Funding medical degrees when 25% of junior doctors quit within 1 year

Dear Mr. Willetts,

Why is the Government going to continue to subsidise medical degrees through teaching grants, when it is clear that:

(a) medicine is a very over-subscribed degree, unlike other science subjects;

(b) doctors' lifetime salaries are far above the average UK salary, so medical students will be well-positioned to repay higher tuition fee loans than the average graduate;

and

(c) Up to 25% of junior doctors leave the NHS before completing their foundation years
(http://www.bbc.co.uk/news/health-11199099)

Surely this is a huge waste of money, as you will be paying to train students who will never work for the NHS as qualified doctors, and thus never use the thousands of pounds of medical training which the taxpayer has paid for? Even if they do stay in the medical profession, as the BBC article says, and practice abroad, that is not helping the NHS.

Would it not be better to either stop subsiding medical degrees, as you are going to stop subsidising arts, humanities and social science degrees, or to make medical students agree to either work for the NHS for x number of years after graduating, or have the rest of the teaching grant added onto their fee debt?

The army and some employers already sponsor students through university on the condition that they join the army/employer after graduating, so why doesn't the Government employ a similar scheme?

Thanks for your time.

(edited 13 years ago)

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Reply 1

TSR Community Staff

I think you're title and question as a bit wrong though. It's 23% after 2 years who do not enter the next stage of their training. Not 25% quitting after a year.

Plenty of these people will return to medicine, or indeed are still in medicine, just not in a job to further their training or career. This could be for many reasons. Many may wish to take some time out as they will have just had 7 or 8 very intensive years since they started their training.

Others may not have been able to get a training post in location/job area they want and so wait to reapply the next year and instead work in a role that doesn't count towards their training.

Finally consider that the article says that nearly all training posts are filled - which means it could actually be that there are not enough places for them all to enter the next stage of their training and so some are forced to do other things whilst they wait for a place in the next stage.

The solution to having 23% not enter the next stage may be to increase the funding to create more places.

(edited 13 years ago)

Reply 2

angelmxxx

Original post by RK

I think you're title and question as a bit wrong though. It's 23% after years who do not enter the next stage of their training. Not 25% quitting after a year.

Plenty of these people will return to medicine, or indeed are still in medicine, just not in a job to further their training or career. This could be for many reasons. Many may wish to take some time out as they will have just had 7 or 8 very intensive years since they started their training.

Others may not have been able to get a training post in location/job area they want and so wait to reapply the next year and instead work in a role that doesn't count towards their training.

Finally consider that the article says that nearly all training posts are filled - which means it could actually be that there are not enough places for them all to enter the next stage of their training and so some are forced to do other things whilst they wait for a place in the next stage.

The solution to having 23% not enter the next stage may be to increase the funding to create more places.

2% isn't a huge difference though, is it really? I do understand that people have gap years, etc. but the fact still remains that a significant number of medical graduates do go into business, or abroad, or into private medical practice.

If all the positions are filled then either more places could be created (although not if the NHS doesn't have the money or space for more staff), or perhaps fewer medical student places should be available at university - but I think that the fairest way would be sponsoring people if they work for the NHS for a few years, as people would still drop out if there were fewer places.

Reply 3

nexttime

Its kept competitive for a reason - you'd rather it was otherwise?

Reply 4

Organ

Medicine costs around £250K per person - you can't expect people to pay that amount of money and retain the British salaries for doctors. The 23% is for after F2 I believe. Modernising Medical Careers has a lot to do with it, I doubt this many left before MMC was introduced.

Regards the 23% - Majority of these are people who take a gap year/work overseas for a year. Some pursue research jobs which are classed as "non-training". Some people are overseas students who having trained in UK and completed foundation programme want to go "home". Increasing numbers are on maternity leave, starting family etc. at this point in their career. So the numbers packing up and leaving altogether is rather low.

Original post by angelmxxx

or into private medical practice.

NO THEY DON'T.

Why make these threads if you don't appreciate the basics! Nobody employs junior doctors in private practice, and the over-over-whelming number of consultants in private practice spend the majority of their time in the NHS. Only in the unique cases of people like Harley St. doctors are they purely private. Jeez!

Original post by angelmxxx

If all the positions are filled then either more places could be created

But decisions about the numbers of doctors has to be made years in advance. And the funding and so on has to be available, the infrastructure to cope with new doctors yada yada hs to be planned.

or perhaps fewer medical student places should be available at university

Numbers have increased in recent year - with the enlargement of existing medical schools and the opening of new schools - HYMS, Warwick and so on.

It's odd that of all the courses to take a stick to you pick medicine :curious:

(edited 13 years ago)

Reply 5

David Willetts

There is a lot of debate about whether we are pro science degrees or anti humanities. I did a humanity degree myself and do not believe we should bias the system against them. We are trying to put all the basic teaching costs into the new loan scheme. Some subjects have a higher cost because they need more expensive facilities - eg physics or medicine. We will cover those extra costs so the system is fair and not biased either way..

Reply 6

Beijing

TSR Group Staff

Original post by David Willetts

So what you're saying is that you're cutting as much from funding science and medical degrees as you are art and humanities courses. That you're going to be hitting all courses as much and just leaving some funding for sciences and medicine as they already cost more.

Seems to me that those who thought you were supporting the sciences are wrong. You're hitting all courses equally hard and making every subject suffer.

This will seriously damage the UK and it's economy if the Government do not support any part of our university education.

Reply 7

angelmxxx

Original post by David Willetts

It's not fair if some students take advantage of all those teaching grants and then run off abroad/go into business and never work for the NHS though, is it?

Reply 8

TSR Community Staff

Original post by angelmxxx

It's not fair if some students take advantage of all those teaching grants and then run off abroad/go into business and never work for the NHS though, is it?

If they are international students from outside the EU would they not already be paying more for their tuition.

Equally, does the UK not employ doctors who trained elsewhere, thus benefiting from their training abroad for free?

Reply 9

GodspeedGehenna

Original post by angelmxxx

Are you trying to suggest that, because of such high demand, training places should be given out based on who is and is not priced out of studying the subject? Please..

Original post by angelmxxx

(b) doctors' lifetime salaries are far above the average UK salary, so medical students will be well-positioned to repay higher tuition fee loans than the average graduate;

This is more reason to FUND these students. I don't want grants. I just want a loan so I can actually afford to get into medicine in the first place. By all means, charge me interest, make a profit, use that profit to push more money into the system for other students.

I don't want my fees paid for me. I just don't want to be priced out of the market by not having to money to pay the fees up-front.

Absolutely these students are going to be well-positioned to repay their fees. But you need to help them pay for it in the first place.

Original post by angelmxxx

and

(c) Up to 25% of junior doctors leave the NHS before completing their foundation years
(http://www.bbc.co.uk/news/health-11199099)

And how many return to the NHS in some form after that year? This statistic is meaningless for your cause until you find that out. Great, some doctors choose to take a year out after 5 years of study and a year as an FY1. And? Some doctors choose to drop out of medicine all together. Are you trying to say that because of this, all medical students should be paying for all of the costs of training them?

Original post by angelmxxx

Surely this is a huge waste of money, as you will be paying to train students who will never work for the NHS as qualified doctors, and thus never use the thousands of pounds of medical training which the taxpayer has paid for? Even if they do stay in the medical profession, as the BBC article says, and practice abroad, that is not helping the NHS.

You're making very huge policy suggestions here despite not actually citing any substantial numbers to support your claims. Is this even a significant problem? Would the regulating beaurocracy be even more expensive than a leaky funding system?

Reply 10

Phalanges

Start making every medic pay £250,000 and you won't have enough supply for the demand of doctors.

Would you prefer that to the current situation?

Reply 11

beepbeeprichie

Government shouldn't be funding medical education. Let medics pay for it themselves. Why the hell should the taxpayer pay for their education AND their enormous salaries? Doctors have a very good reason for supporting the current system which limits medical education which is that they limit competition with other doctors and so drive their prices up.

Reply 12

star631

Original post by tomheppy

If you make medics pay for themselves, you'll end up with fewer doctors and I'm sure you'd be complaining even more if someone you know is in a critical condition whilst there is a shortage of medical staff