Medical students at Robinson, like all those undergoing clinical training within the University of Cambridge, are expected to undertake an elective period of clinical practice and research during their fifth year of studying medicine (the second clinical year). Students select an elective opportunity depending on a range of factors. Many try to use this period to work in a completely different environment from the NHS in order to broaden their clinical and research experience and to provide comparisons for the system in which their training is based. Often they do this by arranging an elective overseas, either in a developing country with limited healthcare resources, or in a developed country with different funding systems for, or approaches to, healthcare or research. Such electives are invaluable in helping to train and develop the best possible patient-centred clinicians. Approximately 80% of students chose to undertake their elective abroad in order to experience a different health system from the NHS. The remaining 20% chose to complete their electives in the UK and used this time to gain greater experience in one or two particular speciality areas, as for many students this elective is their only chance to spend more than a week or two in certain specialities before they had to make decisions about applying for a speciality registrar place later in their career progression.
Students are expected to cover the costs of these electives, including travel, occupational health costs (such as inoculations), elective fees payable to the host hospital, accommodation and subsistence. These costs can have a significant impact on the choices that students are able to make about their elective period, with those from lower income backgrounds sometimes unable to pursue their preferred elective due to of lack of funds. Given these electives are compulsory, this can also mean that students have lower personal funds available for subsistence during term time.
The number of students affected in this way at Robinson is increasing, in part because of the increase in student fees for UK/EU students in recent years creating a situation in which medical students are already heavily in debt by this stage of their training and also because the allocation of clinical training places in the UK is changing. From 2015 all pre-clinical medical students at Cambridge will remain in Cambridge for their clinical training. Previously, the allocation of clinical places around the UK was decided by a funding formula that resulted in up to half the pre-clinical students from Cambridge having to move to London, Oxford or other centres of medical training because there were insufficient places available at Cambridge. It will be a great benefit to medical students to be able to complete their training within a single university, but it does mean that Robinson will have up to nine students going on medical elective placements each year, instead of the previous three.
In addition to the compulsory clinical electives, the brightest students are encouraged to undertake a summer placement during their pre-clinical training. These are approximately 2 months long and usually based in a high-level bioscience lab in the UK or overseas. The best students are encouraged to undertake these projects in order to further develop their capabilities and realise their full potential as a clinician by providing a more detailed understanding of the scientific research behind clinical practice. It also encourages students to consider applying for combined MB/PhD programmes, or complete a PhD or MD later in their clinical training. These programmes are highly competitive, and summer research projects provide valuable research experience for their applications, as well as important insights into academic medical careers. The College would like to offer up to four grants per year averaging £750 each.
This combination of the increase in student fees, the increased numbers of clinical students at Robinson and the restricted grant-making resources already available in College has resulted in the decision to seek to raise funds for a dedicated and permanent medical student support fund. In the first instance, we aim to be able to offer each medical student an average of £1,500 towards their medical elective expenses and later to also award up to four summer project grants per annum. With up to nine students per annum applying for elective support, this £13,500 per annum cost for electives, plus £3,000 for summer projects, requires an endowment fund of £413,000 based on the College’s 4% draw down rule. Seed-corn funding of £30,000 has been given to establish the Chaffield Shaw Medical Support Fund.