Our failure to train doctors in the UK hurts the developing world
Today is A-level results day. Thousands of aspiring doctors will be waiting anxiously for their grades. Will they achieve their conditional offer, or get a chance at clearing, or do well enough to reapply next year? Gaining a place in a UK medical school is a lottery.
The pandemic and the example – even heroism – displayed by hospital staff, has resulted in a surge of applications to nursing and medical courses for autumn 2021. Nursing applications have increased by 32 per cent compared with 2020 and medical school applications by 21 per cent.
But the number of medical school places is capped because of cost. The Medical School Council has predicted that there will be around 9,000 available slots this autumn for the 28,690 applicants. The Government has raised the cap marginally this year. But thousands of students with proven aptitude and the necessary A-level grades will be rejected. This is a waste of talent considering the desperate need for more doctors to staff the NHS.
For decades, governments have realised that it is cheaper to recruit doctors from abroad than to train our own. In 2018, and for the first time, the UK imported more doctors than it trained. In 2019, 60 per cent of new doctors were trained abroad. The intention was to increase this figure further in 2020 but it was temporarily halted by the pandemic.
Foreign graduates have made an invaluable contribution to the NHS but surely the pendulum has swung too far and for the wrong reason, namely cost? There are moral and ethical consequences to consider. The UK cannot continue to recruit an ever-increasing number of doctors from low-income countries to plug manpower gaps in the NHS. These doctors come from countries where the patient/doctor ratio is large multiples greater than that in the UK. In 2019, the General Medical Council registered 7,343 new UK graduates and 10,966 foreign graduates. Of the latter, 2,461 came from EEA countries and 8,505 came almost entirely from low-income countries outside the EEA.
The UK is a signatory to the World Health Organisation code of practice on international recruitment of health workers, which states that “member states should discourage active recruitment of health professionals from developing countries facing critical shortages of health workers”. A similar code of practice was drawn up by DOH and DFID which included a list of 145 countries the UK should not recruit from. The GMC breaches both of these codes.
As a matter of urgency, the UK needs to double the number of medical school places. In 2015, Jeremy Hunt, then health secretary, promised 5,000 more GPS by 2020 and also said that the NHS would be “selfsufficient in doctors” by 2025. The first target was missed and the second is mathematically impossible given medical school capacity. To his credit, Mr Hunt in 2018 did announce the creation of five new medical schools, the first for 12 years. They will produce a total of 1,500 new doctors, starting in 2023.
Grade inflation means that hundreds of extra students will have achieved their grades for medical school entry this year. Some students are already being asked to defer entry until next year. This means fewer, if any, places for clearing and for next year’s applicants stricter entry criteria. Eligible UK students who want to be doctors deserve better. Their talent should not be wasted.