Protections for medical students in Wales

by Dr Alessia Waller

Read about the working arrangements that the BMA has secured for medical students who are starting in workplaces across Wales.

Location: Wales
Published: Friday 17 April 2020
Blog Article Illustration

As many medical students are starting, or have already started, in workplaces across Wales, I wanted to give you all an update on where we are with protections for medical students in Wales.

The BMA has been working to ensure medical students are protected in the workplace and despite many hurdles, we’ve achieved a much better situation for students taking up clinical work. We have secured the following:

  • students in all years will be provided with three documents: a job description (final years will be 'medical student assistants'); a model contract with Agenda for Change terms and an appointment letter
  • the appointment letter will set out that the notice period to be given by students is two days
  • hours of work under this post will depend on the job description provided. The medical student assistant role is between the hours of 9am to 5pm, Monday to Friday (excluding bank holidays). Hours can be varied-increased or decreased- with the mutual agreement of the student and employer and as long as there is sufficient supervision in place. Two exceptions to this are that international students still cannot exceed 20 hours a week of paid employment and no student may exceed 48 hours a week (as per the European working time directive). All posts will attract a minimum of 30-minutes uninterrupted break every six hours, plus natural breaks
  • all students will be automatically enrolled into the NHS Pension scheme, therefore taking the benefit of death in service
  • all students will be indemnified via the Welsh Health Risk Pool. All students should have signed up with a medical defence union when they started medical school, but I would encourage you to check that your membership is up to date
  • work undertaken under the contract will count towards continuous statutory and NHS service. This is particularly relevant for final year students who will automatically move into a junior doctor role via early GMC pre-registration.

One thing the BMA consistently lobbied for was, that regardless of the specifics of job description or pay or role, all medical students should have terms and conditions that matched those of junior doctors. This was to facilitate the transition to junior doctors’ contracts for final years, when that happened, and also to facilitate students 'buddying up' with junior doctors who would supervise them. With different contracts come different shift patterns, so having student doctors and 'proper' doctors on the same type of employment contract would have been important for twilight and night shift rotas.

Despite NHS Employers being unwilling to give final year medical students the same terms and conditions as doctors, on the basis that they are not (yet) doctors, Welsh Government has agreed to send out a message to accompany the Documentation to NHS Employers expressing that:

  • they expect any student who takes up employment to be offered the three documents described above and
  • they expect NHS Employers to switch any employed final year students who graduate early to the junior doctor contract and associated medical terms and conditions.

In their communication to NHS employers, Welsh Government will also expect them to provide adequate support to students during all posts. Finally, NHS Employers are expected to follow the guidance set out by the Medical School Council. This is also detailed in the model appointment letter.

It’s a lot to get your head around! But what’s important to take away is that this represents a significant step forward for Welsh medical students. It means that all students will have adequate employment protection, including pension (DIS), indemnity, sick pay, and holiday pay. As many of us may be working straight up until we are due to start anyway in August, it’s really important that we have these entitlements.

We have a written instruction from Welsh Government confirming that final years who take up junior doctor roles early will be placed on the model junior doctor contract and associated medical TCS. Final years will be offered a job description consistent with the one we have commented on and students in other years will be offered other job descriptions, depending on the role they undertake.

We haven’t seen or agreed to all of the various job descriptions going out to non-final year students—these have been locally negotiated, based on the needs of the health boards and with input from the two different medical schools.

We know there are some discrepancies between what students at the two different schools are being offered. What’s most important is that you are happy with the hours you are being offered, the description of what tasks you’ll be doing, and the terms regarding notice, sick pay, and leave. No student should feel pressured to accept a clinical post and no student should be penalised for choosing to focus on family, learning, or other interests instead.

It’s something I keep saying but I’d strongly encourage you to utilise the BMA’s contract checking service! It’s free for members – and don’t forget, membership is also free for final year students at the moment. It’s more important than ever that students be part of a union like the BMA – it is extraordinary that students are being graduated early to join the workforce, and during a pandemic no less. We’re all doing our best but even so, it’s important to be safe and to be sensible. Your union can help make sure you are the former and your employers the latter.



If you’re unsure about anything, please contact the BMA for advice. They are here to support you. The wellbeing services are also available 24/7 and are free and confidential. You can call on 0330 123 1245.

I’d also like to say, once again, good luck to everyone starting in workplaces. We’ve trained for this and we can do this together. Pob lwc!