Medicine could become a postgraduate only subject and be transfered from universities to the NHS, a British Medical Association meeting heard this week.
Colin Smith, chairman of the BMA Medical Academic Staffs Committee, warned the meeting that teaching and clinical medicine were suffering because of the research assessment exercise. He said that as a result teaching could be taken from the universities.
The move to a postgraduate subject is being fuelled by the need to increase the breadth of experience of medics, to attract the right people and to reduce the drop-out rate.
Dr Smith said: "There have been discussions, certainly in the civil service and the Dearing inquiry, asking if you make medicine a postgraduate degree why does it have to be part of the universities."
The meeting heard how virtually all medical schools were suffering as a result of the RAE. "How is it when no school scores worse than a 3, that they are so badly off after the RAE?" said Dr Smith. He pointed out that medical schools had deficits of up to Pounds 2.2 million. At Newcastle University medical school up to 20 jobs were under discussion.
Dr Smith said that any attempt to separate medicine from the universities and transfer it to the NHS, where the focus could be purely on training doctors, would be a major mistake. "There is more to medical education than a vocation," he said.
Dr Smith said that unless the Higher Education Funding Council for England rewarded excellent teaching with more money, research would continue to dominate. Brian Fender, HEFCE's chief executive, told the meeting that he was "warming to the notion".
The prospect of medicine becoming exclusively a postgraduate entry degree was described as "financially disastrous" for students by Charles George, chairman of the General Medical Council academic committee. "Finances will preclude many students taking up the option," he said.
Maxwell Irvine, vice chancellor of Birmingham University, which sees a quarter of its resources used in medicine, said the implications for the university of losing medicine would be enormous. "I would be deeply concerned about losing the links which exist between medical schools and other subjects which underpin medicine, and about the ability to maintain standards in research if the division takes place."
A spokesman for HEFCE refused to comment on possible outcomes of the Dearing inquiry.