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A new and more accessible route into medicine can only be a good thing

A new and more accessible route into medicine can only be a good thing

Apprentice-doctor roles could help tackle staff shortages and broaden access to NHS jobs at the same time, says Nichola Hay MBE

To help solve NHS staffing issues in England, the Government could soon roll out a medical apprenticeship scheme that would give school-leavers the opportunity to take a vocational route into medicine.

The scheme is part of a package of measures that could be introduced under the much-anticipated NHS workforce plan. And if approved, it could be launched as early as September.

With the BMA reporting more than 8,500 unfilled medical vacancies across England towards the end of last year, it was imperative the workforce plan sought to address that through introducing new entry routes and widening the opportunities for people to choose a career in medicine. Ensuring it is an attractive and, for many, achievable profession is key for the future of the NHS.

In fact, with over 124,000 vacancies across the NHS in England last year – double the amount that existed in March 2021 – it is clear that bold new ideas are needed to widen access into the NHS.

It was therefore concerning to read and hear so many responses from those within the medical profession and the media earlier this week, seemingly concerned about the calibre of doctors that an apprenticeship scheme could deliver.

Apprenticeships have been successfully adopted by a huge number of professional occupations in the past decade. Indeed, it remains a key pillar of the Government’s wider skills strategy.

Apprenticeships bring with them major benefits for both the employer and the trainee: the trainee receives a wage while learning and gains on-the-job experience that a classroom cannot provide; meanwhile, the employer has an extra member of staff with the Apprenticeship Levy funding the apprenticeship training.

The idea, however, that an apprenticeship scheme cannot work within the medical profession is both ill-judged and damaging. Especially considering similar schemes have played a vital pathway to train many of the NHS’s nurses and support the critical workforce shortages in nursing.

What apprenticeships can bring to medicine

Firstly, it’s important to highlight that any doctor trained via a degree apprenticeship will be required to meet the same entry requirements and pass the same GMC-regulated exams as a university student doctor. These standards will in no way drop following the launch of an apprenticeship scheme in medicine.

What apprenticeships can do, however, is widen the opportunity for people to study to become a medical professional. With no university debt and the ability to earn a wage while studying, a significantly higher proportion of people will be able to choose this career path.

We have already seen this across other professions. The legal sector, for instance, once known for being a gated community for people from a particular background, introduced solicitor apprenticeships in 2016. Seven years on and the diversity across the legal sector continues to improve year-on-year as more people from non-traditional backgrounds opt for a career in law.

Secondly, the NHS has been benefitting from apprenticeships for years, following the launch of the nursing apprenticeship scheme in 2017. A recent study BPP conducted with Health Education England found that 80% of trusts now have more than 100 apprenticeships in their organisation. Meanwhile, 85% of trusts across England find apprenticeships to be a solution to the skills gap.

If similar figures were reported in four years’ time for medical doctor degree apprenticeships, this proposed scheme would no doubt be looked back on as an enormous success. 

Breaking the apprenticeships stigma

One of the biggest challenges for newly launched apprenticeship schemes in highly skilled sectors, such as medicine, is the initial level of appetite from people wanting to choose an apprenticeship route over university. The stigma that a degree apprenticeship cannot provide the same level of education or produce the same quality worker continues to hold back the rollout of apprenticeship schemes. Indeed, we witnessed similar mindsets following the launch of legal apprenticeships. But these arguments are entirely unfounded.

However, some of the responses to the workforce plan this week from those within the medical profession and the media, questioning whether apprenticeships will meet the standards of a university degree, only fuel that stigma. And, at worst, it will hinder those from non-traditional backgrounds from considering a career in medicine.

The future of the NHS is being called into question on a daily basis, driven – in most part – by an acute lack of staff. A new and more accessible route to enter medicine can only be a good thing and we should all rally behind it to make it a success.

Nichola Hay MBE is director of apprenticeship strategy and policy at BPP


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Please note, only GPs are permitted to add comments to articles

John Graham Munro 13 May, 2023 12:09 am

One is not dealing with a life in other apprenticeships.

Dr N 13 May, 2023 5:38 am

I will admit half the stuff I learnt in pre-clinical Med school years was pointless so the course could be 4 years. But to suggest that you can learn this job from day one ‘on the go’ is offensive.

Rachel Bennett 13 May, 2023 9:53 am

The amount of GP time needed to teach, support and assess an individual apprentice would be prohibitive. Medical school courses provide high quality teaching with economy of scale plus the essential peer support social life. It would be a tough and lonely experience for an apprentice.

Anonymous 13 May, 2023 9:20 pm

This country is a laughing stock on so many levels amongst the countries in the European community. This one will certainly top the list. We have enough noctors and PAs. We need more doctors not some apprentice after a levels.

Bob Hodges 14 May, 2023 2:08 pm

The title ‘can ONLY be a good thing’ tells you all you need to know about the originators of this idea, which is is without doubt the silliest one that I have witnessed in the 23 years I’ve been a doctor. ONLY be a good thing? Are you honestly not able to produce a single possible unintended consequence for the risk register?

The way to make medicine more accessible as a career is to make MEDICAL SCHOOL more accessible and less of a financial burden, then to improve the terms and conditions of junior doctors so that they stay in the UK workforce.

Having witnessed the stringent process required to set up a new medical school locally, I am perplexed that anyone could imagine that that quality assurance could be applied to ‘apprenticeships’.

We have a profound dearth of clinician time that can be devoted to training/teaching as things stands. Introducing a new assessment and teaching programme will simply erode teaching time available.

Rogue 1 15 May, 2023 8:36 am

If a 3yrs law degree takes 7years as an apprenticeship
Then a 5yrs medical degree (165 wks) equates to 13yrs !
I cant see anybody who would take on that amount of work with no exit plan if they decide after 6yrs its not for them.
Or is it another way of hand-cuffing people to the workplace?

Tim Atkinson 15 May, 2023 6:19 pm

The dumbing down of the professions continues.

Michael Mullineux 16 May, 2023 12:38 pm

Might be best to stick to appropriate apprenticeship training and your Day Job Ms Hay. The constant under-estimation and de-valuing of the specialist training required to be a GP with the all encompassing medical knowledge required to distinguish the serious from the mundane at a rate of 30+ million consultations a month is something Ms Hay and others in HMG/NHSE just do not get whilst the erosion of the profession gains increasing traction.

Andrew Jackson 16 May, 2023 2:34 pm

The course will be 5 years (cant be shorter than the current entry course) and they will be paid £5.25 per hour as an apprentice

Keith M Laycock 16 May, 2023 4:50 pm

Just more nonsense – another indicator that the less one knows about a subject the more dogmatic can be their opinion.

David Church 19 May, 2023 12:19 pm

Can ‘Only be a good thing’ ?
No, it can be a silliest thing ever, if you have failed to notice first that actually, Medicine ALREADY IS a type of Apprenticeship system, from the first days of PRHO or F1 job, until the end of specialty training – which is already a minimum of 5 years to become a new junior GP, and 5 years to become an ‘SAS-doctor’. in hospital. These years of advanced study are paid at fairly low, ‘apprenticeship-like’ salary rates!
Before then, most medical schools work on a basis of 2-3 years mainly university-based in learning higher basic sciences and relevant specialist biology; followed by 2-3 years which ALREADY ARE a kind of apprenticeship system, wherein students learn by working in hospitals and assisting in clinics and operative procedures, alongside a huge amount of further academic learning; albeit the pay rate for these 3 years is usually zero-pounds per hour – but the employers get a huge amount of free labour in return fo the teaching input.
So, seeing as years 3-6 students already work for the NHS (but get no pay), the only difference in Mrs Hay’s plan would be to pay them for the work they do.
But in years 1-3, students do very little work beside their academic learning, ,ainly because the learning is so much more intensive than other courses, that the only opportunity for paid work realistically is during university vacation time – and most, if not all, medical students already do some form of paid work during those periods to support the lack of ability to earn during term-time.
When a year 1-2 medical student, I had about 28hours of timetabled ‘compulsory’ activities during the week, plus about 2 hours a week of ‘evening activities’ being medical meetings and learning opportunities. That does not include the time we were expected to put in reading and in library or home study and writing up assignments. In addition, students could volunteer to learn first aid and similar activities to help their learning, and were also expected to participate in university life.
In comparison, some other students I lived with had only 3 hours a week of timetabled activity, at most of which attendance was not noted, so one flat-mate actually got up about 5 pm each day, dis his studies for a couple hours, and then worked overnight in ‘gainful employment’.
i am all for students being paid for the work they do in clinical years, but there is not much extra that can be fitted into the earlier academic years, and these should perhaps not be extended – as it would make the profession LESS accessible, if people had to wait longer to get a reasonable salary to pay off university debts.

Peter McEvedy 19 May, 2023 2:07 pm

I see Nichola Hay is chief operating officer at Estio Training – a company providing apprenticeships – but not a doctor but somebody involved in Education – couldn’t find exactly what role. When going through Medical School, I often wondered the relevance of what I was being taught but many things have been found to be crucial in my resulting career. To imagine this can all be learned on the job is, in my view, fanciful. As stated in other comments, becoming a doctor involves what is essentially an apprenticeship but only once one had garnered the knowledge to understand how to use the experiences gained. We need more medical students and I think this idea shows a lack of understanding of what doctors in all disciplines deal with.

John Evans 22 May, 2023 11:42 am

Agree with the ludicrous comment “only be a good thing”.

Educationalist – not medically qualified – won’t have to live with the failures, fall out, caul ties with the profession or the patient population.

John Evans 22 May, 2023 11:43 am

Auto spelling error sorry … Casualties