Medical school heads say this is the hardest year “in living memory” for A-level students to get a place to study medicine, with several thousand high-achieving applicants left without a place. Unless the government increases the number of doctor trainee places now, they say, there will be “disaster” in the NHS in 10 years’ time.
Medicine has long been one of the most difficult subjects for A-level students to net a place in, but this year competition has been tougher than ever because many places are already allocated to students who were encouraged or paid to defer during the pandemic disruption last year, and thanks to a demographic surge in the number of 18-year-olds.
Ucas, the admissions service, says fewer than 16% of applications to study medicine and dentistry resulted in an offer this year – down from 20.4% in 2021.
Andrew Hargreaves, co-founder of Data HE, a consultancy advising universities on admissions, and a former director at Ucas, told the Guardian: “The largest group of unplaced applicants are in medicine. I’m hearing that we have several thousand medical applicants without any firm choice.”
Medical schools say they were extra cautious about offers this year after the government wrote to them before Christmas saying institutions would have to foot an annual bill of over £30,000 for each extra student on a clinical training placement if they went over their pre-Covid allocation of place numbers.
Sir Andrew Goddard, gastroenterology consultant and president of the Royal College of Physicians (RCP), said: “To me it’s obvious and quite frightening. If we don’t invest in training more doctors now, in 10 years’ time the NHS will face disaster.”
The RCP has been calling for 7,500 more medical school places to be funded each year in the UK at an annual cost of £1.85bn, but Goddard says the Treasury is blocking expansion. The Medical Schools Council has echoed these demands, though it says the country could manage with 5,000 extra students a year and 13 new medical schools if it continues to plug gaps with doctors from overseas.
He warns that the NHS is being hit by a “perfect storm”, with insufficient staff at the same time as a high demand for services, including an unprecedented backlog of patients as a result of the pandemic and an ageing population with multiple conditions needing treatment.
Research by the RCP and its counterparts in Scotland last year revealed that just under half of all consultant doctor posts remained unfilled in the UK – the highest figure in almost a decade.
Prof John Alcolado, executive dean of Chester University medical school, which opens this autumn, said: “With many universities sitting on deferred students, this year will be the hardest year to get into medical school in living memory.”
Chester is taking only international students because of the government cap on UK medical student numbers. Alcolado would like to be able to recruit local people, particularly from disadvantaged backgrounds, to train as doctors who might practise locally when they graduate. However, he says this is currently impossible.
“We are being told there is no funding for you to train UK students, but you can take students from other countries who can afford to pay for their clinical training placement as well as their tuition,” he said.
“The NHS has tended to rely on taking doctors from countries who have trained people when they could ill afford it. This is not going to be a sustainable model to cover all our needs in the future, and it is also parasitic.”
Kat Ferguson (not her real surname), an NHS consultant in Wales whose daughter has applied to study medicine, said: “One of her friends had the best GCSE results in the year and is predicted top A-level grades and she didn’t get any offers at all for medicine.”
Her daughter is “one of the lucky ones” because she has received one offer but is worried about what happens if she doesn’t achieve the straight A grades she needs in the first high-stakes exams she has ever taken – having missed GCSEs during the pandemic.
“These students are among the brightest in their year and it is hard for them watching friends getting lots of offers for other subjects,” said Ferguson.
“As a mum who also works in the NHS it feels like there is a real disconnect in the system. Universities are having to turn away good applicants, but we know there are thousands of doctor vacancies.”
Prof Ian Fussell, associate dean of education at Exeter University’s medical school, said: “We knew it would be very competitive this year and it has been.” Many of Exeter’s places for this year are already taken because last summer the university offered medical students £10,000 and a year’s free accommodation to defer until 2022, after the number of successful applicants with the course as their first choice shot up from 20% to 60%.
Vice-chancellors say privately they are not ruling out the government performing a last minute U-turn this summer and allocating extra numbers if more students than expected meet their offer requirements, as happened in 2021 and 2020, but at best they say this would be hundreds of extra places spread across the country, not thousands.
Fussell urges applicants who haven’t got offers to “stay positive”. Some may still get lucky as other candidates miss grades, but he adds: “Most doctors would look back and say ‘Don’t rush it. Take a year out. It gives you a chance to gain some life experience and think about the future. It demonstrates commitment and builds your story’.”
A spokesperson for the Department for Education said: “Every year we work with universities to ensure full capacity on vital courses like medicine and dentistry and that these numbers reflect England’s workforce requirements to help protect NHS services.”
They added that caps were in place in medicine “to ensure students receive a high standard of teaching” and to ensure there was enough capacity for training placements in local areas.
