UK medical education is being hit hard by a lack of funding and resources, says the BMA

In a response to the Education and Skills Committee inquiry the BMA highlights concerns about the current situation in medical education and voices opposition to the cap on student fees being lifted.

The BMA is concerned that medical teaching has been shifted from universities to the NHS, where funding is under increasing pressure. The university funding structure - in particular the Research Assessment Exercise - has meant that medical schools have focused on research rather than teaching, which in turn has been shifted across to the NHS, where it is a ‘soft target' for budget cuts.

In November the BMA warned that NHS Strategic Health Authorities (SHAs) are taking money from budgets previously set aside for education and training in order to meet deficits. Targets for the cuts include academic posts in medical schools, which could result in doctors being made redundant (2).

The movement of teaching from universities to the NHS is also the result of falling numbers of medical academics, the BMA response says. It points out that over the past five years the number of medical students has increased by almost 10,000, while at the same time there has been a 25% reduction in numbers of medical academics.

The BMA is also strongly opposed to any plans to lift the cap on student fees (3) - currently set at £3,000. Student debt is at an all time high, with the average final year student owing £21,755, this is more than the basic pay of their first job as a junior doctor.

The funding for medical degree courses is criticised as complex and lacking transparency, making it difficult to ascertain how much is actually spent on medical education and training. As an example the eight new medical schools have only employed 128 new academic posts between them, many of which have been funded by the NHS. The BMA would like the income raised from student fees to be ring-fenced and used to fund medical school teaching and training. It calls on universities to introduce a more transparent system which makes clear where student fees are being spent, and reassure medical students that they are getting ‘value for money'.

Emily Rigby, Chair of the BMA's Medical Students Committee said: "These are worrying times for medical students. The erosion of funding for medical education is putting good quality medical teaching at risk, debt levels have reached a high and the job market for junior doctors is increasingly uncertain.

"Removing a cap on student fees will in one step, place a medical career out of the reach of many and make income as, if not more important, than talent and aptitude. Becoming a doctor should be about your commitment to medicine and patient care, not the amount of money you are prepared to borrow."

Professor Michael Rees, chair of the BMA's Medical Academics Committee said: "Medical education is under attack on several fronts. Teaching posts are being cut and university funding mechanisms mean medical schools are forced to focus on research rather than teaching. As a result, more and more education takes place in the NHS, where financial problems make it an easy target for cuts. This is all happening at a time when increasing numbers of students are entering medical school and the situation cannot continue like this. If numbers of teaching posts continue to dwindle, the quality of medical education, as well as the viability of medical schools themselves, will be endangered. This will have a consequent adverse effect on the future medical workforce and an impact on patient care."

1. The future sustainability of the higher education sector: purpose, funding and structures
2. BMA release, 14 November 2006:
http://www.bma.org.uk/pressrel.nsf/wlu/SGOY-6VHE66?OpenDocument&vw=wfmms
3. The cap on current fees is in only in place until 2009. The House of Parliament will then be able to vote on whether or not the cap
is removed.