Medicine is a course which involves determination and resourcefulness. Shrinking violets find it difficult and the pure memory work at the beginning puts off some intelligent students who would like a more cerebral approach. Problem Based Learning courses are different, and more and more students are learning this way, especially in fast track graduate entry courses. Adult learning, where one is self sufficient, addresses and understands, and looks up learning needs, is the method preferred. Unfortunately undergraduate entry has less mature students. It also has 80% bias to women, so presumably more women than men drop out. It would be interesting to know the ratios for acceptances: dropouts for each sex at undergraduate and at graduate level. Why not let all who reach a certain standard and wish to do medicine do so? Overcapacity will ensure we do not have to import doctors, and since only 2 out of 11 applicants are successful we know there is potential for a lot more.
An ‘epidemic’ of mental health problems is being blamed as a large number of would-be medics fail to complete their degrees
Nearly 1,600 of Britain’s brightest students have been asked to leave medical degrees or have dropped out in the past five years, costing the taxpayer millions.
Data from more than 30 medical schools, released under freedom of information laws, reveals that nearly 1,200 British students, most with top grades at A-level, left with no qualification. Others changed course or were awarded a BSc.
One expert spoke of an “epidemic” of mental health problems among students and said more support was needed. Another, Alan Smithers, professor of education at Buckingham University, said: “This level of attrition is a terrible waste of public money as well as being desperately sad for the individuals concerned.”
It costs about £250,000 to train a doctor and gaining a place on a degree course is ferociously competitive. Experts were concerned by the figures, particularly as NHS England has launched an overseas recruitment drive for 2,000 doctors to plug gaps in GP surgeries.
Professor Les Ebdon, head of the Office for Fair Access, which regulates access to higher education in England, said: “Obviously it would be better to help our British students become doctors . . . We cannot keep relying on other countries.”
More than one in 10 students failed to become doctors on some courses. At Leicester University the figure was 37 out of the cohort of 240 (15%) who started in 2011-12. Richard Holland, head of the medical school (elect) at Leicester, said completion rates were improving. The University of East Anglia said its drop-out rate for undergraduate medicine was 8.5%. By contrast, just five students at Swansea failed to complete the course.
The General Medical Council, which regulates doctors’ training, cited an attrition rate from all medical degrees of 1.8% in 2014 but is understood to be working on new figures. Some medical schools said they had seen a rise in mental ill health. “There is an epidemic among young people of mental health problems and it requires much greater support from universities,” Ebdon said.
Hannah Overton, 22, who attended a state school in Ipswich, was accepted at University College London (UCL) to study medicine two years ago. She left after being diagnosed with a mental health condition and says she did not receive adequate support to qualify as a doctor. She is now a midwife’s assistant.
She said: “There is a very old-fashioned attitude in medical schools that you are weak if you have a mental health issue. It broke my parents’ hearts.”
Professor Deborah Gill, medical school director at UCL, said: “We are sorry Hannah felt she lacked support and would be happy to speak to her if she feels this would help other students.”
CARE FOR DOCTORS’ MENTAL HEALTH
There is a history of higher rates of psychiatric problems in the medical profession (“3O0 student doctors quit a year”, News, last week). However, understanding of mental health conditions has been boosted via social media and other outlets supporting medics’ mental health, the majority of which are not “official” and are peer-led, such as Nightline and MedSocs as well as Twitter.
Perhaps now more doctors and medical students are publicly seeking help. Recent data suggests one in four doctors have experienced suicidal thoughts, yet only one in five are diagnosed with clinical depression. Some of the best doctors I know are peers who have struggled with, taken responsibility for and ultimately improved their own mental health.
To make a difference, universities need to challenge expectations, fund services and normalise talking about the subject. Progress is inhibited by a public discourse that sees young doctors’ mental health struggles merely as a financial penalty for the taxpayer, rather than a public health issue that requires care and investment to solve. This attitude was prevalent in your article, which discussed the need for a “recruitment drive” to fill the gaps of those who did not complete their courses, rather than the lack of official support available.
Dr Sarah Simons, Nottingham
The government’s plan will see an expansion in training places from 6,000 to 7,500 a year.