More hands-on training for doctors required if policy changes

February 23, 2016

Research into views on whether doctors should be fully registered to practise on graduation has highlighted scope for improvements in the medical education training system. Students would benefit from more hands-on training and responsibility, research carried out at the Universities of Exeter, Cardiff, Dundee and Queen's University Belfast indicates.

A paper written by a panel of experts including Karen Mattick, Professor of Medical Education at the University of Exeter, and Lynn Monrouxe, now Professor and Director of the Chang Gung Medical Education Research Centre, Taiwan, and published in BMJ Open, suggests that medical students need to be embedded in practice at an earlier stage. The team also found that assessments to judge medical students' clinical and professional capabilities in the workplace need further development.

The paper arises from research commissioned by the General Medical Council to evaluate the preparedness of graduates for medical practice. This specific issue arises from recommendations outlined in the Shape of Training report, an independent review of medical education published in 2013, which recommended that full registration should be granted when students graduate from medical school.

Currently junior doctors are only provisionally registered with the GMC on graduation and work for a year under close supervision as Foundation Year 1 (F1) doctors, with some restrictions on their practice.

However, the new findings have concluded that medical students should take on greater responsibility for patient care as undergraduates, that assessment methods in clinical practice and professionalism need improvement, and that good practice in postgraduate supervision and support must be shared. The conclusions were based on interviews with 185 participants across the UK, including foundation year doctors and other trainees, health professionals, leaders of undergraduate and postgraduate medical education, patients, and representatives of policy and government.

Professor Mattick said: "Research participants felt that medical students currently do not get enough experience embedded in the workplace and in multidisciplinary healthcare teams. This makes it difficult to assess the domains of clinical practice and professionalism with confidence - for example with workplace based assessments of practical procedures, decision making, communication skills and team-working." Professor Monrouxe, who led the overarching study, said "Some felt that undergraduate programmes found it difficult to fail underperforming students."

The Shape of Training report's recommendations were underpinned by concerns with the current fragmented system where graduating medical schools remain responsible for aspects of the F1 doctors' training, even though many of them train remotely with an NHS employer and in a new postgraduate training environment. This is important given the alarming levels of career-related ill health in medicine and growing concerns about retention.

There is also growing competition for Foundation Programme places, with increasing numbers of graduates from UK medical schools and applications open to European and international medical graduates.

However, participants in the research described the F1 year as a 'safety net', which allowed new doctors to be closely supervised and supported, and senior doctors to identify struggling trainees. There was also an assumption that full registration would imply higher expectations from the outset, which might put further pressure on junior doctors.

Professor Monrouxe emphasised that the research was not designed to be an opinion poll, but when asked whether doctors should be fully registered at graduation, 57 per cent of comments were against the change while 23 per cent were supportive, with the remaining comments expressing no strong view. Professor Mattick said: "Our research indicates that, regardless of whether or not a change to the timing of registration is ultimately made, the process of thinking through the implications could lead to positive and significant change, for example to undergraduate clinical placements and postgraduate supervision and support, which can only benefit medical students, trainees and patients."
-end-
Implications of aligning full registration of doctors with medical school graduation: a qualitative study of stakeholder perspectives is published today in BMJ Open by K Mattick, K Kaufhold, N Kelly, JA Cole, G Scheffler, CE Rees, A Bullock, GJ Gormley, and LV Monrouxe.

University of Exeter

Related Medical Education Articles from Brightsurf:

How can education researchers support education and public health and institutions during COVID-19?
As education researchers' ongoing work is interrupted by school closures, what can they do to support education and public health institutions dealing with the Covid-19 pandemic?

Online education platforms could scale high-quality STEM education for universities
Online and blended (online and in-person) STEM instruction can produce the same learning outcomes for students as traditional, in-person classes at a fraction of the cost, finds research published today in Science Advances.

Teaming basic scientists with clinicians may improve medical education retention
There is a trend in modern medical school curriculum design to integrate the basic sciences and clinical sciences.

Medicare overpayments for graduate medical education could total $1.28 billion annually
If Medicare capped funds for Graduate Medical Education (GME) at the rate of $150,000 per resident, the move would free up more than $1 billion a year, according to a study published today in JAMA Internal Medicine.

Gamification can give dental and medical education a boost
Introducing gamification to medical and dental education can boost student motivation and lead to better learning outcomes, a new study from the University of Eastern Finland shows.

Flipped classroom enhances learning outcomes in medical certificate education
The quality of medical certificates written by students of medicine was better when they were taught by using the flipped classroom approach instead of traditional lecturing.

Most surgical residents want personal financial education offered during medical training
Close to 80 percent of resident respondents to one online survey said they think personal financial education is needed during residency, according to study findings in the Journal of the American College of Surgeons.

Centralized infrastructure facilitates medical education research
The Council of Academic Family Medicine Educational Research Alliance has enabled a large number of research teams to conduct meaningful scholarship with a fraction of the usual time and energy.

Individual education programs not being used as intended in special education
Gone are the days when students with disabilities were placed in a separate classroom, or even in a completely different part of the school.

Springer Healthcare launches Medicine Matters, a new medical education website
Springer Healthcare launches Medicine Matters, a new medical education website.

Read More: Medical Education News and Medical Education Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.