This is an alternative route to becoming a medical doctor, being recognised by the GMC and joining the NHS foundation year programmes in the UK. The development of this degree has been supported by Health EducationEngland and was approved for delivery by the institute of Apprenticeships and Technical Education in July of this year. The pathway into and journey through medical school has always involved a unique and prestigious selection process with a four(graduate-entry), five or six-year course. The existing Medicine course maintains high standards through the integration of pre-clinical sciences to clinical practice together with developing clinical knowledge and skills crucial for the role of a foundation doctor. This new, drastically different training programme would consist of studying alongside work, so apprentices can apply their learning to practice immediately. This aims to benefit patients through additional expertise on the ward and benefit the apprentice through early exposure to the environment they will inevitably be working in. This training post will be available to those who meet the required entry criteria as agreed by the employer and medical school but has the advantage of opening up the opportunity to those financially and geographically restricted. This may also include current healthcare workers wishing to progress in their roles.Local employers (university hospitals) and medical schools will be able to advertise these apprenticeships to build up their workforce, particularly in under-staffed areas.
The degree apprenticeship will span 60 months, similar to all other standard five-year medicine courses. However, this does not include the ‘en-point assessment' period undertaken in any standard apprenticeship. The employer (university hospital) will pay the apprentices for their labour, equivalent to the starting salary of allUK doctors- ranging from £29,034 to £34,012. Tuition fees (£9,250) to the medical school will still be required, however, these will be subsidised by the healthcare organisation employing the apprentice. It is stated that a maximum funding of £27,000 can be contributed to this tuition fee cost. This programme is much more accessible and will pick up those with the potential to become excellent doctors who have struggled with financial stability or who have had to fulfil a caregiving role. It also aims to produce a workforce that better reflects the societal and economic diversity present in the UK - having definitive benefits for the patients they serve as we continue to promote ‘patient-led’ healthcare.
Currently, the organisations participating in the initiation of this scheme scheduled to commence in September 2023 are: Barts Health NHS Trust, Bedfordshire Hospitals NHS FoundationTrust, Black Country and West Birmingham Sustainability and TransformationPartnership, Bromley By Bow GP partnership, Croydon University Hospital EastLancashire NHS Trust, East London NHS Foundation Trust, Epsom & St HelierUniversity Hospitals NHS Trust, HCA Healthcare UK, Imperial College Healthcare NHS Trust, Milton Keynes University Hospital NHS Foundation Trust, NHS Blackpool Clinical Commissioning Group, Norfolk and Norwich University Hospitals NHS Foundation Trust, North Cumbria Integrated Care NHS Foundation Trust, Northumbria Healthcare NHS Trust, Oxleas NHS Foundation Trust, Royal Marsden NHS Foundation Trust, Sandwell and West Birmingham Hospitals NHS Trust, TheDudley Group NHS Foundation Trust, University Hospitals Birmingham NHS Foundation Trust, University Hospitals Bristol and Weston NHS Foundation Trust, University Hospitals of North Midlands NHS Trust, Walsall Healthcare NHS Trust.As you can see, this is an extensive list of employers willing to participate in this new and exciting method of training. It would also include any additional medical schools associated with the facility providing the tuition.
Key medical organisations, such as the BMA, are not completely on board with medical doctor degree apprenticeships. In July, following the approval of this scheme, the BMA released a statement expressing their concerns with the ability of local employers to provide a high enough standard of medical education, similar to that seen in medical schools, for individual apprentices. The medical schools enrolling on this apprenticeship will be approved to do so by the General Medical Council, but whether they really adopt the high-level teaching standards already strictly regulated across the UK in undergraduate programmes is another question. Health EducationEngland already recognises that this plan will not automatically meet the expectations of increasing widening participation needs but understands the importance it will have in improving the selection of trainees. Would we be better off further reducing the barriers in standard programmes already seen with widening participation efforts rather than completely changing the way we train doctors?
In addition to this, the logistical implications of additional student doctors on the wards remain. In addition to expanding training doctors, this expansion needs to be seen down the line (academic medical staff, clinical placements etc.) and later on with the security of higher numbers of foundation doctors on the wards. Otherwise, a ‘bottleneck’ will be created where there is an excess of graduating doctors to foundation places atNHS UK sites. Additionally, if these new places are included within the remits of current thresholds for starting student doctors, then we will not see a dentin the 46,300 deficit of doctors currently present in the UK.
Author: William Coni
Editor: Allegra Wisking
