United Kingdom Medical Schools Research Articles

An evaluation of the performance in the UK Royal College of Anaesthetists primary examination by UK medical school and gender

BackgroundThere has been comparatively little consideration of the impact that the changes to undergraduate curricula might have on postgraduate academic performance. This study compares the performance of graduates by UK medical school and gender in the Multiple Choice Question (MCQ) section of the first part of the Fellowship of the Royal College of Anaesthetists (FRCA) examination.MethodsData from each sitting of the MCQ section of the primary FRCA examination from June 1999 to May 2008 were analysed for performance by medical school and gender.ResultsThere were 4983 attempts at the MCQ part of the examination by 3303 graduates from the 19 United Kingdom medical schools. Using the standardised overall mark minus the pass mark graduates from five medical schools performed significantly better than the mean for the group and five schools performed significantly worse than the mean for the group. Males performed significantly better than females in all aspects of the MCQ – physiology, mean difference = 3.0% (95% CI 2.3, 3.7), p < 0.001; pharmacology, mean difference = 1.7% (95% CI 1.0, 2.3), p < 0.001; physics with clinical measurement, mean difference = 3.5% (95% CI 2.8, 4.1), p < 0.001; overall mark, mean difference = 2.7% (95% CI 2.1, 3.3), p < 0.001; and standardised overall mark minus the pass mark, mean difference = 2.5% (95% CI 1.9, 3.1), p < 0.001. Graduates from three medical schools that have undergone the change from Traditional to Problem Based Learning curricula did not show any change in performance in any aspects of the MCQ pre and post curriculum change.ConclusionGraduates from each of the medical schools in the UK do show differences in performance in the MCQ section of the primary FRCA, but significant curriculum change does not lead to deterioration in post graduate examination performance. Whilst females now outnumber males taking the MCQ, they are not performing as well as the males.

Knowledge of and Attitudes Toward Electroconvulsive Therapy of Medical Students in the United Kingdom, Egypt, and Iraq

To investigate the knowledge of and attitudes toward electroconvulsive therapy (ECT) in 3 samples of medical students from Iraq, Egypt, and the United Kingdom, respectively. Medical students from Baghdad, Iraq, Cairo, Egypt, and Sheffield, United Kingdom medical schools completed a self-administered questionnaire including item of factual knowledge and of attitudes toward ECT. The Iraqi and Egyptian students were in their final year. The United Kingdom students have just finished their psychiatric placements. A total of 339 students responded (181 from Iraq, 85 from Egypt, and 73 from the United Kingdom). The theoretical knowledge base of the Iraqi sample was found to be better than that of the other 2 samples. Overall, the knowledge of ECT was not good especially in the Egyptian sample, where nearly two thirds were unable to mention any indication or side effect, and only 3.5% of them had the chance to observe ECT. The United Kingdom sample showed very positive attitudes (no one said that psychiatrists abuse ECT, and only 4% thought that ECT is a cruel treatment), followed by the Iraqi and the Egyptian samples. Different teaching styles and possibly some cultural factors affect the knowledge base of and the attitudes toward ECT. Finishing a psychiatric placement might have led to the very positive attitudes in the United Kingdom sample. Ensuring that medical students from the other 2 samples should observe ECT might improve their attitudes. A specific lecture about ECT would improve the knowledge of the 3 samples.

Undergraduate public health education in UK medical schools - struggling to deliver

Recent policy initiatives in the United Kingdom (UK) have underlined the importance of public health education for health care professionals. We aimed to describe teaching inputs to medical undergraduate curricula, to identify perceived challenges in the delivery of public health teaching and strategies that may overcome them. We undertook a cross-sectional survey; questionnaires were sent electronically to 28 teaching leads in academic departments of public health in UK medical schools. These were followed-up by telephone interviews. We obtained a 75% response rate. We found a great deal of variability between schools in teaching methods, curricular content and resources used. In 76% of medical schools, public health and clinical teaching were integrated to some extent. The proportion of teaching delivered as lectures is decreasing and that of self-directed learning is increasing. A range of methods is used to assess students and in 33% of schools these assessments contributed to final Medical School marks. More than half the medical schools had difficulty finding teachers and staffing levels had deteriorated in 55% of schools. Many interviewees felt that their contributions were undervalued. Few were aware of the level of funding received to support teaching. There is a need to increase the supply of well-trained and motivated teachers and combine the best traditional teaching methods with more innovative, problem-based approaches. Faculties need to share 'learning about what works' and teaching resources across medical schools as well as addressing a culture of neglect of teaching in some departments. Suggestions are made as to how undergraduate public health teaching can be strengthened.

Teaching and learning about written communications in a United Kingdom medical school.

Written communications have a long history in medicine. Today, doctors spend a significant part of their work time completing paper work. Although the importance of accurate written communications is acknowledged, medical curricula rarely include focused teaching on this topic. The aim of this paper is to assess the feasibility of a teaching session for second-year medical students aimed at raising their awareness of written communications in the context of health care. Immediately after the session, students and tutors completed written evaluations of their experiences. Four months after the session the entire cohort completed a knowledge test, and scores of attendees and non-attendees were compared. Three of four learning objectives were completely met by at least half of the students and the exercises were rated as helpful. Students' and tutors' comments identified specific aspects of the session that require improvement, in particular, developing the exercise on patient-centred written communications. Students who attended the session scored significantly higher in a relevant knowledge test than non-attendees. The session provided students with the knowledge to identify patient-centred written communications and other features of effective writing in the context of medical care. Introducing the topic early in the medical curriculum may prove valuable in establishing effective practice. Providing students with opportunities to revisit this important topic throughout their medical education may also be beneficial. The long-term impact of the session needs to be evaluated.

Adoption and integration of simulation-based learning technologies into the curriculum of a UK Undergraduate Education Programme.

At a time of significant changes in medical education world-wide, the international dimensions and global issues relating to the application of new learning technologies have been recognised. The aim of this paper is to describe the adoption and integration within the curriculum in one United Kingdom (UK) medical school of 'Harvey', the Cardiology Patient Simulator, and the UMedic multimedia computer-based cardiology curriculum - resources developed in a medical school in the USA. The integration of the resources into the curriculum is described by 3 teachers actively involved in the cardiology curriculum of the UK medical school and 3 teachers associated with the development of resources in the USA. ASPECTS CONSIDERED: The review considers the adoption of Harvey and UMedic in the UK in programmes in relation to: curricular issues, training needs, learning outcomes, curriculum content and sequences of content, educational strategies, teaching and learning methods, assessment, communication about the curriculum and management of the curriculum. Learning resources, in the form of simulators and computer-based learning modules, developed in one country can be successfully adopted and implemented in another. Facets that facilitated the adoption included close liaison between the developers of the resources in the USA and the implementers in the UK, and careful and systematic planning including in-depth integration of the simulation-based resources into the required curriculum rather than their relegation to a peripheral ad hoc position. The successful use of simulators such as Harvey requires the presence of a 'champion', a clinician educator and a supporting administrative staff who ensure the simulator's appropriate use.

A web-based system for teaching, assessment and examination of the undergraduate peri-operative medicine curriculum.

Today's students are generally computer literate and have high expectations of university information technology resources. Most United Kingdom medical schools now provide networked computers for learning, research, communication and accessing the worldwide web. We have exploited these advances to augment and improve the teaching of peri-operative medicine and anaesthesia to medical students in our university, who are taught in several hospitals over a wide geographical area. Course material such as departmental induction information, lecture notes and assessment sheets can be accessed online, contributing to the smooth running of the course. Streamed videos and simulations allow students to familiarise themselves with common practical procedures in advance. Development of a web-based end of course assessment has resulted in substantially less administration and bureaucracy for course organisers and proved to be a valuable research tool. Students' and teachers' opinions of the new course structure have been overwhelmingly positive.

The Centre for Medical Humanities, Royal Free and University College Medical School, London, England.

The Centre for Medical Humanities is based within the Royal Free and University College Medical School. With a student body of more than 2,000, this large United Kingdom medical school benefits from being a fully integrated component of University College London. With its strong humanities and science faculties, University College London was founded more than 175 years ago to make education available to wider social and religious groups. With this background, it is logistically and ideologically well suited to sustaining a medical humanities program. The Centre's aims are to raise awareness of the field of medical humanities, to develop resources for the academic and teaching communities, and to build a broad and well-grounded educational program supported by sound educational principles and innovative research. Since 1998, the Centre and its predecessor, the Medical Humanities Unit, which was established by a group of medical educators with a diverse range of interests in the arts and humanities, has built interdisciplinary links and collaborative relationships with individuals and institutions within the university and beyond, nationally and internationally. These links and relationships have provided invaluable contributions and stimulus to the Centre's activities. The undergraduate educational program described in this article includes core and optional teaching throughout the curriculum, and a 1-year intercalated Bachelor of Science in Medical Humanities degree. For postgraduates, the Centre offers the United Kingdom's first continuing professional development accredited 2-day course in medical humanities, and an annual residential retreat open only to graduates of the course.

Protection from HIV on electives: questionnaire survey of UK medical schools

Elective studies are an important part of the medical curriculum. Sixty to seventy per cent of British medical students (2400-3000 a year) spend their electives in developing countries. In 1999...

Teaching end-of-life issues: current status in United Kingdom and United States medical schools.

Our objective was to determine how broadly end-of-life issues are represented in the undergraduate medical school curricula of the United Kingdom (UK) and the United States (US). Mailed surveys yielded response rates of 100 percent in the UK and 92 percent in the US. With one exception, all medical schools in the survey offered some exposure to dying, death, and bereavement and most addressed the topic of palliative care. Hospice involvement was found in 96 percent of UK medical schools but in only 50 percent of US schools. Overall, the UK appears to provide more exposure to end-of-life issues in medical schools, although the US appears to be moving in that direction.

Is PBL better than traditional curriculum?

Since the problem based learning (PBL) curriculum was first introduced at McMaster medical school in the late 1960s it has been widely recognised as a progressive learner-centred active learning approach and currently underpins the philosophy of the entire medical curriculum in over 10% of medical schools worldwide.1 In the United Kingdom medical schools in Manchester, Glasgow, and Liverpool have already adopted the PBL curriculum as recommended by the General Medical Council,2 and several other schools have partially done so or are planning to do so. But what is PBL? Although many medical teachers hold strong views on what counts as PBL, there is no universal definition.3 Typically, students working in small groups are given written real life problems. From these problems the students identify phenomena which require explanations, agree on learning objectives, research individually on identified issues, report back, and apply newly acquired information to the problem.4 The term PBL is often used to describe a curriculum based entirely on the problem based philosophy—that is, the PBL curriculum—but it …

Doctors' professional values: results from a cohort study of United Kingdom medical graduates.

To examine young doctors' views on a number of professional issues including professional regulation, multidisciplinary teamwork, priority setting, clinical autonomy and private practice. Postal survey of 545 doctors who graduated from United Kingdom medical schools in 1995. Questionnaires were returned by 95% of the cohort (515/545). On issues of professional regulation, teamwork and clinical autonomy, the majority of doctors held views consistent with current General Medical Council guidance. The majority supported the right of doctors working in the NHS to engage in private practice. Most respondents thought that public expectations of doctors, medicine and the NHS were too high, and that some form of rationing was inevitable. On many issues there was considerable variation in attitudes on the basis of sex and intended branch of medicine. The results highlight the heterogeneity of the profession and the influence of specialty and gender on professional values. Doctors' attitudes had also been shaped by broader social changes, especially debates surrounding regulation of the profession, rising public expectations and the need for rationing of NHS care.

UK medical school intake and output 1985-99.

Accurate, comprehensive follow up of individual medical students is not currently available. The best aggregate data source is probably the Higher Education Funding Council for England (HEFCE). According to their Medical Return tables, 43 131 students began undergraduate medical studies in the United Kingdom (UK) in the decade 1985-94, and 38 376 doctors qualified from UK medical schools in the decade 1990-99, being 89% of the intake numbers 5 years previously. Continuous monitoring is required to enable medical school intake to be adjusted according to the demand for more doctors.

An International Survey of Undergraduate Medical Education in Palliative Medicine

A 9-item mail survey dealing with availability and characteristics of undergraduate medical education programs in palliative medicine was sent to all medical schools in Canada (16) and the United Kingdom (UK) (30), and 129 randomly selected medical schools in the United States (US) and Western Europe. The overall response rate was 117/175 (67%). The highest percentage of mandatory (required by the university) rotations in palliative medicine was in the UK medical schools (14/22, 64%). Considerably lower numbers were obtained from the other countries: US; 4/37, 11%, Canada; 2/14, 14%, and Western Europe; 8/43, 19% ( P = 0.001). Elective rotations in palliative medicine were more readily available in the UK; 18/22, 82% and Canada; 10/14, 71%, compared with the US; 23/37, 62%, and Western Europe; 13/43, 30% ( P=0.001). Seventy-two percent (13/18) of UK, 70% (7/10) of Canadian, 59% (16/27) of US, and 9/30 (30%) of Western European medical schools provide educational reading material in palliative medicine ( P = 0.014). Case-based learning in small groups and small group discussion were favored by the UK, 14/22 (63%) and 17/22 (77%), respectively, and Canadian medical schools, 8/14 (57%) and 8/14 (57%), respectively ( P = 0.176). The number of universities with academic faculty positions for palliative medicine and the median number of positions for the countries were as follows—Canada 8/13 (62%) and 2; UK 12/22 (55%) and 1; US 5/36 (14%) and 1; and Western Europe 9/24 (21%) and 1, respectively ( P = 0.001). Besides the UK, mandatory (required) rotations in undergraduate palliative medicine education are lacking in Canadian, US, and Western European medical schools. The median number of 1 academic faculty member per responding medical school is discouraging. In order for undergraduate and postgraduate medical education in palliative medicine to improve, the number of both educational programs and faculty members will need to be increased.

Ethnic and gender variations in university applicants to United Kingdom medical and dental schools

Ethnic and gender variations in university applicants to United Kingdom medical and dental schools

Ethnic and gender variations in university applicants to United Kingdom medical and dental schools.

To explore ethnic and gender variations amongst applicants to undergraduate United Kingdom medical and dental schools. Retrospective analyses of University and College Admissions Services (UCAS) data on all students applying to study pre-clinical medicine and dentistry, during the academic years 1994/5, 1995/6 and 1996/7. Information for each medical and dental applicant included age, gender, social class and ethnic group. Of all applicants, just over half (50.2%) were male, though a greater proportion of applicants to dentistry were male (54.1%) than for medicine (49.3%) (OR = 1.21, 95% CI = 1.15, 1.28). Over one third (36.4%) of all students were from minority ethnic groups, a larger proportion of which were dental students (48.3%) than were medical students (33.8%) (OR = 1.83, 95% CI = 1.73, 1.94). There were also marked differences between medicine and dentistry when the ethnic groups were examined separately. The largest number of applicants from minority ethnic groups came from the Indian community, and this group increased in size annually by 4.1% (P < 0.05) for medicine, and 29% (P < 0.05) for dentistry. Significant inter-ethnic and gender differences are observed amongst applicants to medicine and dentistry. Dentistry appears to be relatively more attractive to minority ethnic applicants.

Equal opportunities to all ethnic groups: from aspiration to reality

Aim To explore ethnic and gender variations amongst applicants to undergraduate United Kingdom medical and dental schools. Method Retrospective analyses of University and College Admissions Services (UCAS) data on all students applying to study pre-clinical medicine and dentistry, during the academic years 1994/5, 1995/6 and 1996/7. Information for each medical and dental applicant included age, gender, social class and ethnic group. Results Of all applicants, just over half (50.2%) were male, though a greater proportion of applicants to dentistry were male (54.1%) than for medicine (49.3%) (OR=1.21, 95% CI=1.15, 1.28). Over one third (36.4%) of all students were from minority ethnic groups, a larger proportion of which were dental students (48.3%) than were medical students (33.8%) (OR=1.83, 95% CI=1.73,1.94). There were also marked differences between medicine and dentistry when the ethnic groups were examined separately. The largest number of applicants from minority ethnic groups came from the Indian community, and this group increased in size annually by 4.1% (P<0.05) for medicine, and 29% (P<0.05) for dentistry. Conclusions Significant inter-ethnic and gender differences are observed amongst applicants to medicine and dentistry. Dentistry appears to be relatively more attractive to minority ethnic applicants.

Social background of minority ethnic applicants to medicine and dentistry.

To explore ethnic variations in social background of successful applicants to undergraduate United Kingdom medical and dental schools. Retrospective analyses of University and College Admissions Services data on all students to commence study in pre-clinical medicine and dentistry, during the academic years 1994/5, 1995/6 and 1996/7. Analyses were undertaken for two categories of social class, namely higher (professional and intermediate) and lower (skilled non-manual, skilled manual, partly skilled, and unskilled) social class. Over 15 thousand students were accepted to study medicine and dentistry during the three-year study period, of which 80% were from high social class backgrounds. More medical (80.9%) students were from high social class backgrounds than dental (73.3%) students (OR = 1.54, 95% CI = 1.39, 1.70). Social class differences were observed, with a greater proportion of higher social class students amongst the white students than amongst the minority ethnic students (OR = 1.42, 95% CI = 1.30, 1.55). This was more marked in dentistry (OR = 1.48, 95% CI = 1.22, 1.79) than in medicine (OR = 1.35, 95% CI = 1.22, 1.49). More students from higher social class backgrounds were observed in medicine than in dentistry amongst the black (OR = 1.55, 95% CI = 0.59, 4.00), Indian (OR = 2.04, 95% CI = 1.58, 2.62) and white (OR = 1.44, 95% CI = 1.26, 1.64) groups. Significant inter-ethnic differences are observed in the social background of students entering medicine and dentistry. Dentistry accepted a greater proportion of students from lower social class backgrounds and from black and minority ethnic groups.

Views of junior doctors about their work: survey of qualifiers of 1993 and 1996 from United Kingdom medical schools.

To investigate the views of junior doctors about their work. Postal questionnaire surveys. United Kingdom. Doctors who graduated from medical schools in the United Kingdom in 1996, surveyed at the end of their preregistration year (2926 respondents), and graduates of 1993 surveyed 3 years after qualification (2541 respondents). Almost 70% of the 1996 qualifiers felt that they worked excessive hours and 80% felt that they undertook too many routine non-clinical duties. Only 24% agreed that their postgraduate training was of a high standard and 22% felt they were being asked to perform clinical tasks with inadequate training. A total of 70% were dissatisfied with arrangements for cover for absent doctors. Senior doctors and nurses were regarded as supportive by most respondents, but hospital management was not. Although 65% were satisfied with their future prospects, only 36% had been able to obtain useful careers advice. Job enjoyment was reasonably high, with two-thirds scoring 6 or more on a scale from 1 (not enjoying at all) to 10 (greatly enjoying), but 70% of respondents felt that they had insufficient time for family and social activities. A briefer questionnaire sent to the 1993 qualifiers in 1996 showed similar results. More needs to be done to ensure that junior doctors are trained appropriately for the tasks they undertake, to ensure that they regard their training highly, to reduce excessive non-clinical work, and to provide reasonable working hours and cover.

Ethnic differences in applications to United Kingdom medical schools between 1990–1992

(1996). Ethnic differences in applications to United Kingdom medical schools between 1990–1992. Journal of Ethnic and Migration Studies: Vol. 22, No. 3, pp. 495-506.

Intake, output, and drop out in United Kingdom medical schools

Precise knowledge about production of doctors is important for planning, but existing data make satisfactory analysis difficult. Intake—Two sets of figures are available: university returns “at the beginning of the autumn term” and a December census for the University Statistical Record of intake “during the year ended 31 July.” Comparison shows differences of 9-56 in the annual intake numbers for 1990-3 over all UK medical schools. Output—Figures from the University Statistical Record—the medical return—give numbers gaining a first registerable medical qualification “during the year ended 31 July.” Other tables, compiled by the Higher Education Funding Council for England, show students “leaving due to success,” and give “revised calculation of % drop out” year by year during the undergraduate course. The methods of calculation are difficult to understand, but these tables, made available to individual medical schools, seem to be the …