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Seems to me it’s a governmental decision? [1] > Despite the NHS’s clear need for more medics, the number of medical and dentistry students each year is capped

Seems to me it’s a governmental decision? [1] > Despite the NHS’s clear need for more medics, the number of medical and dentistry students each year is capped by the government to control costs, as it subsidises the courses. > The Secretary of State for Education, James Cleverly, commented recently that it's not possible to "flick a switch" to increase the numbers of doctors undergoing training, due to having to ensure there is enough funding and capacity for teaching and placements. 1. https://www.newstatesman.com/spotlight/healthcare/2022/08/amid-nhs-staff-shortage-uk-reintroduces-cap-on-medical-students https://www.newstatesman.com/spotlight/healthcare/2022/08/am...

rcarr 4y ago
I did not know this thank you for bringing it to my attention. Seems like a pretty feeble excuse from Cleverly though. In my opinion, anyone who's capable of it and wants to should study Medicine should be supported in doing so because the societal benefits are so great. The fact that we stop 17,000 from doing so is an absolute disgrace. We waste money on a lot of shit in this country, I'm sure the money could be found to send more people on to study medicine. It seems to be universal across the country that councils lay new block paving only to dig it up a few months later on a whim for some reason or another, that could be a place to start.
- MrAlex94 4y ago
  Oddly enough, I’ve heard the same thing regarding doctors voting for a cap. Wonder where that’s from? It’s an awful excuse; I agree with you. If we were to be quite "cold" about this and think of it in a purely beneficial sense to the economy, surely the economic benefits of a healthy population far outweigh the costs, although I imagine it’s quite hard to "quantify" such a measurement?
- a_c 4y ago
  Depends on how you see it, medical degree is a supply chain problem, subjected to the same bullwhip effect. We can't predict demand of doctors 5 year down the road. The worst we could do is to treat today's demand as demand for 5 year in the future. If we double the supply today, in 5 years we will have double supply, hopefully without another pandemic. Many things could happen, if funding stays the same, benefits among all doctors will be affected, or we appropriate funding from other endeavours. If the demand doesn't sustain, funding get cut, less students find it attractive as a career, supply reduces. In reality many more factors get into play. So when Cleverly said "we can't flip a switch", there are some merits to it. https://en.m.wikipedia.org/wiki/Bullwhip_effect https://en.m.wikipedia.org/wiki/Bullwhip_effect
- brippalcharrid 4y ago
  That's an interesting idea, but a lot of people in the profession would reject a move like that, as it would put downward pressure on their earnings (amongst other things): > BMA meeting: Doctors vote to limit number of medical students (Andrew Cole) > Delegates at the annual BMA conference voted by a narrow majority to restrict the number of places at medical schools to avoid “overproduction of doctors with limited career opportunities.” They also agreed on a complete ban on opening new medical schools. > David Sochart, from Manchester and Salford, warned that in the current job climate allowing too many new doctors into the market would risk devaluing the profession and make newly qualified doctors prey to “unscrupulous profiteers.” A glut of doctors would undermine competition and would therefore lower standards and ensure mediocrity, he claimed. He said, “Patients and health care should not be treated as mere commodities, and neither should medical students. We must not allow another lost tribe of doctors to be consigned to the wilderness.” > Grant Ingrams, representing GPs, said that doctors should not be trained if there was no job at the end. He warned that this could spark another “brain drain,” adding: “It is wrong and immoral and a waste of taxpayers’ and students’ money.” > But Paul Flynn from the consultants committee said that the root problem was a lack of effective workforce planning and warned members against a kneejerk response. “This is what blighted workforce planning. It would be hypocritical if we were to do it ourselves.” > The BMA’s chairman, Hamish Meldrum, said he sympathised with the sentiments of the motion but asked members to vote on evidence rather than “gut reactions.” “We want to see an expansion of [the numbers of] GPs and consultants,” he said, “and for that we need more students.” But the motion was passed by a small majority (58% versus 42%). > Members also agreed to a motion accepting that some specialties might need to raise the total number of years spent in training to accommodate the demands of the European Working Time Directive. > Stephen Austin, from the consultants committee, said that the time needed to acquire the necessary competences was likely to increase—especially in procedure based specialties—and that the only sensible solution was to increase the total amount of time in training. > Members also voted to press for an agreed minimum national level of funding for study leave to overcome the widespread national variation in the amounts that are currently available. https://www.proquest.com/openview/b0c6c69bed2854a96acfd2889d93c32a/1.pdf https://www.proquest.com/openview/b0c6c69bed2854a96acfd2889d... From 2008, but I haven't been able to find any publicly-available discussion from within the medical profession that's more recent.
brippalcharrid 4y ago
The British Medical Association is in a position to veto changes to the number of medical students being educated in the UK, as its members have a monopoly on providing medical training, which is why they hold votes on such things at their conferences: https://www.proquest.com/openview/b0c6c69bed2854a96acfd2889d93c32a/1.pdf https://www.proquest.com/openview/b0c6c69bed2854a96acfd2889d... Matters like this are normally discussed behind closed doors, and there is plenty of horse-trading, with favours being negotiated, and assurances, and understandings that are reached before major changes are "unilaterally" "announced" by the Government. There are different factions within the medical profession, and none of them want to lose out when there are changes. Priced into the government's announcement they they are going to train more doctors, therefore, are a range of promises and commitments to the medical profession to make sure that this will proceed without incident.
- MrAlex94 4y ago
  Interesting, thanks for that. Do you know if that only happened the once? I can’t find references to another vote like it. From what I can see elsewhere, the tone seems to have changed slightly since then? > “We welcome the news that there will be extra funding for medical school places as this desperate need for more doctors in training is a recommendation that we made in our Medical Staffing in England report, which we issued last month.“ > “However, this increase in student places must not come at the expense of extra funding for the existing workforce or reductions in funding in future years, because tackling the waiting lists and backlog are going to require sustained investment over many years. And the government must make clear that there will be sufficient clinical placements for all those who succeed at medical school. https://www.bma.org.uk/bma-media-centre/bma-says-increased-medical-school-places-are-welcomed-but-funding-must-be-found-for-extra-clinical-placements https://www.bma.org.uk/bma-media-centre/bma-says-increased-m... A generous take on it seems that the BMA don’t want to make things worse for existing doctors. I suppose if the government funded the NHS more, ensured that existing doctors wouldn’t be worse off, one would hope that the BMA would be fully supportive of training new doctors?
  - brippalcharrid 4y ago

rcarr 4y ago

I did not know this thank you for bringing it to my attention. Seems like a pretty feeble excuse from Cleverly though. In my opinion, anyone who's capable of it and wants to should study Medicine should be supported in doing so because the societal benefits are so great. The fact that we stop 17,000 from doing so is an absolute disgrace. We waste money on a lot of shit in this country, I'm sure the money could be found to send more people on to study medicine. It seems to be universal across the country that councils lay new block paving only to dig it up a few months later on a whim for some reason or another, that could be a place to start.

MrAlex94 4y ago
Oddly enough, I’ve heard the same thing regarding doctors voting for a cap. Wonder where that’s from? It’s an awful excuse; I agree with you. If we were to be quite "cold" about this and think of it in a purely beneficial sense to the economy, surely the economic benefits of a healthy population far outweigh the costs, although I imagine it’s quite hard to "quantify" such a measurement?
a_c 4y ago
Depends on how you see it, medical degree is a supply chain problem, subjected to the same bullwhip effect. We can't predict demand of doctors 5 year down the road. The worst we could do is to treat today's demand as demand for 5 year in the future. If we double the supply today, in 5 years we will have double supply, hopefully without another pandemic. Many things could happen, if funding stays the same, benefits among all doctors will be affected, or we appropriate funding from other endeavours. If the demand doesn't sustain, funding get cut, less students find it attractive as a career, supply reduces. In reality many more factors get into play. So when Cleverly said "we can't flip a switch", there are some merits to it. https://en.m.wikipedia.org/wiki/Bullwhip_effect https://en.m.wikipedia.org/wiki/Bullwhip_effect
brippalcharrid 4y ago
That's an interesting idea, but a lot of people in the profession would reject a move like that, as it would put downward pressure on their earnings (amongst other things): > BMA meeting: Doctors vote to limit number of medical students (Andrew Cole) > Delegates at the annual BMA conference voted by a narrow majority to restrict the number of places at medical schools to avoid “overproduction of doctors with limited career opportunities.” They also agreed on a complete ban on opening new medical schools. > David Sochart, from Manchester and Salford, warned that in the current job climate allowing too many new doctors into the market would risk devaluing the profession and make newly qualified doctors prey to “unscrupulous profiteers.” A glut of doctors would undermine competition and would therefore lower standards and ensure mediocrity, he claimed. He said, “Patients and health care should not be treated as mere commodities, and neither should medical students. We must not allow another lost tribe of doctors to be consigned to the wilderness.” > Grant Ingrams, representing GPs, said that doctors should not be trained if there was no job at the end. He warned that this could spark another “brain drain,” adding: “It is wrong and immoral and a waste of taxpayers’ and students’ money.” > But Paul Flynn from the consultants committee said that the root problem was a lack of effective workforce planning and warned members against a kneejerk response. “This is what blighted workforce planning. It would be hypocritical if we were to do it ourselves.” > The BMA’s chairman, Hamish Meldrum, said he sympathised with the sentiments of the motion but asked members to vote on evidence rather than “gut reactions.” “We want to see an expansion of [the numbers of] GPs and consultants,” he said, “and for that we need more students.” But the motion was passed by a small majority (58% versus 42%). > Members also agreed to a motion accepting that some specialties might need to raise the total number of years spent in training to accommodate the demands of the European Working Time Directive. > Stephen Austin, from the consultants committee, said that the time needed to acquire the necessary competences was likely to increase—especially in procedure based specialties—and that the only sensible solution was to increase the total amount of time in training. > Members also voted to press for an agreed minimum national level of funding for study leave to overcome the widespread national variation in the amounts that are currently available. https://www.proquest.com/openview/b0c6c69bed2854a96acfd2889d93c32a/1.pdf https://www.proquest.com/openview/b0c6c69bed2854a96acfd2889d... From 2008, but I haven't been able to find any publicly-available discussion from within the medical profession that's more recent.

brippalcharrid 4y ago

The British Medical Association is in a position to veto changes to the number of medical students being educated in the UK, as its members have a monopoly on providing medical training, which is why they hold votes on such things at their conferences: https://www.proquest.com/openview/b0c6c69bed2854a96acfd2889d93c32a/1.pdf https://www.proquest.com/openview/b0c6c69bed2854a96acfd2889d... Matters like this are normally discussed behind closed doors, and there is plenty of horse-trading, with favours being negotiated, and assurances, and understandings that are reached before major changes are "unilaterally" "announced" by the Government. There are different factions within the medical profession, and none of them want to lose out when there are changes. Priced into the government's announcement they they are going to train more doctors, therefore, are a range of promises and commitments to the medical profession to make sure that this will proceed without incident.

MrAlex94 4y ago
Interesting, thanks for that. Do you know if that only happened the once? I can’t find references to another vote like it. From what I can see elsewhere, the tone seems to have changed slightly since then? > “We welcome the news that there will be extra funding for medical school places as this desperate need for more doctors in training is a recommendation that we made in our Medical Staffing in England report, which we issued last month.“ > “However, this increase in student places must not come at the expense of extra funding for the existing workforce or reductions in funding in future years, because tackling the waiting lists and backlog are going to require sustained investment over many years. And the government must make clear that there will be sufficient clinical placements for all those who succeed at medical school. https://www.bma.org.uk/bma-media-centre/bma-says-increased-medical-school-places-are-welcomed-but-funding-must-be-found-for-extra-clinical-placements https://www.bma.org.uk/bma-media-centre/bma-says-increased-m... A generous take on it seems that the BMA don’t want to make things worse for existing doctors. I suppose if the government funded the NHS more, ensured that existing doctors wouldn’t be worse off, one would hope that the BMA would be fully supportive of training new doctors?
- brippalcharrid 4y ago