The NHS bursary: what am I entitled to?BMJ 2022; 376 doi: https://doi.org/10.1136/bmj.o561 (Published 23 March 2022) Cite this as: BMJ 2022;376:o561
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The funding for medical students is an important topic and we thank the authors for providing students with useful resources to aid their application for the NHS Bursary.
The case studies used in the article resonated with us as we are sure they did with many of our peers across the country. We thank the authors for using their personal circumstances to illustrate the financial challenges faced by medical students.
The circumstances discussed are likely representative of many medical students across the UK but only scratch the surface of the complexities of financing a medical degree.
Box 1 of the article demonstrates the drop in finance experienced by medical students. For clarity we feel it important to highlight the entitlements and how they change when switching from Student Finance to the NHS Bursary.
The maximum student finance maintenance loan available to students in years 1-4 is £9706. (1)
The maximum amount of funding available for students in years 5 and 6 reduces drastically.
A combination of Student Finance Loan (maximum £2535) and NHS Bursary (maximum £4483), leaves students with a maximum of £7,017 to live on (based on a 40 weeks term, living away from home, outside of London). (2)
Could you live off £7,017?
£7,017 to cover a year’s rent, a year's worth of bills and groceries and transport whilst on such an intense course.
Then there’s the additional costs that come with studying medicine: transport to placement, course resources, online revision aids and GMC registration fees which have to be paid before your first wage.
The University of Manchester estimated living costs for an undergraduate student to be at a staggering £10,330 for the 2021/2022 year(3).
If the student’s household income is £30,000 (the median household income in the UK), the NHS bursary automatically deduct £647. A 9.2% reduction in funding due to the expected contribution from the student’s household. This then leaves £6370 for the whole year. The NHS bursary ignores the fact that one would need a significant contribution from family to achieve a basic standard of living, and this contribution is simply not possible for most low-household income students.
Some of the further disadvantages faced by medical students have been previously discussed by Anna Harvey and Declan Murphy in their article published in 2019. (4)
With the recent focus on the rising cost of living, this reduction in finance is even more devastating. In February 2022, as a nation, we saw inflation reach its highest value since 1992, standing at 6.2%.(5)
There has been no reflection of these rising living costs for our medical students in receipt of the NHS Bursary.
This can be illustrated looking at the bursary available to medical students in 2012. For a 40 week course in 2012 a medical student would receive a maximum of £4050.(6) Inflation since 2012 has averaged 2.6% - The Bank of England inflation calculator states that £4050 in 2012, would be worth £5088.72 in 2021. (7) However, the amount of NHS Bursary available to students in 2022 is only £4483.
The discrepancy between the rate of inflation and the available finance shows a complete disregard for the quality of life of our medical students, especially those from widening participation backgrounds. Why should medical students in years 5-6 receive significantly less money compared to years 1-4?
We hope that, combined with the information presented by the authors in the original article and the points we have raised, medical students and hopeful applicants will be empowered to think about their finances. We strive to raise awareness of the financial strain faced by medical students, with the hope of gaining understanding from colleagues and a will to make change.
NB. The figures used are based on the information available on the referenced websites.
(4) Disadvantages faced by poorer medical students must be challenged - The BMJ
Competing interests: No competing interests
Perhaps what to expect from applying and receiving the NHS bursary, rather than what is entitled
Perhaps it's a generational phenomenon or just a personal perspective but I am intrigued by the use of the word "entitled" in the title and the main text of this article.
To be sure, there is no mention of "entitlement" or "entitled" in the NHS bursary webpage so it is not a term used by the scheme itself.
Ironically as reflected by the personal experience of some of the authors, being on the NHS bursary program does not mean they are financially better off in the immediate future.
However it is important to be aware that the bursary is a non-repayable grant to assist students in senior years studying to be doctors or dentists (and this is not tied to academic or other performance, unlike scholarships), whereas student finance is repayable later. To get either financial support, the applicants have to be eligible for the scheme, apply for it with the correct paperwork and agree to abide to the terms and conditions in order to receive the monies; it is only then the successful applicants are entitled to things they are granted for.
Hence being X amount "worse off on the NHS bursary than on student finance" is a matter of perspective; obviously the acute needs and current financial demands can be more urgent than the servicing of the debt in the future.
Similarly it can be perceived that NHS bursary "abuses the time of the students its supposed to provide for" particularly when the application process requires original documents and receipts; however it is possible that a one way system ensures that that non-repayable grants are not abused or given to those ineligible trying to obtain them by fraudulent means, in an era where it is not hard to fake an document electronically.
If there are more applicants to support, the increment in grant value may not keep up with inflation despite the increase in budgeting; hence the NHS bursary has a duty and a process to ensure only eligible applicants receive these grants.
I do agree however some documentation for identification should not require the originals to be sent off; after all if one can apply for unemployment benefits online in the UK by using a National Insurance number, why shouldn't it be possible for something similar for a student bursary? In Australia the students studying to be healthcare professionals are required to be registered with the licencing authority and this may happen in UK with the GMC in the future, hence another identification number. There should be some flexibility in accepting documentation electronically (while requiring the applicants to keep the originals for sporadic auditing) otherwise I am trying to picture the NHS bursary office receiving actual mail/parcels from about 20,000 medical students each year (2 year eligibility x [8000 current quota+1500 new students from 2018 intake onwards]).
So, yes, it is time to bring NHS bursary into the 21st century in its application process.
The authors may be entitled to use the word "entitled" in their opinion piece, just as I would be entitled to have an opinion of their use. Perhaps it would have been better if the article title referred to what to expect when applying for the NHS bursary and what may be affected when receiving the NHS bursary.
Competing interests: I have previously received a bursary to help with my studies, but the application process tied to good academic performance felt like I was applying for a scholarship (since the grants came from a very limited community budget), hence I have never thought being eligible for a bursary equates to having an entitlement to it.