Kerry Goulston

WHAT does it cost a university to educate a medical student? Medical Deans Australia and New Zealand in 2011 estimated the cost was $50 000–$51 000 per student per year across a selection of medical schools.

With help from PricewaterhouseCoopers, we have estimated the cost in 2010 to the University of Sydney was $53 093 per student per year. This is in line with similar costing in the UK and the US.

While this was the actual cost to the university, we also examined a hidden cost — teaching not paid by the university. This is usually teaching carried out by government employees (mainly in hospitals) and in some cases by clinicians in private practice.

This teaching occurs throughout most medical courses, particularly in teaching hospitals. It includes teaching by paid medical, allied health and nursing staff in lectures, evidence-based learning sessions, small group tutorials at the bedside, in clinics, in skills laboratories and in community settings as well as opportunistic teaching.

Ward rounds, operating sessions, clinician, specialist and GP consulting room sessions take longer when medical students are present. This is effectively “teaching time”.

We found that the value of teaching provided to students at the Sydney Medical School in 2010 for which the university did not pay was $34 326 per student per year.

Taking both university and non-university components into account, the cost of face-to-face teaching in the final 2 years of the 4-year postgraduate course represented 79% of the total cost of face-to-face teaching.

This reflects the fact that while much teaching is given in lectures and in large practical group demonstrations, the majority of teaching in the final 2 years is in small group tutorials as well as one-to-one teaching.

So the true overall cost of teaching a medical student at the Sydney Medical School is the cost to the university of $53 093 plus the value of the time committed to face-to-face teaching by non-university paid teachers of $34 326 — a total of $87 419 per student per year.

International students (24% of the 2012 intake) pay the University of Sydney $62 880 per year.

It is interesting that health is one of the few professions where practitioners teach students on behalf of the university for no financial reward — simply altruism.

Professor Kerry Goulston and Professor Kim Oates are emeritus professors at the Sydney Medical School, University of Sydney.