The Medical Doctor Degree Apprentice standard was approved for delivery by the Institute for Apprenticeships and Technical Education on 19th July 2022. Further information from Health Education England (HEE), including a toolkit and FAQ to assist NHS organisations to introduce medical degree apprenticeships has also been made available. A blog from Professor Liz Hughes, Medical Director for undergraduate education at HEE has also been published, with a HEE funding package for a pilot programme for up to 200 apprentices over the next two years announced in January 2023.
Despite the latest developments, many questions remain about the place of medical degree apprenticeships in the UK medical education and training landscape, and the role they will play in responding to the medical workforce crisis. It remains to be seen whether future apprentices, medical schools and employing organisations can navigate the complexity of implementing medical degree programmes to meet individual apprenticeship needs, while adhering to the exact same high standards of training experienced by traditional medical students.
As HEE recognises, medical degree apprenticeships will not automatically address the widening participation agenda, though they have the potential to help with the use of specifically designed recruitment and selection processes. Beyond apprenticeships, there must be a greater concerted effort to address the educational and financial hurdles faced by school leavers and graduate entrants from underrepresented backgrounds, which themselves act as significant barriers to widening participation in medicine.
While we welcome innovative approaches to education and training, there must be no illusions about the limited impact medical degree apprenticeships will have in solving the dire NHS workforce crisis. A dramatic increase in traditional medical school places to meet the projected future demand on the health service is needed without delay.
The Department of Health and Social Care has confirmed that the 200 apprenticeships included in the HEE pilot programme will sit outside the current restrictive Government cap on medical school places. The BMA has estimated that the medical workforce in England is currently short of 46,300 doctors when compared with the average doctor to population ratio in OECD EU comparator nations. The medical training pipeline is already stretched to its limits, with lecture halls at capacity, limited numbers of clinical placements, and falling numbers of medical academic staff.
It will take many years to put in place the supporting structures needed to train the thousands of additional medical students needed, following a Government commitment to invest in more medical school places. A rapid decision to significantly expand, and increase investment, in medical education and training is urgently required.