Medical doctor degree apprenticeships

There are a number of considerations for employers wishing to adopt a medical degree apprenticeship including:

• salary
• job role
• terms and conditions
• assessing candidates to meet widening participation
• consider current apprenticeship offer
• develop an organisational strategy
• use a costing tool
• develop a business case.

East Suffolk and North Essex NHS Foundation Trust (ESNEFT) was the first trust to get involved with the pilot launch of the medical apprentices programme. The trust paired up with Anglia Ruskin University (ARU) providing medical education for apprentices employed by the trust.

The East of England is an under-doctored region. Areas in North Essex and South Suffolk have low or non-existent numbers of medical degree applicants. The opportunity to support the widening participation of medical training appealed as a way to bolster its medical workforce in the future and support the local community.

The trust intends to take 25 apprentices within the first year, with a view to expand in the future if the pilot is a success.

Entry requirements

ESNEFT worked closely with ARU to establish entry criteria for internal and external applicants. The entry criteria includes:

• ABB at A Level including a science subject within previous five years. Applicants must have GCSE maths and English.
• Science or allied health degree at 2:1 or higher within the past five years or any other degree at 2:1 with a science A Level or access to medicine or science within the past five years.
• Applicant has completed access to medicine or access to science course within the past five years (achieving 30 distinctions and 30 merit).

Employment

There is a desire to develop well rounded doctors throughout the apprenticeship programme. ESNEFT will take the opportunity to give apprentices exposure to areas of the trust they wouldn’t normally see during their medical education. Apprentices will undertake new roles within departments with bespoke job descriptions for each placement.

Apprentices will be able to express a preference, but the final decision on the role will be made by the employer dependent on availability and then rotated each year of the apprenticeship.

Academic teaching will follow the same block learning approach as traditional students, training will be during term time and placements with the employer outside of this. Annual leave will need to be arranged outside of the academic timetable.

Medical apprentices will be employed on local terms and conditions of service, however these will mirror agenda for change for things like entitlement to annual leave. 

Annex 21 of the NHS Terms and Conditions of Service will be used for the apprentice salary calculations. This will increase incrementally for each year of the apprenticeship and is based on the Foundation Year 1 pay scale. For the first year, apprentices will receive 60 per cent of the Foundation Year 1 salary which will increase each year.

Recruitment

There has been a great deal of interest with the launch of the pilot, with over 3,000 individuals applying to participate in the trust's initial information session.

This has led to 388 applications for the 25 apprenticeship posts which will commence in September 2024.

ESNEFT has worked closely with ARU which has an established shortlisting process for widening participations such as adjusted scoring for applications from certain backgrounds, demographics and localities.

Apprentices will remain within the trust for their two foundation years. 

The entry requirements will be set by medical schools and employers. Employers must be assured that applicants have the right values and behaviours expected of doctors and that they are capable of the academic learning involved typically high grades at A Level or above. 

The main difference between a medical apprenticeship and a traditional medical degree is that apprentices will work for their employer alongside their medical education. However, apprentices cannot work as doctors until they have completed their training and obtained GMC registration

They will instead undertake roles appropriate to their training and skill level, to be determined locally by their employer.

Yes, apprentices are salaried employees during their apprenticeship. The decision on pay will be for their employer to determine in line with existing guidelines on apprentice pay.

There are no national agreements for apprentice pay ane employers will need to determine local approaches.

To assist with this, there are different approaches that can be taken based on examples that employers use for other healthcare apprenticeship roles. 

Some considerations for employers deciding how to pay apprentices: 

• Annex 21 of the NHS Terms and Conditions of Service Handbook which outlines paying a percentage of the fully qualified pay  
• National minimum wage rates including living wage and apprentice rates 
• Pay preservation for existing staff members 
• Band below the qualified salary whilst training 
• Role that they will be undertaking and paying accordingly 
• Whether they have any healthcare experience 
• Any other already established apprenticeship pay models within the trust 

We would recommend establishing a system approach to enable consistency within your region. 

As with any apprenticeship, some of the apprentice’s working hours should be in off the job training, which is learning that is outside of the daily working environment leading towards the achievement of their apprenticeship. 

It is expected that the medical degree apprenticeship will require a significantly higher percentage of off the job training, similar to other clinical apprenticeship roles. The precise percentage of time spent out of the daily working environment will be set by the medical school dependent on their programme design. 

Consideration should be given to the time required for students in the traditional medical school route for both study and clinical placements and used the benchmark the requirements for apprentices given the academic requirements for both groups will be the same.

The medical doctor degree apprenticeship would be suited to a range of employers, including secondary care, mental health and learning disability trusts and primary care.

To meet the GMC’s outcomes for graduates, there will need to be some rotation in placements.

Trusts and primary care providers may wish to consider clustering together to provide medical degree apprentices the appropriate rotation of clinical placements.

These placements could be held in: 

• teaching hospitals 
• primary care
• private, independent and voluntary organisations 
• community health centres
• specialist areas.