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Last week the government announced it was temporarily lifting the cap on the number of medical school places in England, after A level students who were unable to sit exams because of covid were awarded grades based on teachers predictions Abi Rimmer examines the fallout Abi Rimmer What does the announcement mean for students? The Department of Health has said that where students have met their offer to study at a medical school they should be able to take up that place this year or be guaranteed a place at their chosen medical school in 2021-22 Additional teaching grant funding will be provided to medical schools that take on extra students Medical schools routinely make more offers than they have places, by around 20%, because they know that around 44% of students will not achieve their predicted grades 2 The Medical School Council has estimated that because students have been awarded their predicted grades this year around 1600-2000 extra places will be needed This means medical schools are expected to take on more students this academic year, award deferred places for next year, or both Will all these students cope at medical school? The MSC has warned that awarding all students their predicted grades could result in \'a higher likelihood of a greater than usual failure rate as students progress through their very demanding studies \' 2 Chris McManus, professor of psychology and medical education at University College London, and colleagues have conducted research that shows that A level exam results, rather than predicted grades, are the better predictor of how well a student will perform at medical school 3 Their results indicate that students whose predicted grades were higher than the grades they would have achieved if they sat their exams may struggle \'We know there are always some students who are challenged by medical school,\' McManus says \'It is a really hard course When people let in students with lower A level grades they tend to do less well There is little doubt about that \' of the BMA\'s academic staff committee and a senior clinical lecturer at the University of Exeter Medical School, warns that many universities are already struggling \'In six weeks\' time we are going to have up to 20% more medical students in universities that are desperately trying to get people back into some sort of lecture programme, while knowing that we don\'t have the space for physical distancing,\' he said Medical schools are also suffering from a declining clinician academic workforce, with senior lecturer numbers falling by 27% since 2004 4 Strain warns that the decline is now being coupled with cuts to hours and, in some places, cuts to jobs \'We are seeing clinical academics being asked if they would defer their pay rises this year, as well as voluntary early retirement and voluntary redundancy schemes,\' he said The covid-19 pandemic has had a huge effect on universities\' finances, Strain says \'Universities haven\'t been applying for grants because of the current environment, and the covid-19 studies that are being done are being done at a loss because the National Institute for Health Research only pays 80% of the total cost of the study,\' he says \'Some universities have also handed back student bursaries and accommodation fees, as well as losing fees from international students Charitable incomes have also fallen because of the pandemic \' All this means that universities will potentially be in the red by hundreds of millions of pounds at the start of the new term, Strain warns What does the government\'s promised funding for the extra students cover? Though an increase in teaching grant funding has been promised, it is unclear whether there will be extra funding for the additional students\' clinical placements The health department has said that work is being done to ensure that clinical placements would be available for these additional students but did not respond to questions from The BMJ about how placements would be funded 1 the bmj ;BMJ 2020;370:m3358 ;doi: 10 1136/bmj m3358 NEWS The BMJ Cite his as: BMJ 2020;370:m3358
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