Next year (likely September 2024), applications will open for a pilot ‘Medical Doctor Degree Apprenticeship’. This alternative to the traditional route of a university degree in medicine is designed to give ‘NHS organisations the opportunity to grow their future medical workforce and attract and recruit from a wider pool of people in the local community’.
Those who cannot or would prefer not to study full-time will have the option to work under supervision in a medical setting while studying medicine. The scheme is designed to attract more people into the medical profession, as the NHS faces a workforce crisis.
There’s an obvious logic behind the initiative, and it could be an exciting development, but as with any innovation, its benefits and its drawbacks need identifying and weighing.
The potential for more doctors
Medical students tend to graduate with heavy debt, sometimes over £100,000, and it’s not hard to see how that would discourage many from a full-time medical degree. For some people, it’s also not practical to spend five years without a wage, so full-time study is out of reach for them. The Medical Doctor Degree Apprenticeship offers an ‘earn while you learn’ path into medicine that could make a career as a doctor far more widely accessible.
That also means greater opportunities for those who already work in healthcare to pursue a career as a doctor. Not only could that mean more doctors, but more doctors who already have experience in medical settings before their training. That could mean doctors with different and broader perspectives, and perhaps even greater empathy for the experiences of their non-doctor colleagues.
New doctors with low or no debt
The question of doctors’ salaries is one of many controversial medical and political topics. The junior doctor strikes that have happened and are due to happen were called because unions feel their members are underpaid. Regardless of whether you think that’s fair or accurate, a workforce that feels that way is not ideal for any employer.
The pay question is as complex as it is controversial, so there isn’t a single solution. However, the staggering debt owed by many junior doctors must exacerbate the problem. Whether it’s the monthly repayments or the consciousness of owing a large sum, it will add to the sense that their finances are under strain.
Junior doctors who earn through their studies may owe very little or nothing, which could be far better for their mental and financial well-being.
Placing great demand on senior doctors and the health service
Like most apprentices, medical apprentices will require heavy supervision as they learn on the job. That will place additional demand on doctors’ time, with the associated risks and disadvantages. If healthcare professionals are overstretched as it is, adding apprentices to their responsibilities does run the risk of spreading resources even more thinly.
Alongside the time with the apprentices, doctors and hospitals would likely encounter a lot of red tape around their apprenticeship schemes. Vanessa Wilson of the University Alliance suggested, “Degree apprenticeships are currently mired in excessive bureaucracy and tied up in complex regulation. Government and NHS England will have to work very closely with universities to address these issues if degree apprenticeships are going to be the solution to the workforce crisis.”
Once the scheme starts, there will be five years before the first apprentices become junior doctors. Given the crisis of resourcing in the NHS, and the risk that the scheme places extra demands on current staff, is there a risk that apprenticeships will make things much worse before they get better?
Would raising the cap on medical school places be more effective?
Dr Latifa Patel, who is workforce lead at the British Medical Association (BMA), isn’t optimistic that apprenticeships will solve the NHS’s workforce challenges.
“Innovative approaches to education and training are welcome - but there are huge question marks over how far medical apprenticeships can solve this crisis. The medical-training pipeline is already stretched to its limits, with lecture halls at capacity, limited numbers of clinical placements and falling numbers of medical academic staff. Where are the extra resources going to come from? Ultimately, the solution the NHS needs is still the same — a dramatic increase in traditional medical-school places.”
There are around 9,500 new places in medical schools every year in the UK, capped at that number “to ensure teaching, learning and assessment standards are maintained as well as ensuring there are enough high-quality placements for each student.”
There’s a long debate to be had as to whether increasing the cap would compromise teaching quality, or whether the ‘artificial’ limitation on the number of new doctors does more harm than good. Without trying both, it may be impossible to know for sure whether the apprenticeship scheme or admitting more medical students would have a greater impact.
We don’t yet know what the immediate cost of medical apprenticeships would be, or whether it would save or justify the money in the long term. When it comes to raising the university cap, though, the Medical Schools Council estimates that adding an extra 5,000 university places for medical students would cost £1 billion every year. That’s an off-putting sum for many politically and economically, and one which makes the question of raising the cap even more complex.
The backbone of any staffing initiative
Any scheme to boost doctor numbers must be supported by a recruitment and retention strategy that matches healthcare professionals to the settings they complement, and that fit them. That means better health outcomes for patients, happier doctors, and a more stable workforce.
MCG Healthcare specialises in matching healthcare professionals with the roles in which they will thrive. To find doctors, nurses, or other staff who are the perfect match, or if you’re a healthcare professional looking for your next role, call 0330 024 1345 or email hello@mcghealthcare.co.uk.
