ABOUT 1,000 extra places will be created for medical students each year from 2005 - a 20 per cent increase on present levels - the government has announced.
But academics are warning that quality will suffer if the additional places are not fully funded.
The extra places will cost Pounds 200 million per year, according to the Medical Workforce Standing Advisory Committee, which recommended the increase in student numbers to the government last year. But government funding for the expansion is yet to be revealed.
"It is extremely important that the places are funded at full cost," said Michael Powell, executive officer of the Council of Heads of Medical Schools. "Universities have done as much as they can to take extra students at marginal extra cost, but the scope for taking more has disappeared."
Most of the additional places will be created in England and Wales, the government said. It is setting up an implementation group to allocate the places between the various English medical schools once the number of English places had been decided. Wales has only one medical school, the University of Wales College of Medicine, Cardiff.
The implementation group will allocate the places according to criteria such as cost, the quality of training and the demand for doctors. It will be advised by bodies such as the CHMS.
The estimated cost of training a doctor varies widely between medical schools. The Higher Education Funding Council for England asked schools to estimate these costs and the number of additional students that could be taken, earlier this year. It is rumoured that the results ranged from Pounds 6,000 to Pounds 42,000 per student per year.
To keep these costs down, HEFCE encouraged the medical schools to form regional partnerships as part of the costing exercise. Other possibilities for expanding the number of medical students include setting up a new medical school and developing fast-track graduate entry schemes.
"We are concerned that the criteria take account of qualitative issues as well as the cost of additional places," said Mr Powell.
But the assessment of quality is always contentious. There has not yet been a teaching quality assessment for medicine in England; the first such scheme is due to start in October. To meet its target of admitting 5,450 medical students in October 2001, the government will need to allocate places before the teaching quality assessment is complete.
The General Medical Council also sets standards for the training provided by medical schools.
However, the reports on individual medical schools are highly confidential. The government has not said when it expects to allocate the places. But the CHMS would prefer it to do so as soon as possible.
"While we welcome the extra places, we would have preferred that the phasing in was over a shorter time," said Mr Powell.
As it is, the first full cohort in 2005 will not register as doctors until 2010 or 2012.
"It is still going to be a long time before the National Health Service and general practices see the fruits of the increase," he said.