You would have to be an idiot to sign one without having a proper read of it/think about it. They're legal documents that will dramatically affect your future!

Preferences in VTAC - Bonded vs. Unbonded: the common myth
There is only a disadvantage if you put a Bonded place above an Unbonded place in you VTAC preferences, only a disadvantage. There is a common urban myth (mainly brought about by ill-informed parents) that because students are less keen about Bonded places, by having it first will give the student an advantage in getting one and hence a place in medical school. This is not true at all. As Bonded places are only given to the bottom 25% of successful applicants, there are two main successful scenarios if you have Bonded ahead of Unbonded:
1) You fall in the bottom 25% and get Bonded, this would have happened anyway if it was your second preference
2) You fall into the top 75% and get Bonded, when if Unbonded was above, you would have got that place
So in essence, NEVER put Bonded spots above Unbonded spots, as there is only a disadvantage to yourself if you do.

Bonded Medical Place (BMP): **worth noting in the para that it is exactly the same as CSP except the bond

Extended Rural Cohort (ERC): A small stream of students whereby the clinical years are undertaken in rural/regional areas. All students here are CSP, except these students accept their place knowing that their clinical years will definitely be in a rural/regional setting. Preference is given to domestic rural applicants.

YAY I GOT IN! What do I do in the summer holidays?

Enjoy your holiday. You'll be spending your future holidays working, so enjoy it now. If you want to do some preparation, then brush up on your biology. If you never studied it before, then spend some time getting the basics down and give your university a call to find out whether they have any advice. Don't buy any textbooks. 80% of them you don't need and will consult once a week to source something you could have found via your online access. Only get the essentials in hard copy and you'll find out what these are after you start. If you want to get a steth before uni starts that's fine, just don't get the MASTER III CARDIOLOGY PRO WITH ELECTRONIC STUFF. Most of the people I know spent $70 and got the Littmann Classic II. Make sure it has a bell and a diaphragm because you need both.

If you go to Monash, be aware that your student society will help get you a discount on equipment if you wait until second semester. See here

How hard am I going to have to work?

It is, to some extent, subjective, but I don't think anybody would say "not very hard". Universities in this country are slowly being moved away from the didactic teaching curriculum (google it, it's a good interview talking point) towards a more self directed learning one. This places a lot of responsiblity on the student for taking control of their learning and ensuring they're managing their education. This means you're going to simultaneously face two challenges; there's little clarity over what is/is not examinable and; the content is a lot greater and more complex.

Most medical degrees will average something like 23 or so hours a week in the preclinical stages. In contrast, an arts degree averages 12 and a science degree a bit more (perhaps 17). You'll be given a ridiculous volume of content crammed into those hours, so most students find that they'll need to commit a couple of hours a day to making sure they're not forgetting it and falling behind. A lot of medicine is rote learning and memorizing things so that you can interpret a patient in the context of that information.

For example, for a disease an intern would be expected to know: how common it is, who it affects/doesn't affect, how it develops and the underlying pathophysiology, the symptoms it causes, the procedures to assess those symptoms, the diagnostic criteria, the treatment plan/management, the drugs to prescribe and then the side-effects/indications of those drugs. It's a lot. But it's interesting. If you don't find it interesting, then you should probably reconsider your choice, because you're going to be doing a lot of this human disease stuff.

I heard that there are problems with doctor employment! Can that really be true? Don't we have a doctor shortage?

This is a chart that summarizes the situation as it stands currently (with respect to the 2012 graduates who were offered their internships on the 23rd July). Currently all CSP students are guaranteed internships and all international/domestic FFP students are not guaranteed internships.



It can be seen that the numbers of domestic graduates vs. internships are starting to come together and, in Victoria, have already crossed over (albeit slightly).

This isn't the end of the world but it's definitely something that should make you realise that the future is unclear and will be challenging. Don't let it completely dissuade you from studying medicine, but be aware of the real world limitations.

But really, who cares? Engineering students don't always get jobs straight after graduating, so aren't doctors just being greedy by wanting a 100% employment rate, so they can start getting their BMWs on schedule?

I stole the following from a different website, since it's a reasonably good summary of why this isn't actually true

Quote
1. We are a socialised medical system and the government is the sole provider of the training required to turn a medical student into a registered doctor. The same does not apply for engineers.

2. The increase in medical places (which have always been controlled by the department of health) was a deliberately formulated policy to address a specific problem [doctor shortage]. ie it was a specific strategy, with specific goals. The same does not apply to an increase in engineering places – which are not regulated by the government in this manner.

3. The objectives of this strategy, which involved substantial taxpayer dollars, cannot be achieved if governments only provide part of the basic training. It is analogous to the government not providing the final year of university training for engineers – ie why offer the place at all, if it amounts to nothing?

4. Practically speaking, a doctor cannot practice medicine in this country without a medicare provider number. The only way to get a provider number is via training in government-funded positions in government facilities. This type of regulation does not apply for engineers.

Quote
There are plenty of jobs that need to be filled in medicine, in fact a dire need in several regions, but in order fills said jobs, medical graduates must first complete an internship – and internship can ONLY be provided by the government. From then on there are a range of variables, but at the very least, there is no justification for not ensuring access to internship.

A medical graduate is useless to the public health system if they do not have an internship. We have pumped money into medical school places to address a shortage, but the shortage can only be addressed when the government provides the means for these medical students to become registered at the very least.


Do I really need to want to help the downtrodden and put others before myself?

Medicine is somewhat of an idealistic profession and there are good and bad elements in that. You'll spend a lot of your professional career dealing with the ill and often working to your detriment (unpaid overtime). My opinion is that you don't, as such, need to be driven to help others and see it as some sort of higher calling. Plenty of people say you do, but ignore them. You do, however, need to be comfortable with the fact that you'll be working in an environment where you're expected to prioritize the care of others. If you have no interest in dealing with others and helping them, you're probably not going to enjoy the next 40 years.

I don't understand the whole training thing, explain it

After you graduate you get to be a intern. That's one year.

Then you are a doctor with the power to prescribe drugs but you're not allowed to work/bill Medicare independently. You also don't really know a whole lot. So you spend some more years working out what you want to do with your life and so forth. How long this takes is up to you. Some people already know and follow a direct path, some people take a sabbatical and go on holiday and do locum work etc. Anyway, whilst you're deciding on this, you're working in the hospital as something called a resident (or Hospital Medical Officer, PGY etc., there are a lot of names...)

At some point, you'll decide you want to specialize in a certain area (GP, respiratory medicine, endocrinology, orthopaedic surgery etc.). This means you get to spend another X years (depends on what you choose, but unless you choose GP it's going to be at least 5) studying that field whilst also working full time. As you can imagine, this is rather busy but you get to apply for the nice title of registrar to make you feel better about it.

Over the course of your training, you'll sit multiple exams (and probably fail them and resit them) until you manage to obtain your fellowship.

You said "probably fail them". I'm a personality type A student...I don't fail things

Yes well you see, high school exams are nothing compared to university exams are nothing compared to your specialty exams. I'll talk about the exams for the RACP, as an example. After your basic training there's a written exam, which consists of two papers split between morning and afternoon.

Morning is 5 minutes reading time, 2 hours writing time and 70 MCQs with 5 answers to choose from. This covers the medical sciences and the fundamental principles that are relevant to medicine (all that stuff you thought you got to forget after moving into clinical practice...)
Afternoon is 5 minutes reading time, 3 hours writing time and 100 MCQs. This covers the actual clinical side of medicine and how you should act/prescribe/treat/interpret results etc.

Just to make it truly traumatic, the written exam covers the entire physician training program. So everything from dermatology to infectious disease to psychiatry is on there. No, it doesn't matter if you only ever wanted to be a nephrologist, you still have to know anything else. The results are also bell curved, just to make it extra fun. Starting to see why this is so hard yet?

If you manage to pass that, you get to sit the clinical exam. For some reason the RACP refuses to let you sit this exam in your own state, so you have to fly interstate to do it. The actual exam involves two long cases/four short cases, which really just means you have to clinically examine six people and present to a board of examiners on their problem/treatment/answer questions about it etc.

That was a lot...erm...how long is this going to take me?

It is a pretty long training pathway. Often a lot of students get scared by this but the important thing to remember is that you are working (and being paid) whilst you do this whole "specializing" thing. Just as you wouldn't do a law degree and expect to be a partner in a firm / do an accounting degree and expect to be...whatever accountants aspire to be etc. you shouldn't do a medical degree and expect to be a top cardiothoracic surgeon. It's not different to other jobs in that respect.

But since you asked:
Medical School (5-7 years, depending)
Internship (1 year)
Residency (varies but probably "a few" years)
College (specialty) training (3 years if GP, 5-6 if surgeon or physician and assuming you pass everything first time)

That makes a absolute bare minimum of 10 years. That sounds like a lot, but remember that you're getting paid after you leave medical school, so it's not all bad news.

I'm going to get massive dollars out of this though...right?

So how much will you make? It depends on the stage of training you're at and where you're working. In Victoria, interns get ~66k a year (current as of 2015). That excludes overtime, which you're paid a penalty rate for if it was rostered. It also excludes extra hours that you do willingly (*willingly*). You get a pay hike as a resident by about 5% each year and the same as a registrar. So you can work out how much you'll be getting at X years after starting work.

Basically, until you're well into your training, you're not going to be making 100k+ as a base rate. Obviously with paid overtime and extra shifts etc. you'll make well above the base rate, but it's difficult to put a figure on it. Given the recent change in the market due to the influx of medical graduates, there is less overtime/extra than before. There is also pressure on staff to not claim their overtime.

Once you factor in tax, you'll lose a chunk of your income, even with a salary package offset. Then you probably need to repay that HECS debt you ran up, so you lose some more there. Once you factor in the expensive exams and so forth, you'll start to see that this isn't really a super high earning profession in the early years (eg. it costs $3000 a year just to enrol in a physician training program and it costs another $3000 to sit the exams to progress into the advanced stage of training)

That said, research has indicated that Australian specialists have roughly the same payment relative to GDP (or some other complex economic measurement I don't understand) as our American colleagues, so really the only thing you can draw from it is that you will be well remunerated. If you want to know more about specific wage rates, the salary awards are typically available on different hospital websites if you want to go have a look.

« Last Edit: August 25, 2021, 11:45:29 pm by Russ »

pi

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Re: Medicine FAQ / So You Want To Be A Doctor
« Reply #1 on: July 06, 2012, 06:47:42 pm »
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AMAZING FAQ Russ!


For those wanting some anecdotal views on med, I'd STRONGLY recommend a read of shinny's post here, another great post like the one above: Re: The reality of medicine



YAY I GOT IN! What do I do in the summer holidays?

Enjoy your holiday. You'll be spending your future holidays working, so enjoy it now. If you want to do some preparation, then brush up on your biology. If you never studied it before, then spend some time getting the basics down and give your university a call to find out whether they have any advice. Don't buy any textbooks. 80% of them you don't need and will consult once a week to source something you could have found via your online access. Only get the essentials in hard copy and you'll find out what these are after you start. If you want to get a steth before uni starts that's fine, just don't get the MASTER III CARDIOLOGY PRO WITH ELECTRONIC STUFF. Most of the people I know spent $70 and got the Littmann Classic II. Make sure it has a bell and a diaphragm because you need both.

I'd go a little further and advise against buying anything at all before med school starts (at least for Monash). Personal steths/sphygs/etc. aren't really needed a all for first semester (and definitely don't get the Cardio steth!).

As for textbooks, as Russ said, don't buy any. Try them all by borrowing them from the library when uni starts so you can get the ones you like :)

As for another thing to do on the holidays (really only applies to undergrad places I guess) is that if you didn't do Bio in VCE (in specific: immunity, nervous system, cell parts, biochem, genetics, translation/transcription), try and read up on it if you can, but other than that (and as Russ said), enjoy the break!
« Last Edit: July 12, 2012, 11:42:51 pm by VegemitePi »

Russ

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Re: Medicine FAQ / So You Want To Be A Doctor
« Reply #2 on: July 06, 2012, 07:07:19 pm »
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Eh, you'll still need it eventually (whenever you lot start using them, 2nd sem I assume?) and it's not like buying a laptop where 6months is going to make a difference in what you get.

pi

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Re: Medicine FAQ / So You Want To Be A Doctor
« Reply #3 on: July 06, 2012, 07:24:23 pm »
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Eh, you'll still need it eventually (whenever you lot start using them, 2nd sem I assume?) and it's not like buying a laptop where 6months is going to make a difference in what you get.

Yep, sem 2, but our medsoc arranges discounted prices with engravings for us then too (with a certain portion going to charity as well) along with lab coats (which aren't needed in sem 1 at all), sphygs, penlights, etc. :)

paulsterio

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Re: Medicine FAQ / So You Want To Be A Doctor
« Reply #4 on: July 06, 2012, 07:38:24 pm »
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HOLY SHIT 336K AVERAGE FOR AN ANAESTHETIST! WOAAAAH! D: ok, aims are to be an anesthetist again :D heheh

Anyways, good FAQ! :)
« Last Edit: July 06, 2012, 07:50:35 pm by Baby Spice (.|.) »

paulsterio

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Re: Medicine FAQ / So You Want To Be A Doctor
« Reply #5 on: July 06, 2012, 07:43:23 pm »
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As for another thing to do on the holidays (really only applies to undergrad places I guess) is that if you didn't do Bio in VCE (in specific: immunity, nervous system, cell parts, biochem, genetics, translation/transcription), try and read up on it if you can, but other than that (and as Russ said), enjoy the break!

I spend every day of my first semester cursing and being annoyed at myself for not studying over the holidays, sitting around and wasting time whilst I could have gotten so much done :P Should have started as soon as I got that VTAC offer =.=

Russ

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Re: Medicine FAQ / So You Want To Be A Doctor
« Reply #6 on: July 06, 2012, 07:51:21 pm »
+1
Cleaned up derail.

Yep, sem 2, but our medsoc arranges discounted prices with engravings for us then too (with a certain portion going to charity as well) along with lab coats (which aren't needed in sem 1 at all), sphygs, penlights, etc. :)

Ahk, I'll add that then.

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Re: Medicine FAQ / So You Want To Be A Doctor
« Reply #7 on: July 06, 2012, 08:02:07 pm »
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Is Physics important for medicine course? I didnt study it so a bit worried if they teach in Uni

pi

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Re: Medicine FAQ / So You Want To Be A Doctor
« Reply #8 on: July 06, 2012, 08:03:48 pm »
+1
Is Physics important for medicine course? I didnt study it so a bit worried if they teach in Uni

Not at all for undergrad med, however I believe there is a physics component in the GAMSAT test to apply for courses such as the UoM MD :)

paulsterio

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Re: Medicine FAQ / So You Want To Be A Doctor
« Reply #9 on: July 06, 2012, 08:04:37 pm »
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Not at all for undergrad med, however I believe there is a physics component in the GAMSAT test to apply for courses such as the UoM MD :)

Physics component of GAMSAT is Year 12 Physics (or Foundation Physics at Uni)

Jenny_2108

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Re: Medicine FAQ / So You Want To Be A Doctor
« Reply #10 on: July 06, 2012, 08:16:22 pm »
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Is Physics important for medicine course? I didnt study it so a bit worried if they teach in Uni

Not at all for undergrad med, however I believe there is a physics component in the GAMSAT test to apply for courses such as the UoM MD :)

When I read the course plan about bachelor of biomed at UoM, why is Physics a compulsory subject? :( :( :(
Anyways, Physics always goes along with med at UoM

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Re: Medicine FAQ / So You Want To Be A Doctor
« Reply #11 on: July 06, 2012, 08:21:31 pm »
+1
Is Physics important for medicine course? I didnt study it so a bit worried if they teach in Uni

Not at all for undergrad med, however I believe there is a physics component in the GAMSAT test to apply for courses such as the UoM MD :)

When I read the course plan about bachelor of biomed at UoM, why is Physics a compulsory subject? :( :( :(
Anyways, Physics always goes along with med at UoM

because biomed is not medicine.. they are difference courses

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Re: Medicine FAQ / So You Want To Be A Doctor
« Reply #12 on: July 06, 2012, 08:25:03 pm »
+1
because biomed is not medicine.. they are difference courses

Yep, it's a separate course, not everyone doing Biomed wants to do med (some prefer research options, academia, etc.)

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Re: Medicine FAQ / So You Want To Be A Doctor
« Reply #13 on: July 06, 2012, 08:27:38 pm »
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To elaborate, usually aspiring med students at UoM either do BSc, or Biomed as undergraduate, take the subjects needed to qualify for a  graduate medical degree, then they have to do really well on the GPA & GAMSAT side to get an MD offer (graduate medicine) at UoM. 
B.Comm / B.Eco @ Monash 2012 - 2015

Research Assistant, Faculty of Business and Economics, Monash University

pi

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Re: Medicine FAQ / So You Want To Be A Doctor
« Reply #14 on: July 06, 2012, 08:28:20 pm »
+2
To elaborate, usually aspiring med students at UoM either do BSc, or Biomed as undergraduate, take the subjects needed to qualify for a  graduate medical degree, then they have to do really well on the GPA & GAMSAT side to get an MD offer (graduate medicine) at UoM. 

+interview for MD too :P


Full info http://medicine.unimelb.edu.au/study-here/md/selection_criteria