Becoming a doctor is a dream for many. But for too many students, it’s becoming a financial nightmare, forcing them to take on considerable amounts of debt before they even graduate. Worse, it’s causing many of them to consider jobs in health systems with higher rates of pay elsewhere in the world to help pay off this debt.
A maze of financial barriers
Administered between two separate government departments (economy and health) with wide variations in available support depending on whether medicine is your first or second degree, medical student finance here is anything but straightforward.
If you are an undergraduate (medicine is your first degree), the Department for Health offers an income-assessed bursary for students in their fifth and later years of study. However, if awarded it reduces other financial support, such as the student maintenance loan offered by the DfE (Department for Economy) which is an essential loan to help with day-to-day living costs. DfE is increasing the maximum amount available for this loan by 20% in the 2025/26 academic year, but it will still be subject to reductions should you be awarded the DoH bursary. Giving with one hand and taking with the other.
And unlike their peers in other parts of the UK, graduate medical students (medicine is your second degree) are excluded entirely from any maintenance grants, final-year tuition fee support and the DoH bursary. Graduate medical students studying at Queen’s University Belfast still cannot access tuition fee loans.
Currently, Northern Ireland medical students may have the lowest tuition fees in the UK, if they choose to stay and study here, but this advantage is cancelled out by the overall financial package they receive. For example: the maximum available maintenance loan available for the 2025/26 is between 21-34% lower for Norther Ireland-domiciled students than their counterparts in the other UK nations. Adding in the cost of travel to mandatory clinical placements that can be in areas hard to reach by a poor public transport infrastructure, the financial cost of studying medicine adds up.
It leaves many relying on high-interest bank loans, fitting part-time jobs around one of the most time-intensive degrees courses you can undertake, and (if they are lucky) family support just to stay in med school. Most unfairly, it puts studying medicine out of reach to people from lower socio-economic backgrounds.
Debt that influences career intentions
With some students graduating with upwards of £70,000 in debt, this financial pressure isn’t just stressful, it’s causing many of them to consider careers in health systems outside of Northern Ireland where there are higher salaries to help pay off this debt.
This month we published the findings of our career intentions survey of penultimate and final year medical students at both medical schools here. The responses were stark: more than 50% of respondents plan to leave the country after their foundation training, with 92% of those leaving citing better pay elsewhere as the main reason. This is a red flag for a health system already in the grips of a medical workforce crisis.
Lobbying for change
Earlier this year, the BMA Northern Ireland medical students committee commenced a targeted lobbying campaign to highlight the dire state of medical student finance with Northern Ireland’s main political parties. At each meeting we have called on their support to help stop the coming medical workforce crisis by supporting the following urgent reforms:
– Extend the DoH bursary to all final-year medical students, regardless of degree status
– Stop reducing maintenance loans for students receiving bursaries
– Tuition fees to be set at a level that ensures studying medicine in Northern Ireland is not out of reach to those from lower socio-economic backgrounds
– Extend the offer of tuition fee loans to graduate students at QUB
– Improve clinical placement travel support allowances.
The culmination of this lobbying campaign will be an MLA Roundtable next week at Parliament Buildings where we will put our case directly again to all the political parties and seek their support to make our asks a reality.
The cost of inaction
Medical students are an investment in the future of the health service. If Northern Ireland wants to retain them, it must invest in them now. That means simplifying the financial support system, making it fairer, and ensuring that no student no matter what their socio-economic background, is forced to choose between their calling and their bank balance.
The cost of inaction is clear: a continued exodus of talent, a deepening workforce crisis, and a health system that cannot meet the needs of the population.
Milan Kapoor is chair of BMA Northern Ireland medical students committee