Letter to the Committee Specialist from
the Director of Standards and Education, General Medical Council
1. The GMC's Education Committee has statutory
responsibilities for quality in medical education. These include
setting the standard for undergraduate teaching and learning opportunities,
and ensuring that this is maintained by all UK Medical Schools.
2. While the Medical Schools themselves
will have more detailed first-hand data on retention issues than
the GMC, our Education Committee is concerned to ensure that able
students are recruited and retained on medical degree courses.
In our programme of visits to all undergraduate Medical Schools,
we ask questions about retention. We thought it might be helpful
to report our views in this area.
3. Although the wastage rate from undergraduate
medical courses is generally relatively low, the fact that the
undergraduate medical course is a five or six-year programme may
pose financial problems, particularly for students with limited
financial resources. We have heard concerns expressed, especially
in London Medical Schools, that the very high cost of living and
travelling (bearing in mind that medical students may need to
undertake clinical attachments at a considerable distance from
the Medical School) causes considerable financial hardship. While
we have no first-hand evidence that this is directly causing retention
problems, we know that it is a considerable worry to many students
and staff, and we will be very concerned if this position were
4. As it is, many students feel the need
to work during term time to supplement their finances. The Education
Committee is concerned that this may eat into the reflective time,
which is essential if students are to make the most of their courses,
and thus become good doctors.
5. Financial factors are not, of course,
the only ones affecting retention. Much of the Education Committee's
effort is directed towards ensuring that the undergraduate medical
curriculum provides students with the learning opportunities they
need to become doctors, and that the curriculum is delivered through
good quality medical teaching. Our requirements for Medical Schools,
and for teaching, are set out in Tomorrow's Doctors and
in The Doctor as Teacher (copies of which were sent to
you in January last yearI enclose additional copies in
case this is helpful). We have been very encouraged by the major
reforms to the undergraduate curriculum which the medical schools
have achieved over the past few years.
6. There are many organisational factors,
well beyond the GMC's remit, which affect the ability of universities
with Medical Schools to recruit able medical teachersdoubtless
you will receive evidence from others about this.
7. Our Education Committee works closely
with the University Medical Schools, and the Department of Health,
to try to ensure that graduating doctors are fit for modern practice,
and therefore registration. Minimising unnecessary retention problems
through high quality teaching, and through adequate financial
support, is important for patients in the future.
General Medical Council