Quicksand.
The weight of money in medical school
Written By Amman Ahmed
In this edition we’ve discussed widening participation (WP) within medical schools, but it would be a disservice to not consider the other side of the coin - money! A somewhat taboo, often underexplored topic that can be at the forefront of many medical students’ minds. One decision by a sixteen year old can become a six year commitment to rent, food and many other worries. This is part-article and part-diatribe, talking through the scope of medical school and some personal run-ins with this topic.
Layer One
UCL is a glorious institution, is it not? You leave the wonderful walls of the Cruciform basement, pushing past those heavy doors and face the beauty of the Main Quad… Or rather, a construction site teeming with hardhats and loud noises. You want to take it in, but a look at your phone reminds you that your shift is almost starting, you’ve got to get to work!
I draw attention to the quad because it encapsulates the first half of this diatribe. There’s a dissonance when you stare at this garish renovation whilst you live a life dictated by fine budgets and awkward shifts. While it is a little puerile to connect the construction work to an individual experience, those experiences are numerous and aren’t represented by the image UCL is so set on building. Some appreciation is deserved when you compare UCL’s bursary to other universities, but my eyebrows do still raise as UCL declares a “hiring freeze” (which affects both staff and student roles) amidst a renovation that seeks to turn the beautiful Portico into a mock-White house. Does this kind of investment help student development or is it set to encourage a more wealthy demographic to join the University?
Layer Two
We can narrow our scope to the 10% of UCL students encapsulated within the medical school. The medical school offers their own bursary in addition to UCL’s undergraduate bursary. This is a lovely treat when written down, but on careful examination it’s somewhat infuriating. The bursary asks for a personal statement that details exactly why you, on a 9-5 course with strict attendance policies, require additional funding. You need to provide a story that convinces the finance team you deserve their money.
From my light research none of the other top ten UK medical schools have such a laborious process. Above us, both Oxford and Cambridge offer very tantalizing bursaries that are medical-student specific. While they have strict requirements to not work during term time, they match this by making up for that financial need. We on the other hand are told from fourth year onwards that our degree is a strict 9-5 and are left to make sense of that ourselves.
By the time you reach Year 5 your SFE changes dramatically, with major implications on both your academics and general wellbeing. This forces students to constantly have one eye ahead of the game, futureproofing their decisions to make sure they can actually afford to stay on the course they’ve committed to. The bursary could be a clean and easy solution to this financial quicksand, but instead it’s awkwardly timed in the year, with decisions coming in by December - entirely inconvenient to plan anything around. And again, the personal statement forces you to spend time laying out your lived experiences, your worries and your fears into something you’ll never hear a human respond to. While there is some sense to having a personal statement match students to appropriate funding pots, this entire process is very cold and lacks a human touch, again forcing you to question how you fit into this institution.
Layer Three
If we narrow our scope even further, we can look to the people around us. Our differences as a cohort are what enable us to have interesting discussions and find unique solutions, but they can also leave you feeling even more disconnected from your degree. This was something I ran into last year as I signed up for an event that promised to be a chance to practice presenting research to real experts, getting both feedback and experience. This event was promoted as student-run and student-focused, with a great emphasis on filling a gap within the research pathway. Their promotion continued for quite a while, encouraging submissions, all while emphasising why it was such a useful event.
One fateful morning I received confirmation of acceptance. Yay! But there was a new piece of information - I had to pay £5 to accept my place and attend the event. This had not been stated anywhere before in the marketing. While £5 is not an excessive amount, its omission is the issue. An event advertised as student-run, championing student success that got people to write up abstracts during a very busy period of the year should never have thrown in a surprise fee and ten hours to pay it. It indicates a lack of awareness behind the scenes that really highlights why this topic is worth talking about.
The surprise cost was intended to cover “merchandise, food, refreshments, and prizes”. Merchandise is far from essential to running a successful event and prizes have the potential to foster unnecessary competition, antithetical to the aim of making research less daunting. While refreshments and food are good incentives for attendance, the wider society has many sponsors and the SU support. My thoughts are only worth so much, but at the time I contacted a staff member volunteering at the event. He also had no idea students had to pay, and was similarly surprised by the way it was announced. He’s a seasoned man, so I’d put some value in those opinions.
There is a great divide that runs throughout our six years and beyond. A financial line that allows for some people to attend conferences, submit abstracts and network with academics, advancing their careers while others are fighting to afford their degree. While our WP initiatives are great at getting people in, the playing field becomes uneven once admitted and the divide remains. As competition ratios get scarier, it’s lines like this that can shape people’s futures.
I do think the medical school is aware of these issues, but there’s a stark difference between indifferent awareness and conscious proactivity. It’s only through careful insight into the systems that we exist in that meaningful changes can be made to people’s experiences. This means looking at the system of the UCLMS bursary and trying to understand not just who it helps, but also who isn’t being helped. This responsibility stretches into our student body too. If RUMS wants to represent all medical students, they need to lead the conversation and be active advocates. Those event organisers told me they wished to “fill the gap identified within our community”, but what they needed to do first was take stock of everyone within that community.
One of the hardest parts of fighting for change within medical school is the six-year window. Realistically, first year is too early and sixth year is too late, so for most people there are only four years to try making any change - and not enough time to reap the benefits. We need to think of those who will come after us and find some hope in making UCLMS better for them. With enough small steps, that great divide could become a small crack to skip over.
Diatribe over.
Read the rest of the edition here
