The Royal College of Physicians (RCP) has called on the government to double the number of medical school places from 7,500 to 15,000 to meet the needs of tomorrow’s patients.
In a policy briefing entitled Double or quits: calculating how many more medical students we need - launched today at the RCP’s Innovation in Medicine 2018 annual conference - RCP registrar and president-elect Dr Andrew Goddard outlined new calculations for the number of doctors needed, and set out the key issues facing workforce planning in the UK that affect current supply, future service demand and predicted losses in the workforce.
Double or quits
Currently physicians make up around a third of all consultants in the UK, just over 15,700 of 47,800. Of these, 36% are women and 64% are men. 42% of the women and 10% of the men work less-than-full-time (LTFT). Those that work LTFT are contracted to work an average of 7.4 programmed activities (PA) compared to 11.4 for full-timers. That means a headcount of 15,700 equates to 14,510 FTE.
Based on vacancy data, and to correct for the current shortage, the medical workforce are short of 2,330 consultants of which physicians make up a third, meaning 760 heads or 630 FTE. This seems a reasonable estimate as there were 679 unfilled consultant physician posts advertised in 2017. Correcting for this shortfall, if our current workforce was replete we would have 15,140 FTE consultant physicians.
We will therefore need an additional 2,840 medical students per year for the next 5-years to create 2,270 additional consultant physicians in 2030
Discussing the figures, Dr Goddard said:
[The figures] become even more frightening when we remember that physicians are just one-third of the workforce: general practice, psychiatry and emergency medicine are all equally under pressure and have a similar shortfall. I have not done the maths for each of those but it seems a reasonable estimate to say that an additional 7,500 medical students per year will be needed at the very least.
In other words, we need to double our numbers because quitting on the workforce issue is not an option.
RCP president Professor Dame Jane Dacre underlined the message in her opening address at the conference, stating:
I believe that we have reached the limit of what we can do as a college to influence the workload in individual Trusts. There is only one conclusion and only one solution, we need more of us - a lot more.
We all know this and take it for granted, but how many of us know the scale of the workforce problem not just right now, but 20 years into the future? For the first time our registrar and president-elect Dr Andrew Goddard has calculated how many more physicians we will need if patient demand continues to increase at the same rate – an additional 2,270 consultant physicians by 2030. So we need 2,840 extra medical school places per year to achieve that overall gain.
This is a huge figure and I can already see you thinking that this is impossible, that the figure is so enormous that it isn’t realistic. Yet what choice do we have – do we want to pretend that we can struggle on without a major increase just because that isn’t popular with the Treasury? Pretend that artificial intelligence will really make our jobs redundant? Pretend that somehow the population will magically become healthier despite all the evidence to the contrary including cuts to public health services and a lack of political vision to enact healthy legislation?
No, I’m not going to pretend any longer. We need more of us - full stop. What’s more, physicians make up a third of doctors working in hospitals – what happens when we add on the increases needed in all the other specialties? A conservative estimate is that we will need 7,500 extra medical students a year – twice the current intake and 227 per medical school.
Dr Goddard will be available for interview on Monday 25 June at the RCP’s annual conference: Innovation in Medicine 2018.
To arrange interviews and for further information please contact RCP head of PR Linda Cuthbertson by phone on +44 (0)20 3075 1254 / +44 (0)7748 777919, or by email at Linda.email@example.com.