Medical school places: balancing quality, clinical need, and supporting studentsBMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3738 (Published 28 September 2020) Cite this as: BMJ 2020;370:m3738
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While I recognise the importance of high-quality education at medical school (1), I propose that training more medical students with the same resources may still result in a better health service, with better patient outcomes.
With GP vacancies projected to increase to 70,000 by 2024 (2) and 2 in 5 consultants reporting daily or weekly rota gaps (3), the NHS remains hugely understaffed.
Increased workloads and job stress resulting from understaffing may lead to worse patient-perceived care (4), which could be rectified by greater numbers of qualified doctors.
Despite the potential worsening of medical school education being both unclear and difficult to measure, the sheer magnitude of the shortage of doctors means that an increased number of doctors may result in better patient outcomes, even if these doctors receive a poorer education in medical school due to funding constraints.
It is also important to consider that a doctor's education extends far beyond medical school. Large workloads may reduce educational opportunities for trainees after graduation, due to an increased focus on meeting service provision needs. If an increased number of doctors leads to smaller workloads, it may also lead to better post-medical school training and education of doctors, thereby also providing better quality doctors in the long run.
(1) Davies J, Medical school places: balancing quality, clinical need, and supporting students BMJ 2020;370:m3738 doi: https://doi.org/10.1136/bmj.m3738
(2) The Kings’ Fund, Closing the gap: key areas for action on the health and care workforce 2019. https://www.kingsfund.org.uk/publications/closing-gap-health-care-workforce
(3) Royal College of Physicians, Focus on physicians: 2018–19 census (UK consultants and higher specialty trainees) 2019. https://www.rcplondon.ac.uk/projects/outputs/focus-physicians-2018-19-ce...
(4) van den Hombergh, P, Künzi B, Elwyn G et al. High workload and job stress are associated with lower practice performance in general practice: an observational study in 239 general practices in the Netherlands. BMC Health Serv Res 2009;9:118. doi: https://doi.org/10.1186/1472-6963-9-118
Competing interests: No competing interests