{"id":5102,"date":"2010-10-18T11:58:04","date_gmt":"2010-10-18T10:58:04","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=5102"},"modified":"2010-10-18T11:58:04","modified_gmt":"2010-10-18T10:58:04","slug":"richard-smith-medical-schools-to-close","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/","title":{"rendered":"Richard Smith: Medical schools to close?"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.bmj.com\/site\/blog\/icons\/bmjh7648e.jpg\" alt=\"Richard Smith\" width=\"160\" height=\"110\" align=\"left\" \/>Until now medical schools have had it easy. They have lots of high quality applicants, most students graduate, and all of them can find jobs. Suddenly, as for many others in Britain, the world looks more hostile.<\/p>\n<p>I hang around medical schools, and many people think it likely that one or two medical schools may close in the next 10 years. The country may well not be able to afford the number of doctors set to graduate in the next decade, and the NHS may be increasingly interested in cheaper alternatives like physician assistants and nurse practitioners. Medical unemployment may be close.<!--more--><\/p>\n<p>And if unemployment becomes a reality then potential students may be more reluctant to take on the increased debt that will be the result of lifting the cap on tuition fees. At the very least students paying large fees may become more discerning customers and turn away from schools that don\u2019t offer a rich experience and a high likelihood that they will be well regarded by future employers and so be able to get the jobs they want. In other words, competition among schools will increase\u2014and the competition may be on quality and price. And some may go the wall.<\/p>\n<p>\u00a0So as a dean how might you ensure that your medical school will survive and flourish? The general answer is easy: like any business you must delight your customers and offer value for money. But who are the customers? Essentially there are two: students and future employers of doctors. What is it they want?<\/p>\n<p>Employers, essentially the NHS in Britain, want doctors who are clinically competent, patient centered, empathetic, good communicators, team players, and ethical.\u00a0 But that\u2019s the minimum (even though it\u2019s not always achieved). What might be the extra factor, the USP (unique selling point) of a graduate? I believe that it\u2019s the capacity to understand, work in, and even enjoy a complex system (all hospitals) and to be able to contribute to improving it. That sounds pompous, and it could be just a capacity to enjoy change\u2014but I think that it\u2019s more, not least it\u2019s a knowledge of the crunchy complexities of improvement science. And I think that this could be the right extra factor because I hear so many leaders of hospitals complain that doctors are more part of the problem than part of the solution.<\/p>\n<p>And what do students want? I\u2019m tempted to say \u201cminimal hassle in the transition from schoolchild to doctor,\u201d but it must be more than that. Might it be the capacity to flourish within a complex environment? So might it be that students and employers want the same thing?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Until now medical schools have had it easy. They have lots of high quality applicants, most students graduate, and all of them can find jobs. Suddenly, as for many others [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":38364,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[955,224],"tags":[],"class_list":["post-5102","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-richard-smith","category-students"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Richard Smith: Medical schools to close? - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Richard Smith: Medical schools to close? - The BMJ\" \/>\n<meta property=\"og:description\" content=\"Until now medical schools have had it easy. They have lots of high quality applicants, most students graduate, and all of them can find jobs. Suddenly, as for many others [...]More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/\" \/>\n<meta property=\"og:site_name\" content=\"The BMJ\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/bmjdotcom\/\" \/>\n<meta property=\"article:published_time\" content=\"2010-10-18T10:58:04+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/Richard-Smith.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"540\" \/>\n\t<meta property=\"og:image:height\" content=\"350\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:site\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2010\\\/10\\\/18\\\/richard-smith-medical-schools-to-close\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2010\\\/10\\\/18\\\/richard-smith-medical-schools-to-close\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"Richard Smith: Medical schools to close?\",\"datePublished\":\"2010-10-18T10:58:04+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2010\\\/10\\\/18\\\/richard-smith-medical-schools-to-close\\\/\"},\"wordCount\":453,\"commentCount\":2,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2010\\\/10\\\/18\\\/richard-smith-medical-schools-to-close\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2017\\\/02\\\/Richard-Smith.jpg\",\"articleSection\":[\"Richard Smith\",\"Students\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2010\\\/10\\\/18\\\/richard-smith-medical-schools-to-close\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2010\\\/10\\\/18\\\/richard-smith-medical-schools-to-close\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2010\\\/10\\\/18\\\/richard-smith-medical-schools-to-close\\\/\",\"name\":\"Richard Smith: Medical schools to close? - The BMJ\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2010\\\/10\\\/18\\\/richard-smith-medical-schools-to-close\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2010\\\/10\\\/18\\\/richard-smith-medical-schools-to-close\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2017\\\/02\\\/Richard-Smith.jpg\",\"datePublished\":\"2010-10-18T10:58:04+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2010\\\/10\\\/18\\\/richard-smith-medical-schools-to-close\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2010\\\/10\\\/18\\\/richard-smith-medical-schools-to-close\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2010\\\/10\\\/18\\\/richard-smith-medical-schools-to-close\\\/#primaryimage\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2017\\\/02\\\/Richard-Smith.jpg\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2017\\\/02\\\/Richard-Smith.jpg\",\"width\":540,\"height\":350},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2010\\\/10\\\/18\\\/richard-smith-medical-schools-to-close\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Richard Smith: Medical schools to close?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#website\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/\",\"name\":\"The BMJ\",\"description\":\"Helping doctors make better decisions.\",\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\",\"name\":\"The BMJ\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2018\\\/05\\\/The-BMJ-logo.jpg\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2018\\\/05\\\/The-BMJ-logo.jpg\",\"width\":852,\"height\":568,\"caption\":\"The BMJ\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/bmjdotcom\\\/\",\"https:\\\/\\\/x.com\\\/bmj_latest\"]},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\",\"name\":\"BMJ\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"caption\":\"BMJ\"},\"sameAs\":[\"https:\\\/\\\/blogs.bmj.com\\\/\"],\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/author\\\/admin\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Richard Smith: Medical schools to close? - The BMJ","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/","og_locale":"en_US","og_type":"article","og_title":"Richard Smith: Medical schools to close? - The BMJ","og_description":"Until now medical schools have had it easy. They have lots of high quality applicants, most students graduate, and all of them can find jobs. Suddenly, as for many others [...]More...","og_url":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/","og_site_name":"The BMJ","article_publisher":"https:\/\/www.facebook.com\/bmjdotcom\/","article_published_time":"2010-10-18T10:58:04+00:00","og_image":[{"width":540,"height":350,"url":"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/Richard-Smith.jpg","type":"image\/jpeg"}],"author":"BMJ","twitter_card":"summary_large_image","twitter_creator":"@bmj_latest","twitter_site":"@bmj_latest","twitter_misc":{"Written by":"BMJ","Est. reading time":"2 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/#article","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/"},"author":{"name":"BMJ","@id":"https:\/\/blogs.bmj.com\/bmj\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe"},"headline":"Richard Smith: Medical schools to close?","datePublished":"2010-10-18T10:58:04+00:00","mainEntityOfPage":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/"},"wordCount":453,"commentCount":2,"publisher":{"@id":"https:\/\/blogs.bmj.com\/bmj\/#organization"},"image":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/#primaryimage"},"thumbnailUrl":"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/Richard-Smith.jpg","articleSection":["Richard Smith","Students"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/","url":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/","name":"Richard Smith: Medical schools to close? - The BMJ","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/bmj\/#website"},"primaryImageOfPage":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/#primaryimage"},"image":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/#primaryimage"},"thumbnailUrl":"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/Richard-Smith.jpg","datePublished":"2010-10-18T10:58:04+00:00","breadcrumb":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/#primaryimage","url":"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/Richard-Smith.jpg","contentUrl":"https:\/\/blogs.bmj.com\/bmj\/files\/2017\/02\/Richard-Smith.jpg","width":540,"height":350},{"@type":"BreadcrumbList","@id":"https:\/\/blogs.bmj.com\/bmj\/2010\/10\/18\/richard-smith-medical-schools-to-close\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/blogs.bmj.com\/bmj\/"},{"@type":"ListItem","position":2,"name":"Richard Smith: Medical schools to close?"}]},{"@type":"WebSite","@id":"https:\/\/blogs.bmj.com\/bmj\/#website","url":"https:\/\/blogs.bmj.com\/bmj\/","name":"The BMJ","description":"Helping doctors make better decisions.","publisher":{"@id":"https:\/\/blogs.bmj.com\/bmj\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blogs.bmj.com\/bmj\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/blogs.bmj.com\/bmj\/#organization","name":"The BMJ","url":"https:\/\/blogs.bmj.com\/bmj\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/bmj\/#\/schema\/logo\/image\/","url":"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/05\/The-BMJ-logo.jpg","contentUrl":"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/05\/The-BMJ-logo.jpg","width":852,"height":568,"caption":"The BMJ"},"image":{"@id":"https:\/\/blogs.bmj.com\/bmj\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/bmjdotcom\/","https:\/\/x.com\/bmj_latest"]},{"@type":"Person","@id":"https:\/\/blogs.bmj.com\/bmj\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe","name":"BMJ","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","caption":"BMJ"},"sameAs":["https:\/\/blogs.bmj.com\/"],"url":"https:\/\/blogs.bmj.com\/bmj\/author\/admin\/"}]}},"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/5102","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/comments?post=5102"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/5102\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media\/38364"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media?parent=5102"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/categories?post=5102"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/tags?post=5102"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}