Altogether 181 students recently started their medical studies at UiT The Arctic University of Norway. That is far more than the university believed it had capacity for.
In August this year, we introduced the Journal of the Norwegian Medical Association to the new students at Norway's medical faculties. In Tromsø, most of them had gone home for the day, but the timetable coordinator assured us that they could follow the session online. Nonetheless, the auditorium did not have space for everyone. The lectures were recorded so that they could still be accessed by those who lost out on a seat, but I am not sure about the set-up or where the students sat if they were not physically present.
All four of the medical faculties could admit more students until 2027, according to the Grimstad Committee
The high number of new medical students in Tromsø is a result of Norway's need for more doctors (1). To meet this need, the intake of new students in Norway should be increased (2). In June 2018, the Ministry of Education and Research established a working group, the Grimstad Committee, to assess how many students could receive their education and training in the different faculties (1). The report was completed in 2019. All four of the medical faculties were able to admit more students until 2027, according to the Grimstad Committee. UiT The Arctic University of Norway had estimated that they could increase their capacity by 25 new places (1). However, the Ministry of Education and Research decided that the number of places should increase from 116 to 181 over the course of three years (3) – i.e. 40 more than the university claimed to have capacity for. The justification for this dramatic increase is that training more doctors in North Norway will most likely boost the recruitment of doctors in that region (4).
The increase has not come about without resistance
The increase has faced considerable opposition. The Norwegian Medical Students' Association, doctors at the University Hospital of North Norway in Tromsø, the deputy managing director at the University Hospital of North Norway, and the dean of the Faculty of Health Sciences at UiT The Arctic University of Norway have all expressed concern about the high number of students (5, 6). The region has the lowest patient population in Norway and correspondingly few specialists, and the medical communities are small and vulnerable (7). The Norwegian Medical Students' Association is concerned that the quality of teaching will not be maintained given the short time that the university, and especially the hospital, has had to prepare for the dramatic increase (8, 9).
Even with its 116 student places per year, UiT The Arctic University of Norway expressed challenges in finding clinical placements in the primary health service and mental health care (1). When I started my medical studies in Tromsø in 2016, the cohort consisted of 116 students, and in much of our practical teaching there were between 8 and 10 students per patient. Often there was one student who talked to the patient and one who examined them, while the rest stood around and watched. Some also had to share a clinical placement and patient list in general practice. This meant that they had half as many patients as the rest of the cohort, because the faculty had not found enough clinical placements for everyone.
To maintain a good learning arena for medical students in Tromsø, UiT The Arctic University of Norway and the University Hospital of North Norway have tried their best to find solutions. For example, UiT – The Arctic University of Norway has suggested dividing the students into several groups of the same size as in previous cohorts, as well as establishing several decentralised teaching pathways where students complete their fifth and sixth years of study at hospitals other than the University Hospital of North Norway in Tromsø (10, 11). Decentralised pathways apply only to the final two years of the medical study programme and are a good alternative to the same education and training in Tromsø, but they do not solve the problem that UiT The Arctic University of Norway and the University Hospital of North Norway face in the first four years of study. With a health service that is already under pressure, and a medical profession under perhaps even more pressure, additional teaching commitments without the extra resources to accompany them are a cause for concern (7).
The concerns of the students, the hospital and the university have been put to the Ministry of Education and Research, but no specific response has been forthcoming (6, 10). It is worrisome. Because if a lack of places in the lecture hall proves to be a portent of a poorer quality teaching programme and more work for already pressured doctors in the region, it raises questions about whether the initiative will have the desired effect on recruitment that the Ministry of Education and Research envisages.