theMEDICALSTUDENT
November 2013
The voice of London's Medical Students/www.themedicalstudent.co.uk
RAG season kicks off
Barts leads the way >> page 4
Polio resurgence
Outbreak hits Syria >> page 7
Healthcare for Migrants
Should they be charged? >> page 10
Still Life
ICSM get acting >> page 18
An End to Cambridge Transfer Students Peter Woodward-Court Making the transition from preclinical to clinical medicine brings with it many changes, but uniquely for London medics we see the addition of a body of students from Cambridge and Oxford, as they finish their degree in preclinical medical sciences and embark on their clinical careers. This process has taken place for a number of years, but it has recently been announced that Cambridge intend to stop all transfer students coming to London from 2017. Cambridge’s Clinical School was founded relatively recently, in 1976, and in the past has not had the capacity to accommodate all the students from its well-established undergraduate preclinical course. Thus, a number of students transfer and come, traditionally, to the London universities. Over the past four decades, Cambridge’s clinical school has been gradually expanding and they now intend to increase its capacity to the point where they can manage their entire preclinical cohort. The Medical Student has spoken to a number of senior staff from both universities to gain perspective on this issue. Cambridge describes the “anomaly” of transferring from Cambridge’s preclinical course to a different clinical education as “no longer fit for purpose from an educational perspective.” Over the past decade, Cambridge has been put under pressure from external stakeholders such as the GMC, Department of Health and NHS Employers to meet “more precise requirements” which Cambridge claims are difficult to achieve in a divided curriculum where 40% of students leave at the end of year 3. Indeed, Cambridge describes the process of transferring students as “severely hindering innovation,
since any change [we wish to make] would require coordination with the clinical and preclinical courses in [the] other medical schools.” Cambridge argues that having a full sixyear programme will provide the university with exciting opportunities to innovate educational themes with a currently underused teaching capacity, and emphasising the interdependence of core and clinical sciences and their importance for future clinical practice. London’s view was more blunt: “It’s nothing more than money.” The Medical Student was told, “Medical students attract money from the government and part of that money underpins the hospital.” The idea that Cambridge is making the decision to improve the educative experience was dismissed as “nonsense”: “Medicine is best in London, and it’s driven by the hospitals. The biggest hospitals have the most complicated patients, have the best doctors, have the best training environment.” We were informed that UCL partners have 6.3 million patients (10% of the country’s population) as a captive group. For Cambridge, we received an estimate of 300,000 patients from our London source, and 4.8 million from our Cambridge source. “Cambridge’s motive is ‘there’s nothing more than money driving this’, it’s nothing to do with the student experience.” “The question to ask is, does Cambridge have the capacity to train [the extra students]? I think they will struggle. I think the quality of placements would not be the quality of the placements they’d have in London”. Another source told us: “There is a question of capacity for students at Cambridge. It implies from their statement that students will stay in Addenbrookes. There isn’t the capacity in... [cont’n on page 2]
£16k of Debt and Rising for First Years
Chris Smith
A recent BMA survey showed that after just one year of Medicine, students could be in up to £16,000 of debt. In total, 623 first year medics and dentists replied to the annual survey with two thirds saying they’d have to cut back on food to survive. This comes at a time when Student Finance maintenance grants and loans rise by less than one percent, lower than the rate of inflation. This has forced many to pursue high interest borrowing such as commercial loans and credit cards to supplement their income. Medical students work more hours per week and study an additional two years compared to conventional degrees. The possibility of debt is a real concern that hangs over the head of students; with graduates studying a second undergraduate degree hit the hardest. No student finance support
for tuition fees means that graduates have to pay £9,000 upfront for the first four years. One graduate in the BMA survey already owed £84,000 going into his second year. Since the rise in tuition fees, the debt for medical students has almost tripled with a 2010/2011 graduate owing just £24,000 while a student entering in 2012 could owe £70,000. This is an enormous leap in debt and puts pressure on students already under enough academic stress. Jo Wagland, a first year medic at Barts and The London, said “Four years of maintenance loans really scares me – it makes me wonder if the increased earning potential we will have will be worth it in the end, especially as it takes so long to work up to a consultant’s salary.” With increasing debt and Oxford University asking to raise tuition fees further, future medical applicants could be forgiven for having second doubts.
Daniel Gibbons, former Deputy Chair of the BMA Medical Students’ Committee, agreed that such high debts would put anyone off entering the medical profession. “Medicine is already significantly more expensive than other courses, and our research shows that the problem would worsen with the introduction of top-up fees. The government’s measures … fail to take into account the fact that medical students study for an extra two or three years. On top of this, we face extra costs for travel and equipment, and have fewer opportunities to supplement our income through paid work.” The demands of a medical or dental course can be incompatible with a part-time job, yet the BMA survey showed that more than half of the respondents (57.5 percent) are thinking of taking paid work to support their studies. The pressure on students to seek [cont’n on page 2]