If you are a home student studying medicine, you may wonder how funding for the entire duration of your degree works. What do NHS bursaries cover, how might changes in circumstances affect your funding and are there any external sources of financial support available? If you are asking these questions, you may find the following article written by the Head of Money & Housing Advice at King’s College London helpful:
This article responds to common questions from home students who are eligible for UK statutory funding. We are working on guidance for EU and international students which will be published in due course. In the meantime, we recommend you consult the RMBF pages for international students, King’s International Hardship Fund if you are in financial difficulty, and Scholarship Hub for opportunities based on your personal circumstances, nationality and year of study.
I am aware that from the 5th year of study my funding changes to NHS Bursaries, why is this and what is different?
Yes, the medical degree has traditionally been funded by NHS towards the latter end of the programme, to help with the cost associated with becoming a medic. This dates back prior to tuition fee charges and has evolved to reduce the burden of graduate debt, by covering the additional years of fees, due to the length of the programme. It also provides means-tested financial support to those from a lower household income, who cannot rely on financial support from their families. For many years critics of the scheme have highlighted that the means test does not reflect the true cost of study and real residual income of families, especially when based in the Southeast where living costs tend to be much higher than in other parts of the country. Not to mention that by the 5th year of study most families who have not had to financially support their children at the beginning of the degree reasonably do not expect to have to start doing so several years into the programme.
This switch to predominantly NHS funding occurs in most cases from the 5th year of study but there are some differences if you are on a graduate accelerated programme (see below).
In years 1-4 you will receive funding from SFE (or your regional equivalent) which comprises of:
- SLC Tuition Fee loan which needs to be repaid with interest
- SLC means-tested Maintenance Loan which needs to be repaid with interest
- Additional allowances for dependants and children, means-tested by SFE and non-repayable
- King’s bursaries which form part of our access agreement with the Office for Students (Access to the Professions and King’s Living Bursary). These are not repaid.
In years 5 and onwards you will need to apply to the NHS for means-tested support and (if you are on an extended programme and/or intercalate) your funding will comprise of:
- NHS Tuition Fee bursary which is not repaid
- NHS non-means-tested Maintenance Grant £1000 which is not repaid
- NHS means-tested Living Cost Bursary (means tested)
- Additional allowances for dependants and children, means-tested by NHS Bursaries and non-repayable
- SLC non-means tested top-up student loan to be repaid with interest
When will NHS funding start if I am not on the standard 5-year medical degree?
If you are undertaking either:
- Standard 5-year MBBS
- Standard 5-year MBBS plus an intercalated year [6 years study]
- Extended medical degree programme [6 years study]
- Extended medical degree programme plus an intercalated year [7 years study]
Your NHS funding will always start from the 5th year of study, consequently, students on the standard 5-year programme receive 1 year of NHS funding, students on EMDP and intercalating will receive 2-years of NHS funding and those on the EMDP programme who are also intercalating will receive 3-years of NHS funding.
If you are on any of the graduate entry programmes you receive NHS funding from year 2 of the course and the first year is a mix of self-funding and some access to student loans (see below).
Do re-sit years count?
Repeat years of study do not count toward the number of years of study you do before NHS funding kicks in. When funded by SFE, there is one additional year of funding provided you have not had previous study elsewhere. If you did not progress from one academic year to the next due to Mitigating Circumstances, which SFE terms as Compelling Personal Reason (CPR), evidence of this can be provided to request additional years of funding on exceptional grounds. However, when funded primarily by NHS Bursaries, additional funding is only permitted for a maximum of 12 months whether there are CPRs or not. The only exemption is maternity allowance. Students who are required to re-sit any part of their programme are advised to consult the Money & Housing Advice Service.
What happens to my funding if I later decide to intercalate?
In most cases the course is simply extended by an additional year, you would still receive funding from SFE for the first 4 years only; essentially you get an extra year of funding from the NHS.
Something to be aware of is the impact on funding if you intercalate after Year 2 and do a Masters. The Master’s year will count as Year 3 and when you return to the MBBS you will be in the 4th year of study and still subject to SFE rules. As you now have a MA/MSc you could lose your SFE funding due to the ELQ rules. There can also be problems if the term dates don’t match up as you cannot be registered on two courses at once. It is a scenario that needs to be unpicked on a case-by-case basis but our advice is that if you want to do an intercalated Masters, time it for when NHS funding is due to when you return to the main programme. We strongly advise that if you plan to do an intercalated Masters during your studies always seek funding advice from the Money & Housing Advice Service before committing to the intercalated programme.
Any special rules for mature learners?
Students over 25 are non-means tested by SFE from the September after they turn 25, NHS does not make the same distinctions. Unless the student can demonstrate that they have lived independently for 3 years prior to the start of their course or are living with a partner, they will need to submit evidence of their parent’s income. If this is impacting your ability to claim funding consult the Money & Housing Advice Service for help.
What can a graduate on the 5-year programme claim?
The arrangements for graduate medical and dental students on a five-year course are different. In the first four years of the course, you are not eligible to receive a loan for tuition fees regardless of whether or not you previously received funding. However, students may be able to apply for a full, income-based, maintenance loan from Student Finance England and the targeted support for students with dependents if you meet all the other eligibility requirements. From year five of the training, graduate medical and dental students receive the same support as undergraduate medical and dental students (see above).
Find out more about student finance (including Student Finance England) on the Gov.uk website
And the Royal Medical Benevolent Fund guide to Medicine as a second degree if you live in England (they also have guides for the other regions).
What about graduate entry medicine and dentistry
Graduate-entry students starting an accelerated 4-year course will have to self-fund the first £3,465 of their tuition fees in the first year. In the subsequent years of their course, the NHS Bursary scheme will pay up to £3,715 towards their tuition fees.
In year one of the graduate programme, a loan of up to £5,785 will be available to students from Student Finance England to cover the difference between £3,465 and the tuition charges of their universities, to a maximum charge of £9,250 (in 2022/23). For years two to four of the programmes the available tuition fee loan will be up to £5,535 to make up the difference.
All the discretionary hardship funds and grants listed are also open to graduates.
I currently receive the King’s Living Bursary does this stop in NHS funded years?
Yes, the King’s Living Bursary is not available to NHS-funded students as the criteria relies on students being means-tested by Student Finance England. It also forms part of the agreement with the Office for Students, which permits the university to charge the maximum fees when undergraduate home students for which they will have to self-fund or take a loan. As the NHS pays the fees on the student’s behalf the King’s Living Bursary is not available, however, there are other sources of help at King’s to help with this gap in funding and potential gaps in funding from NHS Bursaries in comparison to previous years if you cannot cover your costs.
Overall, this looks like less money to live on, how will I cover all my costs?
The main difference between NHS-funded years and SLC-funded years is that there is more cash available for living costs in the earlier part of the programme. Whilst the reduction in overall debt may be welcomed by some, for other students, especially those who are paying rent throughout the course, this creates a financial burden at the most critical time of their studies.
Some students can reduce their costs by securing free accommodation if their placement is outside London, consequently foregoing the need to pay rent throughout the year in London, which takes a large proportion of any student’s income. This however is not an option for students who do not have a family home they can return to or other temporary accommodation options when they are between placements and/or need to return to London for classes.
There is help you can claim with the shortfall both in King’s and outside the university.
What financial assistance can I claim from King’s?
The King’s Medical & Dental Hardship Fund [KMDHF] was created to provide additional assistance to medics and dentists whose funding is not sufficient to cover their costs, at any stage of their degree, and their families are unable to assist with some or all of the shortfall.
Whilst medics are eligible to apply to any of the hardship funds for home students, they are advised to apply to the KMDHF as the form is more tailored to the needs of medics and there is no cap on housing costs as there are in the standard hardship fund. This fund will also consider tuition fee costs if you are not eligible for fee loans, for example, graduate medics. The fund is largely focused on living costs, especially in the latter years of the course but students can apply in any year if help is needed. The maximum award is £5000 for living cost support.
From time-to-time other funds, prizes and bursaries become available due to kind donations from alumni or supporters of the King’s community. Please check the hardship fund pages regularly for opportunities.
Are there any external sources of support?
Yes, there are other sources of support through NHS Bursaries and the medical community:
NHS Bursary Hardship grant: this grant application is open to all students who have been assessed as eligible for a means-tested bursary and can demonstrate that the funding is not sufficient to cover their costs. To apply, you must first apply to King’s for our hardship funds and request a letter from the funding office to confirm this, and that they support your application for a hardship grant from the NHS. Students who are finding it difficult to demonstrate their situation can receive support by applying from the Money & Housing Advice Service. Awards are between £100 and £3000 depending on your needs.
Royal Medical Benevolent Fund also offers financial support to medical students in the final two years of their course who are unable to fully cover the cost of their studies. To be eligible for support you must be able to answer ‘Yes’ to all of the following:
- Are you currently studying medicine as a registered student on a course at a university in the UK which meets the eligibility requirements for GMC registration?
- Are you in the final two years of your training (i.e. expecting Provisional Registration within two years)?
- Are you in exceptional and unexpected financial hardship due to a change in circumstances caused by ill health, disability or bereavement?
- Are you at serious risk of failing to qualify as a result of the financial pressures you face?
- Do you intend to work in the UK after qualification?
The award is based on individual needs, and although it states that it cannot provide help with a shortfall in parental assistance, it will look at this in exceptional circumstances.
This sounds like a lot of hoops to jump through, why isn’t it more straightforward?
The simple answer is historic policies, that have had several statutory instruments tacked on to them over time. As a result, this potential mishmash of funding feels a lot more complicated than your funding package in years 1-4, and although this requires you to apply for top-up funding from several additional sources, your overall debt for these additional years of study will be significantly less than you have accrued year 1-4. I appreciate that this comes as little comfort when you are undertaking an incredibly demanding degree, possibly holding down a part-time job and caring responsibilities. Where is the time to chase after funding that you need to continue on your course? Why would you need less money to live on when your study is increasing in intensity?
There is no denying that the current policy of statutory funding for medical students needs a full review, similar to what happened for nurses, midwives, physios and other allied health professional courses a few years ago, which saw the introduction of a £5k training grant on top of student finance. Regrettably, this has not been on the government’s agenda, but campaigns have gained some traction this year on the back of the backlash about junior doctor pay. Consequently, the Doctors Association and other pressure groups are pushing for reform under the banner of A Liveable Bursary for Medical Students, change will not come without students sharing their experiences so consider if you can get involved.
In the meantime, it is in your interest to apply for all the additional discretionary funding we have listed, and the Money & Housing Team is here to assist you with your application should you need us. We have drop-ins every Wednesday afternoon at Guy’s campus and an adviceline runs through the week too. If you are away from London and would prefer to meet online, we can also arrange appointments via Teams.
Researched and written by Gretta Gavin, Head of Money & Housing Advice at King’s College London. If you have any feedback about this article or need advice, please email advice@kcl.ac.uk.
Please note that the Money & Housing Advice Service is not responsible for the drafting and delivery of statutory or university policies related to student funding. We endeavour to provide impartial and detailed advice to students who approach our service for help. Our services are confidential and non-judgemental. Our goal is to empower the student community to thrive at King’s and overcome the financial burdens that may cause barriers to their success.
Further information and support
The Money & Housing Advice Service at King’s
NHS Bursaries for medical and dental students
Health Careers – financial support for medical and dental students