There has been a lot of confusion and uncertainty for students this year, especially for those receiving their A-level results and preparing to start university. Applicants may now be wondering how recent events will impact their 2020/2021 medical school admissions.
The algorithm used to estimate students’ grades resulted in medical schools rejecting several applicants. The government has since reversed the decision to use an algorithm, opting for teacher assessed grades instead.
For non-medical subjects, original offers have been honoured, places permitting. However, this is not the case for medical schools where there is a cap on the number of students (currently around 7,400). The Medical Schools Council estimates that between 1,600 to 2,000 additional students may be eligible for medical school offers due to the government's U-turn on exam results.
Applicants are now unsure what will happen to their revised grades, with many emailing or phoning admission offices all over the country.
The simple answer is money. Each medical student costs the government £350,000. For a medical school with 400 places to accept 80 extra students, increasing its capacity by 20%, it would need a £28,000,000 funding, which the government has to approve. The Health Secretary Matt Hancock has said that he is looking at lifting the cap on medical school places.
Medical schools are like cinemas. Each cinema has a set number of seats. If the cinema sells too many tickets, then the cinema will have to spend money to install more seats. If the cinema, however, fails to fill all the seats, then it will lose money, since there are fixed costs (popcorn machine, staff, etc.) regardless of how many people turn up to watch the film. That’s why medical schools are keen to fill out all their spaces. They must have just the right number of students to function.
After the initial grades were released and students did not initially make their offers, medical schools sought to fill the available spaces to avoid making a loss. However, after the backtracking of predicted grades, more students meet medical schools requirements and can reclaim their offers.
Medical schools are now in a tight spot. Their initial offers were made based on students’ final grades which have now been revised, but they cannot accept more students unless there is extra funding. It resulted in applicants left without a definite medical school space whilst others expect medical schools to honour their original offers.
Some non-medical schools have already made offers to students to defer their admission to 2021. It would not come as a surprise if medical schools chose to divert some students to 2021 by offering bursaries, electives, or guarantees of some sort.
Alternatively, they might want to accommodate as many extra students as possible by making use of digital learning solutions and rotating students through attachments and lectures.
There are limited trained mentors and medical educators. Adding extra students does not mean medical schools can add equal numbers of trained staff straight away. Room capacity is also an issue. There are only so many anatomy dissection spaces, lecture halls, laboratories, and space in ward rounds for clinical students.
Groups would have to be larger, and students might have to rotate through non-clinical or lecture-based learning. It would change how students are taught—medical schools have already conducted some exams remotely, and they would need to move more rapidly into digital learning. By accepting a large number of students without preparation, teaching quality could potentially suffer, so this has to be carefully managed.
It will depend on what the Health Secretary Matt Hancock plans to do. Will he provide enough funding to cover the costs as a one-off increase in spaces for 2020? Will he continue to invest in medical school spaces in 2021?
Also, if medical schools defer a lot of students to 2021, there could be even fewer spaces next year. It will mean that competition for 2021 admissions will be fiercer than now if there is no extra funding.
Increasing medical school spaces in 2020 means that the students will join the workforce in 2030 in meaningful numbers—and the NHS needs to be able to receive them after graduation in suitable Foundation Year training posts, which are limited, as well as within various specialities. It is simply far too early to tell what will happen in the future.