Abstract
Ten years ago in the JRSM, Calvert et al. described the academic performance of graduate-entry medical students exceeding the performance of mainstream students in their cohort.1 We write as graduate-entry students who are concerned that access to medicine is narrowing for students such as ourselves. In recent years, four-year graduate-entry courses have closed or narrowed requirements to exclude individuals with non-scientific backgrounds. King’s College London accepted their last arts graduates in 2015. St George’s halved places on its programme in 2014. Leicester, Bristol and Imperial closed their four-year courses altogether.
This is occurring in anticipation of future constraints on recruitment. The 2013 UK Shape of Training Review advised: ‘Full registration should happen at point of graduation from medical school.’ This threatens the eligibility of graduate-entry courses, where the first Foundation Programme year counts as the fifth year of medical study; current European Parliament guidance states qualifying medical degrees require five years of study. Universities have responded to this uncertainty by narrowing their intakes.
This is disappointing given the clear case for graduate-entry programmes. Graduates facilitate peer-to-peer learning – many have worked as healthcare assistants, nurses or pharmacists, and can provide clinical skills teaching to students without such a background. Arts graduates can teach on relevant areas such as critical appraisal, history and philosophy: knowledge that is vital for a well-rounded doctor. Graduate-entry courses increase the diversity of a historically middle-class profession2 and graduates are more likely to pick careers in General Practice, which fits with current UK health policy priorities.3 Theoretically, five-year undergraduate courses are open to graduates, but are financially punitive because they do not allow those with prior degrees to receive a student loan.
New avenues should be explored to ensure that able and talented graduates from diverse backgrounds are not blocked out of the profession for financial or technical reasons.