For too long training to be a doctor has been the preserve of those from more affluent backgrounds with a more privileged schooling, more likely to achieve the A level grades required, write a good personal statement, have access to relevant work experience or internships, to perform well at interview and to receive financial support from their families. This has meant that doctors are not representative of society and are often ill equipped to appreciate cultural differences.
Good A level grades, personal statements written with intensive support and a slick interview technique do not necessarily predict who will become a good doctor and serve their patients well.
Fear of the debt incurred while training to be a doctor is a huge disincentive to application and once qualified may send some doctors into the arms of the private sector, robbing the NHS of valuable workforce.
Many young people who would make excellent doctors are excluded from medical education due to discrimination.
The Race Inequalities Commission in Tower Hamlets has shown that even in areas, such as Inner London, where comprehensive education is good and less privileged students achieve high grades at A level, they are far less likely to be able to progress to higher education and beyond.
Racism is a well evidenced source of discrimination against entry to medical school. https://www.bmj.com/content/317/7166/1111
Covid has shown how understaffed the NHS is with respect not just to doctors but to nurses and all health professionals. Workforce planning is too interlinked with the short-term electoral cycle and does not meet the needs of the NHS and the patients it serves.
Governments try to cut costs by creating lesser paid workforces such as Physicians Associates, or diverting patients to existing health professionals who are not trained to deal with their problems, such as pharmacists and paramedics. Alternatively, they propose medical apprenticeship schemes for which the funding is unclear and which could lead to a hierarchy of medical degrees with these “second class” doctors sent to under-doctored areas and unable to get onto the more prestigious post graduate rotations, perpetuating inequality.
UK Government cuts the costs of training by poaching health professionals trained in other countries. We are in support of opportunities to work abroad and the sharing of ideas and cultures enriches us but this exodus poses a particular problem for the third world who lose very valuable personnel.
Training of health professionals is too segregated into unhelpful silos. Many tasks are carried out across professional boundaries.
Medical schools are vastly oversubscribed, there is plenty of opportunity to train more doctors.
Doctors in Unite demand:
Free medical education with the abolition of tuition fees and proper cost of living grants to allow young people from all backgrounds to access places at medical school.
Racism in the selection process is particularly pernicious and must be robustly challenged.
Pre-clinical courses should be set up which act as a gateway to young people from less privileged backgrounds into medical school.
Medical Apprenticeships could be an entry point to traditional medical education for young people from less privileged backgrounds in a similar way to pre-clinical courses, but must not be allowed to perpetuate inequality and lead to a tier of “second class doctors.”
There must be proper, long term workforce planning removed from the short termism of the electoral cycle. An independent commission should be set up which looks at need across the country and sufficient numbers of health care professionals must be trained.
Health professionals from abroad are welcome but there must be recompense to their countries of origin.
Barriers between professions should be flexible giving Physicians Associates, nurses, paramedics and pharmacists an entry into medical education to train to be doctors should they so wish.
We support graduate level entry into medical school, especially as this may allow young people who did not acquire the necessary A level grades to access straight from school. We acknowledge that funding would be an issue for many young people under the current system and would support the introduction of bursaries for this level of entry.
There should be core joint education with multidisciplinary training where appropriate to share skills, break down barriers and encourage teamwork.
Decisions on access to medical school must involve some democratic, community input to ensure that doctors represent the communities that they will serve.