New Med Schools lock out home students

[giveandtake]

Story in the Sunday Times yesterday.

Brunel and Chester will only train lucrative international students, who pay £45,000 per year.

Presumably, the students will be taught by a fair number of medical professors; the latter trained by the tax funded NHS; in taxpayer funded hospitals and grant supported institutions.

Meanwhile, homegrown pupils with A stars and first class degrees, are left to wither on the vine, such is the ridiculous competition for places.

This is shameful and demotivating/insulting to our students, led to believe that merit and hard work may give them a chance at a medical career.

Once trained, what is to prevent the newly trained fledgling medics from returning overseas?

lljkk · Today 19:55
It would be fantastic if UK can profit from international demand for medical school places & use that profit to support domestic medical student places (or NHS or other public goods).

Yeah, right. Lets divert scarce resources from the NHS to make more profit elsewhere.

What matter if almost nobody can see a doctor when there is profit to be made.

Loads of 4 A star kids (from this summer) didn't get med school places. I know two that have embarked on alternative degrees. Absolutely scandalous IMO.

If I remember correctly there have been 3 new medical schools in the northwest. Cumbria which recruited from their region.

Edge Hill uni

And UCLAN - which initially only took overseas students. But now take uk students.

Looks like Chester are following a similar path.

Link to the article

www.thetimes.co.uk/article/df703148-7351-11ed-9810-4f6146eab184?shareToken=14a3649bdaf27301d6df75c56d3b57cd

This has not been caused by universities' greed, it has been caused by how the UK government funds places for UK medical students.

At the moment, these new courses do not receive government funding to provide places for UK students. This means that unlike other universities providing these courses, they receive no additional subsidy to supplement the fees paid by the students.

The government's subsidy is used primarily to pay organisations hosting training placements, which costs upwards of £35K per student. A very small amount is actually taken by the universities to meet the cost of their own teaching. The universities do not have multiple millions of pounds floating around at their disposal to just spend on paying for UK students' placements because this would be a nice or helpful thing for them to do. They need to get this money from somewhere. Consequently, these new courses can only afford to take students who can, essentially, pay the cost of their own training. In theory, they could take UK students who could pay their own fees in excess of £40K, but in practice there are various regulations around how much you can charge UK students which do not exist for international students.

These new university courses hope that by demonstrating that they can effectively run these courses and meet all the various regulatory and other requirements, which is a fairly long and complicated process, the government will eventually recognise them and give them some subsidised places for UK students. Then they will be able to afford to train UK students. Various other universities have recently gone through this process, Brunel, Chester and Worcester/Three Counties are just the latest ones.

This still does not necessarily mean there will be more places available for UK students wanting to train as doctors. It is possible that the government could decide to simply reshuffle the existing number of places for UK students, taking some places away from established courses and giving them to these new courses. It is the government that decides how many UK medical students should be trained, not the universities.

@titchy Do they though ? On the continent you graduate and are eligible for a full license so there is no F1 equivalent jobs in home countries. So they may at least have to do f1. So it really depends on where these students are from as to whether they will go home.

There can not be more medical students than there are placements for the clinical years. Too many students and they won't get the chance to learn. Until we have more doctors we can't train more doctors. If there are not enough F1 places this year it will be a total scandal. Again.

It’s a tangent but I disagree with you. Having at least a year out between A level & med studies can only be a good thing.

every day I see clearly bright med students who cannot make eye contact or string a sentence together or interact with patients. These skills take time but we are slightly better at it at 20 than we are at 18. When I see them, most are in their 4th yr (21-22) & still quite hopeless. Mature students with a few yrs behind them are much more confident and well rounded.

My best students was a former Porter. His people skills were incredible.

apols for going off topic - but they def all need a few yrs out before med studies!!

AgathaMystery

and who should fund those years out? What should they be doing with that time?

seeing as it takes many years to become a consultant, and 20 years before you reach top of pay scale, I think most would want to get on with it, not do some random other thing for a few years.

across the board people mature and it benefits all jobs, no need to single this out

I have one DC currently at med school and another applying this year. I don't think you can generalise about interpersonal skills. I know some 17 year olds with better empathy and communication skills than some 50 year olds. It is a long and hard road and many want to get on with it when they are sure that is the path they want. The last thing they need is more obstacles like enforced gap years. There are more than enough hoops for them to jump through. For less financially privileged DC, enforced gap year(s) could act as a real barrier to pursuing medicine.

The priority should be patients - how to better support them now, and those of the future. Not making sure Jonny never failed an exam in his life doesn't have to have a gap year FFS.

Eh? Who funds gap years - the kids taking them. No one is suggesting some scheme paid for by Gov to keep would be med students happy, merely suggesting that gap years are often a good thing.

Honestly I despair of MN sometimes - no kid has the bloody right to a medicine place, (or an Oxbridge place). Everyone is looking at tbis from the pov of the straight A star applicant - medicine planning should only ever be done to benefit patients.

Erm think the mass vacancies in the nhs should tell you that retention of doctors is a major problem, and retaining doctors benefits patients. It doesn’t matter if you have lots of teens wanting to study medicine if the pay and conditions as an nhs doctor result in many leaving.
it certainly doesn’t help patients to have lots of doctors leave due to poor conditions and enormous pay erosion since 2010 approx

Well said Lapland. Same goes for nursing and other allied health professionals too.

absolutely Titchy, nurses, AHPs… if the public want to have them in the nhs, they need pay and conditions that attract them to stay.

otherwise number of school leavers wanting to study x, y or z is a moot point, really

Of course medicine planning should be done to meet the benefit of patients. No-one is entitled to a place, irrespective of their A level results. In any case A levels are only one element of the selection process. There are plenty of other hoops that DC need to jump through and, whatever your view of the irrelevance of the med student in the big picture, it is a brutal selection process. I would say there are much easier and more financially lucrative paths that 'Jonny never failed an exam in his life' could take and I frequently wish mine had done.

I was pointing out the fact that if a child has set his mind on a particular altruistic career and has put in the effort to achieve a good academic standard in my opinion they deserve a chance. A levels are not the be all and end all but certainly A levels act as a filter and it is unarguable that academic ability plays a part in medicine. Having good qualified trainee doctors learning in their formative years benefits both the individual and the patient.

Gap years are more easily funded by those from wealthier families and I believe we need to widen participation in the medical profession (as Oxbridge have done for other subjects). Making medicine a career where there may be an expectation of taking a gap year doesn't act in favour of some students.

The media and government say we need more doctors . A child sets his ambition on becoming a medic and finds that in reality it is a competitive field to get into. What is the reality?

If we are talking about patient benefit doesn't it make sense to recruit from abroad as there are financial savings to the NHS and in some instances the doctor is cheaper to employ? This means more money for equipment and nursing staff

I thought we were moving away from this model as we are draining other countries of competent medical staff?

@Lapland123

It's a nuanced question. Compared with the rest of the general population consultants are well paid with the expectation of a 6 figure salary However given their academic ability they possibly could have chosen other lucrative careers with much better working conditions

Papers like the Daily Mail continually bringup GP salary to berate the profession with regard to patient access and desired working hours

The places are only for overseas students because the government won’t allow home students sue to the number of training places on the uK. There’s no element of the students “testing it out”. As to the colonialism nonsense- well it’s just silliness.

To be fair there is always turnover in high stress professions. We are not training enough doctors- generally because of the cost. We should be training much more regardless of the debate on pay and conditions

There can not be more medical students than there are placements for the clinical years. Too many students and they won't get the chance to learn. Until we have more doctors we can't train more doctors. If there are not enough F1 places this year it will be a total scandal. Again.

You are right, as usual. A couple of additional points, though.

1. There is a major problem with these additional places being made available for international students when there is no clear plan for expanding the foundation training programme. From 2025, F1 will be open to anyone who has a recognised medicine degree (all of these new medical schools are accredited by the GMC) and has passed the medical licensing assessment (MLA). Like other UK medical graduates, those graduating from the new schools will only have provisional GMC registration, so they are pretty much unemployable until they have completed F1 and achieved full registration, regardless of which country they are planning to practise in.
2. Almost everyone agrees there has to be an expansion of medical training places in the near future, whether this means more conventional medical students, apprenticeships, or whatever. This cannot happen without (a) greater clinical placement capacity or seriously more efficient use of the capacity that already exists, and (b) either full registration at graduation (which will require major changes to specialist training programmes) or a large expansion of the foundation programme.
3. Even if the foundation programme is expanded, it's just kicking the can a very short distance down the road as there isn't sufficient capacity in core & speciality training programmes. If students are being trained to enter a workforce where a large proportion of them won't be able to progress to consultant level, this must be made clear to them before they commit to the expense and demands of medical training. I have no confidence that Health Education England (HEE) or the General Medical Council (GMC) will be fully honest about this, while I can guarantee that government (of whatever colour) will be fully dishonest about it.

Thank you @Phphion for your especially thorough explanation.

@SueVineer I had already confessed to being taken in by the spin from The Times (and some other web sites), long before tou posted.

Papers like the Daily Mail continually bring up GP salary to berate the profession with regard to patient access and desired working hours

Viscount Rothermere, chair of Daily Mail & General Trust (and noted non-dom tax-avoider) was paid £10.9 million in 2021. Chief executive Paul Zwillenberg was paid £9.7 million. I can't find the current editor's salary, but in his last year in charge Paul Dacre got £2.7 million. Given a choice between 27 full-time GPs and one Daily Mail editor, I wonder which would have the greater value to the country. That's even before you consider the brass neck of people who don't pay tax complaining about how taxpayers' money is spent.

Lol - our IMG doctors actually have a saying for this

“CCT and flee”

ie get your training and consultant level in the UK and then flee…it’s nothing new. They’re very open about it