Three down two to go just started my fourth year. I am excited about sinking my teeth into some of the diverse fields of medicine. Orthopaedics, gynaecology and dermatology are some of the specialities I can look forward to. My excitement was short lived for I received my loan papers today. Granted my initial reaction was a sense of relief as the cash strapped summer holiday was officially over and now it was time for some spending. However as I scanned through the documents I came across my depressing loan repayment form. I felt as if someone handed me a subpoena. Over the years I had gathered a debt of £15,000. This came as a shock to me as I thought I had kept a close eye on my financial situation. How could have this happened? Moreover, what is with this interest? I thought Tony Blair told us that we would only be paying back what we borrowed. Adamant to find the aetiology of this student debt I reflected on my previous student years.

After much pondering I soon realised that it was not my spending that was the cause.

Accommodation and school fees were by far my biggest costs. Accommodation was dictated by commercially minded landlords. The possibility of bringing any change there is unlikely but something radical like changing the five year course could be interesting. Imagine for one second that medicine was only four years long. Imagine the amount of money you would save by not paying school and accommodation fees for a year. Not possible you would say. Reflect back to years one and two of medicine. How much of it do you remember and more importantly how much do you think was useful. Granted the holidays in years one and two will probably be shorter, but it is a price I would gladly pay in return for making huge savings. Four year courses already exist for postgraduates and USA medical students, so why can’t we have something similar?

You might think it doesn’t matter because you are guaranteed a decent paid job and will be able to pay your debts off but today’s doctors are guaranteed nothing. The lack of training posts and over production of junior doctors has made it extremely competitive to get a job. Why does the government invest over £250,000 (http://www.hefce.ac.uk) into our training and then let us wither and die. You can see how employing foreign doctors saves the government loads of money. I propose that medical schools should reduce their intake. Obviously there is no longer a shortage of doctors, so why is there any need to have 200 plus students in a year? And why are we trained using economies of scale? The answer is simple it is all about the money. Training medical students is a lucrative business; medical schools and teaching hospitals together receive £250,000 per student. Do you think you received training which was worthy of this investment? I know I have not; countless number of times I have been part of a group of medical students assigned to one busy ward. Teaching has been awful but I do not blame the staff. Hospital doctors and wards are extremely busy and it is irrational to believe that they can take on six medical students or more on top of their daily responsibilities. Training would be much better if there were fewer medical students.

I realise that radical changes like these will never happen but I thought as a medical

student you should be made aware of some of the reasoning that goes on behind our

education. Additionally to get students to start thinking about their education; questioning the way they are taught and hopefully making changes for the good.

Zabair Ahmed is a 4th year medical student at Leeds University.