22 April 2011

A reader writes

Dear Dr Grumble,

I’m writing to you to raise awareness of an issue that is affecting not only myself, but thousands of prospective medical students across the UK.

Currently, if you are a graduate you are not eligible to apply for a student loan to cover course fees for a degree in medicine (or any other degree). With the sudden increase in tuition fees, graduates are now paying £9000 for year-one of the four-year, graduate entry, medicine course, instead of £3600, (an increase of 150%) without access to a loan. There is also a massive chance that the NHS funding for years 2-4 and year 5 of the five-year undergraduate medicine course is either going to be removed or reduced.

Whilst I can see an argument for not funding course fees for graduates (as we’ve already done one degree), by not allowing us access to student loans, so we can borrow the money and pay it back once we graduate, the government are, in effect, blocking us from continuing our education and becoming doctors. If the government go along with this plan of action then graduate medical programmes may either close down all together, or (which is more probable), end up being for the rich only.

I am a 31 year old, arts graduate, who has worked in education for the past ten years. I would very much like the opportunity to study for a degree in medicine and believe that my life and work experiences will make me a good doctor. I have research skills, developed through previous study and work experience and I have got the relevant health care experience required for medical school entry.

If the NHS funding is removed, the price of a graduate medical degree will have gone from £3600, to £36,000, a 900% increase, in the space of one year. We won’t have access to a loan, from the Student Loans Company or from a bank, as all careers loans have been removed.

Graduates bring to the table both, professional and life experience, research skills, passion and most of all, a drive to succeed. We are more likely to finish the course and we have made an informed, adult decision, to return to education and pursue a career in medicine. To be penalised and blocked from returning to education is backwards thinking and in my opinion, discriminatory. We should have access to bursaries or at the least, a repayable loan.

I’m not looking for sympathy, because that won’t help me. I just want to raise the issue and most of all, I want to study medicine.

If you would like to read other graduates' thoughts on this matter, you can here. Thanks for your time.

Rebecca

77 comments:

Fuddled Medic said...

Most of the best medical students I have met are people who have done another degree. They have wisom and experience that people like the FM simply dont have.

Plus they will be better doctors then people like the FM, they tend to learn what is necessary to become good doctors, as opposed to revising for exams.

Personally I feel we should be doing more to encourage more graduates to apply for medical school, as opposed to putting them off. Lets hope it doesn't become the case that most are put off

Dr Grumble said...

Yes, FM. The problem with many students is that they are too exam focussed. It is not surprising because the selection process is largely based on exam results. I have students who spend far too much time in the library and not nearly enough time on the wards. But they are not the graduates who seem to have a better understanding of how to learn.

NHS Student Nurse said...

This is so disappointing. The best FY doctors and Reg's I've worked with have been the ones who have done previous degrees and worked, they are a little more mature and wise to the responsibilities that medicine brings. You can't just cut them off. They (as in medical students) are the only NHS students who don't get their tuiton paid or a decent bursary? Physio's do, Radiographers, Para's, OT's, christ even clinical physiologists (whatever they are) get something. Why is this? Why has medicine as a degree being shunned? Even graduate Nursing (in the few universities that offer it) get tuition/bursary.

Something needs to be done, medical degrees need to be protected if it's going to be the only degree you can get whilst working alongside the NHS you have to re-mortgage your house to pay for!

For the rich my arse! I come from a more "privalleged" background and if I asked my dad to fork out 50k+ to do a degree he would laugh in my face! Even if it was medicine! I'd like to meet a parent willing to support their children for 10k+ (don't forget living expenses) a year to do a second degree. Thats alot of money even by rich standards, especially with a 40-50% tax bill. My family finances would sink if I asked them for that kind of money and was given it. Woe is high income earners, I know. I'm just making a point... That medicine is probably too expensive now even for a majority of the "middle class"...

Plus if I had that kind of money to do medicine here, I'd do it abroad at a better school for the same price. Parents would see the appeal in this option too if their little spoilt piglets were thinking about going 10 minutes up the road to study medicine at a local university. I know mine would. My brother was sent to Russia to study for 2 years and the benefits paid off. My other brother plays professional rugby in northern spain and studies civil engineering. Why? Because there are better oppurtunities elsewhere, always.

What will probably happen is that they will get rid of graduate-entry medicine. It's as simple as that. If universities don't get the numbers then the courses will crash.

Grumble you are right students are too exam focussed. It's becoming a theme in Nursing also.

So dissapointing.

the a&e charge nurse said...

Exam success has ALWAYS been a cipher for social class rather than a meaningful measurement of an individuals latent abilities.

Medical school is the perfect exemplar, over represented as it is by those from social class A & B, an arrangement that not only dates back to the year dot, but one that is nicely maintained by the self interests of those groups who benefit from it.

It has always been rotten and now it seems the system has become even more rotten?

I have my vomit bowl ready for those who are self-deluded enough to suggest that a nice house in the suburbs, private education, ready access to tutors and learning materials in no way confers any advantage - and that it is perfectly acceptable to judge all students against a single endpoint (A-levels).

Dr Grumble said...

Is it worse in medicine than in other fields? Is it really a coincidence that our prime minister and deputy prime minister come from the same sort of background?

the a&e charge nurse said...

"Is it worse in medicine than in other fields?" - do you mean are there similar patterns of exclusion in other professions, then I would say, yes, certainly.

According to this item "1.8% of new medical students come from the most disadvantaged backgrounds, while 6 out of 10 (59%) medical school applicants come from the highest social classes, meaning their parents are in professions such as medicine, law or accountancy. In recent years applicants from these groups were twice as likely to be accepted as those from working class backgrounds".
http://www.guardian.co.uk/education/2004/jun/21/students.uk

Dr Vivienne Nathanson, head of science and ethics at the BMA, said: "Medicine must not be the preserve of the middle classes"- not the preserve of the middle class - what planet is our Viv on, eh?.

BTW - some good stuff in Gladwell's "Outliers" when it comes to IQ and job performance - we may get onto some of these issues later?

Dr Grumble said...

For some reason this anonymous post didn't appear:

As a prospective applicant for the GEM course in 2013, I feel utterly frustrated by the potential decision to either reduce or cut the funding that is available to study this course. What makes it even worse is the fact that there are no loan facilities, so unless you are flush with disposable funds to the tune of £36,000 (being just the tuition fees), you will not be doing medicine. As I am one of the many people who do not have a spare £36,000 just floating around, the GEM course will not be an option.

For me (like many people), medicine is very much a realised dream and an opportunity to be able to actually help others that need it. Funding for the GEM course should be seen as an investment and nothing else. It is clear that graduates bring additional skill sets that can only be seen as a benefit to raise the quality of service for both the NHS and the patients that use it throughout their life.

What makes the potential cuts even stranger is that there has been an identified shortage of Doctors over the last couple of years! The government need to keep the funding in place or look to provide loans in the alternative, they need to stop thinking short-term and make the correct long-term decisions that are the right ones to make!

Well that is my contribution and let’s just hope that the government do the right thing and keep the funding in place (even if it is very unlikely). Good luck to all those that are either applying for or starting a GEM course in the near future.

Dr Grumble said...

I think the standard view at the moment is that there may now be too many doctors. Certainly many junior posts are being axed.

Dr Aust said...

I left a long comment about University admissions policy earlier but it seems to have vanished up the proverbial virtual orifice. Didn't save it either.

*Sigh*

Dr Grumble said...

I have it, Dr Aust. For some reason not all the comments are getting through.

Convectuoso said...

I'm very, very glad that you've highlighted this issue Doc.

I'm a prospective applicant for 2012. I come from an Arts background too (BA, MA English) and I'm currently revising my arse off for a gruelling 6-hour GAMSAT exam, with the grim prospect that, should I manage to be lucky enough and to have the tenacity to make it through into the top 20% and into interviews, I'll be forced to give up my dream and future vocation, not to mention the potential of helping countless sick people, all on the worth of my current bank balance.

As has been said, I, like many others could maybe have rustled up the £3,000 to scrape through that first year, but being asked to pay - up front no less - what was only last year the cost of an entire 3-year degree is, well... it's just painful.

The problem is that a medicine degree is seen as of 'equal value' to that of your run-of-the-mill BA/BSc. I freely admit that I would never expect a tuition fee loan if I were to go back to do, say, a degree in contemporary drama, or gender studies; things that many people and the government may well view as an indulgence etc.

But surely they should realise that people applying for GEM are committing to helping the sick of our nation, and only want the chance to study medicine and make it their life's work, with the only barrier to it being their own intellectual merit?

Just because I wasn't seized with the desire at age 18, it feels like I'm now punished for it later on so to speak. Many people, like me, will unexpectedly catch the bug later in life through varying circumstances and with the greater foresight gained from a mature perspective and rich life experiences.

I can't see this going any other way unfortunately, especially since being judged on your wallet and excluding the less fortunate rings so true with classic Tory ideology. I honestly hope I'm wrong, but it's the kind of additional cut that can blithely blamed on the deficit and will pass by with relatively little uproar, it seems.

Dr Grumble said...

Here is Dr Aust's missing comment:

WRT the A&E Charge Nurse's comments -

The problem for Universities is, how to decide who to admit? What we have are A-level scores. From what I have heard through the grapevine, at the moment admissions tutors in the Russell Group do their best to favour non-privately educated kids by using school as an "unofficial" tie breaker (i.e., in a tie they take the kid from the school where they will have had a harder time getting AAB). However, the minute someone takes an ABB kid from InnerCityComp over privately educated middle class Tamsin (AAB), you can bet Tamsin's parents will be reaching for the lawyers, with the enthusiastic backing of the Private Schools Assocn and the local Tory MP. Remember the furore a few years ago when the VC of Bristol (a medic, remember) said Bristol reserved the right to do this.

One alternative is to use "aptitude test" things like UKCAT as well as, or instead of, A level scores. But even then you would be assuming that x years of schooling, and all the other class advantages (like a house full of books) do not affect kids' abilities to do tests like this, which is debatable.

Speaking as a medical school teacher, I think graduate medical students are an important part of the intake. They are about 10% of our intake and have a generally "pulling up" effect on the small groups they are in. It would be very sad if the new fees system made it harder for them to take on medical school. Personally I would favour a system in which the NHS bursary is continued in some form to cover the higher tuition fees. I would make the quid pro quo for this an equivalent number of years service in the NHS as a junior doc. A useful side effect of this would be that people who go to medical school for five years, and then do NOT go on to work as an NHS doctor even through the foundation years, would be liable for the full 5 yrs worth of fees.

Dr Grumble said...

With regard to the UKCAT, this is heavily dependent on getting the right advice too. My youngest son was told, wrongly, by his state school that it didn't matter while other schools were sending their students off on special courses to get them through it. I should have known better but other doctors' children made the same mistake so I wasn't the only one to have taken my eye off the ball. Things change.

Having the right contacts can be enormously helpful for interviews. Mrs Grumble told young Grumble that he might be asked about the funding of the NHS. He was. Unfortunately teenagers know everything and he told Mrs Grumble that there was no way that he would be asked about the financing of healthcare and did rather badly as a result. (He happened to be interviewed by my SHO though if she ever knew this she didn't say anything.)

Fuddled Medic said...

With regards to my earlier comment, my medical school is very keen to point out that more student fail the practical exams (i.e. osce, oslers etc) then the written paper. I hope I am at the stage where I am happy to accept that statistically there is a very good chance I shall pass written exams, therefore leaving more time for ward work/clinics etc.

With regards to admissions policy, perhaps we could have a system where you need ABB, then give more weight to interviews. Everyone does relevant work experience etc, perhaps we could have an interview system when students are asked what they have learnt from there experience, therefore it does not matter if one student goes to daddys clinic whilst one goes to work at the old peoples home. i.e. what can you reflect on?

richard.blogger said...

Oh I am sure it is going to get much worse. Much, much worse.

I wrote an email to the chief executive of my local trust and he kindly sent me details of doctors' pay.

I was told that the annual bill for all doctors (juniors included) was £19.8 million. This included £2.5m from MPET (essentially, part or all of graduate junior doctors' pay) and £2.7m from SIFT (to pay for the time consultants spend training graduates). Thus, one quarter of the salary bill is paid from the NHS £4.8bn annual budget.

However, the white paper (section 4.33) says that "all providers of healthcare services will pay to meet the costs of education and training". If I take that at face value, it means that the trust will have to find an extra £5.2m or to ask graduates to work without pay and pay for the training they receive.

I wrote to my MP who passed on my letter to Simon Burns, who rather lazily replied by quoting verbatim the paragraphs from the white paper that I had quoted in my letter.

Basically, it seems that training in the NHS is going to get very expensive soon (I've used doctors as an example, but I'm sure nursing, and scientific training will suffer too), lumbering employees with huge loans or relying on trainees to be from wealthy backgrounds.

(Oh and by the way, [smug comment] I never voted for this lot.)

Will said...

The UK govt should be encouraging as many grads to study medicine as possible.

The loss in amortisation of tuition fees across the reduced active years was more than offset by reduced pension liabilities even before the increase in fees.

Methuselah

Dr Grumble said...

Some of the comments continue to vanish. Here's an important one from Sam:

Sam has left a new comment on your post "A reader writes":

NHS Student nurse: "They (as in medical students) are the only NHS students who don't get their tuiton paid or a decent bursary? Physio's do, Radiographers, Para's, OT's, christ even clinical physiologists (whatever they are) get something. Why is this? Why has medicine as a degree being shunned? Even graduate Nursing (in the few universities that offer it) get tuition/bursary."

In the old days doctors graduated to a guaranteed career that would lead them straight to consultant level, hence the lack of fairness with other health professionals while student. Only that is no longer the case, as docs graduate not even knowing if they can get a first job so that they can register with the GMC, without which they can not practice as doctors! no bursaries or similat treatment with other HCPs still AND their on call room was axed!

Not only that, but training jobs have and are still being cut dramatically year on year and for every level of training, and if you are lucky to finish training, there are not many, if any in some specialties, consultant posts. For example, last year 1300 out of 6000 FY2 never got offers for training at all, and 23% did not apply to training at all, where did they go and why?! Have a guess

Given that you are paid only 21k as an FY1, which is 3k below national average, maybe those graduates now hoping to study medicine should be given all these facts to enable them to make informed decisions on whether they still want to spend 4 more tough years at uni and commit to all this expenditure, whether rich or can borrow lots somehow, only to graduate to all this!

Please read Remedy UK and guess why are so many young doctors decided to leave medicine upon finishing their foundation years

http://www.remedyuk.org/index.php/RemedyUK-News/Why-are-so-many-doctors-leaving-medicine.html

I am not trying to push anyone from applying to medicine but I think those interested should be aware of the facts before they apply. So, please also read through the Remedy site to understand who they are and why they exist. Other medical bloggers entries on MTAS/MMC, like here at Dr Grumble and also The Witch Doctor and some entries At the Jobbing Doctor, Dr No, etc are also worth a read.

Anonymous said...

http://vulpesmax.blogspot.com/2011/04/everybody-wants-to-be-doctor.html#comments

Dr Aust said...

"In the old days doctors graduated to a guaranteed career that would lead them straight to consultant level.... Only that is no longer the case."

I'm not sure it was exactly guaranteed (Dr G would know more than me), but it must be true that nowadays there is an increasing chance of English grads ending up in the Orwellian-ly misnamed "career grade" jobs (permanent sub-consultant jobs, staff grades as was).

Mrs Dr Aust, in her early 40s, is one of these. I won't bore on with her career history, which I have described before, but suffice to say that after a good few years as an SHO and registrar in acute medicine, anaesthetics and ITU, she ended up in one of these posts. It pays well under £ 50K pro rata, which does not seem terribly generous for someone with an MRCP and over a decade's post-registration experience. It is less than newly-trained salaried GPs get, and only marginally more than I earn as a never-promoted university lecturer.

While no undergraduate in medical school thinks they will end up in such a job, statistically a fair few of them are going to. Whether that puts people off taking out huge loans to go to medical school, especially as a graduate entrant, remains to be seen.

Dr Grumble said...

You are absolutely right, Dr Aust. I deliberately decided to let this drop but probably I shouldn't have. Sam is very well informed about the present but is not in a position to know about the past.

Dr Grumble himself left clinical work for a while because there were no jobs. Mrs Grumble is in a sub-consultant grade. Dr Grumble's father, a consultant, had friends around the globe because they couldn't get jobs in the UK. Dr Grumble's mother, who got a distinction in physiology at a top medical school, never became a consultant.

I would actually go so far as to say that in recent years career prospects have been very much better than they have ever been. I also predict that they are about to get very much worse.

It's a long haul after you qualify so starting in medicine late makes everything even more difficult. Qualifying is not the end but the beginning of an even tougher time. Most have more exams ahead. The oldest Grumble child (F2) has only just realised that. Shift working - with all the problems that brings - has made the job less satisfying than it was.

I don't think even those with medical parents (Grumble included) realised what we were letting ourselves in for when we started out. It is at medical school that you discover that you have to work many times harder and longer than your friends doing artistic subjects - or even other science subjects. It goes on like that. You need to be highly motivated and prepared for a very long haul.

Those who are not doctors don't understand what a struggle it is to learn to do the job, how much we worry about our patients and how difficult it is to do the job - especially when we are learning. But it is those things that also make the job a satisfying challenge.

Paul said...

Medicine (and a couple of others) is partialy exempt from the ELQ criteria, meaning graduates could get a full maintenance loan for Medicine as their second degree. That's not perfect as it stands, since the tuition fee loan and maintenance grant are missing, but that's still something. As the rumor goes, some banks also "offer" loans for professional studies such as Medicine, although the interest rates (and modalities) are not quite as nice as student loans'.

That bit of help put aside, it is certainly a serious issue. I'm myself a 30yo graduate currently going through medicine, and if I can manage with the current fees I'm not quite sure I would be able to cope with the £9000/y every university will ask from 2012 onwards. It already is enough of a strain, especially for those who got themselves a family to cater for over the years.
I'm not in a position to comment on the advantages of having graduates doing medicine (although we obviously are able to "pull up" non-grads in group sessions) but considering the ratio of graduates we have here at Barts that'll cut off quite a lot of people. (this year, we had 60% graduates among the 5y "freshers")

Rebs said...

I thank you all for your comments, which have been very informative and I have been reading the links provided.

I understand that medicine as a career will not be a walk in the park, but the challenge also appeals to me. I would also agree that I will have no idea really, until I actually go through it myself.

I recently set up a project that involved me doing an expedition through the High Arctic, which took me years of hard work to realise. I had absolutely no idea what I was letting myself in for. If I'd have known the metal and physical challenges I would have to overcome over the years and of course during the actual expedition, would I have still pursued it? Maybe not, however looking back, would I still do it? The answer... yes I would, as I learnt and developed so much from the experience.

I don't see medicine as just a job; I see it as something that will become a part of me, something that will develop all areas of me as a person. Another interesting journey, that won't just be for a couple of years, but for the rest of my life. I am under no illusions that there won't be some bitterness and pain along the way.

I'm willing to take all of this on. But the question is, am I willing to take £36000 course fees plus 4 years living expenses on? I really have to say, I don't think I can.

Dr Grumble said...

Good luck, Rebecca.

Sam said...

"Sam is very well informed about the present but is not in a position to know about the past."

Of course I am not a doctor so, I wouldn't dare just make a comment like this without 'evidence'! :-) Of course, any information I have comes from docs everywhere, including yourself Dr Grumble.

In this case, when I said that "In the old days doctors graduated to a guaranteed career that would lead them straight to consultant level" in my comment @5.48 which you kindly published for me Dr G, this was based on 'Fidelio', namely the Eminent Professor Morris Brown and Professor O'Reilly of Cambridge when they both gave evidence to The Health Select Committee's MMC enquiry in 2008. Then Professor Brown said "' Until the MMC debacle, graduates of UK medical schools could expect a training in some branch of medicine'"

http://chezsams.blogspot.com/2007/11/fidelio-world-class.html

Of course, I trust Professor Brown et al and the fact that this statement was given to an offecial government panel on the subject, hence my comment. However, I do not know about whether all those who completed training got jobs at the end straight away or not, but the indications are that the numbers suited were much higher than the current situation now where in some surgical specialities competition for a consultant post is up to tens:1, and, as I understand, this has never been the case before.

The Fidelio site is sadly no longer available, but there were around 30 top Cambridge Professors standing by the juniors during the MTAS debacle. Here is the Fidelio tag if you like to remember with me Dr G, though we haven't forgotten really ...

http://chezsams.blogspot.com/search/label/Fidelio

Dr Grumble said...

Because, Sam, I know that you are strong on the topic of MMC and that you would have evidence for your statement, I decided not to pick you up on this point until Dr Aust intervened. Then I realised that, in the context of Rebecca, it would be wise to point out that in the past, in my view, the career prospects were not as good as they have been recently and, more importantly for Rebecca, they are likely to get very much worse.

What matters for Rebecca is the future. I tried to predict the future with regard to my choice of specialty. There turned out to be an unpredictable glut of jobs in my first choice specialty and hardly any in the second choice specialty I trained in. Also unpredictably, I find the specialty I ended up in to be very much more interesting than the one I abandoned.

Many things make the future difficult to predict. Who predicted the economic crisis we are in? What may be the effect of privatisation of the NHS on jobs (I actually think it might mean more and not less)? What new technique might transform the need for doctors in a particular specialty? I could go on.

Nobody likes uncertainty - especially patients. Managing uncertainty is an important part of medicine. I am reading the The Invisible Gorilla at the moment which addresses how we see things like weather forecasting and also shows how, given too much feedback, people make bad decisions on their investments.

Sometimes I do wonder whether the right advice might be to do what you want to do and follow your heart but when you see some of the hopeless hopefuls on X Factor you realise that this advice is probably wrong - an issue also addressed in The Invisible Gorilla.

Sam said...

'Follow your heart'? I don't know if that's wise these days Dr Grumble! Dr Aust said

"A useful side effect of this would be that people who go to medical school for five years, and then do NOT go on to work as an NHS doctor even through the foundation years, would be liable for the full 5 yrs worth of fees. "

So, bear that possibility in mind given that 23% did leave last year! And you can't help but think that given that the prediction is, as you say too, that things will get much worse in future ... and we already have signs confirming this. For example, The White paper wants 'Medical Education for England' to become 'Health Education for England' and to include the training of all other HCPs [Read The Witch Doctor on levelling heads], CCTs to be followed by fellowships for the very few, MMC's 'competence' and the narrowing of subspecialties to lead to precise medicine giving rise to 'the ear lope specialist'... etc. Simple ma here thinks the trend is definately leading to 'production line medicine', where 'the majority' of docs will be cheap sub grades catering for the poor and a 'selected' few will be allowed to escape the net and will be for the service of those who can afford to pay. Only, 'production lines' have no art in them, so 'the Art of medicine' will become a thing of the past! And, how fair will the selection of those few 'lucky' ones be?! Dr Aust said that he is "A never promoted lecturer" even though he had the potential with PhD and experience to prove!

I think this is all very unfair! And unfair means waste!

The White Paper doesn't change this scenario much but adds fragmentation of training too since individual employers would take over training, and so, how valuable a doc will be will depend on where they trained too [?].

Assume you are applying to training in the near future yourself, I would ask you, do you have good contacts?! Does your dad?! ... Welcome the old boys club again? ... or the under 50k a piece for life 'worker, never promoted doc'!

Medicine is a different ball game altogether now! For those hopefuls, 'No emotions' should be involved, but decisions based on facts ... that goes for all other subjects and professions too.

the a&e charge nurse said...

"how fair will the selection of those few 'lucky' ones be" - it won't be fair, but then again it never has been, has it?

Let's not pretend that there are not enough rich families to pay whatever the asking price is, so those from social class C,D or E will become even more under-represented than they already are.

Dr Aust said...

Re. the large fraction of UK medical graduates leaving medicine, I'm not clear precisely what the 23% figure Sam quotes refers to. It could mean people who are not working in the NHS a few yrs after graduating (which therefore includes people migrating to other countries). Or it could refer to people who don't even complete the Foundation years (which I would say is more likely to reflect those who have decided they are not going to be practising doctors, and would worry me more). While there is often said to be a large problem with "leakage" of people out of postgraduate medical training in the UK, the devil is in the detail as far as the numbers are concerned, so I'd like to be clear what the number refers to.

One of the reasons (though certainly not the only one) that we push intercalating degrees quite hard to medical students is precisely that they can offer people who are students in a medical course, but are realising they WON'T want to be a doctor, an "out" before the (costly) clinical undergrad years. There is little point putting someone through those in-hospital years just so they can come out with an Honours degree, IMHO.

Coming back to the original topic of the thread, it is often suggested that a way to reduce the "leakage" would be to take more graduate entrants, who are often felt to be making a more informed decision to do medicine that those entering the course aged 18-19. Of course, that assumes one doesn't have a fees regime that will deter all the graduate entrants...

Rebs said...
This comment has been removed by the author.
Rebs said...

I just found this info on the NHS Student Bursary, however it doesn't say anything about the graduate degrees?
http://www.bma.org.uk/careers/medical_education/student_finance/thenhsbursaryreviewsept09.jsp

Sam said...

"it won't be fair, but then again it never has been, has it?"

Ironically, MTAS would've been fair had there not been 15,000 extra doctors from abroad applying too and had British applicants been allowed to list their qualifications, prizes, etc ... and had the notorious psychobabble 'white boxes' not been thought ... interiews are another matter though!

"Let's not pretend that there are not enough rich families to pay whatever the asking price is"

Only, why would the rich put up with the end result unless they know before hand that they can also 'steer' their child's career how they want on graduation too? So, yes, there will be some of those, but where will the bread and butter NHS worker doc come from? It must be that those will be from the C,D,E classes you mention ... and those are the ones who need to be 'fully' informed, whether fresh from A Levels or graduates of other disciplines before they commit. Because those are the ones most likely not be able to change careers again if shackled with debt and/or have family commitments.

BTW, what does a&e stand for? :-)

Anonymous said...

A&E is a new name for casualty or an old name for the emergency department depending on how old you are.

Sam said...

Dr Aust "It could mean people who are not working in the NHS a few yrs after graduating (which therefore includes people migrating to other countries)"

Yes, the biggest exodus was in 2007 when loads of the 'lost tribe' docs fled to Australia. More still fly away because of the lack of training posts to this day still.

"there is often said to be a large problem with "leakage" of people out of postgraduate medical training in the UK, the devil is in the detail as far as the numbers are concerned"

Spooky, eh? I actually know one of these cases, a college mate of my F1 son, she resigned two months into the job saying that "This sh*t is not for me", I have always wondered what she meant by that, especially that that particular med school exposes students to clinical from day 1 so it is not as if the experience was new to her!

"a way to reduce the "leakage" would be to take more graduate entrants, who are often felt to be making a more informed decision"

I hope they are better informed, but how can you be sure? It could well be that it is harder for those to change yet again at around 30 years old and just stay, whether they like it or not.

And I have always wondered what this intercalated degree was for Dr Aust, so, thanks for the explanation. My kids have all done it though so I hope it will be of some benefit someday when doing research though ... or just be nice to have on a wide business card :-)

[Again, we don't want to put anybody off, just to inform so that those can be sure ... and I would go for medicine tomorrow if I can]

the a&e charge nurse said...

Thanks, Sam - my thesis is this - selectors belatedly addressed racism that so marred application to medical school but to this day there is barely a murmer about the routine exclusion of those from the lower social classes.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1282200/

Of course this situation is not rectified by excluding another group of aspirants (post graduates looking to pursue medical training) but in the great scheme of things this injustice pales into insignificance compared to the generations of bright working class youngsters who have virtually no chance of entertaining such loft ambitions.

I did post on this earlier but it seems not all comments are getting through?

Sam said...

thanks Anonymous, but I forgot the 'amp' bit, and that's what I don't understand ...

... and thanks again for the coming explanation :-)

Dr Grumble said...

The comments are coming in so thick and fast that I might have missed a few that haven't appeared. I will see if the missing one is in my email.

Dr Grumble said...

This may be the missing comment:

the a&e charge nurse has left a new comment on your post "A reader writes":

As an aside - "A report from the King's Fund, Racism in Medicine, summarizes the evidence that British medicine systematically discriminates against its ethnic-minority workforce.
The obstacles begin at medical school entry and re-emerge at various points in a medical career.
For example, in certain specialties many non-white clinicians encounter a ‘glass ceiling’ beyond which promotion is impossible; and the consequence is that some are forced into a less competitive specialty.
So, the National Health Service suffers a double loss: one specialty is deprived of individuals with strong motivation, while another gains members whose enthusiasm may be low.
Two decades after the matter of racism was first highlighted, there has been little obvious progress in improving the race-relations record of medicine in the UK.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1282200/

At least a few decent souls woke up to the fact that such racism stinks - but curiously class discrimination remains impervious to any serious analysis despite the overwhelming evidence that medical school is very much the bastion of the well off.

Dr Grumble said...

I have heard it said that the white male who used to be dominant in medicine is now rare amongst medical students. But I have no data. There is no doubt that he is much rarer than he was.

The class divide is much greater than the racial divide depending a bit on what race you look at. The government has blamed medical schools and in the same breath cuts off the financial support to those that most need it.

And some would say that it is not fair that males are now in a minority.

As has been said the world is not fair.

Fuddled Medic said...

White males are less common but certainly not rare, at least where I study anyway.

Current consultant was surprised to see his new group were 90% men. Stated it made a change from having a group that composed of nearly all women.

There are certainly to many toffs in medicine, spoke to one last week who was annoyed her parents had stated they wouldn't get her another car if she wrote (currenly on car 4) this one off.

Most of them think they had a god given right to study medicine and dont appreciate it at all

Dr Grumble said...

There do seem to be a disproportionate number of very rich but I have no data. Some of these have told me that they have no intention of working after they qualify. Isn't that simply awful?

Sam said...

A&e charge nurse, look,

"Racism"

... and bullying females, anyone who is different in any way; weight for example ... etc

I remember one doctor saying that they know before hand who would be selected for top posts. It was also mentioned that the new person must be viewed as to be able to 'fit in' ... that doctor did not explain what they meant by that and I did not ask. Good that his kind of practice is being addressed now because so long as there is lack of proper transparency and accountability in the NHS, then prejudice of one sort or another, including racism, will exist. The problem is also to do with the vicious hunt whistle blowers endure when they speak out. So, unless you all, of whatever colour, gender, creed, etc speak out and refuse to be abused, this practice will continue ... and cost the NHS a lot of money too.

Rebs said...

I have just spoken to the BMA and the link I published last night refers only to maintenance grants/loans, not tuition fees, so that is still up in the air.

We (a number of prospective graduate medical students) are going to start an e-petition for No 10.

We are trying to think of ideas of how we can get this e-petition seen.

I have suggested emailing each university's medical school student leader (I presume there is such a thing), for them to distribute to their fellow students and to the BMA Student Committe.

Do any of you have any ideas of how I might get doctors throughout the country to see it?

Rebs said...

Could I also ask, do you think that the potential changes in NHS funding for gem is linked to the broader changes taking place in the NHS and higher education? If so, please can you discuss them to give us a broader awareness?

Andrew Dickins said...

I am a 25 year old looking to apply to Medical School for 2012. I am replying to this topic as the bursary for years 2-4 in graduate entry medicine is currently unknown to apply beyond 2011. As a mature student, I currently do not qualify for a tuition fee loan to cover the costs of studying Medicine due to completing my BSc in Medical Sciences as well as my MSc in Cancer Pharmacology (although this MSc was self-funded). I only have ~£6000 left on my student loan, and if I was to pay it off before starting a medical degree I would still not be considered for tuition fee help.

In this position, I can just about afford to stump up £9000 to cover the first years costs, if the funding stays in place for years 2-4 in graduate entry medicine. If, however, this funding was revoked and not replaced in some way, I (as well as the vast majority of graduates) would be priced out of going to medical school. This would presumably affect ALL graduate programs across the country, meaning only the wealthy in the country stood a chance at furthering their education.

In the case of medicine, this would be a disaster as it would effectively end graduate entry programs or if they still existed, would simply allow the rich to go into medicine at the expense of the middle and lower classes. I don't think anyone would argue this being a positive.

It is a daunting prospect of having to find up to £36'000 to cover the cost of medical school for four years, especially since entry in 2011 is only £3250 for the first year with the rest being covered by the department of health. This is an astronomical increase over one year that should not be overlooked. I cannot stress enough at the magnitude of increase with the COMPLETE WITHDRAWL of bank funding. A lot of students who chose to apply in 2012 last year over entry in 2011 to better prepare themselves financially are reeling at the speed at which this is being pushed through by the government.

This would have a negative impact on the future or healthcare as you would be blocking thousands of potential doctors over the coming years that have been through previous study or life experiences that I believe is extremely beneficial in any profession.

I am asking for is for some sort of funding support or access to a tuition fee loan for courses such as Medicine. This may be me being biased, but the benefits for this country are as clear as daylight.

Debt is obviously a concern to all of us, however to pursue our dream of becoming a doctor is a price I am personally willing to pay. With no funding support and an overall cost of up to £36’000 (excluding living costs), only a very few select group of wealthy students would be able to pursue their dreams of becoming a doctor.

Regards,

Andrew Dickins

Sam said...

For Rebecca and Andrew Dickens,

Contact Remedy UK

Web: http://www.remedyuk.org/

Email: office@remedyuk.org

Maybe they can help, I hope they can, or at least advise what you should do.

Good luck

Sam said...

" do you think that the potential changes in NHS funding for gem is linked to the broader changes taking place in the NHS and higher education?"

There hasn't been any information regarding that Rebecca, the reason why I recommend you contact Remedy UK because one of their founders, Dr Matthew Show, is on the 'listening' panel now advising the government on the new reform 'The White Paper'. I think maybe he can help raise this graduate entry into medicine and how to finance it with the SoS for Health.

Regards

ethaniha said...

I'm also a 31 year old graduate-to-be (Food Science) and was unable to study medicine at 18 due to my personal circumstances. I've spent the last 15 years working and bringing up my son. Now he is older I feel I have an opportunity to realise my dreams (if that is not too revoltingly cliched) and I also have the benefit of maturity, life skills and experience that I could not possibly have had aged 18. I find it incredibly disappointing to finally be in a position where I can study medicine only to find that I can no longer financially afford it. As a graduate, I could have afforded £3K tuition fees and have managed to support my son but if that is going to rise to £9K and possibly higher if NHS support is reduced or removed then it will be virtually impossible for me to contemplate. I think by pricing mature students and graduates out of medicine the NHS and patients will suffer as we bring a wide range of different skills to the group which benefit our colleagues, fellow students and ultimately patients. Universities will also suffer if this leads to a decline in the number of graduate students as they may end up pulling the courses completely. So much for widening access to medicine. It may be that there are too many people who want to study medicine or too many junior doctors, but shouldn't the NHS be looking to attract the best, not just the richest?

ethaniha said...

Oh, and thanks to Rebecca and Dr Grumble for providing this space for us to air our views and for the information provided here :o)

JordanNewell said...

If DH were serious about widening access to medicine (and having medical students who are able to afford to eat properly in final year) then medical school would be free on condition that you work for the NHS for X years afterwards. People who choose to become an investment banker would then be liable to pay back their nominal fees.

Also, I don't agree with some of the comments here that graduate students will by default be "better doctors" - people who start straight out of school certainly won't be "worse doctors"! I think it is generally true that graduates are more confident and so perhaps make a better first impression with staff. But when it comes to the real work of making patients feel comfortable and generating a sensible differential then I don't think it is possible to make general statements about ability along the graduate/non-graduate divide.

Dr Grumble said...

Rebecca asks whether potential changes in NHS funding for GEM linked to the broader changes taking place in the NHS and higher education?

I don't have a feel for this really but I think it is a good question. When talking to teachers I have often been struck by the similarities between the damaging things government does to the NHS and very similar things going on in schools. There is often a common theme to the rottenness politicians purvey.

There would certainly appear to be a common theme to the changes we have been seeing to tuition fees as a whole and the difficulties of the GEM student. And the difficulties the NHS is going through (which is worse than many realise) is going to mean a reduction in training posts. They are already planned. The students on shorter training are the obvious ones to cut because they will come through more quickly.

All of this is taking place on a background of a rather nasty right-wing political agenda which is being implemented by telling the public that we are in dire straits, that drastic cuts have to be made and that there is no alternative. The prevailing view is that everybody needs to stand on their own two feet. So, instead of the taxpayer paying to subsidise students, the student borrows the money and pays it back when he earns enough. The process could be conducted in a simpler way by just collecting the tuition costs through income tax. But the politicians went to great lengths to explain that it wasn’t fair for people who had never been to university to pay taxes to support university students.

I don’t really agree but these sentiments are very seductive. You need to be aware of them. Given the harsh economic environment and all the other demands on government money, those in charge might well ask why somebody who has already been to university merits support to do yet another degree? If Jordan is right that they are not going to make better doctors that's quite a tough one to answer.

Sam said...

"those in charge might well ask why somebody who has already been to university merits support to do yet another degree? "

But they are not asking for support as such Dr G, they are asking for 'a loan'. Now, it may well be true that a graduate medical student is not better than an A level entrant, I even thought of that myself. But when you want something so bad, you think of ways to make yourself attractive so that you can give yourself a better chance of being accepted. Frustration leads to innovation, I like this one - 'Unique'! :-)

And knowing how it feels like wanting to be a doc myself but never getting there, I do feel for those who despite all the negatives we discussed here, including the misre pay, lack of training posts, no longer a career for life, sub grades, etc, I think those who still want to do it despite all this may well make better doctors, graduates or not. At least those most probably will not leave medicine when they graduate like those drop outs who depart for no convincing reason like the young woman I mentioned before, and waste the 250k the country spent on traing them! Those are a good investment.

I hope the government is listening ... and good luck to them ... and the government.

Of course, some may have applied when at A levels but did not get in so they went for another degree hoping to apply again on graduation only to find the door shut firmly now! That IS unfair. Because they may have chosen a degree attractive for entry to medicine and not one to use as a career for life!

Dr Grumble said...

I think the most unfair thing about this is the changing of the ground rules at short notice. As Sam says, you may have made plans to go into medicine by an alternative route and then found the rug pulled from under your feet.

Rebs said...

I would agree with Jordan Newall in that we can not say graduates always make better doctors than younger undergraduates. I also don not think that any other doctor/poster on this forum said it quite like that though. They said that in their experience 'some' of their best students and doctors had been graduates...

I thank Sam for the lead and I will be following this up. I am very grateful for your help.

Dr Grumble, you are right to point out these arguments as we do need to be aware of them. My main issue with the potential instant removal of the NHS bursary to cover the fees of years 2-4 on the GEM is that it is a double whammy! The fees have just increased to £9000 a year, so from £3600-£36000 for the course. We have no access to a loan, so it is my opinion that we are being blocked from returning to education.

I received a response from a UK academic yesterday, I won't say who, but I thought their perspective may interest you. They said:

Dear Rebecca,

I didn’t know about this, but it is not surprising. The government plans to privatise the NHS both funding and delivery and so why should the state underwrite the costs of medical education, that is the reasoning. At the same time government is privatising higher education and very soon we will see private universities opening up to offer private medical degrees the idea being that as in the US medical graduates will be competing and operating in a market. Universities are positioning themselves accordingly for globalisation. It is important to continue to oppose the changes and to be aware of the big picture - of course if the government is defeated on the Health and Social Care Bill it may be easier to show the lack of logic in and oppose HE proposals.

Dr Grumble and fellow posters, what are your thoughts on this?

Dr Grumble said...

I agree absolutely, Rebecca. I could have written that letter myself. That's essentially what I was referring to by the nasty right-wing agenda. If people of your generation do not know this is happening (I rather assumed you did)it is because your generation is not so politically aware as ours was compounded by the way the political class deliberately conceal unpopular plans(especially for the NHS).

My own feeling is that we should all go out on the streets and protest against the Health and Social Care Bill. What we really must stop is the market in healthcare. There has been talk of Lansley's bill being this government's poll tax. It could be if people realise what is happening and protest accordingly. But will they?

Sam said...

"What we really must stop is the market in healthcare."

That's unstoppable Dr Grumble, it's 'globalisation'. Gordon Brown spoke about a 'new world order' and it is here. As Britain can do nothing about this tide, she has to join or get left behind.

"There has been talk of Lansley's bill being this government's poll tax."

Not to that extent, there is opportunity with everything and Andrew's work has plenty, although it needs some tweeks, hence the 'listening' excercise. 'Tweeks' maybe, but there will 'never' be a full U turn to the past.

I am in a stagnant mode these days or I would write about this, meanwhile, maybe this explains why 'a bit':

http://chezsams.blogspot.com/2009/04/moral-capitalism.html

... and Rebecca, have you contacted a few med schools to find out about funding for graduate entry? Because the government made it clear that in order for unis to charge the maximum of 9k, they had an 'obligation' to widen access, meaning there may well be new schemes in individual medical schools now that all med schools will most likely fall into this catagory. Maybe you should e-mail them all individually to find out.

Dr Grumble said...

If we all take the view that Lansley's bill is unstoppable then it will be. The arguments for privatisation of healthcare just do not stack up. The emperor has no clothes. If enough people were to point that out this bill would drop dead in its tracks.

the a&e charge nurse said...

"If enough people were to point that out this bill would drop dead in its tracks" ....... ssshhh, don't mention the 'P' word!!

The public and indeed most NHS staff will not realise that our health system has changed irrevocably until they receive their first computer generated invoice for services rendered.

We won't be charged with everything to begin with, just a few select items, but once the concept is established the number of freebies on the health menu will soon diminish.

Imagine if Tony B had pitched tuition fees at £9k in 1997 - no, the wily fox started off with a more managable £3k before Gove & his coalition stooges lit the blue touch paper.

the a&e charge nurse said...

BTW - remember this?
http://www.youtube.com/watch?v=nH2EmVGowCk

Yes, I have no problem taking D-Cam's utterances at face value!!

Dr Grumble said...

I do remember. I think that video clip is worthy of a post all to itself.

Sam said...

"If we all take the view that Lansley's bill is unstoppable then it will be. The arguments for privatisation of healthcare just do not stack up."

I just like to be realistic when need be Dr G.

The NHS should remain in public hands - that is an A1 priority. But to think that private sector involvement can be reversed is impossible to achieve, nor is it desirable either, because it leads to stagnation, and that has a multitude of ills. There are good parts in The White Paper, but overall, it is way ahead of it's time as it assumes there is a global system in place to support it's high ambitions when there isn't - yet. Example, competition on price, now ditched, would've allowed 'any willing provider' from 'around the globe?' to cater for NHS patients. While this may be much cheaper, there is no global system to protect patients from rogue providers or bad practice -yet. and the reason why it is good that this particular part was ditched - for now.

It is an opportunity the government is listening so there is hope to remove more, and as many unagreeable bits as 'realistically' as possible. It is up to you doctors to do that now.

Dr Grumble said...

You should know, Sam, that the plans are not that the NHS should remain in public hands. The government intends to divest itself of the NHS in various ways inlcuding, perhaps, giving it away. All the evidence suggests that privatisation of healthcare costs more and not less. Unfortunately, people believe what they are told or exptrapolate from the success of markets on the high street.


There is widespread misunderstanding on this. I fear I may have to spell it out in a post devoted to the topic. The problem I have is that the details are a bit turgid. There is little point in publishing something that few will read.

If you work within healthcare the truth of why markets don't work is self-evident (to most though not all). Proving it is more difficult.

Sam said...

I respect your opinion Dr G, but I believe that some competition from the private sector is good and aids a healthy environment in any public setting where, without it, workers feel no ownership, they just go to work to collect the pay cheque at the end of the month, hence the stagnation, all types of prejudice and enivitable waste and rising costs as a result flourishing as is the case with the NHS as you can see even from some comments on this post.

I know The white paper wants to rid the DoH from the responsibility of providing a universal cover for all, Dr No wrote an excellent post on that:

'The Secret Nail in the NHS Coffin'
http://badmed.net/bad-medicine-blog/2011/03/secret-nail-nhs-coffin.html

I too say No to that.

... awaiting your new post :-)

Rebs said...

Dear Dr Grumble,

Please spell it out, we would be very interested.

Sam, thanks for the links. I have contacted Mathew Shaw and also Julie Moore, who is heading the Future Forum on Education. Julie has said she will bring it up in one of the sessions.

For your information I have set up a Facebook Group to oppose the potential GEM cuts, it is here if you would like to join:

https://www.facebook.com/profile.php?id=617108713#!/home.php?sk=group_162471393813902&ap=1

Dr Grumble said...

If I have the strength I may attempt a post explaining why markets are just not the way to deliver cost-effective healthcare.

Rebs said...
This comment has been removed by the author.
Rebs said...

ha ha, take it easy Dr Grumble, feet up, cup of tea and all of that. It's a bank holiday isn't it? :)

By the way, Dr Phil Hammond tweeted my Doc to Doc blog and the BMA have just posted asking for graduates to email in answers to four questions they've asked for case studies to submit to ministers.

Dr Grumble said...

Sadly, Rebecca, I have to do a ward round tomorrow. The hospital never closes, the patients keep on coming and there may be more people in London than usual. The support we need in the community to take our discharged patients disappears during holiday periods and this royal wedding with yet another 4 day weekend is proving a perfect pest for us.

Our managers have recently starting panicking about this problem to the extent that they did at one stage try to claim that the public holiday did not apply to hospital staff. They are not really interested in patient care just potential bed problems. They have cut the beds so much they are worried about a real crisis. Dr Grumble anticipated the potential difficulties as long ago as last year:

http://drgrumble.blogspot.com/2010/12/off-with-their-heads.html

Interestingly Sam commented on this post and pointed out the number of unpaid hours juniors work and their poor pay. This is the NHS that she thinks could be made more efficient by privatisation. I was phoned last night by one of my F1 doctors. She should not have been at work. I wasn't on call. They (and I) do this all the time. I would be less inclined to want to do this for an organisation that was profiting from my good will.

Dr Grumble has some wonderful young doctors working for him at the moment.

We need to be very wary of getting rid of the NHS and the good will it runs on.

Sam said...

"By the way, Dr Phil Hammond tweeted my Doc to Doc blog and the BMA have just posted asking for graduates to email in answers to four questions they've asked for case studies to submit to ministers. "

You know what Rebs? You'r gonna be OK! In whatever you do! Keep it up and remember 'Where there is a will ..."

I am not a Facebooker though so, all the best and please let us know how you get on, and thank you for the invitation to join:-)

BTW, why not just e-mail SoS for Health direct? I think he's a nice man, he may well reply, maybe even favourably, you never know! ;-)

Dr G

"I was phoned last night by one of my F1 doctors. She should not have been at work. I wasn't on call. They (and I) do this all the time. I would be less inclined to want to do this for an organisation that was profiting from my good will."

My 3 kids are working this weekend Dr G, youngest one on nights too! As they did last Christmas and 2 were working this easter! ... and more hours than they should fr free too, docs don't feel the hours when at work so they never say a word about it either! But 'Ma' thinks they should! Every young doctor that is not just my kids! ... of course, had they been working for somewhere private, they would have had a decent pay to start with and would've been paid for every minute extra. Te juniors are having it tough these days in the NHS Dr G, in every way! So, it's not too bad this Andrew Lansley Foundation Trust everywhere idea, for patients AND doctors, eh?

... AND I DO NOT WANT TO SEE THE NHS FULLY PRIVATISED ... cross my heart and hope to die!

NO AMERICAN SYSTEM FOR ENGLAND!

... look what you're making me do Dr Grumble ... but I understand why Americanisation is not the way, thanks to you, the excellent CC and Wikipedia too

And, I am sure those patients at your hospital will be just fine, as will your juniors ... enjoy if you can, or just listen to Rebs and put your feet up with a cuppa whenever you can ... and I'll keep an eye on that happy wedding for everybody, promise :-)

Rebs said...

Dr Grumble,

I am hoping to organise a group of graduates to have a presence at the Save the NHS Demo on May 17th.

Tuesday 17 May 5.30pm, University College Hospital, Gower St, WC1
6.00pm march to Department of Health, Whitehall

More info at http://www.keepournhspublic.com

I am coordinating our efforts via our open Facebook Group which is
Save Graduate Entry Medicine at
https://www.facebook.com/#!/home.php?sk=group_162471393813902&ap=1

The younger generation won't just sit on our arses and let policy be changed without making our opinions heard! Our opinions matter too!

Dr Grumble said...

Spare a thought for those who have already qualified but cannot register because there are no jobs for them. It's looking OK for this year but I wouldn't count on it for the future:

http://careers.bmj.com/careers/advice/view-article.html?id=20002743

http://careers.bmj.com/careers/advice/view-article.html?id=20002742

Cockroach Catcher said...

You have gone viral!

Dr Grumble said...

It wasn't my post that attracted all this interest. I was a little worried that Rebecca's plight might be ignored or that any comments would be unsympathetic but clearly the issue matters a lot to many people and the topic struck a few raw nerves.

Cockroach Catcher said...

I know.

I am of Chinese ethnic origin but adopted the British way.

I do worry as when I first arrived in the UK in the early 70s, the top doctors wear Bow ties and were all white. I have nothing against any race being a minority myself.

Now, my wife needed major surgery at a London Teaching hospital, her surgeon was Jewish, and all his Junior staff were Iranian, Indian sub continent and Chinese. Not a single white Caucasian in sight.

What has happened? All working for RBS?

Everything was on the NHS as her PPP from her previous employment would have meant that we have to pay 90%. Yes 90%.

In Hong Kong, my colleagues would do it for free.

I do not think David or Andrew care what we say. But then I do not care either.

Keep going.

Anthony Udi said...

Cut is necessary, but it should never be at the expense of long term progress. Make cuts in departments that need cut. I, as a person, would greatly suffer, and probably give up on serving the country that I love, in the capacity that I aspire. For up to two years now, I have been volunteering my service for care homes and the NHS, and doing everything possible to make me a good doctor in the future (only if given the chance to study medicine).

If the NHS withdraws tuition fee support (grant or loan), for graduate applicants, my years of toil would be in vain. I might as well give up hope for life. I am from a family background where no one ever had the opportunity to attend a University – so, I was the first to attend, and graduate from a university. It was not easy – I had to work most of the time to be able to meet the cost of my education. However, I do not think it is possible to work as I did before, if studying medicine; it requires a year round attention to studies. The possible thought of not being able to study medicine, despite my hard work and determination to serve, makes me feel like I am inferior to more privileged applicants. I would not be surprised if policy makers do not heed my plea – after all, if you have never been poor, it might be harder to understand what the poor have to put up with.

If support is not provided to cover my fees, I am going to be devastated, but I would do whatever is necessary to realise my dream of becoming a doctor. I might even live the country, and never come back; or take a blind gamble at it, working and studying at the same time again, and accept whatever the outcome.

The government should consider the experience and determination that graduates like me have to offer, and what the country stands to lose if we give up hope and trust. Yesterday, the 29th of April, 2011, I witnessed a global marriage ceremony, between Prince William and Kate Middleton (now the duke and duchess of Cambridge respectively), something struck a chord with me: That, this country is a great country, and we must not compromise our future by saving penny to lose a pound, because the world look up to us; and also, a commoner, given the chance to marry a prince, is only heard of in fairy tales – if this can happen, why am I being priced out of studying medicine?

Rebs said...

Hi Anthony, thanks for sharing your story on Dr Grumble's blog.

Clearly, the removal of the NHS bursary to cover fees for Years 2-4, without access to a student loan will make it impossible for most graduate entrants.

I have started an e-petition here:
http://www.ipetitions.com/petition/save-graduate-entry-medicine/

I urge anyone who opposes the scrapping of the NHS fees bursary and agrees that graduates should have access to study a degree in medicine to sign it.

Rebs said...

I just wanted to let those know who have been posting on this thread that there is a video from the Keep the NHS Public march, which took place in London this Tuesday. There is a short speech from me, slightly cringy for me to watch, but I'm glad I did it non the less.

Thank you for posting a link to the NHSCA on your website recently Dr Grumble. I emailed them and they have asked me to write a short piece for their newsletter next month. They have said they fully endorse our e-petition and campaign.

http://www.youtube.com/watch?v=-tPnHUPJCtw

Graduate entry medicine said...

I find this website very informative. A must bookmark for anyone wanting to know the secrets to getting Graduate entry medicine.Graduate entry medicine