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MMM: What is it and why does it matter?

8 Aug 2022

The Modified Monash Model (MMM) is the official method for classifying locations as cities, rural, remote, or very remote, writes CRANAplus Professional Officer Michelle Mason. Do you know how your work location ranks?

Michelle in the ear­ly days of her nurs­ing career.

Can I hon­est­ly say that when I first jour­neyed into remote area nurs­ing, I knew what MMM was? Where I was going and whether it was clas­si­fied as rur­al or remote? To be hon­est, the answer was no.

I had a nurs­ing back­ground in a met­ro­pol­i­tan emer­gency depart­ment. That was my day-to-day work, in a busy ED, clients com­ing and going and col­leagues every­where! Lit­tle did I know that my jour­ney was going to change ever so slightly.

I applied with a nurs­ing agency to get some expe­ri­ence work­ing with­in the NT. I had no ideas of where or what was required.

The agency informed me that with my back­ground, I should be start­ing in a rur­al hos­pi­tal, which might be a more sup­port­ive envi­ron­ment to begin my tran­si­tion to remote. I was hap­py and thought that this sound­ed like a great idea.

It was only a few days lat­er that the agency called back and I sud­den­ly found myself with a plan to fly out to a remote Abo­rig­i­nal com­mu­ni­ty approx­i­mate­ly 400km away from the clos­est region­al hos­pi­tal! It was accessed by dirt roads and cut off in the wet season.

Com­ing from a city hos­pi­tal, I was sur­prised to see that the emer­gency room was fit­ted with a ward bed, some out­dat­ed equip­ment, and a doc­tor that only attend­ed to emer­gen­cies if they occurred dur­ing the day. There was no press­ing the blue but­ton and hav­ing every­one come run­ning to help!

So, where does the MMM fit in with all this, and what is it exact­ly? The MMM (Mod­i­fied Monash Mod­el) defines whether a loca­tion is clas­si­fied as a city, rur­al, remote or very remote. 

It mea­sures the remote­ness and pop­u­la­tion size of that area to deter­mine a num­ber between MM1-MM7, with MM1 being a major city and MM7 being very remote. To give some exam­ples, Bourke is a 7, Alice Springs is a 6, Oberon is a 5, Ather­ton is a 4, Albany is a 3, Dar­win is a 2, and Syd­ney is a 1.

Table show­ing the mean­ing of MMM cat­e­gories in more detail includ­ing region­al cen­tres, large, medi­um and small towns.

The Depart­ment of Health uses the MMM to deter­mine work­force dis­tri­b­u­tion, so this might help under­stand where and why health pro­fes­sion­als are locat­ed where they are, and why some loca­tions might have more ser­vices than others. 

The MMM is used in con­junc­tion with oth­er data by the Depart­ment of Health in work­force clas­si­fi­ca­tions to deter­mine the population’s access to health care. It is used also to deter­mine areas clas­si­fied as geo­graph­i­cal remote­ness and town size together.

If this isn’t con­fus­ing yet, you may have heard of oth­er words such as ASGS-RA (Aus­tralian Sta­tis­ti­cal Geog­ra­phy Stan­dards – Remote­ness Areas) and the pre­vi­ous Monash Mod­el. These were very use­ful in pre­vi­ous years but as time has elapsed and the indus­try has evolved, mod­els have been reviewed and stake­hold­er con­sul­ta­tions have deter­mined the MMM, which is what we have now.

The MMM now includes more descrip­tion, includ­ing the Aus­tralian Sta­tis­ti­cal Geo­graph­i­cal Stan­dards regard­ing remote­ness area (2016).

So, if you are asked about your rur­al or remote loca­tion, or want to be pre­pared by know­ing how remote you are going (unlike I was!), or you’re apply­ing for a grant or schol­ar­ship with a spe­cif­ic rur­al or remote eli­gi­bil­i­ty, now you know about the MMM.

In hind­sight, if I knew what the MMM was and looked it up, I would have realised I was going from MM1 to MM7. Which was a very unplanned tran­si­tion to remote!

Michelle bogs the work car after heavy rains.

Read more about the Mod­i­fied Monash Mod­el and deter­mine the remote­ness of your place of work.