An End to Cambridge Transfer Students

Making the transition from preclinical to clinical medicine brings with it many changes, but uniquely for London medics we see the addition of a body of students from Cambridge and Oxford, as they finish their degree in preclinical medical sciences and embark on their cliniucl-summercal careers. This process has taken place for a number of years, but it has recently been announced that Cambridge intend to stop all transfer students coming to London from 2017.

Cambridge’s Clinical School was founded relatively recently, in 1976, and in the past has not had the capacity to accommodate all the students from its well-established undergraduate preclinical course. Thus, a number of students transfer and come, traditionally, to the London universities. Over the past four decades, Cambridge’s clinical school has been gradually expanding and they now intend to increase its capacity to the point where they can manage their entire preclinical cohort. The Medical Student has spoken to a number of senior staff from both universities to gain perspective on this issue. Cambridge describes the “anomaly” of transferring from Cambridge’s pre-clinical course to a different clinical education as “no longer fit for purpose from an educational perspective”. Over the past decade, Cambridge has been put under pressure from external stakeholders such as the GMC, Department of Health and NHS Employers to meet “more precise requirements” which Cambridge claims are difficult to achieve in a divided curriculum where 40% of students leave at the end of year 3. Indeed, Cambridge describes the process of transferring students as “severely hindering innovation, since any change [we wish to make] would require coordination with the clinical and preclinical courses in [the] other medical schools”. Cambridge argues that having a full six-year programme will provide the university with excitingKings_College_Chapel_Cambridge opportunities to innovate educational themes with a currently underused teaching capacity, and emphasising the interdependence of core and clinical sciences and their importance for future clinical practice. London’s view was more blunt: “It’s nothing more than money.” The Medical Student was told, “Medical students attract money from the government and part of that money underpins the hospital.” The idea that Cambridge is making the decision to improve the educative experience was dismissed as “nonsense”:  “Medicine is best in London, and it’s driven by the hospitals. The biggest hospitals have the most complicated patients, have the best doctors, have the best training environment.” We were informed that UCL partners has 6.3 million patients (10% of the country’s population) as a captive group. For Cambridge, we received an estimate of 300,000 patients from our London source, and 4.8 million from our Cambridge source. “Cambridge’s motive is ‘there’s nothing more than money driving this’, it’s nothing to do with the student experience.”

“The question to ask is, does Cambridge have the capacity to train [the extra students]? I think they will struggle. I think the quality of placements would not be the quality of the placements they’d have in London”. Another source told us: “There is a question of capacity for students at Cambridge. It implies from their statement that students will stay in Addenbrookes. There isn’t the capacity in Addenbrookes.” All Cambridge students will continue their clinical education in hospitals based in East Anglia and Health Education East of England supports Cambridge’s developments.

In our correspondence with Cambridge, they remarked that a great deal of consultation had taken place in preparation for these changes, both internally and externally, and claimed that London had been aware of Cambridge’s intentions since 2011. Conversely, when TMS spoke to senior staff at London, it was remarked that “Cambridge have made a unilateral decision…this was done without any consultation; they were not open to discussion and there are no mitigating circumstances. There’s been a series of exchange of letters, which are perfectly polite, but the answer is a blunt ‘no’”.  Another source told us: “We’ve been aware that it might happen for about 12 months or so. The actual proposal came out of the blue and with a set time limit – there’s no staged approach, there’s a big bang from 2017. We’re very keen to meet with Cambridge, but Cambridge seem to think there is no need for discussion.”

“Cambridge does not reflect the diversity of the population of London, and that diversity is important when learning medicine. But that’s the choice of Cambridge. I do think there needs to be that opportunity for students to understand it better. I’m not certain whether the students coming into Cambridge are aware of the circumstances from 2017.” Despite this difference in viewpoint, Cambridge claims it has involved its own students, the Clinical Students’ Society commented: “The current system causes significant disappointment every year to students who are not able to stay in Cambridge”. TMS enquired about this, and spoke to a handful of recent transfers to London. All the students we spoke to disagreed that the transfer method caused significant disappointment and were unanimous in their appreciation of having the opportunity to transfer. This was true even in a student who was not enjoying her time at London. This was recapitulated by the senior colleagues TMS spoke to: “At least, you want to have the opportunity.  Because for some people it’s not right to move, for some people they would prefer to stay in Cambridge with their friends, and some people would prefer to stay in the college environment, but it’s about choice. You have to be able to decide what you want to do, and not be constrained by politics or inflexibility.  Cambridge [are] not acting in a terribly honourable fashion in that the thing is driven by money rather than the student experience. It’s destabilising a system that’s worked very well for many years. The other point that we are just as concerned about is the fact that so many Cambridge students say to us how they relish that opportunity between dividing their time between Cambridge and London. From the perspective of the clinical experience, the wonderful experience that is valued by students from being in London. I do feel at the end of the day the argument should be one primarily on education and of the variety of education. I don’t hold that six years at Cambridge will provide great innovation and continuation of education. I’d like to see the evidence for that.”

All this comes at a time when London hospitals are facing a £2bn cut, and the loss of Cambridge students will contribute a further £24m deficit. Asking whether the significant cuts to London hospitals would affect the quality of clinical education: “Well, hopefully we would work hard to preserve the experience. The hospitals will still be here. It shouldn’t be that apparent, it’s a question of whether it will affect things in the long term. [The hospitals] won’t slip in terms of performance, nor in reputation or prestige. But we may need to approach the government for more funding – it’s a solution. Money will be tight and we may need to be more imaginative.”

Peter Woodward-Court, Editor-in-Chief




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