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If doctors can train part time, why not medical students?

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g4897 (Published 11 August 2014) Cite this as: BMJ 2014;349:g4897
  1. Peter W Raven, faculty tutor, UCL Medical School, UCL Faculty of Medical Sciences, London WC1E 6BT, UK
  1. p.raven{at}ucl.ac.uk

Part time degrees may better suit some of today’s medical undergraduates for several reasons, writes Peter W Raven, including finances and caring responsibilities

It is increasingly the case that changes in postgraduate medical training are drivers for change in the undergraduate curriculum.1 The shift in postgraduate medical training that followed the UK General Medical Council’s endorsement of less than full time (LTFT) training in October 2012 has yet to generate a response from medical schools.2 We have positively embraced the concept of part time training of junior doctors and yet the only way to study medicine is on a full time course. So should we be offering part time undergraduate courses in medicine?

Undergraduate medicine is a highly regulated programme of study but the GMC does not take a formal position on part time bachelor of medicine, bachelor of surgery (MBBS) degrees. It certainly has no rules against them: as long as students complete their 5500 hours of theoretical and practical training, an MBBS programme can be as short as a four year graduate entry programme or as long as the eight to 10 year MBPhD.

Universities are increasingly well equipped to deliver teaching in formats that allow students to gain qualifications while working or raising a family. Degrees are available in a range of learning modes: for students attending part time, by distance learning, or by following the Open University model of blended learning. Historically, most of the courses available for part time study have been postgraduate programmes. However, data from the Higher Education Statistics Agency show that more than half a million UK students are now enrolled as part time undergraduates, compared with 1.3 million full time students.3 It is not just the “new” universities that offer part time study. Members of the Russell group are beginning to recognise the possibilities that part time study can offer. It would require careful thought to support part time study, but there is no reason to stop medical schools from offering part time medical education.

In accepting the idea of LTFT training the GMC acknowledges that there are “changing demographics in the medical profession and demands for greater flexibility and choice in work-life balance . . .”2 In the past 30 years it is not just the demographics of the medical profession that have changed; the medical student demographic has changed hugely too. The average age of medical students has risen along with the numbers of graduates undertaking medical training. This shift presents several issues: it is no longer unusual for a student to have parental responsibilities; and changes in student finance mean that it has become a much bigger challenge to undertake an MBBS as a second degree.

Medicine is in an interesting position. With the new £9000 (€11 000; $15 000) fee, medical students are facing an accumulated debt of £50 000 to £100 000 by the time they graduate. For some students this is unthinkable and so they choose not to apply for medicine. Some medical students start with the expectation that they will be able to undertake part time employment during term time as well as during the vacations, which can affect their studies. Others, especially graduate students, start thinking that they have sufficient funding to complete their studies but find, at some point, that they have run out of money and need to work.

The other main group of students seeking a part time option are those with caring responsibilities, in particular parents and usually women who find it difficult to juggle child care with full time study. Finally, there are the students who develop serious health problems during their course and who would benefit from a gradual return to full time study, perhaps needing to balance the demands of ongoing treatment with their studies.

The option to transfer to part time study for a year or two would be a popular alternative for all of these groups of students. It would certainly be preferable to the option of a so called “interruption of studies” to take a year out to earn enough money to continue. During an interruption of studies a student easily becomes isolated from the medical school, academically and socially: they are not registered as a student and therefore not eligible to use library and other college facilities, sometimes even email. Part time students could work and use all college facilities. Due to the time factor, it seems unlikely that many students would wish to take the whole degree on a part time basis, but the flexibility to go part time for a year or two could be beneficial.

At present there is no mechanism to allow any of these students to transfer onto a part time training programme until after they graduate, when suddenly the less than full time training can start. If we are committed to properly widening participation we must surely tackle this anomaly and seriously consider establishing the ground rules for part time MBBS study. There are no regulatory restrictions to prevent this. The old culture of part time study being anathema to the Russell group of universities is long past. All it needs is for one courageous medical school to take the plunge.

Notes

Cite this as: BMJ 2014;349:g4897

Footnotes

  • This article was jointly written with Professor Joy P Hinson, Dean for Postgraduate and Postdoctoral Studies, Barts and The London School of Medicine and Dentistry, Queen Mary University of London.

  • Competing interests: I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: I am employed by a medical school, which may or may not decide to offer part time undergraduate medical degrees. I have no direct financial interest in the outcome of such a decision. The views expressed are mine and do not necessarily reflect the view of my institution.

  • Provenance and peer review: Not commissioned; externally peer reviewed.

References

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