Expansion of medical school places
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 in the post pandemic society.
The latest data shows that, over the last year, from June 2022 and June 2023, the NHS gained the equivalent of 6,075 full-time secondary care doctors. This amounts to an annual increase of 4.8%, which is higher than the previous year (3.3% between June 2021 and June 2022). Mental health issues are the highest reported cause of sickness absence in secondary care. We know that COVID-19 is having lasting effects on the mental health of doctors. BMA surveys have consistently shown that since the start of the pandemic, doctors have been left feeling increasingly depressed, anxious, stressed, or burnt out as a result of their work or study. Violence and abuse directed at NHS staff is also a growing issue, the BMA survey, since July 2021 more than one in three doctors have experienced verbal abuse and one in six have been threatened in the last month.
Furthermore, the general population, the workforce is ageing, 13% of secondary care doctors and 18% of GPs will be reaching minimum retirement age in the next one to 10 years. This is going to lead to a loss of over 25,000 doctors through retirement alone eventually, and 43% of respondents to the BMA survey in September 2021 agreed with the statement I plan to retire early, while 50% agreed with the statement I plan to work fewer hours after the pandemic.
The Medical Schools Council (MSC) recommended that the number of medical students should be increased by 5,000 making a total of 14,500 graduating doctors per year. This figure is based on current levels of doctors entering the NHS and it is acknowledged that the exact needs of the UK population and the NHS are difficult to predict.
The suggested figure falls short of the number of graduates required for the UK to have a fully sustainable medical workforce because MSC believes that medicine is a global profession and the input of doctors trained overseas is invaluable to the NHS:
One potential challenge to facilitating medical school expansion is placement capacity. Medical schools are already developing ways to enhance clinical training that could support increased capacity including the use of virtual learning opportunities. Medical and dental school places are capped in each part of the UK, with intake targets used to limit the number of students a higher education provider may recruit in each year. There are caps for both home students and overseas/international students. The UK Government has said medical and dental school places are capped in England to ensure teaching, learning and assessment standards are maintained as well as ensuring there are enough high quality placements for each student, but it sounds more like a gatekeeping education, from less fortunate and less useful for the wealthiest.
The development of new ways of delivering medical education will also have an impact on the feasibility of expansion. There is already a course up and running in Scotland that utilizes online learning and part time education to support healthcare professionals wishing to become doctors and Health Education England (HEE) is looking to develop medical apprenticeships in the near future, when in England options for online students are so limited that barely exist.
Therefore, the government will expand medical school places a year early, with 205 additional places for the new academic year in 2024, this follows the NHS Long Term Workforce Plan which will deliver the biggest training expansion. This comes in advance of the larger expansion across the country from 2025 onwards that will deliver the NHS Long Term Workforce Plan commitment to double medical school places by 2030 to 2031.The first NHS Long Term Workforce Plan was commissioned by the government to set out a series of interventions to train, retain and reform the workforce and put the NHS on a sustainable footing into the future. Backed by more than £2.4 billion in government investment, it sets out how the NHS will address existing vacancies and meet the challenges of a growing and aging population by recruiting and retaining hundreds of thousands more staff over the next 15 years.
As part of the plan, the government and NHS England will also work closely with medical schools and the General Medical Council (GMC) to move from 5- to 4-year undergraduate degree programs and will pilot a medical internship program for newly qualified doctors. This will shorten undergraduate training time and bring newly qualified doctors into the NHS workforce better prepared to deliver patient care, with more understanding and compassion.
Sources:
https://www.clinicalservicesjournal.com/story/42875/expansion-of-medical-school-places-to-be-accelerated-to-next-year
https://researchbriefings.files.parliament.uk/documents/CBP-9735/CBP-9735.pdf
https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/workforce/nhs-medical-staffing-data-analysis
