Changes to the UK foundation programme: a catalyst for the decline in intercalating medical students

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Intercalation degrees have long been recognized for their numerous benefits, as extensively documented in the literature1. Despite this, there has been a significant nationwide decrease in intercalating students in recent years, with the underlying factors largely remaining undocumented2. While Politis, Womersley and Summers highlighted that the introduction of preference-informed allocation for academic foundation posts3 does not explain why a declining number of students are undertaking intercalated science degrees4, it is evident that the decline is concerning. Historically, intercalating medical students have shown a notable interest in academia. However, recent changes in the allocation of academic foundation posts, which fail to acknowledge applicants’ research interests and achievements, will likely discourage students from investing an additional year in pursuing an extra qualification. This lack of recognition in foundation job applications significantly diminishes the incentive for medical students to undertake intercalated degrees, contributing to a downward trend in intercalation rates nationwide.

Intercalation is vital in nurturing a cohort of future clinician-academicians poised to translate scientific breakthroughs from the laboratory to bedside patient care. Medical students considering intercalating are already grappling with the soaring cost-of-living crisis and inflation pressures5. Failure to provide recognition for intercalated degrees in the allocation of academic foundation posts would undoubtedly deter students from pursuing such endeavours, resulting in a further decline in intercalation nationwide. A concerted effort is required from all stakeholders to rectify the multifaceted nature of students’ decision-making process around intercalation to ensure the continuity of the pipeline of undergraduate medical research and the nurturing of future academic clinicians.

1. Jones M, Hutt P, Eastwood S, Singh S. Impact of an intercalated BSc on medical student performance and careers: a BEME systematic review: BEME Guide No. 28. Med Teach. 2013;35(10):e1493-510.
2. House of Lords Science and Technology Committee. Clinical academics in the NHS inquiry. 26 Jan 2023. https://committees.parliament.uk/publications/33678/documents/184035/def…
3. Lynn É. Changes to academic foundation jobs spark concern. BMJ2024;384:q423. doi:10.1136/bmj.q423. pmid:38373794
4. Politis M, Womersley K, Summers C. Changes to the UK foundation programme add further challenges for doctors pursuing clinical academic careers BMJ 2024; 384 :q485 doi:10.1136/bmj.q485
5. Murray A. Medical students across the UK are feeling the financial heat: BMA 2022 [Available from: https://www.bma.org.uk/news-and-opinion/medical-students-across-the-uk-a….

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Electronic Publication Date: 
Wednesday, February 28, 2024 – 01:51
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Changes to the UK foundation programme: a catalyst for the decline in intercalating medical students

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Last Name: 
Lim
First name and middle initial: 
Jun Jie
Address: 
University of Sheffield, Beech Hill Rd, Broomhall, Sheffield S10 2RX
Occupation: 
Specialised foundation doctor in medical education
Affiliation: 
School of Medicine and Population Health, The University of Sheffield
BMJ: Additional Article Info: 
Rapid response
Twitter: 
@JJLim_MedEd

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