‘Routine failures’ in Scottish medical schools due to overcrowding

Scottish medical students are suffering from overcrowded lectures and a lack of placements after numbers were expanded without investment in teaching capacity, the British Medical Association Scotland has warned.

A 72 per cent rise in the number of students over the last decade, from 3,928 to 6,761, has resulted in “routine failure to deliver core elements of training”, according to a stark report published by the doctors’ body on 12 March.

One student interviewed for the study reports people having to sit on the floor in lecture halls with overcrowding also affecting placements “limiting hands on experience and patient engagement”.

The vast majority (85 per cent) of students told researchers there were already too many medical students at their university and nearly three quarters believe that current numbers are not compatible with high quality education and training.

The Scottish medical students committee (SMSC) chair, Joe Payne, said the findings showed that recruiting more medical students was not the way to address doctor shortages without corresponding increases in opportunities for training and employment.

Beyond Capacity represents the views of 549 medical students across all Scottish medical schools and all stages of training, 8 per cent of the current cohort.

After the rise in students, Scotland now trains almost twice as many medical students per head of population as England, it highlights.

Despite this, the report cites data that show the number of medical academics has “remained broadly unchanged for around two decades, leaving Scotland with similar academic staffing levels to those seen in the mid-2000s”.

This was creating pressures on the system that were being widely felt. Nearly two thirds of respondents report “being denied teaching they were scheduled to receive, most commonly because clinical staff were too busy or because there were too many students present at the same time”.

On clinical placements, more than four in five respondents report that large numbers of students had negatively impacted their experience.

Six in ten students say they had been turned away from a scheduled placement “most often because staff were too busy or because excessive numbers of students were already present”.

This was also having an impact on patients who are made to feel uncomfortable. “I think it’s terrible for patient wellbeing when they have a massive group of medical students there,” a third year student at the University of Aberdeen is quoted as saying.

“The good will of academics and doctors can only stretch so far when ward rounds try to accommodate six or seven students, anatomy laboratories are full to the brim, and students sit on the floor of lecture theatres to avoid missing out,” said Payne.

The worries were also impacting students’ fears about future employment opportunities, despite Scotland needing more doctors.

Anxiety about employment was found to be “near universal”, with 99 per cent worrying about employment after foundation training and 97 per cent concerned that student numbers will limit their access to speciality training.

This was pushing a third to consider leaving medicine altogether, with most citifying the “recruitment crisis” as a factor.

“At the moment, high-quality education is still being provided and high-quality graduates produced but that does appear to be in spite of the circumstances they train in and not because of them,” said Payne.

“The system is currently being held together only by the goodwill of academics and doctors, which is being stretched to the limit and cannot last indefinitely.”

The report called for student numbers to be “urgently reassessed” alongside investment in pre-clinical and clinical education “including expanding the medical academic workforce”.

tom.williams@timeshighereducation.com