Article Text

Download PDFPDF
Impact of the implementation of the additional cost of teaching (ACT) levy on prospective international medical students applying to Northern Ireland and Scotland
  1. Tanya Rebekah Enoch,
  2. Rucira Ooi,
  3. Setthasorn Zhi Yang Ooi
  1. Centre for Medical Education (C4ME), Cardiff University School of Medicine, Cardiff, UK
  1. Correspondence to Setthasorn Zhi Yang Ooi, Centre for Medical Education (C4ME), Cardiff University School of Medicine, Cardiff CF14 4YS, UK; ooisz{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

International medical students have often been termed ‘‘cash cows’’ due to the hefty amount of fees paid each year.1 It has been reported that only 7.5% of international students are permitted at UK medical schools1; however, multiple medical schools are currently exceeding this cap in order to earn a larger sum of fees. This amount can range from £20 000 to £40 000 for preclinical students and £35 000–£70 000 for clinical students per academic year.1 Furthermore, international medical students’ fees are also subjected to an annual inflation of 1%–2% as per the Retail Price Index.1

Since August 2016, additional training costs were implemented for international students under an Additional Cost of Teaching (ACT) levy in Scotland.2 This levy was intended to finance clinical skills and placements for international students delivered by medical health professionals. It required all international medical students applying to Scotland to pay a national levy of an additional £10 000 per academic year.2 Likewise, Belfast has implemented a similar system for all European Union (EU) and international students, from the 2021/2022 intake onwards, in order to allow access to clinical placements in the Northern Ireland Health and Social Care system.3 However, the full £10 000 only has to be paid in years 3, 4 and; in year 1, no levy has to be paid and in …

View Full Text


  • Contributors TRE, RO and SZYO contributed to the design of the work, and the acquisition, analysis and interpretation of data. TRE was involved in drafting the work. RO was involved in revising it critically for important intellectual content. TRE, RO and SZYO have provided final approval for the letter to be published. TRE, RO and SZYO agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.