If we want to invest in our future NHS workforce, then studying medicine should be affordable

The BMA recently published survey data that found 43% of UK medical students out of 3500 surveyed have considered taking a break or leaving their course entirely because of financial difficulties.1 As a graduate entry medical student who has taken time out of my course due to financial pressures, I think it is clearer than ever that increased financial investment is necessary to support the future of our NHS workforce.

With the rising cost of living, both student finance and the NHS bursary are proving to be insufficient to meet students’ everyday expenses, but the latter is particularly meagre. In the second year of medical school, graduate entry students transition from being funded by Student Finance England to an NHS bursary. For students on standard entry medical courses, this switch happens in their fifth year of study. This change was introduced so that the NHS could directly fund healthcare students, a scheme brought about to incentivise studying medicine, but while it leaves students with less debt longer term, it tightens their budget while they’re at university. Students’ maintenance loan reduces from a maximum of £10 277 to £2670 an academic year. The NHS bursary then provides an additional non-means tested bursary of £1020, and a means tested grant offers a maximum award of £2696 for those outside of London, and £3255 for those in London. As most medical schools have a longer academic year than other courses, an additional £86 a week is awarded for every week over 30 weeks. Even with these financial sources combined, it still leaves students with an abrupt shortfall of thousands of pounds of funding. Many medical students have no option but to work to support themselves alongside their studies, and this comes with its own problems.

I started my medical degree in 2020, immediately following a three year undergraduate degree, a year of postgraduate study, and a year working in healthcare. Once I’d completed my first year exams, however, I felt I had no choice but to pause my studies. Being on an accelerated graduate entry course alongside working and juggling burdensome financial responsibilities had left me burnt out. I opted to spend a year working full time in healthcare. On returning to my course, I still had to work to make ends meet, despite receiving a hardship fund from my university. I am far from alone in this; the BMA survey reported that more than 500 respondents out of about 3500 students surveyed had accessed university hardship or emergency funds. These loans are often in place to help with short term financial hardship, but they’re a sticking plaster for a chronic problem.

Many of my peers rely on part time jobs or family support to pay for essentials, including food, rent, and transport to placements. I know students who have opted to take days out of university to work because they need the money. In a sign of the severity of the situation, my university recently began providing food and toiletries to those in most need. The BMA survey also found that more than a hundred respondents (3% of those surveyed) had needed to use food banks while at medical school.

Medicine is an intense course and students should be able to focus on their studies without the additional worries of how to pay for rent, food, and travel that is essential to their course. With adequate financial support, students have more time to be involved in extra-curricular activities, such as attending conferences, peer-to-peer teaching, and research opportunities—activities that would no doubt support them in their future career. It is disheartening to know that there are so many other medical students facing financial challenges, and that without a commitment to support medical students, this is likely to continue for future cohorts.

Students from lower income households, who are already under-represented in medicine, are likely to be the most affected by the lack of financial support available and may be deterred altogether by the costs associated with a medical degree. Graduate entry medical students, for example, are responsible for paying £3465 of their first year of tuition fees—some universities allow this to be paid termly or in installments, but many expect it to be paid upfront. To fund this, I, like many others, opted to take out a bank loan, with other students relying on the support of family or savings. Further costs add up to a financial picture that can discourage students from applying to study medicine in the first place if they do not have the social and financial support necessary under the current system. The BMA survey found that students previously receiving free school meals were more likely to report their finances as extremely detrimental to their educational attainment and academic performance.

As someone who is the first medic in my family, and the first generation to attend university, I feel passionate about ensuring that future aspiring medics do not experience the same barriers to becoming doctors. Medical students should not be faced with having to make decisions about whether to disrupt their course, or abandon their medical career entirely, because they cannot afford to live while at university. Financially supporting medical students, and those wanting to study medicine, needs to be recognised as a vital investment in the future of our healthcare system.