The health paradox: a dearth of doctors and a surplus of applicants

The writer is a sixth-form pupil at school in Manchester

When I chose the A-levels that would set me on my journey to becoming a doctor, I faced older pupils matter-of-factly telling me that getting into medicine is a lot harder than actually studying it. I dismissed this, needing to keep my optimism intact. Skip forward to today and I’m knee-deep in the application process and increasingly reminded of that ominous warning.

Pre-pandemic, getting into medicine was already tough. But now it has become even more of a lottery. According to the Medical Schools Council, courses that started in 2021 received over three times more applications than places available: 28,690 applicants for 9,500 slots. For 2022, however, the government reintroduced the cap that they had lifted for one year. The number of places fell to 7,500 but applicants rose to a record 29,710. Only 15.6 per cent of applicants this year received an offer — medical school heads branded it the hardest conditions “in living memory”.

The reason for this chaos and waste is Covid-19 coupled with the lack of a robust plan needed to address the shortage of NHS doctors — the health service is losing medical staff and not enough are in training. As a professor at the University of Manchester explained to me at an open day, medical schools tend to make more offers than can be accommodated because many students will not secure the required grades. During the height of the pandemic, however, when two years of cancelled exams resulted in centre-assessed results followed by teacher-assessed results, grade inflation was high. This meant that more students met their conditional offers than places were available.

The result was students being told to defer (some were even offered £10,000 to do so). Then, in the next year’s round of applications, a sizeable chunk of places were automatically seized by those who had deferred, and many sixth-formers were left without a place and had to reapply the next year.

School staff have warned us that the pattern will not end soon — even in the current cycle, we should expect about a third of places to go to students from the previous cohort, who also have the advantage of having real A-level grades rather than predictions. The most recent data showed that, for 2022 entry into medicine, reapplications increased by 28 per cent.

I came across many students in real life and online who achieved top GCSE grades, participated in the expected year or more volunteering, shadowed doctors for work experience, obtained their required grades and even aced the UK’s all-important (and notoriously difficult) clinical aptitude test but still had multiple applications rejected.

Even if students surpass entry requirements, luck plays an increasing role. One student I know received a regretful email from a medical school in the Midlands informing her that she had been rejected because they had resorted to drawing a name from a hat.

Despite the growing pressures, the Commons health select committee said this year that the government had “shown a marked reluctance to act decisively”. It’s a strange paradox: on one side the NHS faces a staffing crisis and on the other UK students desperately fight over scarce training places.

Perhaps now that former health secretary (and former health committee chair) Jeremy Hunt is in charge of the Treasury, this will change. With the NHS short of more than 12,000 doctors, according to the committee, it is a false economy not to train more — Labour pledged last month to provide an extra 7,500 medical school places.

Older medics are becoming disenchanted with conditions in an overstretched system — one in three GPs in England plans to quit in the next five years. Quick-fix overseas recruitment is unsustainable. But there does not seem to be any end to the supply of enthusiastic sixth-formers wanting to follow them into the profession. Why lock us out when we are needed?