The Medical Schools Council (MSC), which represents UK medical schools, has published a position paper recommending that the number of medical students be increased by 5000 making a total 14500 graduating doctors per year.
The report expands upon the work of the Royal College of Psychiatrists and the Royal College of Physicians, both of which have called for the number of medical school places to be doubled.
The UK has never produced enough doctors to be self-sufficient and even before the pandemic there were widespread concerns about the workforce’s ability to meet the growing needs of patients. Expanding the medical workforce is essential if the NHS is to deal with the backlog of patients requiring elective care and reduce the pressures on doctors exhausted from working on the COVID-19 front line.
Currently the UK is over reliant on international medical graduates who make up over half of all doctors joining the medical register. While international medical graduates make an invaluable contribution to the NHS, the UK’s dependence on them is widely regarded to be unsustainable and inappropriate in relation to the drain of doctors largely from low-and middle-income countries to the NHS. Medical schools propose that training 5000 more medical students will address NHS staffing needs while also ensuring that a reasonable degree of overseas recruitment continues.
The principal challenges to facilitating medical school expansion are the cost and the availability of clinical placements for medical students. The report suggests that new mechanisms for tariff funding could have the effect of reducing the overall cost of training medical students and increasing placement capacity within GP practices and hospitals. New ways of delivering medical education could also increase capacity through the use of virtual learning opportunities and trained educators within placements.
Key to MSC’s proposal is that expansion should take place through a collaborative rather than competitive process. New medical schools should be placed in areas based on the availability of clinical placements and the needs of local populations within geographical areas. The report recommends that expansion should draw upon medical schools’ commitment to widening participation by offering a range of routes into the profession including graduate entry, apprenticeship schemes and access and conversion courses in addition to standard entry for school leavers.
Expanding the number of places will allow medical schools to recruit from a wider talent pool and to continue their efforts to widen participation in the profession. The experience of medical schools shows that there is no lack of qualified candidates for medicine, with three applications to every place.
Commenting on the proposal, Professor Malcolm Reed, Co-Chair of the Medical Schools Council, said:
“Even before the pandemic, it was evident that the medical workforce is not growing sufficiently to meet the demands of an ageing population with increasing comorbidities. The pandemic has only worsened the backlog of care, with the number of people waiting for hospital treatment in England reaching a record high of 5.7 million this week.
“The temporary adjustment of the cap on medical school places in 2020 and 2021 was welcome but a strategic approach to growth is now needed. Even if we increase the number of medical school places today, it will take ten to twelve years for those students to become GPs, and even longer to become consultants. Without a planned and funded approach, we are storing up problems for future patients, who will not get the care they need or deserve.
“If the pandemic has taught us anything, it is that the staff working in the NHS are its greatest asset. Investing in a more sustainable workforce will be integral to safeguarding the health service from future threats and strengthening its ability to deliver high quality patient care.”