When almost 60 eager would-be medics arrive at the UK’s newest medical school on Tuesday, instruction in areas such as anatomy and physiology will be supplemented by a less conventional offering — free driving lessons.
The unusual perk encapsulates the challenges, but also the opportunity, awaiting the inaugural class at Pears Cumbria School of Medicine in Carlisle.
The northwestern English county’s stunning scenery and pockets of affluence belie the constant struggle to treat a highly dispersed rural and coastal population, constrained by acute workforce shortages.
Wheels are not only a must to traverse the region while the fledgling doctors train. They also signify the school’s willingness to think laterally in pursuit of its central purpose: to inspire rising generations of medics to remain in the region after they qualify.
“You’ve got to do things differently if you want to get a different outcome,” says Mary Morrell, head of PCSM.
Mary Morrell is the head of the new medical school which will welcome nearly 60 students © Jeremy Sutton-Hibbert/FT
“We’re the only medical school, as far as we know, to get a fleet of cars and are going to offer driving lessons to our students,” notes Morrell, referring to a deal the school has signed with Co Wheels, part of MG Motor group, through which they receive vehicles at a special rate.
Although the NHS is built on the notion of high quality care for all regardless of economic circumstances, in areas such as Cumbria the pledge often rings hollow.
Adrian Clements, medical director for North Cumbria Integrated Care, one of two trusts the school is working with, says less than two-thirds of his consultant posts are occupied by permanent appointees. The remainder are filled by temporary locum or agency staff who cost twice as much.
Cumbria’s recruitment difficulties find an echo in places such as Lincolnshire and Cornwall, he adds: “If we don’t solve that, then we don’t have a health service that is equitable across our populations.”
Martin Lupton, vice dean for education at Imperial’s Faculty of Medicine, has sought to tackle the problem at source.
Martin Lupton: ‘Evidence suggests that people are far more likely to practise close to where they qualify’ © Jeremy Sutton-Hibbert/FT
An obstetrician by background, he began to develop the idea for the school at a time when talk of “levelling up” — a slogan promising to reduce geographical inequality championed by former prime minister Boris Johnson — was “pretty much everywhere”, alongside a growing understanding of the need to expand medical student numbers.
Yet the answer to doctor shortages was not simply to “churn out more people from the established schools” in the hope that some would settle in needier areas such as Cumbria, he said. “Evidence suggests that you are more likely to practice near where you qualify.”
Lupton sent “an unsolicited email” to Brian Webster-Henderson, deputy vice-chancellor at the University of Cumbria, who was enthusiastic about the prospect of adapting the institution’s facilities to add medicine to the roster.
Brian Webster-Henderson, deputy vice-chancellor at the University of Cumbria, who was enthusiastic about adding medicine to the roster © Jeremy Sutton-Hibbert/FT
But, as the two jointly developed the concept of a graduate-entry school, the challenge was to raise the necessary funding. Lupton recalled: “We had to come up with a model where it cost the state zippidy-do to set up.”
While the government’s 2023 NHS workforce plan called for a doubling of medical school places — and additional places were later allotted to the region as part of that expansion — the Cumbria initiative predated it.
Lupton approached the Department of Health and Social Care seeking approval to move 50 medical school places from Imperial to Cumbria, backfilling with overseas students who pay much higher fees than their domestic peers.
Imperial has invested about £1mn in the school, while the philanthropic Pears Foundation, after which the school is named, has given £5mn. It has also benefited from many additional charitable donations from inside and outside the region. One such contribution is paying for the driving lessons.
The Pears Cumbria School of Medicine on the Fusehill Street campus in Carlisle, England © Jeremy Sutton-Hibbert/FT
Not only the funding model, but the admissions procedures and curriculum distinguish it from other medical schools. For example, learning about the prevention of disease, and how the NHS works, in part through practical research projects designed to root the students in local communities, is not a discretionary add-on but integral to the programme.
While the Cumbria team was developing the approach long before publication of a 10-year plan for the NHS in July, staff point out it aligns with the government’s focus on shifting care from hospitals into neighbourhoods and staving off sickness rather than simply treating it.
At every stage, Morrell says she was looking to lower barriers that may have deterred some people from considering a medical career.
More than a third of the incoming class is receiving a bursary or scholarship, with access widened to draw in students from non-traditional backgrounds. Over half are northerners.
Dr Chris Chiswell is head of prevention and healthcare delivery at PCSM © Jeremy Sutton-Hibbert
Chris Chiswell, public health consultant at University Hospitals of Morecambe Bay, the other trust covered by the school, and PCSM head of prevention and healthcare delivery, says: “In the very same breath that our students are learning about respiratory physiology, or the pathology of a lung illness, for example”, they will also learn about health promotion approaches.
This might include attending sessions covering “the corporate determinants of health” to understand how the tobacco industry may target particular communities.
Also central to the training is the need to prepare students for a world in which doctors will increasingly be expected to work as part of a much wider healthcare team.
Dr Amit Paik says he has already begun to receive emails from sixth formers interested in studying at PCSM © Jeremy Sutton-Hibbert/FT
Local health leaders hope the medical school now on their doorstep will raise the population’s aspirations about what can be achieved.
Amit Paik, a GP who heads the school’s education hub, says he and his colleagues have already begun to receive emails from sixth formers and people working in other medically-related fields. “We want to learn how to develop some work experience, because [we’d] love to then put an application in”, reads the typical message.
Clements believes the school’s blueprint points the way forward, not only for Cumbria but for other similarly strained health economies. “If this proves to be a concept that works, then it needs to be replicated in other challenged health environments,” he adds.
Morrell, meanwhile, acknowledges that both the University of Cumbria and Imperial have taken a risk in setting up the new school; for all the faculty’s efforts, there are no guarantees its graduates will choose to continue their careers in this beautiful but complex region.
Morrell adds: “I will do everything I can, but in the end, you can come back in four years’ time and judge me [on] whether or not I have managed to do that.”