Okay, lunch time. Re how much it costs to train a medical student...
During the first couple of years at medical school (or three years in some six-year courses), medical students are mostly taught in the same facilities as other bioscience students, and often by many of the same staff, so the only obvious additional cost is the cost of running laboratories (similar to costs for other lab-based subjects) and anatomy facilities (massive cost). This is addressed by Office for Students (OfS) high-cost subject funding, through which universities receive a small amount of extra money from OfS in addition to the tuition fees paid by the student.
However, there are hidden additional costs even at this stage. Namely that a medical school requires some teaching staff and senior leaders to be medically qualified. Clinical academics cost much more than non-clinical academics, because medically qualified people just wouldn't do the job if they were only paid on basic academic salary scales: they would spend the time doing high-paid clinical work rather than lower-paid academic work. This is a relatively minor contributor to costs in early years but it's not negligible.
The big difference comes in the clinical years. Here, nearly all of the tutors for classroom sessions are either clinical academics (see above) or consultants/specialists with education programmed activities (PAs) in their job plan. A PA is a half-day of a consultant's time. In a teaching hospital - or, really, in any hospital that hosts students - a large number of consultants will have to have education PAs for them to teach students. These are paid on the same basis as the rest of their work, as they are part of their NHS contract. But, obviously, a consultant who is teaching isn't doing clinical work. So the number of consultants employed needs to be increased to ensure service delivery is covered. So the total number of education PAs, which will be several full-time consultants' worth each week, has to be covered by employing more consultants. A full-time consultant with a merit award might be earning on average around £125,000 pa (£2,700 per week) plus on-costs (employer NIC, empolyer pension contributions, etc.) of probably another £25,000 pa (£550 per week). Some consultants will be doing several education PAs in a week as they have roles like head of school, director of clinical skills, year lead, student support tutor, etc. You will also need to allow for doctors working at a slower rate while they have students with them on placement, although for year-5 students (and possibly year 4), some of this time is repaid by the students doing work like clerking patients and making initial assessments. Finally, if you have students in a hospital, you need teaching spaces. You need these anyway, for clinical staff's continuing professional development, but you might need more space or additional equipment. And you need libraries. Again, hospitals need libraries for their own staff but if they have undergraduate students they need quite a lot of resources that practitioners don't need. Many of the resources provided in the university library have to be replicated across multiple hospital sites. And you need administrative staff to co-ordinate placements, timetabling, etc., which are outside of the university's normal activity.
The money to pay for them comes from Health Education England (part of the NHS) via universities in the form of what used to be called SIFT (strategic increment for training) and is now called tariff payments. The medical school is allocated a certain amount of money depending on the number of students, with the assumption now that all are undertaking similar numbers of hours of placement. The basic payment is £30,750 per student per year ( bit less in GP), with additional market forces factor (MFF) payments where the costs are higher owing to higher salaries or higher costs of teaching space in trust (i.e. not university) buildings. So, over 3 years, this adds up to £92,250 per student + MFF.
So, when you add up contributions from student tuition fees (4 x £9,250), year-5 tuition fees paid by NHS (£9,250), OfS high-cost funding for clinical subjects (£33,000 across 5 years) and tariff (£92,250+), you get a minimum total of £171,500, with MFF added on to this. A bit less than £200,000 because the tariff calculations have changed this year and total payments are lower than in recent years. Still a big wedge, though. Of this minimum amount, the student pays £37,000 (21%), the OfS pays £33,000 (19%) and the NHS pays £101,500 (60%).