The hidden cost of medical student education: an exploratory study

Abstract

Objective. To examine the hidden cost of medical education at the Sydney Medical School, for which the University of Sydney does not pay.Methods. All face-to-face teaching provided for students in the Sydney University Postgraduate Medical Program was listed under two headings: teaching by university employed staff; and teaching by other health providers not paid by the university. All teaching hours in 2010 were extracted from detailed timetables and categorised under these headings. Time spent in lecture preparation and exam marking was included. Students were sampled to obtain information about additional teaching that was not timetabled.Results. Teaching by university paid staff accounted for 59 and 61% of face-to-face teaching costs in years 1 and 2 of the 4-year Graduate Program, but only 8% in the final 2 years. The cost of medical education provided by the university, including infrastructure costs was $56 250 per student per year in 2010. An additional $34 326 worth of teaching per student per year was provided by teachers not paid by the university.Conclusion. The true cost of medical education is the cost of education met by the university plus the value of teaching currently provided by government funded health providers and honorary teachers. In 2010, 38% of the medical education cost at Sydney University was provided at no cost to the University. As government health departments seek to trim rising health expenditure, there is no guarantee that they will continue to contribute to medical education without passing this cost on to universities.What is known about this topic? Some medical student teaching is provided by teachers who may be employed by a government health provider or who are honorary teachers. There is no cost to the university for this teaching. What does this paper add? An estimate of the total value of teaching provided to students at Sydney Medical School, for which the university does not pay, is approximately $34 000 per student per year, compared with the total cost of approximately $56 000 per student per year incurred by the university. What are the implications? Medical education is a partnership between the university, the government health sector and honorary teachers. Without contributions by non-university paid staff, the cost of medical education would be unsustainable.

The process and challenges of obtaining and sustaining clinical placements for nursing and allied health students

“…They did identify that apart from staffing costs, other costs included administrative time, decreased productivity and procuring extra equipment for student training. In some disciplines, such as medicine, it is commented that the cost of practicums is not sustainable without the voluntary teaching contribution of clinicians (Oates & Goulston ). From the projects’ results, it can also be seen that small private practices express similar concerns over costs.…”

The cost of teaching an intern in New South Wales

“…The cost to the university was $56 250 and the cost of non-university-paid staff (mainly from the NSW Health Department) was $34 326 per student per year. 5,6 Considerable concern has been expressed in Australia and overseas that relatively little time is spent on education during the intern year, [7][8][9][10][11][12][13][14][15][16] and it has been suggested that the intern year should have a greater educational emphasis than service emphasis. 15 There are few estimates in the literature of the proportion of interns' time devoted to education.…”

Selling medical education to international students: time for review

“…There is another aspect of goodwill that the industry's growth is threatening. A large proportion of clinical teaching of medical students is done by senior medical clinicians whose teaching is usually added on to a demanding clinical load with in many universities little or no payment for teaching . As governments demand increasing efficiencies from the health care system (making participation in teaching even more stressful) and as student numbers continue to increase, the goodwill of such teachers is also at risk.…”