United Kingdom Medical Schools Research Articles

Social media quality in undergraduate medical education: A reconceptualisation and taxonomy.

Social Media (SoMe) as a learning tool, though ubiquitous in society and popular within medical education, is often criticised as superficial. Its limitless output has been blamed for encouraging shorter attention spans and shirking in-depth reflection. The evidence base is itself superficial and lacking rigour or meaning. We aimed to consider a theoretical basis for how 'quality' learning may happen on such platforms. Our findings then informed the construction of a taxonomy for SoMe learning. We conducted a qualitative interview study of United Kingdom (UK) medical students using a theory-informed inductive study design. The research question was: 'How do medical students conceptualise quality of learning on social media?'. We purposively sampled participants from responses to a short survey collecting demographic and SoMe usage data. Interview data were analysed using framework analysis and informed by Blooms taxonomy, connectivism and communities of practice (CoP) theories. We received survey responses from 118 medical students across 25 UK medical schools. From these, 13 participants were recruited to individual semi-structured interviews. We constructed three themes through framework analysis of interview data: cognitive hacking, professional identity reflection and safety, control and capital. Quality SoMe learning may be conceptualised as a socially connected process, built upon constantly evolving networks but inexorably influenced by fluctuating hierarchy within learner-centric CoP. Educators and institutions may support high-quality learning for students through engagement which promotes community development, and safe, listening environments which foster professional identity formation.

Aligning the education of medical students to healthcare in the UK

Abstract How can universities improve their ability to cultivate high-quality and innovative medical talent? The Ministry of Education in China is in the process of implementing the ‘Six Excellent and One Top-Notch’ Plan 2.0 with the aim of substantially revising the teaching of medicine. The United Kingdom (UK) and other countries around the world are also continuously aiming to innovate their medical teaching. With respect to medical education in China, the primary goal is to develop a new medical talent training system that meets future needs, with an emphasis on integration, innovation and interdisciplinary approaches. Here we mainly discuss medical student education systems in the UK with an emphasis on teaching philosophy, objectives, curriculum, and the various types of teaching delivery and assessment that are used in UK medical schools. Through in-depth review of the current situation of medical education in the UK, we hope to provide reference for the reform of the medical education system in China.

Everyone can draw: An inclusive and transformative activity for conceptualization of topographic anatomy.

Anatomical drawing traditionally involves illustration of labeled diagrams on two-dimensional surfaces to represent topographical features. Despite the visual nature of anatomy, many learners perceive that they lack drawing skills and do not engage in art-based learning. Recent advances in the capabilities of technology-enhanced learning have enabled the rapid and inexpensive production of three-dimensional anatomical models. This work describes a "drawing on model" activity in which learners observe and draw specific structures onto three-dimensional models. Sport and exercise sciences (SES, n = 79) and medical (MED, n = 156) students at a United Kingdom medical school completed this activity using heart and femur models, respectively. Learner demographics, their perceptions of anatomy learning approaches, the value of the activity, and their confidence in understanding anatomical features, were obtained via validated questionnaire. Responses to 7-point Likert-type and free-text items were analyzed by descriptive statistics and semi-quantitative content analysis. Learners valued art-based study (SES mean = 5.94 SD ±0.98; MED = 5.92 ± 1.05) and the "drawing on model" activity (SES = 6.33 ± 0.93; MED = 6.21 ± 0.94) and reported enhanced confidence in understanding of cardiac anatomy (5.61 ± 1.11), coronary arteries (6.03 ± 0.83), femur osteology (6.07 ± 1.07), and hip joint muscle actions (5.80 ± 1.20). Perceptions of learners were independent of both their sex and their art-based study preferences (p < 0.05). Themes constructed from free-text responses identified "interactivity," "topography," "transformative," and "visualization," as key elements of the approach, in addition to revealing some limitations. This work will have implications for anatomy educators seeking to engage learners in an inclusive, interactive, and effective learning activity for supporting three-dimensional anatomical understanding.

Betwixt and between student and professional identities: UK medical students during COVID times

The COVID-19 pandemic lockdown in Spring 2020 brought about unprecedented disruption to medical education in the United Kingdom (UK). Medical students were encouraged to take up paid roles in the National Health Service to help with workforce shortages. This article explores medical students’ views and experiences of the COVID-19 pandemic vis-à-vis their professional identity formation. Semi-structured interviews were conducted with 22 medical students from all five undergraduate years in one UK medical school, between April and June 2020. Three themes were generated: (1) disruption to medical education involving suspension of clinical placements, cancellation of assessments and ceremonial markers; (2) decision-making around joining the clinical workforce, decisions which were influenced by students’ sense of professional obligation, perceived personal gains, and health and safety considerations; (3) experiences of working in clinical settings during the pandemic, including reflections about managing risks and challenges, learning on the job and becoming a better doctor. The findings provide evidence that the UK’s first lockdown destabilised many medical students’ expectations tied to their educational and career trajectory, requiring them to improvise to address gaps in learning and professional development. Taking on a paid healthcare role catapulted them into a liminal period, working in a space ‘betwixt and between’ a medical student and healthcare professional. This swift readjustment of roles and responsibilities accelerated their identity formation as ‘future doctors’. Support for medical students around negotiating such dual role is important in present and future public health crises.

Plastic Surgery Teaching to United Kingdom Undergraduate Medical Students: A Systematic Review.

Background There are varying reports about United Kingdom medical students' exposure and teaching methods regarding plastic and reconstructive surgery. To date, no systematic review has been done looking at this topic. Methods Three databases (PubMed, Embase, and Medline) were searched from January 1, 2011 to July 20, 2023 for studies that assessed United Kingdom medical students' exposure to plastic surgery and suggested recommendations to improve teaching. Three authors performed data extraction and screening, as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Fifteen studies were included. Medical students' average current exposure to plastic surgery was 29.44%, but this was highly variable across the studies. The most common method of currently teaching plastic surgery was through lectures (34% of studies), and the most common suggested method of teaching was through courses (40% of studies). Many of the studies (12/15) were deemed as being at high risk of bias. Conclusion More recent studies need to be performed to assess current levels of teaching of plastic surgery in the United Kingdom medical school curriculum. Greater exposure to plastic surgery through lectures and integrated clinical placements is needed to ensure equitable access for all medical students to plastic surgery as a profession.

Creating a sport and exercise medicine undergraduate syllabus: a delphi study

BackgroundSport and Exercise Medicine (SEM) is a growing speciality in the United Kingdom (UK). This growth has not been replicated in SEM teaching at an undergraduate level and SEM-related topics in schools of medicine in the UK are under-represented. As SEM continues to develop as a specialty it is important to consider how it is embedded at all levels of training. The aim of this project was to establish a consensus on SEM-related skills and knowledge relevant for undergraduate medical students in the UK, ultimately creating a curriculum of learning objectives (LOs).MethodsA modified Delphi survey was utilised to seek consensus on LOs suitable for incorporation into UK medical school curricula. An expert panel with adequate knowledge in the field was recruited. The initial curriculum was created by the research team using already established postgraduate SEM curricula. All learning objectives were sent to the expert panel for opinions in phases. Levels of agreement and comments made by the expert panel were reviewed after each phase until a consensus on each learning objective was made.ResultsThe expert panel was made up of 45 individuals, with 35 also completing phase 2 (78% retention rate). The initial curriculum contained 58 learning objectives separated into 9 themes. In phase 1 31% (18/58) were accepted outright, 48% (28/58) were altered and 19% (11/58) were rejected. Two additional learning objectives were added. Of the 49 LOs included in phase 2, 98% (48/49) were accepted. The final curriculum was made up of 9 sub-themes and 48 LOs.ConclusionSport and Exercise Medicine is a broad ranging and rapidly growing speciality. It is important to establish SEM education in all levels of medical education, including undergraduate level. This is the first published version of a Delphi SEM curriculum for undergraduate medical teaching.

Transforming musculoskeletal anatomy learning with haptic surface painting.

Anatomical body painting has traditionally been utilized to support learner engagement and understanding of surface anatomy. Learners apply two-dimensional representations of surface markings directly on to the skin, based on the identification of key landmarks. Esthetically satisfying representations of musculature and viscera can also be created. However, established body painting approaches do not typically address three-dimensional spatial anatomical concepts. Haptic Surface Painting (HSP) is a novel activity, distinct from traditional body painting, and aims to develop learner spatial awareness. The HSP process is underpinned by previous work describing how a Haptico-visual observation and drawing method can support spatial, holistic, and collaborative anatomy learning. In HSP, superficial and underlying musculoskeletal and vascular structures are located haptically by palpation. Transparent colors are then immediately applied to the skin using purposive and cross-contour drawing techniques to produce corresponding visual representations of learner observation and cognition. Undergraduate students at a United Kingdom medical school (n=7) participated in remote HSP workshops and focus groups. A phenomenological study of learner perspectives identified four themes from semantic qualitative analysis of transcripts: Three-dimensional haptico-visual exploration relating to learner spatial awareness of their own anatomy; cognitive freedom and accessibility provided by a flexible and empowering learning process; altered perspectives of anatomical detail, relationships, and clinical relevance; and delivery and context, relating to curricular integration, session format, and educator guidance. This work expands the pedagogic repertoire of anatomical body painting and has implications for anatomy educators seeking to integrate innovative, engaging, and effective learning approaches for transforming student learning.

Exposure and awareness of oral and maxillofacial surgery for first degree medical undergraduates in the United Kingdom

Most of the current oral and maxillofacial surgery (OMFS) specialty trainees in the United Kingdom (UK) remain as those who first undertook a degree in dentistry. However, OMFS is an increasingly popular career choice amongst ‘first degree’ medical school graduates. The UK medical school curriculum should reflect this trend by ensuring that there is sufficient teaching and exposure to allow medical students to make informed career choices. The purpose of this study was to evaluate levels of awareness of, exposure to, and teaching on, oral and maxillofacial surgery amongst undergraduate medical students in the UK. An online survey was distributed via university representatives and responded to by 76 final year medical students from 15 medical schools across the United Kingdom. No OMFS-related clinical exposure was reported by 69 respondents throughout their time at medical school. Of the seven who did report exposure, the mean length of that exposure was four days. Sixty-three respondents believed that medical students would benefit from more guidance and information on OMFS. Clinical exposure to OMFS by medical undergraduates is low therefore awareness of the specialty is limited. With many dissatisfied with the OMFS exposure and teaching provided by their medical school it shows that there is no lack of interest in OMFS amongst medical undergraduates, rather a lack of opportunity for them.

Preparing for medical school selection: Exploring the complexity of disadvantage through applicant narratives.

Despite a growing drive to improve diversity in medical schools, those from state schools and less-advantaged sociodemographic backgrounds remain underrepresented. We explore applicants' approaches to preparing for medical school selection, considering the complexity of sociodemographic disadvantage in this highly competitive process. Narrative interviews were undertaken with applicants to a United Kingdom medical school, exploring experiences of preparation for selection (n = 23). Participants were purposively sampled based on involvement in widening participation schemes, school background, gender, and ethnicity. Transcribed data were analyzed using Labov and Waletzky's analytic framework. Bourdieu's concepts of cultural capital and habitus provided a lens to constraints faced and variable experiences. This informed a consideration of the ways applicants approached and navigated their preparation, in the face of various constraints. Constraints to resources and support were often apparent for those from state nonselective (SNS) schools. These applicants and those beginning their preparation later (12-18 months before application) appeared particularly vulnerable to myths and misunderstandings about the application process and appeared less confident and less discerning in their navigation of preparation. Some of the applicants, particularly those from independent and state selective schools, appeared confident and competent in navigating the complexities of the application process, while others (often from SNS schools) were more frequently lost or stressed by the process. Those who lack particular preparatory tools or resources (materially, culturally, or perceptually) must "make do" as they prepare for medical school selection, In doing so, they may risk a haphazard, ill-informed or ill-equipped approach. Constraints to opportunities, more typically experienced by those from SNS schools, appeared to motivate the process of bricolage for a number of the applicants. Perversely, medical schools have introduced nonacademic requirements to level the playing field of disadvantage, yet applicants in this group appear to experience challenges as they prepare for selection.

A survey and critical analysis of the teaching of medical ethics in UK medical schools

This article surveys and analyses the reflections on medical ethics teaching by colleagues teaching in United Kingdom (UK) medical schools in the early 2020s. Participants were recruited mainly by using the worldwide web to identify 64 people from 41 UK medical schools who were thought to contribute to teaching medical ethics based on their internet profiles. Twenty-three people responded. The survey data reveals that many staff are happy with the provision of medical ethics teaching, but also that some are concerned about the quality of provision due to concerns with staff expertise and teaching time. In spite of the fact that the General Medical Council (GMC) and other organisations are perceived to have contributed to raising the profile of medical ethics, there is significant concern with how it is embedded within local UK medical curricula. Some participants contributed hardly or not at all to research in medical ethics, where one attributed this decline in research to the pandemic. Future work will need to address what can be done to improve the provision of medical ethics teaching to address some of these findings and to survey and analyse how perceptions might have changed in light of recent challenges and developments.

Dissecting the Medical Student Approach to Chest Pain: A Cross-Sectional Study Focusing on Aortic Dissection.

Background and purpose: To understand if medical students consider rarer, but highly fatal conditions, such as acute aortic dissection, when assessing chest pain.Methods:An online virtual clinical case (in two 'stages') was distributed to medical students. Stage one presented a chest pain scenario, asking participants to give relevant questions, clinical findings, investigations, and differential diagnoses. In the second stage, students were given a detailed case, populated with the aortic dissection ‘red flags’ and asked to re-evaluate their differential diagnosis and investigations. A total of 113 students in their final two years of study, across six United Kingdom (UK) medical schools, were accepted into the study.Results: During stage one, students were able to assess chest pain with radiation (93%), character (83%), and onset (89%), which were asked commonly. However, students failed to enquire on severity (38%) and important risk factors such as connective tissue disorders (4%) and hypertension (46%), or clinical signs such as blood pressure differences (5%). Myocardial infarction (97%) and pulmonary embolism (78%) were the most considered differentials with acute aortic dissection only considered by 31%. However, in stage two, 73% recognised the acute aortic dissection and 76% were able to request a CT thorax.Conclusions: Students effectively consider myocardial infarction and pulmonary embolism when assessing chest pain, but often fail to examine acute aortic dissection. This could lead to delayed treatment of a cataclysmic event and may be due to a deficiency in diagnostic synthesis rather than a lack of knowledge. More can be done to ensure these conditions form part of their diagnostic workup.

833 Is the Undergraduate Medical Curriculum Aligned to and Is It Facilitating Medical Students to Learn the Ear, Nose and Throat Content in the New UK Medical Licensing Assessment? a Study of One UK Medical School

Abstract Aim Every medical student in the United Kingdom (UK) must pass a new Medical Licensing Assessment (MLA) from 2024/25 before graduating. This includes Ear, Nose and Throat (ENT) content: ‘Conditions’, ‘Patient presentations’ and ‘Practical skills and procedures. Research shows the provision of UK undergraduate ENT training is controversial. This research aimed to determine whether a UK medical school curriculum is aligned to the ENT content in the UK MLA, and if it is facilitating students to learn it. Method A mixed methods approach examined one UK medical school curriculum in relation to the ENT content in the UK MLA. A document analysis reviewed the learning set for ENT. A survey collected the final year medical student cohort's recall and perceptions of their ENT learning. Data was analysed using descriptive statistics. Results The curriculum documents met 6/10 ENT ‘Conditions’, 6/18 ‘Patient presentations’ and 3/5 ‘Practical skills and procedures. There were 17 (13.1%) survey responses; most students generally recalled learning the ENT content during the curriculum. The teaching activities most commonly used to learn the ENT content generally helped most students to learn it; the activities least commonly used generally helped the fewest students. Conclusions The curriculum is largely aligned and facilitates medical students to learn the ENT content in the UK MLA. The results contribute to the existing literature, with further research needed to determine the degree of student learning. Learning outcomes should be added to the curriculum documents for unmet content with learning redirected to the most helpful teaching activities for curriculum optimisation.

Cultural diversity and inclusion in UK medical schools.

BackgroundRacially minoritised groups across the globe continue to experience differential outcomes in both health and education. Medical schools can play an instrumental role in addressing both these disparities, by creating inclusive student communities and ensuring that tomorrow's doctors can care for our increasingly diverse populations.ObjectivesThis collaborative, qualitative study led by three United Kingdom (UK) institutions aimed to explore the perspectives of Heads of Primary Care Teaching (HOTs) on cultural diversity and inclusion across UK medical schools.MethodsIn December 2020, five focus groups were conducted remotely with 23 HOTs, or a nominated deputy. We explored participants' opinions regarding opportunities and barriers to cultural diversity and inclusion in medical education, ways to overcome these challenges and shared examples of best practice. Data were transcribed verbatim and thematically analysed by three researchers.ResultsInvestigators identified six themes from the data: lack of faculty diversity, tokenistic faculty training, institutional mindset, diversifying the formal and hidden curricula, intersectionality and student voice.ConclusionMedical schools worldwide face similar challenges, uncertainties and opportunities when integrating diversity and inclusion throughout the learning environment. Although the importance of the topic is increasingly acknowledged, current efforts are viewed as being passive and tokenistic, hindered by challenges at multiple levels. Partnership with students and collaboration within and between institutions nationally and internationally will enable us to move forwards with both local and global positive, sustainable change.

Longitudinal integrated clerkship evaluations in UK medical schools: a narrative literature review

ABSTRACT Purpose Longitudinal Integrated Clerkships (LICs) are a recognised model of curriculum design used internationally as an alternative to traditional block rotations in medical schools that have been shown to offer a multitude of educational benefits. As a relatively new development in the United Kingdom (UK), it is not yet clear whether these benefits will translate into a UK healthcare context. This article provides an early review of evaluations of UK LIC programmes. Methods A narrative literature review of LIC programme evaluations in UK medical schools. Results UK students and faculty found value in the LIC programmes with reported benefits including continuity of relationships, increased responsibility and purpose for students, a patient-centred approach and development of professional skills. However, students and GP tutors expressed initial anxieties adapting to the newness of the programme design and preparedness for exams. Conclusions UK LIC programmes appear to be offering benefits for UK medical students and faculty members including personal and professional development in line with international literature. However, the current data is limited with significant gaps that need addressing for the impacts to be fully realised.

Radiation oncology teaching provision and practice prior to and during the first wave of the COVID-19 pandemic in medical schools in the United Kingdom and the Republic of Ireland: a cross-sectional survey.

Objectives:Radiotherapy is a key cancer treatment modality but is poorly understood by doctors. We sought to evaluate radiation oncology (RO) teaching in medical schools within the United Kingdom (UK) and Republic of Ireland (RoI), as well as any impacts on RO teaching delivery from the coronavirus disease 2019 (COVID-19) pandemic.Methods:A bespoke online survey instrument was developed, piloted and distributed to oncology teaching leads at all UK and RoI medical schools. Questions were designed to capture information on the structure, format, content and faculty for RO teaching, as well as both the actual and the predicted short- and long-term impacts of COVID-19.Results:Responses were received from 29/41 (71%) UK and 5/6 (83%) RoI medical schools. Pre-clinical and clinical oncology teaching was delivered over a median of 2 weeks (IQR 1–6), although only 9 (27%) of 34 responding medical schools had a standalone RO module. RO teaching was most commonly delivered in clinics or wards (n = 26 and 25 respectively). Few medical schools provided teaching on the biological basis for radiotherapy (n = 11) or the RO career pathway (n = 8), and few provide teaching delivered by non-medical RO multidisciplinary team members. There was evidence of short- and long-term disruption to RO teaching from COVID-19.Conclusions:RO teaching in the UK and RoI is limited with minimal coverage of relevant theoretical principles and little exposure to radiotherapy departments and their non-medical team members. The COVID-19 pandemic risks exacerbating trainee doctors’ already constrained exposure to radiotherapy.Advances in knowledge:This study provides the first analysis of radiotherapy-related teaching in the UK and RoI, and the first to explore the impact of the COVID-19 pandemic on radiationoncology teaching.

What impact does teaching in outreach activities have on medical students' own learning and teaching skills? A pilot study

Widening Participation outreach activities in United Kingdom medical schools aim to build aspirations and support progression to medicine for those from under-represented groups. Medical student ambassadors (SAs) deliver much of the outreach work, but there is a paucity of literature to show evidence that it benefits their own studies. This quick glance, mixed methods questionnaire study aimed to elicit the perceived benefits for SAs in terms of improving knowledge, skills and attitudes in their course. 14 SAs in two medical schools completed the anonymised online questionnaire. They reported that the work improved their own learning, with increased knowledge in different subject areas, as well as improved their teaching skills and self-confidence. The authors plan to follow up these findings with a mixed method, multi-centre study to look for objective improvement in assessments for SAs.

Impact of the COVID-19 pandemic on UK medical school widening access schemes: disruption, support and a virtual student led initiative

BackgroundCOVID-19 has disrupted medical education in the United Kingdom (UK). The pandemic may result in a long-term disproportionate negative impact to students applying to Medical School from a low-socioeconomic background. In addition, the upsurge in Medical School applications increases the likelihood of stricter University entry criteria over the coming years. There is no current research to determine how widening participation of Medicine to students from low-socioeconomic backgrounds can be improved virtually. The aim of this study is to establish the impact of COVID-19 on students enrolled in UK widening access schemes and the role of virtual student led initiatives in widening participation.MethodsA voluntary online survey was distributed to UK Sixth Form students (N = 31) enrolled in a widening access scheme who attended Sheffield Neuroscience Society International Virtual Conference in February 2021. The event was free to attend. The five-domain survey consisted of questions determining demographics, career aspirations, impact of COVID-19, academic skillsets and an educational manipulation check.ResultsThere were 30 pre-conference and 26 post-conference responses. 76.7 % had work experience cancelled due to COVID-19. A total of 36.7 % of participants reported participating in virtual work experience. ‘Observe GP’ and ‘Medic Mentor’ were each specified as attended virtual opportunities in 20 % of answers. Post conference, students felt significantly more confident in applying to Medical School (p = 0.008) and more prepared to undertake a presentation (p = 0.002). Educational manipulation check scores increased significantly (p = 0.003). 100 % of students felt inspired to do further CV building activities.ConclusionsCOVID-19 has negatively impacted pupils enrolled in UK Medical School widening access schemes. Virtual student led initiatives can instill confidence in delegates from low socio-economic backgrounds, increase their career knowledge and inspire them to take part in further CV building exercises. Both Medical Schools and medical students play a key role in widening participation. This study recommends Medical Schools promote access to virtual events, urge private and state schools to declare offered opportunities and act mindfully when determining student’s academic potential in the context of their socioeconomic and/or educational background.

What should medical students be taught about abortion? An evaluation of student attitudes towards their abortion teaching and their future involvement in abortion care

BackgroundOne in three women in the United Kingdom (UK) will have an abortion before age 45, making abortion provision an essential aspect of reproductive healthcare. Despite this, abortion remains ethically contested and stigmatised, with variable teaching in UK medical schools and concerns about falling numbers of doctors willing to participate in abortion care. University College London Medical School (UCLMS) has designed practical, inclusive, teaching that aims to give students an understanding of the importance of abortion care and prepare them to be competent practitioners in this area. This study aimed to determine students’ opinions of this teaching and their wider attitudes towards abortion.MethodsWe invited all 357 final-year UCL medical students to complete an online survey consisting of closed-ended questions, exploring their opinions on their abortion teaching, their personal beliefs about abortion and their future willingness to be involved in abortion care. We analysed responses using non-parametric tests.ResultsOne hundred and forty-six questionnaires (41% response rate) showed 83% of students identified as pro-choice (agree with the right to choose an abortion). Fifty-seven percent felt they received the right amount of abortion teaching, 39% would have liked more and 4% stated they received too much. There was no correlation between students’ attitudes to abortion and the rating of teaching; both pro-choice and pro-life (opposed to the right to choose an abortion) students generally rated the teaching as important and valued the range of methods used. Students requested more simulated practice speaking to patients requesting an abortion. Students with pro-life beliefs expressed lower willingness to discuss, refer, certify and provide future abortions. Students interested in careers in specialties where they may encounter abortion were more likely to be pro-choice than pro-life.ConclusionsThe majority of participating UCL medical students were pro-choice and willing to be involved in future abortion care. Efforts to make teaching on abortion practical, engaging, sensitive and inclusive were appreciated. As well as preparing students to be competent and caring practitioners, the teaching appears to contribute towards them viewing abortion as an essential aspect of women’s healthcare, and may contribute to destigmatising abortion.

Could the UK Foundation Programme training post allocation process result in regional variations in the knowledge and skills of Foundation doctors? A cross-sectional study.

Background and AimsThe allocation of medical school graduates to Foundation Schools (post‐qualification training, organized at regional level) in the United Kingdom uses a ranking process that takes into account educational performance at medical school and performance on a situational judgment test (SJT). We aimed to compare the performance of United Kingdom graduates allocated to different United Kingdom Foundation School according to three metrics: educational performance measure (EPM), SJT, and prescribing safety assessment (PSA).MethodsWe used a cross‐sectional study design using data from the UK Medical Education Database, studying 19 United Kingdom Foundation School groups. A total of 33 730 graduates from United Kingdom medical schools in the period 2014 to 2018 (inclusive) who started Foundation Training in August 2018 or earlier were included in the study, excluding those allocated to the Academic Foundation Programme or the Armed Forces Deanery. The outcomes were within‐year standardized mean scores (by Foundation School) on the EPM, SJT, and PSA.ResultsThere was a significant difference between Foundation Schools in the Educational Performance Measure (F = 401, P < .001), SJT (F = 213, P < .001), and PSA (F = 95, P < .001). Tukey‐Kramer pairwise comparisons between Foundation Schools showed a very high percentage of statistical significance (78%, 402/513 comparisons). The Cohen's d effect size for the difference in means and Tukey‐Kramer 95% confidence intervals between the Foundation Schools with the highest (North West Thames) and lowest (West Midlands North) means were 1.92 (1.77‐2.07) for the EPM, 1.59 (1.44‐1.73) for the SJT, and 0.94 (0.79‐1.09) for the PSA.ConclusionThere is a statistically significant difference between the knowledge and skills of doctors (as measured by the three metrics used in this study) entering the Foundation Programme in different Foundation Schools. It is less clear whether this has an impact on patient care and thus is unfair from the perspective of the patient.

Global health education in medical schools (GHEMS): a national, collaborative study of medical curricula

BackgroundGlobal health is the study, research, and practice of medicine focused on improving health and achieving health equity for all persons worldwide. International and national bodies stipulate that global health be integrated into medical school curricula. However, there is a global paucity of data evaluating the state of global health teaching in medical schools. This study aimed to evaluate the extent of global health teaching activities at United Kingdom (UK) medical schools.MethodsA national, cross-sectional study assessing all timetabled teachings sessions within UK medical courses for global health content during the academic year 2018/19. Global health content was evaluated against a comprehensive list of global health learning outcomes for medical students.ResultsData from 39 medical courses representing 86% (30/36) of eligible medical schools was collected. Typically, medical courses reported timetabled teaching covering over three-quarters of all global health learning outcomes. However, a wide degree of variation existed among granular global health learning objectives covered within the different medical courses. On average, each learning outcome had a 79% [95% CI: 73, 83%] probability of being included in course curricula. There were a number of learning outcomes that had a lower probability, such as ‘access to surgeons with the necessary skills and equipment in different countries’ (36%) [95% CI: 21, 53%], ‘future impact of climate change on health and healthcare systems’ (67%) [95% CI: 50, 81%], and ‘role of the WHO’ (54%) [95% CI: 28, 60%].ConclusionsThis study served as the first national assessment of global health education and curricula within UK medical schools. Through a formalised assessment of teaching events produced by medical schools around the country, we were able to capture a national picture of global health education, including the strengths of global health prioritisation in the UK, as well as areas for improvement. Overall, it appears broad-level global health themes are widely discussed; however, the granularities of key, emerging areas of concern are omitted by curricula. In particular, gaps persist relating to international healthcare systems, multilateral global health agencies such as the WHO, global surgery, climate change and more.