Statement on four-year medical degrees in England

The College was surprised and concerned to hear of the announcement made at the recent NHS Confederation meeting regarding the planned introduction of four-year undergraduate medical degrees in England. We are fully familiar with graduate entry four-year courses, but believe that undergraduate courses of this duration must be regarded separately.

We have not been part of any consultation on this, nor are we aware of any consultations or discussions involving any other Medical Royal Colleges, the UK Academy of Medical Royal Colleges, the Medical Schools Council or the GMC. 

This College previously welcomed the opportunity to engage with the GMC in consultation and discussion about their Vision for the Future of Medical Education and Training. We note the GMC's comments released on social media, subsequent to the NHS England announcement, indicating that a four-year undergraduate medical degree must meet their existing standards if it is to be accepted. We are however concerned that the timing and method of this announcement is very much against the spirit of engagement and consultation necessary to lead change of any sort in UK medical education. 

We believe that NHS England’s primary responsibilities are to deliver healthcare to the populations it serves, and to ensure that adequate conditions and human resource for the teaching and training of doctors and other healthcare staff of the future are provided in its facilities. We do not view NHS England as a primary body responsible for curricular design, particularly when design deviates from well-established models of the education and training of doctors.

Finally, should increasing student debt be a driver for the shortening of medical degree courses, we would suggest that NHS England lobbies government to review the financial support available for medical students over the full duration of existing courses, rather than try to reduce the length of medical undergraduate education and training in an unproven and controversial manner.

Commenting, Professor Andrew Elder, President of the Royal College of Physicians of Edinburgh said:

Few details of a four-year undergraduate degree course in medicine have yet been released but, at face value, the suggestion is concerning. The doctor is distinguished from other healthcare professionals by the length, depth and breadth of their education, training and experience, and the intensity of the assessments they undergo during that education and training. We do not believe that a four-year undergraduate degree course in medicine can provide sufficient depth and breadth of education and training, and predict that individuals so trained will find themselves less well prepared for clinical work than is currently the case.