University of St. Andrews - degrees and licenses in medicine and dentistry: consultation analysis

Introduction

1. Between 18 May and 29 June the Scottish Government undertook a formal targeted consultation to seek views on removing a legislative prohibition which prevents the University of St. Andrews ("the University") from awarding medical and dentistry degrees. The legislative prohibition is contained in paragraph 17 of schedule 6 to the Universities (Scotland) Act 1966 ("the 1966 Act").

2. The impetus for consulting was primarily to enable the University to award, jointly with the University of Dundee, undergraduate Primary UK Medical Qualifications (PMQ) to Scottish Graduate Entry Medicine (ScotGEM) MBChB^[1] students, ahead of the first cohort graduating in 2022.

3. The University was founded in 1411 and is the oldest university in Scotland. In 1897, it amalgamated with a new academic centre, Queen's College in Dundee ("Queen's College"). The 1966 Act reconstituted the four ancient Universities of Scotland (Aberdeen, Edinburgh, Glasgow and St. Andrews) and reorganised the University of St. Andrews by separating it from Queen's College, which then became the University of Dundee. The 1966 Act also conferred upon the four ancient Universities more autonomy in academic matters, such as the institution of new degrees.

4. In the immediate separation of Queen's College from the University, the clinical part of the medical degree offered at that time was moved to the new University of Dundee. As a consequence of this, the 1966 Act put in place a legislative prohibition to prevent the University from granting degrees in medicine and dentistry.

5. ScotGEM is Scotland's first graduate entry programme for medicine and it is jointly delivered by the Universities of Dundee and St. Andrews, in collaboration with the University of the Highlands and Islands and partner Health Boards. It was announced by the First Minister in 2016 and formed part of a package of initiatives to meet the Scottish Government's commitment to create a more sustainable medical workforce and encourage more people into a career in healthcare, whatever their background. The first cohort of graduate students commenced in the 2018-19 academic year.

6. ScotGEM was jointly awarded to the Universities of Dundee and St. Andrews following an open competitive assessment process conducted by the Scottish Government. The bid was awarded to both universities on the understanding that ScotGEM would be jointly delivered and awarded, as was detailed in the initial bid.

7. The Scottish Government carried out pre-consultation engagement with the University, the other medical degree providing universities (in Aberdeen, Edinburgh, Glasgow and Dundee), the General Medical Council (GMC), the Scottish Funding Council (SFC), NHS Education Scotland (NES) and Universities Scotland.

8. The Scottish Government then issued a formal targeted consultation on 18 May for a period of six weeks. It was decided that a targeted consultation was the proportionate approach given that the proposed repeal of the prohibition impacts on a very narrow area of law and group of stakeholders. The only persons or bodies directly affected are ScotGEM students and the Universities of St. Andrews and Dundee. Those universities currently offering degrees in medicine and dentistry, as well as all other higher education institutions in Scotland, would be impacted indirectly given that one of their potential competitors would no longer be subject to an additional caveat requiring legislative change should it be successful in any future competitive commissioning process to become a medical or dentistry degree provider.

9. The consultation sought views on the proposal to fully repeal the prohibition contained at paragraph 17 of schedule 6 of the 1966 Act. Respondees were invited to provide any details on the impact to themselves, their organisation, or to others. The consultation asked one question, as follows:

Do you agree that the Scottish Ministers should seek the Parliament's approval to repeal paragraph 17 of schedule 6 to the Universities (Scotland) Act 1966 and therefore reinstate the ability of the University of St Andrews to hold qualifying examinations and award degrees in medicine and midwifery, as well as degrees and licenses in dentistry?

10. Although the consultation referred to removing the prohibition for midwifery degrees as well as medical and dentistry degrees, it has since been clarified that the prohibition essentially relates only to degrees in medicine and dentistry. Historically, legislation commonly referred to the medical professionals being qualified for the practice of 'medicine, surgery and midwifery'. However, at the time of the 1966 Act, the term 'midwifery' was understood to be a reference to the discipline of obstetrics which forms part of the modern medical degree. The first higher education undergraduate programmes in midwifery were not introduced in Scotland until the early 1990s. The 1966 Act could not, therefore, have intended to cover modern midwifery degrees.

11. Further stakeholder discussions took place during the consultation period. These included discussions with: the Universities and Colleges Union, the Academy of Medical Royal Colleges in Scotland, the British Medical Association, a ScotGEM student representative, the Chair of the Directors of Medical Education (NHS), the Principal of the University of the Highlands and Islands, the Principal of the University of the West of Scotland, the Royal College of Midwives, the Nursing and Midwifery Council, the General Dental Council, the British Dental Association, the GMC and the Chair of the Board for Academic Medicine.