Our medical students are in crisis; we need to act!

Our medical students need to be heard before we reach the point of no return.

Author: Altay Shaw
Editor: Haonan Liu

On November 4, Education Secretary Bridget Phillipson told MPs that tuition fees would see their first rise since 2017. The annual fees will now stand at £9535 a year, up from the current figure of £9250. While the amount may seem trivial in the grand scheme of things, British Medical Association (BMA) Medical Students’ Committee Chair Rob Tucker voiced his concerns, stating, “This announcement of increased tuition fees for already stretched medical students is frustrating and represents a continued failure to address the current medical student funding crisis.”

Whilst the impact can be debated when students already incur up to £90,000 worth of debt during the course of their studies, this change in university tuition fees is the latest difficulty that stands to break the camel’s back for medical students across the United Kingdom. So, what are the other issues our current cohort faces?

Exam resources are limited for all students

Since UCL made the switch to single-best answer style papers around 2009, there has been a greater focus placed on using question banks. These paid-for resources aim to mimic the style of written multiple-choice exams most students complete at the end of the year. It should be noted that while these resources are fairly cost-effective, not every student can afford these question banks for revision purposes. Indeed, financial barriers still remain an ever-present aspect of medical school, putting some off from applying and remaining a reason why some exit their programs early.

Whilst UCL will be the first to point out there is financial support available for students, accessibility to these resources remains an issue. Indeed, there are plenty of medical students who are currently repeating or have repeated a year of study within medicine (the author of this piece included); financial options are limited, especially as most medical students complete an intercalated BSc program in the third year, effectively nullifying their options without having to provide evidence of exceptional circumstances for applications to be successful.

Adding to this stress is the fact that these question banks often serve as the main port of call for learning the core content. Most university students are used to modules, specific lectures, and exams that focus on specific areas of the syllabus rather than a cumulative single-attempt paper. Medicine is not taught in this manner. Whilst students cover their content with long and short-term placements, everything that is covered in the year is covered within an exam setting, with anything on the curriculum map being fair game. As such, it is not solely for exam purposes, but rather an overarching learning aid that ensures students are prepared for exams and is not reliant on Moodle being up.

Conditions are driving medical students out

While the financial cost of medical school cannot be underestimated, the physical and psychological toll cannot be discounted. For medical students to graduate, a minimum of 5500 hours need to have been completed. These cannot include the intercalation, which despite losing its’ points under the changes to the foundation program, still remains a compulsory part of the medical degree.

To put this into context, students complete a vigorous pre-clinical period, where isolation prevents students from being able to interact and socialise with peers across a variety of programs. This is compounded by the fact the medical school will push their students hard to join the RUMS alternatives of societies, only to be subjected to a drinking culture that still causes problems to this day. To the extent that efforts made by the RUMS Welfare VP are ignored by sports societies and any attempts to make changes to the culture are met with contempt and pure ignorance. It almost feels as if the culture is deliberate in its nature, aiming to ensure a hierarchy of the status quo rather than actually focus on supporting students.

It should be noted that these exam resources are not extremely expensive. Rather, not everyone has access to these types of resources. Indeed, this was made evident during the clinical mentorship training session in early September of this year, where a member of staff stated that not all students had access to these resources. However, their concern was not for the finances, but rather a point of accessibility. Whilst it should be noted that UCL Medical School does provide multiple-choice questions and practical exam example stations, the gradual shift away from specific question types and changes to longer stations. Furthermore, these sites tend to offer the accessibility requirements students have in their Summary of Reasonable Adjustments (SoRA’s) which can go unnoticed by staff members – either due to lack of communication or lack of knowledge about adjustements needed for disabled students.

So what do we do now?

Whilst it may seem little is being done, there is action being taken by your colleagues across UCL. Our BMA representatives have worked tirelessly with student reps and Academic VP’s to understand the changes that have occurred within the assessments and how changes to the foundation programmes will impact medical students at UCL. Although this is a start, it is only the tip of the iceberg.

We need thorough reform present within medical schools across the country. This needs to take the form in proper guided financial support, whether students are sitting their first exam or are repeating a year. Accessibility to UCL Finance meetings and Student Support for any students struggling needs to be implemented, as many continue to require support long after the term has started.

We still face a potential exodus of the next generation of doctors from the NHS or even out of medicine completely. As such, immediate and definitive action is required to ensure all students are supported and know where and whom to turn to when they start to struggle.