The cost-of-living crisis is at the forefront of all of our minds; people are struggling to stay afloat in these difficult times and sadly many are drowning as the prices rise. Times are hard across the board, but some groups are being disproportionately affected. Among those feeling the squeeze are our junior colleagues, the doctors of the future: our medical students.
A group of medical students, supported by the Doctors Association UK, is taking action and has begun a campaign addressing the medical student funding crisis. #LiveableNHSBursary has three core aims targeted at taking away the financial stress many medical students round the country are feeling. They are demanding immediate access to full maintenance loans for medical students in line with other healthcare professional courses for the entire duration of their medical degree programme. They are asking for access to the NHS Learning Support Fund which is used by other healthcare trainees, to replace the standard medical student bursary. This would enable all medical students to access a non-means tested grant of £5,000. Finally, they are pushing for a review of travel and dual accommodation expenses, so that reimbursements are reflective of the ongoing cost of living crisis.
I spoke to one of the cofounders of the campaign, Dr Erin Lawson-Smith, who recently graduated from the University of Birmingham and who just happens to have been a medical student I tutored in the third year of her degree, when I was still working in general practice. She explained that she had been in contact with medical students across the country who were struggling financially.
In particular, undergraduates were finding it hard in their fifth year when their funding provision switched solely from loans provided by Student Finance England (SFE) to a combination of money received from the NHS bursary scheme and an additional loan from SFE which together only provide approximately 50% of the income they have been receiving in the first four years of study. There seems no good reason for this discrepancy.
She described the additional stress this was putting on them whilst they were already undertaking stressful, demanding full-time studies. She had spoken to students who were working two or three jobs alongside their training to pay their bills and even described circumstances in which students were using foodbanks as money was so tight. Others have taken to crowdfunding websites and found other innovative ways, just to gather the money to pay their way through medical school. She told me about the impact of these added pressures and how they were leading to a shift in how medical students felt as they transitioned to be doctors.
She explained we were at risk of producing junior doctors already burnt out by the financial pressures of being a medical student. A worrying place to be considering the epidemic of burnout among NHS staff in our post-pandemic world. She told me medical students were overall feeling less affinity with the NHS and feeling unsupported by the UK government. These things made it much more likely that doctors would choose to leave the country for Australia or New Zealand after qualification, with hope of better work circumstances overseas.
Of course financial hardship is not something all medical students experience. Some are lucky enough to be supported through university by their families supplementing their loans. In the course of our discussion, I asked Dr Lawson-Smith why it was that funding for medical students was not aligned with funding for other clinical degrees such as nursing or midwifery. She told me that in their research they had not found evidence of any robust reasoning behind this, but it was simply a historical hangover that people training to be doctors had come from wealthier families who could support their children through university. This now outdated legacy, with no firm foundations, is causing harm more than ever as successful widening participation schemes are becoming more commonplace.
It’s rather cruel that students who have hard-earned their university places to study medicine are faced with a reality that is not financially viable. It is crucial that our medical profession is reflective of wider society for it to remain relevant and responsive to the needs of all of our communities. If the cost-of-living crisis for medical students is not addressed, we are at risk of taking a step backwards, producing a less diverse workforce. We need the system to support the great work universities are doing, encouraging students from many and varied communities to train to be doctors.
This is a call to arms to support our medical students. Fifth year medical students should simply be preparing to be doctors. This is a full-time pursuit in itself. We as patients and our families deserve to have doctors who are starting out in their careers from a place of wellbeing not burnout. Medical students deserve the support to allow them to flourish in their studies, with the only pressure being the one to forge the skills to be an excellent clinician. Being a doctor is an emotionally taxing profession, supporting the wellbeing of our most junior colleagues is paramount so that they have a chance of thriving and surviving in their jobs.
The #LiveableNHSBursary team are working hard to drive change by campaigning and recently spoke to MPs at a parliamentary briefing to gain political support. What could you do to raise the profile of this important cause? Start by following them @LiveableNHSBurs on Twitter to find out more about how you can help and to read more about the campaign head over to the Doctors Association UK website.
Dr Lisa Finnikin recently stopped working as a salaried GP in the West Midlands
