A national report examining the financial and personal impact of studying Graduate Entry Medicine (GEM) in Ireland found that tuition fees were the most significant source of stress for students, superseding both academic workload and the cost of living. Half of all students reported working while studying, with 58% of Irish students and 49% of non-EU students relying primarily on their parents for financial support.
Graduate Entry Medicine was introduced in Ireland as an alternative pathway into medicine, aimed at both expanding the country’s domestic supply of doctors and broadening access to the profession.
The report reveals that GEM remains structurally inaccessible to many middle- and lower-income students. With annual tuition fees reaching up to €18,880 for EU students and €63,810 for non-EU students, the programme’s cost stands in stark contradiction to its promotion as a pathway to widening participation.
Before 2022, students could access a dedicated GEM loan through Bank of Ireland. Since the withdrawal of this option, however, there are no longer any financial mechanisms specifically for GEM students, limiting the funding sources available to them.
In the report, students expressed both frustration and guilt at being forced to rely on their families for financial support. One student spoke of the “Constant stress about the financial burden of it all,” while another described the guilt of relying on their parents as “Immense.” A further respondent highlighted the strain of balancing work placement with three part-time jobs alongside their studies, “just to get by”.
The data also sheds light on the educational and socioeconomic background of GEM students. It reveals a striking lack of socioeconomic diversity, with the most common parental income bracket exceeding €150,000 per year, well above the national median of €61,666. 90%of respondents reported that at least one parent held a third-level degree, while 21% indicated that one parent had a medical qualification, and 12% reported that both parents held medical degrees.
Despite all the hardships faced by GEM students, many still described the programme as worthwhile. “It’s a lot of work and nerve-wracking at times, but I’m delighted to be on a path where I feel like I’m doing what I love,” said one student.
Nearly 90% of respondents believe fees are unfair and call for a model that reflects the founding principles. Across the board, students’ preferences for reform leaned towards some form of tuition support, either through an extension of the Free Fees Scheme, expanded SUSI eligibility, or a centrally funded loan scheme.
The report highlights the tension between the need for a larger, more diverse medical workforce and GEM’s financial structure, which limits access to higher-income students. Yet, despite ongoing debate and repeated reform proposals, the government has failed to implement any meaningful change. Meanwhile, the Irish Medical Organisation (IMO) has warned that this inaction poses a “hugely concerning” risk to the ability to attract applicants across all medical specialities.
Indeed, Ireland falls well below the OECD average for the number of consultants and GPs per capita. More than one in five consultant positions remain vacant, with the HSE struggling to attract even a single applicant for some advertised roles. The situation is further compounded by the fact that nearly 30% of consultants and GPs are expected to retire within the next five years, while an estimated 3,000 doctors have left Ireland over the past five years to take up positions abroad.
The report issues several recommendations, beginning with an immediate measure to prevent further fee increases. Measures such as extending public student supports to GEM students, alongside the development of a national funding scheme and a state-backed financing option, are also recommended.
The report also recommends assessing the ScotGEM model for potential application in Ireland. In Scotland, the government covers tuition fees for eligible students over a four-year programme, and students can receive a return-of-service bursary of up to £16,000 in exchange for working in NHS Scotland after graduation. Adopting a similar approach in Ireland could better align funding for medical education with workforce planning and public investment.
Above all, the report stresses the urgent need for government action. Not only does the current system cripple students financially, but Ireland’s healthcare system as a whole is at risk if meaningful reforms are not implemented.
“This report makes clear that the challenge is not a lack of ambition among students, but a system that too often asks them to overcome unnecessary barriers. The next step must be turning evidence into action- ensuring that access to Graduate Entry Medicine is shaped by potential, not privilege”, said Anna Hrabovska, UCC Students’ Officer.
The report examining the financial and personal impact of studying Graduate Entry Medicine (GEM) in Ireland was launched on Monday, 23 March, by a coalition led by UCD Students’ Union. The report is based on a survey capturing 20% of the GEM population across Ireland. It highlights the significant financial barriers faced by GEM students, as well as their experiences entering and completing the programme.
Aoife Ruppin-Giltenane – News Reporter