A Liveable NHS Bursary is needed to make medicine truly accessible to all

Eilidh Garrett is a third-year medical student on a four-year graduate entry medicine course. She is a Co-Founder of the #LiveableNHSBursary campaign, which is calling for medical students to have immediate access to full maintenance loans, in line with other healthcare professional courses.

Throughout school, I was told that I was not clever enough for medicine – it was a pipe dream. Before enrolling on the graduate programme, I studied another degree, with the intention of pursuing medicine afterwards – that was okay because I had the financial support to do so at the time. However, tragic life events meant that I no longer had access to that support, and I found myself having to self-fund my medicine degree. With limited support (as this article will go on to explain) I’ve found myself with maxed-out overdrafts, thousands of pounds in credit card debt, and a relentless eagerness to create change for my future colleagues.

Universities across the country have been making efforts to widen participation at medical schools by recognising that prospective students from different socioeconomic groups face different hardships in accessing education – independent of their intellectual ability.

It is recognised that an economically diverse, as well ethnically and culturally diverse, workforce is essential to adequately treat our diverse patient population, who all face differing yet significant barriers to accessing healthcare.

But despite the work of universities and others to widen access to medicine, a lack of government funding is now putting that at risk. These future doctors, who are so integral to UK healthcare, may not be able to complete their degrees due to a lack of financial support.

The funding

Currently, the NHS bursary offers the following to student doctors in their final two years of study. The maximum means-tested bursary rates for full-time students not living at home are:

• up to £3,191 if you’re studying in London 
• up to £2,643 if you’re studying outside of London

This is in addition to a non-means tested £1,000 from NHS Bursary (the NHS bursary portions are not repayable).

If the course runs for more than 30 weeks and 3 days in the academic year (excluding vacation periods), students may also be entitled to an Extra Weeks Allowance. 

Student Finance England also offer £1,975 as a reduced maintenance loan to all students who are outside of London and not living at home.

The problem

For a student with no household income (unemployed or deceased/estranged parents), the maximum they are likely to receive is £6,500 – for many students, this would not even cover their rent and household utility bills.

Additionally, the thresholds at which households are expected to contribute to their child’s living costs are staggeringly low. For a household where both parents are on £17,500 each, this would mean that their child would not receive the full means-tested portion. They would be expected to contribute around £1,000 a year towards their (adult) children’s living costs, and this would be deducted from the total amount of bursary they can access.

This is communicated to parents via a letter from NHS Bursary – no ifs, no buts.

Not only is the paperwork for this long and arduous – siblings’ birth certificates must be sent off to calculate parents’ expenses, for example – it is also unique only to medical and dental students. Student nurses, physiotherapists, and paramedics all get access to a £5,000 bursary, no questions asked. They then also have full access to a maintenance loan.

Why don’t you just get a job?

I am not work shy. I worked throughout my first degree, around 25 hours a week. I am more than willing to work for my money. Fifth year medical students often need to complete 40 hours a week on placement (as fifth year students, they will be performing tasks on wards, and ‘working’) and then must study to pass their exams with the remaining free time they have.

How then, can we expect them to also hold down a part time job?

The current financing forces students that do not have parental or spousal support down the route of having to work to survive at medical school. They’re on placement all day, then coming home to put a uniform on and head out to work so that they can afford to turn up again to hospital the next day.

This doesn’t allow them to maximise their learning opportunities, so that they can prepare to be the best doctors possible. Instead, it forces them to start their junior doctor roles burnt out, over-worked, and likely in personal debt.

This is not like many other degrees, whereby picking up shifts at a local supermarket can be possible – timetables at medical school change constantly, and commutes to placements can be lengthy. Speaking for myself, I am currently on 12-hour night shifts, whilst trying to keep up my regular hours at my part time job.

The implications

The message is clear – whilst universities are welcoming and now recognise talent in students from varied backgrounds, government funding for medical students means only the wealthy may remain.

Diversity stops at the door – you can come in, but you can’t stay. If you do stay, be it off your own back and your own detriment.

As the cost-of-living crisis pulls the nation’s purse strings, medical students are feeling more and more cast away from the system that does nothing to hold onto them. They’re graduating with high interest credit card debt to finance their degree.

The shores of better contracts in New Zealand and Australia are calling. If this country wants diversity in its doctors, something needs to change – and it needs to change now.

The #LiveableNHSBursary Campaign 

I found myself in financial hardship unexpectedly, and the £380 per month I received (the maximum amount) was lasting me only for a couple of weeks at most. Any excesses went onto credit cards. 

I am constantly exhausted from part-time work as well as my full-time degree. More needs to be done. 

There were three other voices that had been enraged by the current state of affairs. I tweeted some raw data under the #LiveableNHSBursary, and it was met with outrage from the public that the system was so inaccessible. I teamed up with the other voices – Penny, Michaela and Trish – and we set about making our aims: 

• Immediate access to full maintenance loans for medical students in line with other healthcare professional courses for the duration of the degree programme. 
• Access to the NHS Learning Support Fund which is accessed by other healthcare professional students, replacing the standard medical student NHS bursary. This would enable all medical students to access £5,000 non-means tested grant. 
• A review of the Travel and Dual Accommodation Expenses, so that fuel and accommodation reimbursements are reflective of the ongoing cost of living crisis. 

So far, 2,800 letters have been sent to MPs. You can join the campaign on Twitter by tweeting #LiveableNHSBursary. Follow us here and find out more detailed information here. 

We will not stop until we get change. 

*As part of its work to improve fair access to leading universities and careers for young people from less advantaged backgrounds, the Sutton Trust runs Pathways to Medicine – a programme which provides academic, admissions and sector-specific support for students who are interested in pursuing a career in medicine. These kinds of programmes are essential to helping young people from a range of diverse backgrounds to access medical school, but unless there is action taken to reform the bursary and ensure that students are properly supported throughout their studies, this hard work is at risk of going to waste. 

The opinions of guest authors do not necessarily reflect the opinions of the Sutton Trust.