The Scottish medical student policy is a sensible use of devolved powers

6 Jul 2019


Last week, the Scottish Government announced a policy which is set to see prospective Scottish-domiciled students looking to study Medicine at Scottish universities given priority over their counterparts from elsewhere in the UK.  It has proved contentious since its announcement, with some saying that it unfairly disadvantages non-Scottish students and even discriminates on the basis of national origin.  Although it could be viewed in this way, the policy addresses the serious issue that NHS Scotland could face a shortfall in its number of doctors if the status quo was to be maintained, and therefore outlines a strategy to increase doctor numbers every year.


Medicine is renowned as being one of the most difficult fields of study to get into, largely down to steep entry requirements and an excessive number of applications from those who meet them, yet it’s commonly understood that the NHS is under more strain than ever before.  A growing number of pressures, such as an aging population and an ever-increasing demand for health service, are forcing the government to make radical decisions to ensure the functioning of the NHS.


The report published by the Scottish Government highlights the retention rate of graduates from Scottish medical schools.  It sheds light on the fact that students from elsewhere in the UK, who have come to study in Scotland, are almost half as likely to remain here and enter specialist training following the completion of their degree compared with Scottish “home” students – 44% to 80%.  To counteract this imbalance, the new policy would see an increase of 100 Scottish/EU domiciled medical students, whilst seeing an equal drop in the intake from the rest of the UK.  The policy would be phased in over a three-year period, and the Government projects the resultant outcome being an additional 36 doctors working in NHS Scotland every year.

So, what’s the problem?  The obvious effect of prioritising Scottish-domiciled students is the lesser chance of students from the rest of the UK being admitted on to Medicine courses.  Critics of the policy have been quick to express their concerns; the Scottish Conservatives are among those in opposition, arguing that the policy is discriminatory, and that the SNP should instead be focusing on making Scotland an attractive place to stay upon graduating.


But that’s exactly what the Scottish Government is doing – just last year the Government announced that it would be funding 85 places on “innovative” medical courses at three Scottish universities with the aim of making general medicine a more attractive career path for medical students.  In May, the Scottish Conservatives criticised the SNP for taking the decision to halt the assignment of VAT revenues to the Scottish budget, arguing that they weren’t seizing the opportunity to utilise their devolved powers.  Yet here we have the Scottish Government now doing just that; the area of higher education is within the devolved competence of Scottish ministers, but the implementation of this policy fails to gather their support.


Let’s not get carried away here – this policy is not going to directly discriminate on the grounds of protected characteristics (as we saw when Oxford’s concerning admissions statistics came to light in 2013), nor is it implying that Scottish medical students are more qualified or better suited to the profession.  The policy simply acts in light of the facts; it allows us to harness the talent of our new graduates, whilst securing the long-term future of our health service, and it is unfortunate that prospective students from England, Wales and Northern Ireland may be disadvantaged by this.


Will it solve the NHS crisis?  Probably not.  But it’s a step in the right direction.

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