Overcoming challenges in recruiting international students

Recruiting international students for Advanced Clinical Practice (ACP) MSc programmes in the UK faces several challenges, including financial constraints, visa requirements, cultural differences and limited awareness of career benefits. Despite these obstacles, evidence-based solutions can enhance global accessibility to these advanced qualifications. 

1. Financial barriers for international students 

For international students, one of the most significant barriers to pursuing ACP MSc programmes in the UK is the high cost of tuition fees, which can exceed £25,000, depending on the institution. In addition to tuition, students also face living expenses, which can be substantial, particularly in cities like London. This makes studying in the UK financially prohibitive for many prospective international students.  

To address financial constraints, we believe higher education institutions (HEIs) should consider expanding scholarship offerings for international students in ACP MSc programmes, as these scholarships significantly boost enrolment (Atobatele et al., 2024; Wilson et al., 2023). Healthcare employers, particularly NHS Trusts, could sponsor international students in exchange for a commitment to work in the UK post-graduation, helping to address workforce shortages. HEIs could also explore providing flexible tuition payment plans and help students find affordable housing. However, the structural deficit in higher education must be recognised, as domestic undergraduate students often fail to generate sufficient income, resulting in a reliance on international students for funding. Lower-cost courses for international students could jeopardise institutional sustainability amid rising home undergraduate fees and higher National Insurance costs. 

2. Visa and immigration challenges 

Visa requirements and immigration policies pose challenges for international students wishing to study in the UK. Obtaining a student visa often requires meeting strict documentation rules, including proof of financial capability, which can complicate the application process for many (UK Government, 2024). Additionally, international students must meet specific language proficiency requirements adding another layer of preparation (British Council, 2024). Understanding the UK's post-study work options, like the Graduate Route visa that permits two years of work after graduation, is essential yet can be confusing for prospective students (UK Home Office, 2024). Higher education institutions can continue to streamline the visa application process for international students by offering comprehensive support and clear guidance throughout the application journey. This could include providing dedicated visa advisory services, assisting with paperwork and offering language support services for students who need to meet English language proficiency requirements. HEIs could collaborate with the UK Home Office to promote flexible visa policies for international students, allowing them to work while studying and after graduation in the healthcare sector. Evidence indicates that countries with lenient work-study visa policies attract more international students, especially in healthcare (Han et al., 2022; Tran et al., 2022). 

3. Cultural and educational differences 

International students often face challenges when adapting to the UK's academic environment and culture, including differences in educational systems, teaching styles and clinical practices. This can lead to stress and feelings of isolation. To support their transition, higher education institutions can implement pre-arrival orientation programmes that include cultural training, language support and academic preparation. Research shows that such programmes, along with continuous academic and personal support—like tutoring, mentorship, and peer networks—can enhance integration, improve retention, and foster a sense of belonging, leading to a more positive academic experience for international students (Atobatele et al., 2024; Wilson et al., 2023). 

4. Limited awareness of ACP career benefits for international students 

International students often struggle to see the long-term career benefits of ACP MSc programmes in the UK, particularly with a competitive job market and visa restrictions. This uncertainty can make ACP programmes less attractive. One way to tackle this would be for higher education institutions to highlight international graduates’ career advantages and success stories in the UK healthcare system. Additionally, the UK, the only G7 country with increased economic inactivity post-pandemic, faces 2.8 million people out of work due to long-term sickness, hindering productivity and growth (Office for National Statistics, 2023). Providing career advice and job placement services for international students is crucial. Higher education institutions could collaborate with NHS Trusts and healthcare organisations to offer internships, giving students valuable experience. Highlighting job security, leadership opportunities, and competitive salaries in ACP positions can attract more international students. 

5. Diversity and inclusion in ACP programmes 

The lack of diversity in the healthcare workforce is a global challenge, affecting ACP MSc programmes in the UK. International students from underrepresented regions may face systemic barriers that exclude them from these pathways. To create a more inclusive environment, higher education institutions and healthcare organisations would promote diversity by forming partnerships with various universities and healthcare providers and offering mentorship programs that connect students with experienced ACP practitioners from similar cultural backgrounds. Research indicates that mentorship can enhance retention and success for diverse students (Han et al., 2022; Penman et al., 2021). A culturally responsive curriculum can also help all students feel supported and valued. 

6. Unlocking institutions 

Higher education institutions have undergone significant changes due to government policies that marketise the sector and treat students as consumers. This has increased dependence on international student recruitment for financial stability. However, inconsistent government policies, have disrupted overseas recruitment, complicating HEIs' strategic planning for sustained financial viability. 

We believe it’s a priority for universities to engage in strategic planning to address structural deficits, with international student recruitment playing a crucial role. This recruitment helps manage financial needs and guides IT systems, staffing and services for diverse students. An effective Business Planning Round aligns resources with strategic goals, enhancing student engagement and satisfaction. Stable policymaking is essential for attracting and retaining students, but current regulatory pressures challenge comprehensive, student-centred strategies.  

While frameworks like the B3 Registration Conditions and Teaching Excellence Framework (TEF) focus on metrics such as student satisfaction, they often neglect the contributions of international students to the UK's educational reputation. Prioritising the success of international graduates should improve academic quality metrics while also addressing global challenges and strengthening the UK’s healthcare workforce. 

Ultimately, a collaborative effort between policymakers and institutions is key to fostering a supportive environment for international students, essential for maintaining the UK’s leadership in education and research. 

Dr Michael Mansfield is an Assistant Professor in Musculoskeletal Physiotherapy at the University of Birmingham. With expertise in program leadership and postgraduate education, he has expertise in advanced healthcare practice. Michael is passionate about musculoskeletal health research and translation of research into practice. 

Dr Anthony Mansfield is the Director of Strategy & Performance at the University of East London and has worked at UEL for eight years. Previously, he worked at Keele University, where he taught Medieval History. He is a Senior Fellow of the Higher Education Academy and holds a PhD in History.