Doctors' and Dentists' Remuneration - 2025-2026 pay round: Scottish Government's written evidence

Annex A

Postgraduate - Medical Trainee Recruitment

255. The recruitment of doctors in training (resident doctors) is predominantly undertaken on a UK-wide basis. There are separate UK-run recruitment processes for the various stages of training i.e. entry into (i) Foundation training, (ii) first year of specialty training (Core & ST1 level), and (iii) higher specialty training levels (ST3+).

256. Resident doctors apply for posts at Core or ST1 level (the first year of specialty training) after they have completed two years of Foundation training (FY1-FY2). If they apply for a post in a run-through training programme, they would typically advance from ST1 through to CCT (Certificate of Completion of Training) without having to reapply, assuming they achieve the necessary competencies required to progress. Core programmes are slightly different in that trainees must reapply for a higher specialty training post (ST3+) in their chosen specialty after completing Core training. For example, after completing three years of Core Psychiatry training (CT1-CT3), trainees would then apply for an ST4 post in General Adult Psychiatry, Forensic Psychiatry or another relevant specialty of their choice. Where Core programmes only last for two years – in surgical training, for example - trainees would apply for an ST3 post after completing CT2.

257. All resident doctors in Scotland are managed by NHS Education for Scotland (NES). The number of posts advertised by NES each year is determined by two factors: (i) who have vacated their post and whose posts are therefore available for new applicants for apply for, and (ii) whether any additional posts have been created i.e. expansion posts (more detail below). The most common reason for individuals vacating their post is that they have completed training. However, those who resign or undergo an inter-deanery transfer would also ‘free up’ their posts for new applicants. Any unfilled vacancies at the end of the recruitment rounds are passed to Health Boards to fill through local action, either using locums or other solutions such as Clinical Development Fellowship (CDF) posts, which have been growing in popularity recently as an alternative to progressing directly into specialty training after completing FY2.

258. This year’s results from recruitment rounds 1 and 2 were published in October 2024. End-year results – which will include the third and final recruitment round of the year - have not yet been published. All data quoted in this section is therefore accurate as of 05 July 2024 and does not necessarily reflect the end-year position. End-year data will be published in November/December. Headline data is as follows:

• As of 05 July 2024, a total of 1,035 posts had been advertised in Scotland and 980 (or 95%) had been accepted. At the same stage in 2023, 1,061 posts had filled from 1,137 advertised (93.31% fill rate).
• Core & ST1 – 719 posts were advertised at Core/ST1 level and 718 (or 99%) filled. This includes recruitment into General Practice Specialty Training (GPST). At the equivalent stage of the 2023 recruitment year, 762 posts had been advertised and 750 (or 98.42%) had filled.
• Higher Specialty Training (ST3+) – 316 posts were advertised at ST3 level and above and 262 (or 82.91%) filled successfully. 375 posts had been advertised at the same stage in 2023 and 311(or 82.93%) had filled.
• GPST - all 275 posts advertised in General Practice filled successfully. Additional posts were advertised in the last recruitment round of the year and results will be available within the coming weeks. At the same stage in 2023, 277 posts had filled from 279 advertised (99%% fill rate). We have been increasing the number of GPST places to support the Scottish Government commitment to have 800 additional GPs in post by 2027. 100 extra places were created in 2016, and a further 35 places were added in 2024.
• The annual review of medical training establishments is currently underway, and the details of any additional specialty training posts created will be available once this has concluded.

Foundation Training

259. Medical school graduates progress into the two-year UK Foundation training programme following graduation from medical school. They obtain provisional General Medical Council (GMC) registration upon graduation but cannot gain full GMC registration until completion of the first year of Foundation training (FY1). UK medical graduates must therefore complete Foundation training in order to progress into speciality training and become qualified GPs and consultants.

260. In line with a UK-wide agreement, each of the four nations have agreed to fund a core establishment of Foundation posts which is equivalent to anticipated output of medical graduates from that nation’s medical schools. In Scotland we currently have 1,002 established FY1 posts. The number of established Foundation posts corresponds broadly to medical school intake 5-6 years before, with a small allowance for attrition. The numbers expected to graduate and enter Foundation are also checked annually with the medical schools by NES.

261. Ministers have been pursuing a policy of medical undergraduate expansion for a number of years in response to a series of political commitments made in the context of NHS workforce need. Between 2016 and 2024 the targeted medical undergraduate places increased from 898 to 1,417.

262. There are 1,002 established/permanent FY1 training places in Scotland. 48 additional posts have been made available this year (2024) to accommodate undergraduate output. 1,007 FY1 posts were therefore advertised overall, and 976 (98%) were accepted (data accurate as at 01 July 2024). 918 posts filled in 2023 (93% fill rate) and 968 filled in 2022 (95% fill rate).

263. As Foundation training is a necessary step in allowing medical school graduates to become qualified doctors, the Scottish Government and NES have projected forward the number of additional Foundation places that are expected to be needed for the next few years to accommodate estimated graduate output.

264. Between 2024 and 2027 we have projected that we will need to increase our FY1 intake by approximately 231 posts to accommodate expected graduate output. This includes 99 FY1 additional posts commencing in 2025, which has been confirmed with NES colleagues. Expansion will likely be required post 2027 to accommodate further graduates arising from sequential and ongoing growth at undergraduate level.

265. The new Foundation posts will provide an opportunity both to support fragile rotas and to innovate. As we increase Foundation numbers over the next few years there is an opportunity for the Scottish Foundation School to move at pace, and in collaboration with stakeholders, to:

• address healthcare inequalities;
• explore and resolve structural issues that detract from a good training experience;
• explore, pilot and evaluate innovative placements that value generalism and social care;
• draw on experience and evidence within and outwith Scotland to drive transformational change;
• co-produce a glide path for innovation in placement design and evaluation.

Targeted Enhanced Recruitment Scheme

266. The Targeted Enhanced Recruitment Scheme (TERS) bursary was introduced in 2016 when the fill rate to General Practice Speciality Training (GPST) was 64%. The intention at that time was to provide an incentive to candidates to take up posts in areas which were historically ‘hard-to-fill’ and/or in remote and rural locations. This one-off, taxable payment was made to trainees as a lump sum upon taking up the post, and in return they agreed to complete the three-year training programme in that location. However, since then fill rates have improved significantly, and have achieved close to 100% over the previous five years.

267. In 2023 SG committed to £1m of bursary funding for 2024/25. In August 2024, 47 posts were advertised which attracted a TERS bursary payment. This resulted in a 97.9% fill rate for those posts. The delivery of an increase in GP headcount and capacity plays a key role in improving primary care services and is essential to providing high quality and sustainable health and social care services. This bursary, however, could not justifiably be claimed to support an increasing GP headcount. As a result, it has been agreed with the Cabinet Secretary for Health and Social Care that the bursary will not be offered to GPST candidates in the 2025 recruitment round, and in future years.

268. We continue to offer a range of opportunities and incentives for GPs to take up posts in harder to fill areas, including the Rural Track Programme for GP registrars looking to develop specific skills to work in rural areas, as well as Golden Hellos for qualified GPs taking up eligible posts in both rural areas and areas of deprivation. We will monitor closely what impact stopping the bursary has on GPST recruitment.

269. We currently have more GPST training posts than ever before, with a further 35 posts added this year. Going forward we will consider the most appropriate way to make use of the resources available to ensure that becoming a GP remains an attractive career choice and that we also support colleagues to stay in practice.

GP Trainer Grant

270. All placements undertaken by GP trainees in primary care settings attract a GP trainer grant. The current grant amount sits at £10,492 (£12,685 with superannuation included). In 2023/24 NES paid 804 GP trainer grants at a total cost of £10.2m - 127 of the 804 were directly related to the additional places created by the Scottish Government in recent years in General Practice Specialty Training, or the second year of Foundation training (FY2). NES have confirmed that there are no unfunded placements taking place.

271. GP trainees contribute to service delivery while on placement in a GP practice, just as they do when they spend time in secondary care. We recognise that this level of service is less than what would be provided by a fully qualified GP. Boards do not receive any funding (other than for salaries) when GP trainees spend time in hospital settings. Funding is only provided to GP practices for the hosting and training of GP trainees – there is no grant funding given for GPST placements in secondary care.

272. We will work with NES to fully understand the extent of costs incurred by GP practices through their hosting of these placements.

Expanding Scotland’s Trainee Doctor Workforce

273. The Scottish Shape of Training Transition Group (SSoTTG) is responsible for making recommendations to Scottish Ministers regarding the need to create additional training places for trainee doctors in response to increased demand and evolving working patterns. These additional places are commonly known as expansion posts. SSoTTG membership includes SG, NES, BMA Scotland, the Scottish Academy of Medical Royal Colleges and various NHS Scotland Health Board representatives including Directors of Medical Education, Medical Directors and regional workforce planners. The group is chaired by Dr Helen Freeman, Senior Medical Advisor to SG.

274. Setting annual training intakes has typically involved forecasting the supply of trained doctors required to maintain the future trained doctor workforce by specialty, using default modelling assumptions initially agreed during the ‘Medical Reshaping’ work, 2010-2013. These assumptions are: retiral age of 60-61; participation reduction factor of 1.4 to reflect increased Less Than Full Time (LTFT) working and a default consultant establishment growth factor of 1% pa.

275. These assumptions, coupled with an annual consultation exercise to make any required deviations from default modelling assumptions, have been used since 2014 to consider the number of additional specialty training posts to be implemented via annual UK national recruitment. All vacancies which arise during the annual recruitment cycle are fed back into national recruitment for replacement. The fundamental principle that trainee numbers and training establishments are determined by the need for future consultant output - not by need to cover ‘service gaps’ in rotas - has remained central to these modelling assumptions and decisions on training numbers.

276. Scottish Ministers have created 153 extra training places for doctors in training in 2024, the largest annual uplift to date. The annual review of medical training establishments is currently underway and the details of this year’s process and any additional specialty training posts to be created in 2025 will be available once this has concluded.

Medical Trainee Progression

277. The Annual Review of Competence Progression (ARCP) process is an opportunity for trainee doctors to demonstrate that they have gained the competencies required to progress to the next stage of their training pathway. The ARCP outcomes which are awarded to trainees (i) reflect the progress they have made in that training year, (ii) identify where there have been issues relating to progression, (iii) specify the reasons behind delayed progression, including where Covid-19 has been a contributory factor, and (iv) confirm whether additional training time is required in order to progress. The definitions attached to each outcome are included in the following table.

278. A total of 7,192 outcomes were recorded for the 2023-24 training year. There were 488 instances where a review had not taken place (6.8% of all outcomes). Of the 6,704 outcomes which were recorded following a review:

• The majority (59.65% or 3,999) signalled satisfactory progress and the development of competencies at the expected rate.
• 27.77% (1,862) showed that trainees had gained all the required competencies and were recommended for completion of training.
• 3.49% of trainees (234) were pursuing OOP (Out of Programme) opportunities e.g. career break, research etc.
• 2.77% (186) required additional training time due to insufficient progress.
• 2.99% (201) required development of specific competencies, however, no additional training time was required.
• 1.61% (108) were LATs (Locum Appointed to Training) who were either making satisfactory progress or had completed their time in post.
• 1.04% (70) received a holding response due to incomplete evidence.
• 0.23% (16) were released from their training programme, with or without specified competencies.
• 0.13% (9) were LATs who needed to develop specific competencies but did not require an extension to their training.
• 0.23% (16) were LATs who had made inadequate progress.
• 0.04% (3) were LATs who received a holding response due to incomplete evidence.

279. For these ARCP outcomes, 49.4% were awarded to female trainees, 35.1% were awarded to male trainees and 15.5% were awarded to trainees who selected ‘prefer not to say’ in regard to their sex.

280. The following table provides an overview of all ARCP outcomes recorded from 2019/20 - 2023/24. These are broken down into the same categories as above. Please note that there is no 2023-24 data which relates to the impact of Covid-19 (10.1 and 10.2) as these were taken out of the ARCP process last September.

2024 GMC National Training Survey

281. The GMC National Training Survey (NTS) is the largest annual survey of doctors across the UK. It focuses on five central themes: learning environments and culture; educational governance and leadership; supporting learners; supporting educators and developing and implementing curricula and assessments. The full survey is available on the GMC website, here.

282. This report focuses on UK-wide trends in postgraduate medical education but includes country-specific data where there are notable differences. It summarises initial findings in three key areas:

• the supportive nature of working environments, including discrimination in the workplace;
• the quality of training and support for trainers;
• doctors’ wellbeing at work and workload.

283. This year, for the first time the GMC have included analysis of some of the national training survey data by personal characteristics. The GMC will also make available a new education data tool which will show responses to individual survey questions as well as national, regional, local, and specialty breakdowns for all indicators and response data by demographic characteristics.

284. This year over 74,000 doctors in training and trainers completed the survey which suggests plans to boost the UK’s workforce by increasing medical school places will fail if the needs of trainers are not prioritised.

285. Though the majority of trainees are happy with their training and quality remains high, half of all of trainers were at moderate or high risk of burnout. This pattern has stayed consistent for a number of years, at 52% in both 2023 and 2022. Twenty-nine percent said they struggled to use the time allocated to train others alongside their regular clinical commitments.

286. A third (31%) of trainers working in secondary care also reported issues with rota gaps not being dealt with effectively. Of those trainers who answered questions on risk of burnout more than half (52%) said they always or often felt worn out at the end of the working day. Despite these experiences the majority of trainers (90%) said they enjoy their role as medical educators.

287. For trainees, more than a fifth (21%) advised that they were at high risk of burnout and had fewer opportunities to develop their leadership skills. In 2022, 69% ‘agreed’ they had these opportunities, falling to 66% in 2023 and further to 63% this year.

Key findings are as follows:

Doctors in Training

288. Wellbeing – Over a fifth (21%) of trainees are now measured to be at high risk of burnout, while this represents a slight decrease of two percentage points since 2023 the GMC remain concerned at this result. Additionally, over half (52%) of trainees described their work as emotionally exhausting to a very high or high degree.

289. Discriminatory behaviours - The majority of trainees continue to say that they work in supportive workplaces. However, of the doctors in training that answered the optional questions on discriminatory behaviours, 29% said they’d experienced micro-aggressions, negative comments, or oppressive body language from colleagues and findings suggest that factors, including gender, ethnicity, religion, sexual orientation, and disability status can affect a trainee’s experience.

290. Developing leadership skills – Since 2022, there’s been a decline of six percentage points (69% to 63%) in the proportion of trainees agreeing that their posts gave them opportunities to develop their leadership skills.

291. Rota design – A quarter (26%) of all trainees think that their training is adversely affected because rota gaps aren’t dealt with appropriately.

292. Quality of training – Despite the continued pressures on the health services, the quality of training remains high: 86% of trainees were positive about their clinical supervision and 83% said the quality of their experience was good or very good.

Trainers

293. Wellbeing – 50% of trainers are measured to be at high or moderate risk of burnout, this is a 2% decrease from 2023. A third (32%) said their work frustrates them to a high/very high degree. Experiences varied by specialty, with emergency medicine and general practice trainers experiencing the highest burnout risk.

294. Rota design – A third (31% a decrease of 2%) of secondary care trainers said that their trainee(s) education and training is adversely affected because rota gaps aren’t always dealt with appropriately.

295. Time for training – Over a quarter (27% a decrease of 1%) don’t think their job plan contains enough designated time for their role as a trainer. And less than half (48% and increase of 2%) said they were always able to use the time allocated for training specifically for that purpose.

296. The vast majority of trainers (90% an increase of 1%) indicated that they enjoyed their role.

Scotland Specific Data

297. 64% of trainers in Scotland ranked the support they received in their role of trainer as very good/good.

298. Scotland has the lowest % of trainees (18%, down by 1%) indicating that they are at high risk of burnout. 43% (down by 2%) are at a moderate risk and 40% (up by 3%) are at a low risk of burnout.

299. 12% of trainers were at high risk of burnout in Scotland (same as the UK average and 2023 result), with 40% (up by 1%) and 48% (same as 2023) at moderate and low risk respectively.

300. Survey completion rates were down by 2% in Scotland for both trainees (78% in 2024) and trainers (31% in 2024).

Less Than Full Time (LTFT) Working

301. Working LTFT is becoming increasingly popular because of the flexibility it offers trainees, regardless of their grade or specialty. Basing training establishments on WTE (Whole time Equivalent) data rather than headcount is therefore imperative, especially in specialties with a high proportion of trainees working LTFT such as in General Practice GP, and work has continued towards achieving this in all specialties, including through the annual expansion of training numbers via the SSoTTG. Good progress has been made in this space, particularly in specialties such as Paediatrics.

302. We also continue to work with NES to streamline selection and recruitment processes, improve flexibilities within medical training to assist movement into and through specialties, and offer Out of Programme opportunities so that trainees can undertake clinical training/experience, research or take a career break.

303. As of November 2024, there are 1,574 (20.9%) resident doctors working LTFT over the various specialties and grades. This includes 3.6% of Foundation Doctors, 17.2% Core/ACCS trainees and 31.1% of higher specialty trainees. Please note that this figure remains subject to ongoing movement.

Wellbeing, Conditions and Rota Evaluation (WeCaRE) Framework

304. WeCaRE is a user-friendly quality improvement framework designed to improve the working environment and experience of doctors in training. It has been co-created through detailed learning from the user experience of the Professional Compliance Analysis Tool (PCAT).

305. The WeCaRE framework acknowledges that the trainee experience is more than rota design and working pattern compliance. The process addresses this in the context of wellbeing, psychological support, professional development and much more. During the WeCaRE cycle trainees are listened to, valued and empowered to make positive changes. The data from the process gives trainees a vehicle to drive structured improvement to the working environment in partnership with their senior/managerial colleagues.

306. WeCaRE is currently being utilised in four health boards (Lothian, Greater Glasgow and Clyde, Lanarkshire and Grampian). The first health board to implement WeCaRE was NHS Lothian, who piloted it early in 2021, with the first cycle completed in August 2021. NHS Lothian have embedded this practice and have good examples of best practice to share.

307. It was then extended to new departments within NHS Lothian including oncology, paediatrics and respiratory care. NHS Tayside had also been in touch with NHS Lothian to see how WeCaRE could benefit them. A new Scottish Clinical Leadership Fellow within SG is now taking this work forward, who is planning to make contact with the regions in Scotland to assess if a progress report is needed on the framework. In addition to this, WeCaRE has been added as an agenda item in an upcoming Scottish Directors of Medical Education (DMEs) meeting to gain a broader insight into if WeCaRE is being used, the impact it has had and any barriers there might there be to implementing the framework more. It is the hope that there will be a substantial WeCaRE update following this meeting.

Softer Landing, Safer Care and support for IMG’s

308. Softer Landing, Safer Care is a programme designed to better support International Medical Graduates (IMGs). These doctors are more likely to encounter challenges early in their career than their colleagues who graduated from within the UK. It is important that we ensure these doctors are appropriately supported in order to flourish and provide better patient care.

309. Softer Landing, Safer Care involves a period of enhanced induction, and an opportunity to shadow current trainees so that they can better understand things such as:

• the interface between primary, secondary and social care
• the use of common acronyms
• roles and responsibilities e.g. prescribing
• how to make referrals
• NHS Scotland cultures e.g. patient-centred care, multi-disciplinary team working, child protection etc.
• the most appropriate methods of communicating with both patients and colleagues

310. Directors of Medical Education received prior notice in June 2023 of how many IMGs would be coming to their Board, allowing them to put local arrangements in place to. NES also ran an orientation event for IMGs and pre-start webinar last year.

311. NES have been proactive again in the IMG space recently and have run a host of work/initiatives to support IMGs in Scotland out with Softer Landing, Safer Care. A few examples include a Scottish IMG pre-induction webinar which is an introduction to working in Scotland, a Scottish IMG Buddy Scheme (SIBS), Trainer support for Softer Landing, Safer Care and Medical Education and Training Pathways. In addition to this, an event named ‘Welcoming IMGs New to Scotland (WINS’) commenced in August of this year. All IMGs across all specialties and grades were invited to this one-day Induction programme. This was delivered regionally, face to face and on 3 separate dates.

312. NES are aware that Boards would like a full list of IMGs working in their Board at any given time to ensure ongoing support so are working to enable this. The data would be added gradually over time, but it should make future reporting and monitoring of progress easier. Finally, NES highlights to DMEs GP trainees who are IMGs and coming to a secondary care post for the first time in order that they can benefit from enhanced induction and support.

Enhanced Monitoring

313. The GMC is responsible for ensuring the quality of medical education and training in the UK and approves both the educational content of training programmes as well as where training can be delivered. It uses Enhanced Monitoring (EM) to support medical training organisations where there are concerns about the quality and safety of training.

314. Issues that lead to the introduction of EM are those that the GMC believe could adversely affect patient safety, the safety of trainees, trainee progression or the quality of the training environment. Local quality management processes alone being insufficient to address issues would also warrant escalation. Staff can raise concerns directly with NES if they are unsatisfied with the training environment or the quality of training. Trainees may also identify a potential need for EM through their responses to the GMC National Training Survey and/or the NES Scottish Training Survey.

315. After being escalated to EM, Health Boards must supply NES with frequent progress updates. NES then share these updates with the GMC which allows them to consider whether any additional support might be required. An action plan is also provided by the Board which sets out in detail what is being done to address concerns and make progress against requirements set by NES and the GMC. Sites subject to EM processes are also subject to quality management/ assurance visits which are undertaken by NES and the GMC. These visits are used to closely monitor progress and identify any emerging, persisting or worsening problems.

316. EM is typically seen as the catalyst for change where there are serious issues that need to be addressed. There are instances however where progress either isn’t evident or is being made at too slow a pace. If NES and/or the GMC is concerned about the rate at which progress is being made, or if challenges continue to persist or even worsen, then the GMC may consider imposing formal conditions on a site.

317. These conditions are designed to clarify responsibilities and the actions that need to be taken within Boards and/or specific training sites. They are intended to facilitate organisations working together in a transparent way, and provide clear evidence that concerns are being addressed. If progress isn’t made even after the introduction of formal conditions, then the GMC may withdraw its approval for training to be delivered at a certain training site, which would see the removal of trainees. This is considered to be a very last resort and would have serious implications for service delivery. This has never happened in Scotland.

318. In 2022, NES adopted a new process which was designed to better support Health Boards with sites under EM. This involved providing more support to Directors of Medical Education, considering how examples of best practice could be shared more swiftly with other Boards/sites facing similar challenges, and providing additional support for sites which have long-term issues which often lead to them being re-escalated as a result of concerns not being fully addressed. Given the number of sites under EM has now reduced by 8, the new approach being taken by NES appears to be having a positive impact in terms of the support that is available to affected Boards.

Trainee Gender Composition

319. The following table shows the gender composition of medical trainees in Scotland. These figures are accurate as of November 2024.

320. There are currently only 2 hospital training sites under Enhanced Monitoring in Scotland, spread across 2 Health Boards. GMC conditions imposed at Dr Gray’s Hospital, NHS Grampian, were removed in June of this year. This means that there are no longer any hospital training sites in Scotland subject to GMC conditions. More information can be found on the GMC’s website.

Undergraduate - Scotland’s medical undergraduate intake

321. The Scottish Government’s Health Workforce Directorate convenes the Medical Undergraduate Group (the MUG) to consider Scotland’s annual medical undergraduate intake. The Group’s primary purpose is to ensure an appropriate supply of high-quality trained doctors to meet the needs of NHS Scotland’s medical workforce whilst avoiding, or minimising, the possibility of medical unemployment.

322. For 2024-25, Scottish Ministers approved a medical undergraduate intake of 1,417. This represents a 67% increase compared to the 2015-16 intake of 848. At the time of writing, the 2025-26 intake has yet to be formally agreed. The MUG will meet in early 2025 and the Scottish Government will send the guidance letter on the 2025-265 undergraduate intake to the Scottish Funding Council thereafter.

323. The Scottish Government remains focused on increasing the number of places at medical schools to grow our workforce to meet the future demands of NHS Scotland. It is necessary to properly plan medical undergraduate numbers in order to ensure there are sufficient educational and training places of appropriate quality in NHS Scotland for our undergraduates and trainee doctors. This is why the 2021 Programme for Government committed to increasing medical school places by 500 over the lifetime of the Parliament, while also doubling the number of available widening access places.

• The first 100 places of this commitment were delivered in AY 2021-22, with a further 100 students being added in both AY 2022-23 and AY 2023-24. These places will contribute towards current priorities such as increasing the number of GPs in Scotland and creating a robust pipeline to supply NHS Scotland with the workforce it needs to meet the demands of the population.
• The places available on the Scottish Graduate Entry Medicine programme (ScotGEM) has remained at 70 places per cohort in AY 2024-25.
• For AY 2024-25 there remains: 35 HCP-Med places, 115 WA places and 85 GP Track places (55 at Aberdeen, 30 at Glasgow – more detail below).

Scotland’s Graduate Entry Medical Programme (ScotGEM)

324. ScotGEM is a four-year graduate entry medical degree which commenced in 2018 and is delivered collaboratively by the Universities of Dundee and St. Andrews. The programme is delivered in partnership with NHS Fife, NHS Tayside, NHS Highland, NHS Dumfries and Galloway and the University of the Highlands and Islands with first and second years being led by the University of St Andrews and third and fourth year led by the University of Dundee.

325. As Scotland’s first graduate entry, undergraduate medical programme, ScotGEM is not directly comparable to a traditional medical degree. Instead, it offers a unique four-year programme tailored to meet the current and future needs of NHS Scotland with a focus on rural medicine, healthcare improvement and developing interest in General Practice.

326. Due to the unique arrangements of ScotGEM, and to encourage graduates into the programme, the Scottish Government (a) funds the tuition fees of those who secure a place, and (b) offers a £4,000 bursary to students per year of study. In return, students who accept the bursary agree to provide one year of service within NHS Scotland. If the bursary is accepted in all 4 years of study, students would receive £16,000 over the course of their degree and in return they would work for NHS Scotland for 4 years following graduation.

327. The ScotGEM graduate entry medical programme has proved popular so far, with the first cohort of 52 students graduating in June 2022 increasing to 59 students in June 2023 and June 2024. For academic year 2024/25 there are 70 ScotGEM places per cohort. This represents an increase of 15 places compared to the 2021/22 intake.

Healthcare Professionals Programme (HCP-Med)

328. HCP-Med is an innovative course delivered by Edinburgh University which allows experienced healthcare professionals to enter medicine and combine part time study with their existing job, with large parts of the course delivered online. It is designed to target high calibre candidates who are more likely to be retained in NHS Scotland.

329. The course commenced in AY 2020-21 with 25 places per cohort, increasing by a further 5 places in AY 2022-23 and AY 2023-24, bringing the total number of places per cohort to 35 in AY 2024-25.

GP Track Courses

330. New courses commenced in AY 2019-20 at the universities of Aberdeen and Glasgow which focus primarily on General Practice. Students who secure a place on Aberdeen’s GP track course undertake an enhanced GP programme, with a set minimum of teaching time in Primary Care. All students who secure a place on Glasgow’s course gain enhanced exposure in Primary Care settings and can opt for intensive experience in rural and deprived areas on the new COMET (Community Orientated Medical Experience Track) course.

331. When these courses were first established there were 30 places on each (60 in total). There are now 55 places at Aberdeen and 30 at Glasgow (85 in total).

Pre-medical entry courses

332. The Scottish Government funds the pre-medical entry courses which are delivered by the universities of Glasgow (Glasgow Access Programme (GAP)) and Aberdeen (Gateway 2 Medicine (G2M)). When both courses commenced in 2017 there were 20 places on each, increasing to 25. The number of places per cohort in 2018 (50 places in total). In AY 2023-24 these increased again to 40 funded places on the GAP and 30 on the G2M programme (70 places in total).

333. The pre-medical entry courses are designed to target high calibre students who are from disadvantaged backgrounds, allowing them to gain the qualifications required to progress onto the standard medical degree.

Widening Access

334. Widening Access (WA) to medicine is one of the Scottish Government’s key policy priorities. We therefore fund a number of places every year which are reserved for students who meeting the criteria for WA, targeting those from the lowest quintile of multiple deprivation (SIMD 20).

335. As part of the 2021 Programme for Government the Scottish Government committed to double the WA places available at Scotland’s medical schools. Raising the total number of available places from 60 places in available in AY 2020-2021 to 110 in AY 2024-25.