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Students hoping to study medicine and dentistry this year are in a uniquely difficult situation. Medical and dental schools throughout the United Kingdom recognise the intense disappointment for applicants who may be unable to gain places for which they have worked so hard for many years.

The Medical and Dental Schools Councils are committed to finding just and equitable solutions to the problems arising from the cancellation of exams, the initial substitution of calculated grades and now the reliance on teacher assessments. When calculated grades were announced more applicants than usual failed to meet the grades required by their offers and this has disproportionately affected applicants from less privileged backgrounds. Nearly all medical and dental schools responded to this quickly and flexibly by accepting firm offer holders who missed their conditions by one or two grades.

Unlike the majority of university courses, medicine and dentistry have tightly restricted entry numbers, determined by Government, and these places have now largely been filled for entry in autumn 2020. Medical and dental schools will respect the further changes to the grading system announced in Wales, Northern Ireland, and England today (17 August 2020), as they have done throughout the 2020 admissions cycle. This does not mean, however, that all applicants who now meet the conditions of their offer will be able to start medical or dental school in 2020. MSC and DSC will work with DfE and DHSC to see what funding solutions can be put in place to facilitate any additional places. Whilst some schools might be able to take a modest increase in numbers, their ability to do so will be limited by specialist facilities for subjects such as anatomy, clinical placement opportunities and numbers of dental chairs, particularly in the latter years of the course.

Of great concern is the impact of large numbers of successful appeal candidates on the cohort of potential applicants for 2021 who have already been significantly disadvantaged by an extended period of school closure. Unfortunately schools’ predicted grades do not align accurately with subsequent exam results being: 44.7 % overpredicted, 6.5 % underpredicted and 48.8% accurate at the level of individual A level subjects.[1] As a result of the change to teacher assessed grades there are now more successful offer holders in the system than there are places. 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.

All graduates are required to undertake foundation training in the NHS and any substantial increase in student intake in the current or subsequent years will have major funding consequences for DHSC/NHS for many years to come. Whilst the expansion in numbers of medical and dental students and future doctors and dentists is undoubtedly required, it should be undertaken in a fully planned and funded manner rather than in response to a crisis in A level assessment.

Signed:

Prof Malcolm Reed, Co-Chair MSC

Prof John Atherton, Co-Chair MSC

Prof Christopher Tredwin, Chair DSC

Dr Katie Petty-Saphon CEO, MSC and DSC

Notes:

[1] McManus et al, Calculated grades, predicted grades, forecasted grades and actual A-level grades: www.medrxiv.org/content/10.1101/2020.06.02.20116830v1.full.pdf