Abstract
BackgroundThere is evidence that graduates of different medical schools vary in their preparedness for their first post. In 2003 Goldacre et al. reported that over 40% of UK medical graduates did not feel prepared and found large differences between graduates of different schools. A follow-up survey showed that levels of preparedness had increased yet there was still wide variation. This study aimed to examine whether medical graduates from three diverse UK medical schools were prepared for practice.MethodsThis was a qualitative study using a constructivist grounded theory approach. Prospective and cross-sectional data were collected from the three medical schools.A sample of 60 medical graduates (20 from each school) was targeted. They were interviewed three times: at the end of medical school (n = 65) and after four (n = 55) and 12 months (n = 46) as a Year 1 Foundation Programme doctor. Triangulated data were collected from clinicians via interviews across the three sites (n = 92). In addition three focus groups were conducted with senior clinicians who assess learning portfolios. The focus was on identifying areas of preparedness for practice and any areas of lack of preparedness.ResultsAlthough selected for being diverse, we did not find substantial differences between the schools. The same themes were identified at each site. Junior doctors felt prepared in terms of communication skills, clinical and practical skills and team working. They felt less prepared for areas of practice that are based on experiential learning in clinical practice: ward work, being on call, management of acute clinical situations, prescribing, clinical prioritisation and time management and dealing with paperwork.ConclusionsOur data highlighted the importance of students learning on the job, having a role in the team in supervised practice to enable them to learn about the duties and responsibilities of a new doctor in advance of starting work.
Highlights
There is evidence that graduates of different medical schools vary in their preparedness for their first post
Focus of the paper This paper focuses on the two main themes: (1) areas of preparedness and (2) lack of preparedness; those interested in the full dataset are referred to the initial full report [41] or for a summary of findings including third interviews see the final report to the General Medical Council (GMC) [42]
Our data suggests that these new doctors quickly ‘got out of their depth’ when dealing with the more complex communications such as dealing with patients and relatives following bad news, a finding reported elsewhere [10,29]
Summary
There is evidence that graduates of different medical schools vary in their preparedness for their first post. This study aimed to examine whether medical graduates from three diverse UK medical schools were prepared for practice. One of the fundamental aims of all medical schools is to ensure medical graduates are prepared to start work safely as junior doctors. Lack of preparedness has been recognised internationally with reports of students being less prepared than they should be for starting practice [4,5,6,7,8]. The longer-term relationship between medical school and career progression is illustrated by findings that performance in certain postgraduate examinations can vary with place of graduation [9]
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