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Double or quits: a blueprint for expanding medical school places

In 2018 the RCP called for the number of medical school places to be doubled. In this report, we look at how to implement such an expansion. We provide a blueprint for growth covering the model of provision, the costs, challenges and opportunities. 

The challenges facing the NHS workforce are significant. Even with decisive action, it is going to take at least a decade to get the NHS workforce back on a sustainable footing. It is vital that we now take stock and plan for the next 10 years. We need to consider and respond to the immediate challenges, but also look over the horizon. 

We hope this report will provoke discussion and debate about the future of medical student training in the UK. While its focus is on undergraduate medical education in England, at times it draws on data and considers what is happening in Wales, Scotland and Northern Ireland. 

There is no one-size-fits-all approach and we are not suggesting that there should be. But we do believe there is a need across the country to realign the graduate attributes of medical school students with the needs and realities of the health and care system. We should take the opportunity to do just that. 


The UK government should:  

  • double the number of medical school places from 7,500 to 15,000 per year, at an annual cost of around £1.85bn  
  • ensure that an expansion of places and the process of allocating places incentivises an increased focus on widening participation in medicine  
  • build on the successful work of the previous expansion to provide medical school education across the whole of England  
  • undertake further detailed work to fully understand the potential undergraduate applicant pool, asking UCAS to carry out research with potential applicants to medical school and other science subjects to understand the appetite for places and the perceptions of the entry process to medicine  
  • consider an increase in undergraduate foundation years for medicine as part of a strategic approach to NHS workforce planning.  

The UK government and regulators should:  

  • ensure that expansion proposals are informed by the Selection Alliance reports, which provide a wealth of insight into the areas that need a greater focus  
  • consult with medical schools about moving towards an apprenticeship-style final year of medical school when developing expansion plans.  

The NHS should:  

  • address the challenges and opportunities facing the clinical academic workforce in the people plan, including year-on-year growth and the development of clear clinical academic career pathways to create a sustainable pipeline to meet future demand  
  • widen the pool of clinical educators to facilitate expansion.  

Medical schools should:  

  • review their curricula to ensure they create cohorts of doctors with a broad base of skills, able to develop into specialists as their careers progress.