BMA strongly opposes changes to foundation programme applications
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4837 (Published 14 December 2020) Cite this as: BMJ 2020;371:m4837All rapid responses
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Dear Editor
As a graduate-entry medical student and even before starting medical school, I have often engaged in discussion about the fairness of the UK Foundation Programme allocation process especially when it comes to the points awarded for educational achievements (EA). The overwhelming majority of medical students I have met have either been graduates or had done or planned an intercalation. Graduates aside, one must question the intent behind the increasing numbers of medical students seeking additional degrees as reflected upon by the UKFPO statement.
Despite being a graduate (which, under the old system, would have entitled me to EA points automatically), I welcome all decisions, including this one, taken to make access to a medical career fairer from the outset. There are, however, two points I would like to raise regarding the change which, in my opinion, have not been handled appropriately. The first is that, as it stands, additional degrees still count towards specialty training applications and no announcements have been made by Health Education England or any of the Royal Colleges regarding this. One example is the Acute Care Common Stem (ACCS) Anaesthetics CT1 self-assessment criteria which awards up to six points for additional degrees. (1) One could argue that the UKFPO decision will do little to help remove barriers when points for additional degrees are still being awarded at career progression points past the Foundation Programme.
I also believe that when a change of this calibre is implemented, there needs to be a concrete plan detailing how those affected by the change would proceed with their application (albeit the change not coming into effect immediately). One of the questions I immediately asked myself when the announcement was made was “so, (how) are these points going to be replaced?”. There was no mention of this in any of the publications and responses following the announcement which led me to contacting the UKFPO in late March 2021 with that same question. I received a very prompt response which, if I have to be completely honest, was not surprising: “We do not have any further information regarding [Educational Performance Measure] EPM at this time. Guidance for 2023 is still a year away (April 2022) so we can’t provide anything else.” While there are multiple scenarios that the replacement (or lack thereof) of points for EA could develop into, one thing is certain: it leaves entire cohorts of medical students, who will be affected by the change, unable to plan for the next big step in their medical careers – beginning Foundation training. Not only would this be anxiety-inducing for many, if not all, but it also leaves the UKFPO’s options completely open to modify the application scoring as they see fit without prefacing any of their decisions or, indeed, consulting with the key stakeholders, medical students, as was the case with the decision to remove points for EA. We must also remember that, owing to the ongoing COVID-19 pandemic, the introduction of the Medical Licensing Assessment (MLA) was postponed 2025. (2) Even though the General Medical Council (GMC), who are responsible for implementing the MLA, have said that they “have no wish in principle to impose a particular selection system on the Foundation Programme” (3), it is reasonable to expect that changes to the current system might need to be made in order to appropriately take into account the role which the MLA is designed to have – “demonstrate that doctors entering UK practice meet a common threshold, no matter where they obtained their medical degree.” (3)
To summarise, the decision made by the UKFPO to remove points for EA from the Foundation Programme application score presents a new set of challenges which, as it currently stands, we are not prepared to face. The very idea behind the decision might be hindered by the fact that later on in their careers junior doctors would still be disadvantaged if they do not hold additional degrees while current cohorts who will be affected by the change are left in limbo as to what the application process will look like for them. Besides, further changes might be deemed necessary once the MLA has come into effect in the 2024/25 academic year. I, therefore, call upon the UKFPO to consults its key stakeholders (i.e., medical students and schools) before clearly stating their plans in relation to the proposed change. This needs to happen in a timely fashion so that those imminently affected by the change (students graduating in 2023) can ensure the best outcome for their foundation training applications.
References
1. Anaesthetics National Recruitment Office at Health Education England. Self-Assessment Criteria Anaesthetics/ACCS Anaesthetics CT1 2019. Available from:
https://anro.wm.hee.nhs.uk/Portals/3/Documents/National/Self-Assessment%...(2020).pdf?ver=2019-10-21-090856-733 [Accessed 12th April 2021].
2. Phillips C. All medical students will sit the same exam from 2025. BMJ 2020;370:m3504. doi:10.1136/bmj.m3504
3. General Medical Council. Securing the licence to practise: introducing a Medical Licensing Assessment a public consultation (p 21). Published online (date unavailable) and available from: https://www.gmc-uk.org/-/media/documents/MLA_consultation_document_Engli... [Accessed 12th April 2021].
Competing interests: I am a medical student expected to graduate in 2024.
Dear Editor,
We are two intercalating students at the University of Manchester. For us, and we suspect many of our colleagues, an intercalated degree is not just ‘an extra year’. Putting aside the large financial costs associated with every year at university, and sometimes an even larger financial burden associated with a post-graduate degree, not acknowledging our degrees ignores the immense effort that goes into such a year. We’ve found this past academic year particularly intense, not just because of the loneliness that lockdown brings, but also because we’re expected to shift to a completely new way of learning and produce things at 3rd year/master’s level with very little guidance. While medicine prepares us for so many things, the teaching and learning in a medical degree is immensely different to other degrees. You finally get into the swing of things towards the end of semester one and submit your essays, and then you’re hit with new modules and a dissertation on top. It’s hard to fully separate the effects of the pandemic from the effects of trying to do our best for our degrees this year, but we are certain our mental health has suffered as a consequence of choosing to intercalate. Already struggling in the first few weeks of the year, we were hit with the blow that our efforts wouldn’t be recognised by the UKFPO. Although not the main/only reason we originally chose to intercalate it was a driving factor that was keeping us motivated during the difficult online learning. Intercalation isn’t just a frivolous decision, especially for those with fewer financial and personal resources, and we are very disappointed that our hard work is being disregarded in this way, especially in the middle of a pandemic with absolutely no warning.
In Manchester, the pandemic meant that our year 3 teaching was cut short and no formal OSCE took place. Our third-year grades will therefore be extrapolated from our fourth-year results, meaning our Educational Performance Measure (EPM) score will be based entirely on the exams done in the coming year. We believe this disadvantages us greatly, due to the fact that we will have spent 1.5 years away from medicine, that we will be compared to people who had the opportunity to sit their year 3 exams, and that arguably examiners have been more lenient this year due to the pandemic conditions [rumoured, not corroborated], but won’t be in following years. The UKFPO’s arbitrary decision to implement their changes in 2023 hits all those currently intercalating after third year, exactly the cohort who need extra support due to the aforementioned disadvantages. It was our choice to intercalate and step away from medicine momentarily, but we did so believing that the extra degrees would be recognised.
Admittedly, we were actually slightly relieved that publications will no longer count, as we lost our opportunity to do research projects in year three and felt under immense pressure to take on extra work this year and next. However, looking at this from the other side, we can see how this might have a negative impact on students contributing to quality improvement in the future, and gaining essential skills for when they are doctors.
While we recognise some of the reasoning behind the UKFPO's decision, we cannot comprehend the timing of it. Along with this, we know of people (including from Widening Participation backgrounds) who struggled to come up with ways to finance an extra year, but decided to do so anyway as they believed it would contribute to their foundation application ranking. The difficulties faced by these peers is going unnoticed. Ultimately, to say we are disappointed with this decision is putting it mildly. After an awful year, this news provided us with even more upset.
Kind regards,
Sameerah Khan and Marie-Therese Angus
Competing interests: No competing interests
Dear Editor,
Undoubtedly, many of us have seen the recent United Kingdom Foundation Post Office (UKFPO)
decision to scrap educational achievement (EA) points [1]. Essentially graduate entry medics,
intercalators and research enthusiasts will no longer be recognised for their extra-curricular activities when
applying for their first jobs as doctors.
My initial reaction was similar to those I saw online: this decision was abrupt, unfair, and not in the
interest of students, like me, who are interested in intercalating. Reflecting on the UKFPO reasoning,
I can understand the need to reduce extra-pressure on students to succeed in an already
competitive and exhausting environment by removing the incentive of EA points. No one should feel
obliged to complete additional degrees or research to prosper, especially with the substantial time
and financial commitments associated. Perpetuating such ideas will ultimately lead to stress,
anxiety, and burnout early in our careers. Ultimately, students should decide to commit to these projects out of
interest, knowing they are mentally prepared to do so. Whatever your view on the EA change is, I
think the focus of organisations and students has been on postponing the change and being so has
overlooked the bigger principle – why was our opinion inconsequential to their decision?
I find it distressing that the sole organiser of foundation jobs (UKFPO) found the opposing opinions
from the British Medical Association (BMA) and Medical Schools Council (MSC) redundant, to the
point where medical schools were caught off guard by the unexpected announcement. Considering
the first announcement was an informal email circulating around twitter followed by an impromptu
open letter in November 2020 that stated the decision was made in February, it is disturbingly clear
that the UKFPO do not view their decisions accountable to us, their stakeholders. Consequentially,
current intercalators potentially motivated by EA points may have made an alternative decision if
informed earlier. This is alarming to me because it demonstrates how unvaluable our voices
seemingly are to what presents itself as a faceless authority we must abide by in order to progress.
The decision parallels aspects of another recent and prominent controversial change seen in medical
training: the 2016 new junior doctor contract [2]. Even after 98% of juniors rejected this contract
through the BMA, it took unprecedented industrial action to open dialogue and bring change.
Watching our not-so-distant predecessors strike was shocking, demonstrating how closed decision
making created a desperate situation. Again, we find ourselves central to a decision unapologetically
made for us, and not with us. I believe we should have a say in decisions that affect us – a
fundamental principle of autonomy. Any changes without discussion should be in a new cohort who
can apply, pursue, and plan, knowing what is expected from them.
Even now, major changes approach but little attention is being drawn to them. The World
Federation for Medical Education (WFME), who provide international accreditation for medical
education, have changed their policy 2024-onwards which affects our eligibility to apply for the
Educational Commission for Foreign Medical Graduates (ECFMG) certification [3]. ECFMG certification
is the first step in the process to practice in America. The WFME will recognise accrediting agencies
in countries who then provide accreditation to medical schools themselves. In the UK, our agency is
the General Medical Council (GMC). This change was announced in 2010 and will come into effect in
3 short years. However, as of now WFME documentation shows that the GMC is neither recognised
nor applying for recognition [4,5]. This means if you wanted to work in America post-2024, you would
be unable to because UK medical education would not be internationally recognised by the WFME, hence, ineligible for
ECFMG certification. Whether you wish to work elsewhere or not, you should feel uneasy about a
huge change to your opportunities taking place with no dialogue or transparency on the GMC’s
position moving forward. Key decisions about drastic changes are being made behind closed doors
which we have no option but to follow.
I feel it is becoming more apparent that we must regain control over our futures by having our views
on what we wish to happen in our profession and career considered and validated. Decisions taken
by authorities should be transparent and made following open dialogue with the students it affects. I
am sure you agree that it is not good enough to hastily publish a letter back-dated several months
with immediate effect. It is also not good enough to act ignorant to an upcoming change until a
decision has already been made and then expect us to accept it unequivocally. As a medical student
interested in keeping my opportunities open at this early stage in my career, I am concerned that my
interests are being disregarded in the eyes of those who decide my future. We should be fighting for
more than 7-extra points; we should be fighting for a seat at the table of our careers.
References
[1] Lawson T, Masding M. UKFPO Letter: Educational Achievements (EA) Removal for 2023. United
Kingdom Foundation Post Office. 30th November 2020. Accessed from:
https://www.bma.org.uk/media/3595/for-entry-to-ukfp2023-1.pdf (Reviewed 31/03/21).
[2] The Medic Portal. NHS hot topics: The Junior Doctor Contract [Online]. The Medic Portal. 2021.
Accessed from :https://www.themedicportal.com/application-guide/medical-school-intervie... (Reviewed 31/03/21).
[3] Educational Commission for Foreign Medical Graduates. Certification: 2024 Medical School
Accreditation Requirement [Online]. Educational Commission for Foreign Medical Graduates. 24th
November 2020. Accessed from: https://www.ecfmg.org/accreditation/ (Reviewed 31/03/21).
[4] World Federation for Medical Education. Accreditation: Countries Served by Agencies with
Recognition Status (Map) [Online]. World Federation for Medical Education. 2021. Accessed from:
https://wfme.org/accreditation/accrediting-agencies-status/ (Reviewed 31/03/21).
[5] Gordon J. WFME: Agencies with or Applying for Recognition Status. World Federation for Medical
Education. 2021. Accessed from: https://wfme.org/wp-content/uploads/2021/03/List-of-Agencies-with-Recogn... (Reviewed 31/03/21).
Competing interests: No competing interests
Dear Editor
In November 2020, details were sent to medical schools and students stating that the UK Foundation Programme Office (UKFPO) had decided to no longer accept additional degrees and publications as part of the point system in foundation training allocation. Being a graduate student in the second year of my medical degree, I felt like I had somewhat wasted the three years I spent obtaining a degree in biomedical sciences.
The knowledge, skills, and experiences I gained from my first degree are invaluable to me now and sure will be in the future. Having a laboratory focussed approach to medicine has provided me with a beneficial perspective when discussing clinical cases at medical school. Not only that, but I have developed a significant appreciation for the experts within the field of pathology who work hard to provide doctors with necessary results and explanations that aid patient diagnosis and treatment. As a result, there is no doubt of how significant and valuable this initial degree has had and will continue to have in my academic and professional lives.
Disregarding the UKFPO change, for now, studying medicine as a second degree is in itself already difficult. With the best part of at least £40,000 worth of “debt” behind me on the first degree, I have to self-fund the annual £9250 tuition fees for the privilege to study a typical 5-year medical degree. I do not regret this one bit but can’t help but feel somewhat disadvantaged that after qualifying I will have a substantial amount of debt compared to the typical medical undergraduate. Hence, when being informed that the UKFPO is now not even going to acknowledge the fact that I had completed an additional degree, it started to feel like a waste of both time and money.
I understand the UKFPO decided to do this because of the impact of widened access to medicine, particularly concerning financial hardship. However, to me, this makes little sense as many postgraduate students studying medicine as a second degree are often doing so because they were not successful on initial medicine applications the first-time round. Therefore, by making the change to additional degrees on foundation applications then they have dismissed those who are part of a widened access to medicine. Additionally, often the individuals with additional degrees will be in financial hardship as a result of studying both the first degree and medicine. The change made by the UKFPO initially made me feel excluded a little, and that those extra three years I spent gaining additional knowledge and skills were not even going to be acknowledged anymore.
A further change by the UKFPO was the discount of publications from the point system. This aspect is somewhat more complex to me; on one hand, there are numerous opportunities to publish student selected components, opinions, letters, and primary research. However, the process of having an article or report, etc. published is and always will be difficult to accomplish and can sometimes not be complete in time for foundation applications. Meaning that to me, this aspect of the changes made makes sense but not based on widened access, but that publishing is extremely difficult and timely for it to be fair to all undergraduates. Having a research placement organised for the upcoming summer, this change lifts a little pressure off my shoulders. With the initial anticipation of a hopeful publication from the project, removal of this now means that I can spend more of my time focussing on developing skills in an area not necessarily covered in the undergraduate curriculum. As a result, I believe this change will be somewhat of a relief for many medical students and will not necessarily refrain them from attempting to publish results or findings rather just focus more on the experience of the project.
I think that both changes raise a particularly interesting question. Should the UKFPO not now drive for increased accessibility to additional degrees and research opportunities rather than simply withdrawing them from the points system? I believe that withdrawing the two components from the points system will stop many students from completing additional learning opportunities such as those discussed. Not only will this impact future speciality applications for the affected students, but it will also diminish interest in pursuing health and medical research in the future.
Competing interests: No competing interests
Dear Editor,
The announcement by the UK Foundation Programme Office (UKFPO) to exclude Educational Achievement (EA) points from EPM calculation has certainly caused fervent debates, with students and organisations responding with outrage (1,2). As a fourth year medical student, I appreciate the distress experienced by my peers who are impacted by this situation. The way this important decision was made without student input was undemocratic, and sadly, the timeframe of implementing the new process will affect current intercalating students. However, I believe that one aspect often not considered is the opinion of international medical students. Being one myself, I support the decision and believe it is a positive way forward.
An additional degree is undoubtedly a significant achievement, when undertaken to explore special interests. Nonetheless, many students intercalate to tick a box for job applications. Who would blame them? This is an opportunity to improve their rankings and get their preferred job choices. The applications for EA points increasing from 30% to 70%, as mentioned by the UKFPO, supports this trend (1). International students already face increasingly extortionate tuition fees studying medicine (around £40k per clinical year); unlike home students, there are no NHS bursaries to support us at any point. Intercalating would possibly cost a further £25k of tuition fees - a part time job would not cover half of the fees for another year. Therefore, this creates a discrepancy in the scores of Foundation Programme applicants. International students also potentially face disadvantages associated with not intercalating when applying for competitive specialties later on. Moreover, with changes to the fees of incoming EU students in effect as of the 2021/2022 academic year, the amount of students affected by these previously-existing issues will likely increase.
Overall, although possibly an unpopular view among medical students, removing additional degrees from the point system is a first step to address issues faced by students who cannot financially afford to intercalate. The merits of this decision have been discussed with regards to widening participation for students of under-represented groups but the perspectives of international students have not been included in the discourse.
Yours Sincerely,
Ashka Moothoosamy
1. UKFPO letter to medical schools about Educational Achievement Points alterations.
https://www.bma.org.uk/media/3595/for-entry-to-ukfp2023-1.pdf?id=%2FUKFP...
2. Response letter from the MSC to the UKFPO.
https://www.bma.org.uk/media/3603/201209-final-draft-ukfpo-eas-corrected...
Competing interests: No competing interests
Dear Editor,
I believe this is a disappointing decision made by the UKFPO whilst the communication and distribution of the details involved was unfortunately poorly managed.
I do see how the justification and reasons given, are relevant to those taking intercalated degrees, and how these can often be qualifications more open and available to those with financial support and reserves to study an extra year. This may impact and disadvantage those students unable to take extra years of study, and impact their place in standings for foundation jobs and competitive positions.
However, I think this decision impacts and disadvantages graduate students significantly. We, as a cohort, we have spent 3 years studying a degree before Medicine, and the extra points were a recognition of this which also almost balanced the financial impact. These pre medical degrees are often a stepping stone and a method of increasing intake into medicine from less represented backgrounds, or those with lower A Levels. These loss of points may impact the amount of students choosing to reach medicine via these pre medical degrees.
I can see how this is appropriate for intercalated degrees, however we have spent 3 times as long studying, to three times the cost and I hope the UKFPO can consider changing the points system to recognise and value those degrees achieved pre medical degree, differently to intercalated degrees.
i also believe the communication of the decision was poor. Most students I think found out about the decision and details through Twitter, and not by official means through their medical schools or emails from the Foundation Programme. I've heard the UKFPO made this decision, or at least were considering this back in March, however the communication to students was many many months later. This was bad timing as there were many intercalators who had already started their degrees. I appreciate however you should never intercalate for the points alone, but it is a factor often in play for those who decide to intercalate.
I hope you can appreciate and understand my comments, and see why graduate degrees should be considered alternatively to intercalated degrees.
Many thanks
Gwenllian
Competing interests: No competing interests
Dear Editor,
As a medical student currently in the middle of my intercalation year, I must admit that points were one of the motivating factors for my intercalation. I am one of the lucky few who will graduate in time for them to remain relevant for UK Foundation Programme applications. However, I feel that in the race for points, we (myself included) may well be missing the point entirely.
Medical students and professionals tend to be very accomplished at jumping through hoops. From the literal tick boxes of UCAS forms to the barely less defined tick boxes of A-level choices, work experience, volunteer work, extra-curricular success, and aptitude tests, our entire experience of higher education is prescribed checklists. This later evolves into OSCEs, e-portfolios, the PSA, and foundation year applications during medical school. We are programmed for points and as a result, are uncomfortable with any un-ticked boxes. This latest change is essentially the result of an insatiable desire for points. As stated by the UKFPO, applications seeking points for educational achievements have increased from 30% to 70%(1). Whilst their reasoning focuses on the increasingly difficult task of differentiating candidates, I believe the changes will encourage students to consider more carefully which hoops are worth jumping through. Intercalation is an opportunity, especially for undergraduate students, to explore new fields and discover career-influencing interests. It should not feel like a necessary step for progression, increasing pressure financially and mentally on a population of already stretched individuals (2,3). Removing this pressure will widen participation and encourage action based on genuine interest, rather than more checkboxes.
I do believe this is a positive change for medicine. However, the notion that the guidelines should change at a time point that will not affect the results of decisions already made (2024) is warranted. It is neither fair nor logical to move the hoop whilst people are still jumping. Whilst I am in no way condoning the frankly appalling communication and proposed timings of the new guidelines, I cannot help but think that this is a step towards more fulfilled, happy, confident medical professionals instead of exhausted hoop jumpers.
Yours Sincerely,
Jared McSweeney
1. UKFPO latest statement sent to medical schools for circulation: Removal of Educational Achievements for entry UKFP 2023. https://healtheducationengland.sharepoint.com/UKFPO/Website%20Documentat...
2. Munn F. Medical students and suicide. BMJ. 2017;:j1460.
3. BMJ. (2015, September 1). Medical students with mental health problems do not feel adequately supported: Survey provides a snapshot of mental health problems among medical students in the UK. ScienceDaily.
Competing interests: No competing interests
Dear Editor,
Recently the UK foundation programme organisation ruled out the contribution of additional educational achievements (publications, additional degrees e.g MSc, BSc) to the foundation programme application, from 2023 onwards. As a representative of Newcastle Academic Medical society, it is the belief of our society that this change in policy may disincentivise students from conducting research, undertaking an intercalated degree and pursuing an academic career. While we acknowledge that the decision behind this policy is to create equal opportunity for medical students who may not be able to intercalate, we believe it is equally important to evaluate student motivations for undertaking an intercalated degree to assess its importance to medical students and their future career prospects.
As such, Newcastle Academic Medicine Society has taken a pro-active approach and began a widening participation scheme to recruit medical students, with and without research experience, to conduct a qualitative study with the aim to understand:
(1) the rationale behind why students from different demographic backgrounds choose to or not to intercalate;
(2) the impact that student experiences of an intercalated master’s degree has on their opinions of academic medicine;
(3) whether student experiences of the intercalated degree affects the likelihood that they will pursue an academic career.
Our study has already begun and till date we have surveyed over 100 medical students at Newcastle University. We hope that by understanding student rationale prior to, and after the implementation of this policy can help make a more informed decision on UKFPO scoring.
Kind regards,
Kartik Bhargava (Intercalating Medical student)
Competing interests: No competing interests
Dear Editor
This article provides an interesting read and highlights points we both agree and disagree with. The purpose of an intercalated degree is to develop a wider knowledge of a chosen topic outside of that taught in the medicine curriculum, which can be valuable for both future applications and personal development. As fourth year medical students who have recently intercalated, we know first-hand that one of the main driving factors for doing so were the extra points on offer. Therefore, I can understand the UKFPOs decision to remove the current points system, as it does not align with the true reasons for undertaking an intercalation.
Publications, on the other hand, we believe should continue to be rewarded, however the criteria for what is deemed a publication should be adjusted. In the old system a point was awarded for supplying any PubMed ID containing the student as a primary author(1). In this way all publications are given the same weighting, 1 point. This meaning that relatively low effort publications, such as ‘Letter’s to the Editor’, are counted the same as research projects, which can take months to complete and over a year to publish. As publications do not have the same financial restrictions as undertaking an additional degree, whether that be prior to or during the medical programme, the opportunity for gaining these additional points is equally available to all students.
In our opinion students that show the initiative and commitment to complete academic research alongside their medical degree should continue to be meaningfully rewarded, with points towards their further training applications. It is the criteria for granting these points which needs to be addressed.
1) UK Foundation Programme . UKFP Application Handbook 2021 [cited 2021 11/03]. Available from: https://nwpgmd.nhs.uk/sites/default/files/UKFP%202021%20Applicants%27%20....
Competing interests: No competing interests
Re: BMA strongly opposes changes to foundation programme applications
Dear Editor,
I have several concerns about this announcement, and feel that little discussion has been had surrounding graduate entry medical students, I will detail my points as per below:
1) For myself, and many peers on my course, the performance of our schools in GCSE/A Levels were such that medical school applications were scarcely supported. It is no secret that some 50% of secondary schools have never had a pupil apply to medical school. A large majority of doctors come from a smaller minority of schools. For many people, again including myself, we had to study another degree first in order to be eligible to study Medicine, and to have the skills and insight required to independently apply to medical school. I do not believe this is because we are privileged, and believe it to be quite the opposite.
2) As a student on the lowest income bracket for finance, I only receive £380 a month to live off from the NHS Bursary, and £800 every term from Student Finance England. This is a rarity, and the majority of students receive less than this. Students receiving funding for graduate entry medicine, if not supported by other means, are often compelled to work to fund their medical degree. It is therefore harder to spend time studying, and to achieve the higher deciles.
3) Sheffield GEM course exists specifically for students from widening participation backgrounds, and do not struggle to find candidates that are eligible in this regard.
4) For graduate only medical schools which are often smaller, and with more experienced learners, it may be relatively harder to achieve a higher decile. The degree points therefore would go some way to make up for this - it is, undoubtedly, very valuable after all.
For these reasons, I believe the decision of the UKFPO is an oversight with too much consideration given to intercalating students. I also believe the full three year degree (or more) gives these graduate students strong analytical and critical thinking skills, alongside with other academic skills that I don't feel are fostered in medicine. Rather than this being seen as an asset, I find myself £100,000 in student debt, with responsibilities that 23 year old medical students/doctors to be don't have, wondering how I am going to manage those alongside moving somewhere that I have little choosing of. Many graduates have long term partners/marriages, and removing points makes these relationships harder to maintain. I would suggest that:
a) This decision has not considered the disadvantages, and I struggle with the evidence base.
b) The ranking system is not fit for purpose as is, and needs to focus more on interpersonal skills and academic skills beyond just counting what was achieved in medical exams, often with a few percentage points separating the higher and lower deciles.
Competing interests: No competing interests