Thursday, 8 January 2015

Carry on doctor!

Medicine – alongside other health professions - is one of the few subjects in UK higher education where workforce planning is a significant part of the equation. Medical Schools are capped on how many students - home and overseas - they can admit. This makes the opening of the UK’s first privately funded medical qualifying degree (since the 1940’s) – at the University of Buckingham – a significant occasion.

The Guardian reports that 500 people applied for its 67 places, and that 60% of its students in this first cohort come from the UK. Fees of £35,000 per year (which is within the range for overseas fees at other UK medical schools) did not deter. (The fee may seem eye-watering, but it doesn’t look to me like profiteering: it does cost a lot to train a doctor, and publicly funded medical education continues, for the time being, to attract a significant subsidy in addition to fee income.)

The critical component of a medical degree is clinical experience, and in this instance the University has agreed with the Milton Keynes NHS Trust that students can undertake clinical placements within the hospital. This benefits the hospital too – there’s prestige and money associated with it.

Finding these clinical placements will have been one of the limiting factors in developing the degree programme. Students spend time with qualified clinicians in every different medical specialty: observing procedures, learning from what they see and practising clinical skills. It’s this that ensures that graduate medics don’t only know about the human body, what ails it and how to cure it; they have some actual experience. But there are only so many clinicians to observe, and only so many patients, so the availability of ‘firms’ (the placement possibility for a group of students) is everything. The negotiations here will have been high stake for the University.

Once students graduate with their degree there’s still a while to go before they are fully licensed: two further years of Foundation Study take place, where they work in clinical settings under the continued supervision of senior doctors. (This is what used to be called the Pre-Registration years.) The University of Buckingham website has a telling phrase:
We expect that our graduates will be eligible to apply for UK Foundation Training posts. (My emphasis.)
Should students worry about being able to continue as doctors? I doubt it: it’s five years until it becomes a live issue, so discussions will still be taking place and contracts not yet signed. My guess is that the NHS Trust will be as keen to have foundation doctors as it was to have undergraduates.

So is this all a good thing? On the positive side, it does get the country more doctors, and that is a good thing. It also shows that alternative models for HE provision can work, and that is arguably a good thing. But in the absence of funding available to all, there’s no doubt that the opportunities available are available, like the Ritz, only for those who can afford it. The Charity Commissioners may be as interested in this degree as they are in the charitable status of public schools...

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