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Training in medicine is an expensive business. The costs associated with examinations and courses can be substantial. These fees can have a huge impact on doctors when they are at their most financially vulnerable, and here I’m talking particularly about those in the Foundation Programme.
To illustrate this, I would like you to imagine you are a Foundation doctor who has recently left medical school. You were there for six years as you intercalated, so you left medical school with an extra year of debt. You are from a background which meant that your parents were unable to support you through medical school. The NHS bursary was unfortunately insufficient to get you through your final year and so you also left medical school with extra bank loans. You had to buy a car in order to get to work, and you had to start paying rent, and all of this before your first pay check comes in. There are also GMC fees, and BMA fees as well. You begin your working career with considerable amounts of debt and stress.
Clearly there is already a large financial burden on many young doctors. It’s worth noting also that in three years time we will have graduates who have been paying £9,000 a year in tuition fees, increasing their monetary woes.
So, returning to our hypothetical junior doctor, assuming you don’t want to take a gap year, you will be applying to specialty training within 15 months of becoming a doctor. Let’s say you want to apply to paediatrics. Obviously you want to be competitive in your application, so you read the person specification and you discover that according to the desirable criteria you should be looking at taking MRCPCH part one, which costs £419, and APLS, which is around £550, wouldn't go amiss either.
Some will say that these expensive exams are necessary and that foundation doctors can afford to take them, to which I say: not all foundation doctors can. Not if they struggled financially through medical school. Not if they’re from a background that didn’t include a lot of money.
The issue of rising exam and course costs goes right back to widening participation, and ensuring that all doctors, regardless of their background, have an equal shot at their career of choice, in a location of their choice. We want doctors of all backgrounds achieving training posts in their dream specialty, not just those who can pay.
It would be interesting to know what the current study leave allowance is for NHS doctors. To the best of my knowledge, it is typically £750 per annum; this is not very much.
The next question is when was the last time study leave allowance was reviewed/revised upwards. I rather suspect typical NHS study leave allowance has been steadily & significantly eroded by inflation.
I detect a motion for next year's ARM! Also an issue for JDC/Consultants' Committee to consider?