EXPLAINER 28 October 2026

Why the NHS bursary needs fixing and fast

Rosie Pearce
by Rosie Pearce
Widening access
Why the NHS bursary needs fixing and fast
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Most dentistry students in England see their financial support drop by over £3,000 just as their clinical workload peaks in their final year. They are not eligible to claim student finance to top up the insufficient NHS England bursary they receive for their tuition fees and maintenance costs. Meanwhile, a timetable mostly reserved for patient appointments for supervised treatment is not compatible with most part-time work. 

The NHS bursary, introduced in 1968 when university education was free, once covered students’ living costs fully and helped them meet expenses of studying a clinical course. It acknowledged their future service and compensated dentistry and medicine students for taking a longer course (both are typically five years). However, today, it leaves students worse off than their peers on standard student loans. 

A counter-productive subsidy?

The Institute for Fiscal Studies has gone so far as to suggest that the NHS bursary in its current form is counter-productive, reducing overall maintenance support during study and subsidising higher-earning graduates decades later.

“Undertaking BDS as a second degree means I have to self-fund. I was fortunate that Plymouth allowed me to join [the five year programme] directly into year two, meaning I only needed to save three years of fees rather than four. Completing a dental therapy degree prior to my dentistry degree has given me invaluable knowledge, experience, and confidence, which I believe will allow me to provide better patient care as a dentist. I am incredibly grateful that the NHS funds the final year of BDS, although the reduced maintenance loan means I must continue to work hard in North Devon practices during holidays to prepare financially. At times, I feel tired and anxious about money, and there is immense pressure to pass each year as I cannot afford to resit. However, this challenge has instilled drive, motivation, and an appreciation for the amazing privilege it is to be studying again.”

Molly Langford
Molly Langford, 2025 Student, Peninsula Dental School Accelerated entry Dentistry

Student hardship and changing cohorts

Around 40% of dental students reported difficulties affording rent and bills in 2023, this is more than double the figure reported in 2021. The bursary leaves students on average over £3,000 worse off than they would be under the standard loans system. This shortfall disadvantages those without a familial safety net and risks excluding precisely the students we most need from widening participation backgrounds. Some students are on the bursary for more than one year, compounding the problem.

We are pleased that progress has been made to make the dental cohort more representative, there is wider access to dentistry careers and the proportion of students from the most deprived quintile of neighbourhoods is rising, while the proportion from the least deprived is falling. This is a welcome shift, however it means the pool of dentistry students is now more likely to lack financial backup. In year five especially, students spend full days treating patients free of charge as part of their NHS training. Unlike their peers on other courses, they cannot take on regular work during the working week. Universities are also increasingly unable to step in, as institutional bursary funds are squeezed by inflation and declining real budgets. 

  • Graduate-entry students are funded by the bursary from year 2 onwards.
  • Students on six-year routes (including Gateway years reserved for WP applicants) receive bursary in years 5 and 6.
  • Second-degree students unable to access graduate-entry places enter standard five-year BDS, with the final year bursary.
  • Intercalating students who take a year out to gain further academic qualifications will receive the bursary for at least an extra year. These students often pursue research careers, which is a workforce that urgently needs to grow.
  • Access/Foundation routes integrated into a degree are also subject to two bursary years at the end.

To enter Dental Foundation Training (a transition to practice year) with the energy and resilience required to start a vocational career, often in a new place far away from home, graduates need access to money. They will usually need to put a deposit to rent a new home, they will need to buy scrubs and sometimes set up with a car. However, their final year is often financially fraught, leaving them poorly set up. Financial worries are extremely stressful and final years deserve to focus on passing their finals and getting ready for their transition to practice.

New debt norms

Student loans are already very large for  the students who take them. For dentistry students the headline figure for maintenance and fees is often around £90,000. It is worth noting government contributions in England represent an additional cost of over £180,000 that is not paid back directly by the graduate. Loan interest is added during studies and until repayments are complete, so the loans are bigger by graduation. The debt is also bigger for typical NHS dentists, who tend earn less than those who move into private practice, which can mean repaying more over a lifetime despite getting paid less. So, the less than £15,000 in bursary savings is usually saved by the student (borne by the taxpayer), is associated with hardship in their final year, and does not have much impact on the overall size of their loan, the supposed benefit.

Recent reforms are hopeful

Government has recently uplifted bursaries for students in medicine and dentistry, by inflation and plans to continue to do so.  Meanwhile, the new lifelong learning reforms will improve graduate access to student finance in the first year for graduate entry students, but the later years of dentistry remain the weakest point for support.

The Dental Schools Council’s preference is to increase and modernise the NHS bursary, so that students are not left short in their most intense years of training. If this reform does not happen, students would be better off with a top-up or the standard loan system, supported by targeted maintenance grants.

Reform will require cross-government department collaboration between the Department of Health and Social Care, NHS England and the Department for Education. Without change, financial pressure will continue to undermine students’ ability to complete their courses and compromise the NHS workforce of tomorrow.

Dentistry students are motivated, capable and committed to NHS careers. It is time to give them the support they need to complete their training well and contribute fully to patient care during and after their course.

  • This article reflects the views of the author and does not necessarily represent the views of the members of the Dental Schools Council.
  • The student quotation included in the article reflects the personal experience and views of the individual quoted and should not be interpreted as agreement with the views expressed by the author.
  • This article was originally drafted in 2025.

 

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