Impact of the increase in tuition fees and demographic factors on medical student intercalation rates between 2006 and 2020

Abstract

Introduction: No quantitative research has assessed the trends in English medical student intercalation. In addition, the impacts of the increase in tuition fees, introduced in 2012, and demographic factors on intercalation rates are unknown.

Methods: Freedom of information requests were sent to all UK universities. Regression analysis compared intercalation rates before (2006-2012) and after (2012-2020) the tuition fee increase. Student's t-tests compared demographics of medical students who intercalated. Questionnaires were sent to all UK universities to explore reasons for intercalating.

Results: In total, 101,085 students from seven universities responded. The intercalation rate increased from 4.70% to 10.53% (mean percentage difference (MPD) 5.84; 95% confidence interval (CI) 2.94-8.73). Intercalating students were more likely to be <25 years of age (MPD 33.36%; 95%CI 28.34-38.39), without a previous degree (MPD 8.56%; 95% CI 7.00-10.11) and without a disability (MPD 3.15%; 95% CI 0.88-5.42). In total, 389 completed questionnaires were received from 10 universities. Medical students believed an intercalated degree made them a better doctor.

Discussion: The proportion of students who intercalated was greater following the increase in tuition fees. This might be explained by the value medical that students placed on the skills and opportunities that accompany an intercalated degree.

Keywords: intercalation; medical education; medical students; tuition fees.

Fig 1.

Flow diagram showing the number of universities included in the quantitative analysis and rationale for the exclusion of others.

Fig 2.

Percentage of intercalated medical students per year in seven medical schools in England between 2006 and 2020.

Fig 3.

Intercalation rates before and after the tuition fee rise and comparison of demographic variables between intercalating and non-intercalating students. (a) Mean percentage intercalation +/2 standard deviation in the cohort before (2006–2012) and after the tuition fee increased (2012–2020). (b) Student's t-tests comparing mean percentage and 95% confidence intervals for demographic variables (disability, ethnicity, age, sex, prior degree and international status) between intercalating and non-intercalating students. *p≤0.05.