The Student Funding Shortfall

[box] Rob Cleaver talks to ICSM Welfare Officer Jennie Watson about the troubling survey that found over 90% of NHS funded medical students have financial concerns [/box]


Adequate funding is a substantial barrier for many UK students but a shocking survey conducted by the ICSM Welfare Officer has highlighted just how desperate the financial situation is for many medical students in their final two years at London medical schools.

Half of the survey’s respondents stated that their financial situation had the capacity to impact their ability to study or complete their medical degree, whilst a mammoth 90% of students stated that they were worried or had ongoing concerns about their financial situation.

Under the current funding system, the first three years, four with an intercalated BSc, of an undergraduate medical degree are funded by Student Finance England (SFE). This  funding is comprised of the tuition fee loan as well as a means tested loan and an additional means tested grant for day-to-day living costs. However, the final two years of a medical degree are funded by an NHS bursary designed to cover both tuition fees and, with an additional means tested element, living expenses. On top of NHS funding, students in their final two years are also entitled to a scaled back loan from SFE. Any shortfall in funding is expected to be covered by parental goodwill.

What this means in real terms is that the funding available for a medical student at ICSM drops from an average of £5,238 in year 4 to £3,964 in years 5 and 6. This demonstrates a hefty 25% decrease in average income for medical students entering the clinical phase of their degree course. The absolute maximum funding available from SFE and the NHS combined is £9,131 which, if modelled onto a 37.5 hour working week for 47 weeks, works out as £5.18 an hour – £1.32 per hour short of the UK minimum wage and a massive £3.97 per hour short of the London living wage without even taking into account the expectation of additional study time in the evenings.

The survey into the state of student finances was the brainchild of the ICSM Welfare Officer Jennie Watson, herself a 5th year medical student feeling the pressures of a meagre student budget. She found that the sudden decrease in funding for students, coupled with increased academic demands, travel costs and timetable flexibility in which to hold down a part time job, has many negative implications.

The average weekly outgoing on rent was £141, an average £25 is spent on travel and £20-£30 on food. Jennie also found that 81.6% of those that responded to the survey felt they were unable to meet their basic living standards for rent, food and travel without parental funding which itself continues to be highly variable. “The established systems expecting parents to foot the bill overlooks the fact that some parents are able to help and some parents are not.”

A further problem, Jennie explained to me, was often because the current funding system has been slow to adapt. “It’s (the NHS bursary website) an antiquated system that hasn’t risen in line with cost of living. In London, the cost of living has gone up 26% in the last five years and the funding available for students just hasn’t”.

The survey asked students to summarise their financial concerns and consequently threw up some troubling stories. Some students are forced to choose which days they attend their hospital placements due to travel costs whilst others have been prescribed anxiolytic medication due to their monetary fears. One student even admitted to having to be savvy with credit card companies by moving credit around from one card to another to avoid racking up even more debts.

Running concurrently to this survey, Dr. Mike Schachter, Faculty Senior Tutor at ICSM, was also monitoring the financial situation of clinical students. His own report into the use of the Student Support Fund, a resource for medical students in particular financial hardship with a maximum value of £1000, demonstrated that many more students were requiring additional financial assistance in the first part of this academic year than ever before. In fact, in the first quarter of the 2014/15 academic year, Dr. Schachter has distributed more than half the amount that he had awarded in the whole of the previous academic year.

“Fundamentally,” Jennie continues, “I think it is very wrong that we sign up to provide a health service as doctors but must first go through a substantial risk to both our physical and mental health in order to do so.”

A solution, however, seems to be very complicated. “SFE and the NHS don’t talk to each other,” Jennie tells me. It is apparent that what they do provide is not enough to cover the costs of being a medical student in London. One proposed method is to integrate funding into one system that would be able to better monitor the needs of medical students and together, they must review the total cost involved in successfully completing a medical degree.

Another hypothesised fix is to extend the Imperial College bursary which students in the first four years of their degree are eligible to receive if their parental income is lower. However this, obviously, overlooks the students in the middle ground whose parents earn too much to allow them to be eligible for both an NHS bursary and an Imperial College bursary but are still unable to provide enough money each month to support their child through the final two years. Of course at other London medical schools, this avenue of funding may not be available and so a widespread and all-encompassing solution is desperately needed.

Jennie also raised the idea of an NHS loan, no different to the student loan received earlier in the course that is repayable at a low interest rate. “It wouldn’t be extra money drained from the NHS because when medical students qualify they are reliably able to pay back their student loans.”

Whatever the direction taken, if any, the problem for funding the final two years of a medical degree is an odorous one. As the gap between the costs of living in London and the amount of money that students receive widens, the situation is only going to get bleaker. One respondent to the survey replied: “If I didn’t work through every weekend as well as attending my hospital placement in the week I would, essentially, not be able to live”. Perhaps it is already bleak enough.


The survey is still available for all London medical students to fill in here

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