UK Edition
Accepting medical students on the basis of teachers' A-level assessments could mean more flunking exams and dropping out, medical leaders have warned.
Following the Government's U-turn on Monday, the Medical Schools Council (MSC) pointed out that nearly half of schools' predicted grades were over-estimates of what students normally achieve in exams.
"As a result of the change to teacher-assessed grades (see graphic below), there are now more successful offer holders in the system than there are places," the regulator said.
"There is also a worry that this could result in a higher likelihood of a greater than usual failure rates as students progress through their very demanding studies."
Professor John Atherton, the co-chair of the MSC, said: "Because we have more students and their grades are less certain, we are going to have, on average, students with lower grades than in previous years. It's going to be difficult for them."
Prof Atherton added that many medical schools will struggle to accept more students this year and will have to offer them deferred places instead – potentially leaving those going into the upper sixth next month with fewer places available when they apply.
Medical students are offered places on the basis of predicted results, specialist tests and interviews at individual medical schools. They then normally have to achieve high grades in their A-levels.
On Wednesday, a spokesperson for the MSC said higher failure rates were "speculative… we mention it as there is a concern", adding: "Not meeting their predicted grades might suggest that students have not built up the knowledge they need.”
Chris McManus, a professor of psychology and medical education at University College London, said some students could be awarded grades two categories higher than they would have achieved had they sat the exam.
"My prediction is that we will either have a higher proportion of people dropping out or having difficulties, or the medical schools will somehow be forced to drop their standards," he said.
Prof McManus's research has shown that the A-levels grades medical students achieved in exams were a better indicator of how they would progress through their degree than the predictions teachers made when they applied – which are likely to be close to the grades now being awarded (see grapic below on the rise in A and B grades).
The British Medical Association has called on the government to increase funding for doctor training to match its lifting of the cap on medical school places, which is usually tightly controlled.
Some students who will now be offered places at medical school following the grades U-turn are likely to be asked to defer for a year. Many courses had filled all their allocated places by the time of the Government's announcement and it would be difficult to expand the number of places quickly, the MSC said.
"It is a big worry to us that the cohort next year will be disadvantaged. There will be fewer places," it added.
Prof Atherton called for a "modest" expansion of places this year and then more next year – and potentially the following year – to ensure that no one lost out.
There are just under 7,000 medical school places available in England each year, with around 450 more going to overseas students. However, medical schools do not yet know how many students have met their offers based on the centre-assessed grades.
The MSC said it wanted to see any increase in places fully funded rather than in response to what it said was "a crisis in A-level assessment".
Matt Hancock, the Health Secretary, has said the Government is "looking at" lifting the cap on medical student places.
Funding additional places would be expensive. It costs around £175,000 to train a medical student, with only part of this funding coming from tuition fees. As well as teaching in universities, hospitals and GPs are paid to provide clinical placements to medical students.
Meanwhile, the Royal College of Physicians of Edinburgh has warned of a "brain drain", with bright Scottish students attracted to English universities if the number of medical school places is increased in England. It wants to see more places created in Scotland as well.