United Kingdom Medical Schools Research Articles

The impact of the COVID-19 pandemic on final year medical students in the United Kingdom: a national survey

BackgroundThe coronavirus disease (COVID-19) global pandemic has resulted in unprecedented public health measures. This has impacted the UK education sector with many universities halting campus-based teaching and examinations. The aim of this study is to identify the impact of COVID-19 on final year medical students’ examinations and placements in the United Kingdom (UK) and how it might impact their confidence and preparedness going into their first year of foundation training.MethodsA 10-item online survey was distributed to final year medical students across 33 UK medical schools. The survey was designed by combining dichotomous, multiple choice and likert response scale questions. Participants were asked about the effect that the COVID-19 global pandemic had on final year medical written exams, electives, assistantships and objective structured clinical examinations (OSCEs). The survey also explored the student’s confidence and preparedness going into their first year of training under these new unprecedented circumstances.ResultsFour hundred forty students from 32 UK medical schools responded. 38.4% (n = 169) of respondents had their final OSCEs cancelled while 43.0% (n = 189) had already completed their final OSCEs before restrictions. 43.0% (n = 189) of assistantship placements were postponed while 77.3% (n = 340) had electives cancelled. The impact of COVID-19 on OSCEs, written examinations and student assistantships significantly affected students’ preparedness (respectively p = 0.025, 0.008, 0.0005). In contrast, when measuring confidence, only changes to student assistantships had a significant effect (p = 0.0005). The majority of students feel that measures taken during this pandemic to amend their curricula was necessary. Respondents also agree that assisting in hospitals during the outbreak would be a valuable learning opportunity.ConclusionsThe impact on medical student education has been significant, particularly affecting the transition from student to doctor. This study showed the disruptions to student assistantships had the biggest effect on students’ confidence and preparedness. For those willing to assist in hospitals to join the front-line workforce, it is crucial to maintain their wellbeing with safeguards such as proper inductions, support and supervision.

How to utilise your time effectively during the Covid-19 pandemic

This article was migrated. The article was marked as recommended. United Kingdom (UK) medical schools have decided to temporarily discontinue face-to-face teaching and clinical placements, due to the Covid-19 pandemic. This has meant that medical students across the country are to study remotely and having no exams for a long period of time can seem strange to a group of people who are continuously assessed. As a current fourth-year medical student at the University of Exeter and a future medical practitioner, it is nevertheless important to appreciate that doctors have a duty of keeping their knowledge and skills up to date (GMC, 2019). This article will highlight the key ways medical students can spend their time productively during lockdown.

Challenges to student transition through a United Kingdom graduate-entry medicine degree programme

Background: The transition experience of graduate-entry medicine degree programme students is less well understood as compared to those from undergraduate-entry medicine degree programmes. Aim: This thematic analysis study aimed to explore the transition experience of graduate-entry medicine degree programme students at a United Kingdom medical school. Methods: Twenty-one student volunteers from the University of Warwick 4-year graduate-entry medicine degree programme took part in this study with fourteen participants attended a further follow-up interview. Audio recordings of their semi-structured interviews were transcribed verbatim and analysed thematically. Results: Results revealed three key transition periods within the University of Warwick Medical School’s graduate-entry medicine degree programme. Learning, professional identity development and managing coping strategies were the three key challenging issues dominating their transition experience. Medical students encountered a range of challenging issues throughout their medical school journey that could be categorised under three conceptual themes: challenges associated with the curriculum, challenges associated with their social role and generic life challenges. Conclusions: The findings from this study could be useful to educators and medical schools in enhancing their student support services. It could also be useful to prospective and existing medical students in understanding the realities of undertaking a graduate-entry medicine degree programme.

Current State of Undergraduate Trauma and Orthopaedics Training in United Kingdom: A Survey-based Study of Undergraduate Teaching Experience and Subjective Clinical Competence in Final-year Medical Students

To assess the quality and duration of trauma and orthopedics (T&O) training in medical schools in United Kingdom (UK), and to evaluate final-year students' self-perceived level of competence in essential T&O skills. This was a survey-based study of final-year medical students that attended 1-day undergraduate T&O courses held between Feb'17 and Feb'19. Outcome measures were duration and perceived quality of undergraduate T&O placements, students' self-rated competence in essential T&O skills, and impact of teaching methods on their subjective future competence. Four courses held at education centers in 3 different locations in UK (London, Nottingham, and Leeds) PARTICIPANTS: All 414 course attendees from 13 UK medical schools completed the questionnaire. 19.3% of students had not experienced a placement in T&O. Mean duration of T&O placements was 2.5 weeks. 37.4% described their training as "poor". Majority of students attended 1-5 sessions of: lectures (50.5%), small group teaching (58.7%), trauma meetings (58.7%), clinics (65.7%), and theatres (72.5%). Lowest competency scores were reported in management of T&O emergencies, fracture management, and interpretation of T&O radiographs. Self-rated competence in essential T&O skills was significantly higher in students with previous experience of a T&O placement (p < 0.05). There was a strongly positive correlation between small group teaching attendance and perceived competence in management of T&O patients in different clinical settings (p < 0.001). Medical schools in UK are currently failing to adequately train medical graduates to manage T&O patients, with students reporting low competency scores in all basic T&O skills. To mitigate the current situation, a minimum duration of a T&O placement for all students must be implemented nationally. Educational boards and medical schools must work in collaboration to improve the delivery of undergraduate T&O curriculum, the structure of the clinical T&O placement, and efficacy of the commonly encountered learning environments.

Attitudes and perceptions of UK medical students towards artificial intelligence and radiology: a multicentre survey

ObjectivesTo explore the attitudes of United Kingdom (UK) medical students regarding artificial intelligence (AI), their understanding, and career intention towards radiology. We also examine the state of education relating to AI amongst this cohort.MethodsUK medical students were invited to complete an anonymous electronic survey consisting of Likert and dichotomous questions.ResultsFour hundred eighty-four responses were received from 19 UK medical schools. Eighty-eight percent of students believed that AI will play an important role in healthcare, and 49% reported they were less likely to consider a career in radiology due to AI. Eighty-nine percent of students believed that teaching in AI would be beneficial for their careers, and 78% agreed that students should receive training in AI as part of their medical degree. Only 45 students received any teaching on AI; none of the students received such teaching as part of their compulsory curriculum. Statistically, students that did receive teaching in AI were more likely to consider radiology (p = 0.01) and rated more positively to the questions relating to the perceived competence in the post-graduation use of AI (p = 0.01–0.04); despite this, a large proportion of students in the taught group reported a lack of confidence and understanding required for the critical use of healthcare AI tools.ConclusionsUK medical students understand the importance of AI and are keen to engage. Medical school training on AI should be expanded and improved. Realistic use cases and limitations of AI must be presented to students so they will not feel discouraged from pursuing radiology.

Evaluating student perceptions and awareness of social prescribing

ABSTRACTThe importance of Social Prescribing (SP) has been highlighted in the National Health Service (NHS) Long-Term Plan. SP is enabling healthcare professionals to refer patients to a link worker, to co-design a non-clinical social prescription to improve their health and well-being. Our aim was to explore perceptions, understanding, and awareness of SP amongst United Kingdom (UK) medical students.Views were collected using pre- and post-session surveys around teaching sessions in 27 UK medical schools as part of NHS England’s National SP Student Champion Scheme. Pre-session surveys suggested 93% (n = 848) of respondents had not heard of the concept of SP before the session. Post-session surveys highlighted that 98% (n = 895) regarded the concept as useful and relevant to their future careers.Findings show a lack of awareness regarding Social Prescribing (SP) amongst UK medical students. New strategies are needed to ensure the doctors of tomorrow are equipped with the necessary tools to achieve the recent outcomes for graduates and implement plans for the NHS and general practice which highlight the importance of personalised care. We believe general practice can play an integral role in shaping values and beliefs amongst tomorrow’s doctors through formal education and mentoring.

Preparing for the National Health Service: the importance of teamwork training in the United Kingdom medical school curriculum.

Doctors are required to work in teams every day at every stage in their careers. In the United Kingdom (UK), with a drive towards an integrated healthcare system, teamwork has become a major focus amongst healthcare professionals and their skill set must reflect this. For doctors, the art of teamwork needs to be developed from the early stages of training, in order to minimise fragmentation of care and its detrimental impact on patients. The World Health Organisation emphasises the importance of doctors adopting a multi-disciplinary team approach, yet amongst medical students, collaborative work is often disregarded. Fundamentally, the system that produces future doctors overlooks the importance of teamwork. Therefore, the undergraduate curriculum must be reshaped to embed teamwork within its principles. Future doctors will thus be equipped with lifelong abilities to collaborate closely amongst peers in order to deliver care holistically. Adapting medical school curricula across the UK will present inevitable challenges and these must be understood, in order to generate strategies that cultivate a culture of teamwork amongst the doctors of the future.

Surgical Skills Workshops Should Be a Part of the United Kingdom Undergraduate Medical Curriculum.

Introduction: Medical students across the United Kingdom (UK) report poor satisfaction with surgical teaching. The Surgical Skills Day (SSD) begins to address this by exposing medical students to surgery through an easily accessible one-day practical workshop. This study shows how the SSD encourages undergraduate engagement in surgery.Method: Feedback forms were emailed to attendees of the SSD and their anonymised responses were used to evaluate the SSD.Results: A total of 144 students attended the SSD across three years and the feedback response rate was 74% (n = 107). Key findings were that 100% of respondents (n = 107) would like the SSD to be an annual event, 79% (n = 83) were more inclined to pursue a surgical career following the event, and 97% (n = 103) would like to see practical surgical skills incorporated into the curriculum. The SSD was able to engage undergraduates with surgery through mentorship, practical skills, specialty exposure, and teaching of the General Medical Council (GMC) mandated skills.Conclusions: Undergraduate surgical teaching in the UK is insufficient. The student-led annual SSD showed improved engagement in practical surgical skills and increased enthusiasm for a surgical career. In light of this, the authors feel the SSD or similar event should be integrated into the UK medical school curriculum.

Rich Stories: Embedding LEGO® SERIOUS PLAY® into Undergraduate Medical Education

In this paper, we introduce the concept of LEGO® SERIOUS PLAY® (LSP) as a means to channel students’ creativity and break down boundaries and preconceptions regarding reflective practice or any other abstract concept. Our working context is a United Kingdom (UK) medical school, on the island of Ireland.

A cross-sectional study on teaching pelvic examination in medical schools in the UK (the COTES study)

Gynaecological teaching associates (GTAs) appear to be effective in aiding medical students to acquire core skills in female pelvic examination (FPE). The aim was to explore the current provision for teaching and assessment of FPE in Obstetric and Gynaecological (O&G) placements across UK medical schools and in particular, the use of GTAs. An online survey was sent to undergraduate academic leads for O&G, representing 29 of the 30 UK medical schools. The response rate was 21/29 (72%). The average placement was 6.7 weeks and teaching of FPE varied including training on manikins (20/21, 95%), instruction in outpatient clinics (17/21, 81%) and instruction on anaesthetised patients (17/21, 81%). The survey revealed that anatomic pelvic models are combined with supervised instruction in outpatient clinics and operating theatres. GTAs are used by less than a third of medical schools, and where used are thought to enhance teaching in this core skill in contrast to those universities not using GTAs. Short placements, a reluctance to use GTAs and a lack of formal assessment may adversely impact upon the competency of newly qualifying medical students in FPE.Impact statementWhat is already known on this subject: Experience of female pelvic examination intimate is limited. Expert patients, known as Gynaecological Teaching Associates (GTAs), have been suggested as a potential solution to improve teaching of gynaecological examination, but the last survey of medical schools in the United Kingdom (UK) conducted in 1989 reported that only two were using GTAs in an average clinical placement length of 11.5 weeks.What the results of this study add: Twenty-five years after the last survey, Obstetrics and Gynaecology (O&G) clinical placements have been reduced to an average of 6 weeks with one-third requiring only an informal impression of competence in female pelvic examination. Despite published evidence since 1989 supporting the effectiveness of GTAs, just six medical schools are using GTAs for teaching and assessment with all believing them to be effective.What the implications are of these findings for clinical practice and/or further research: A combination of short placements, an apparent reluctance to use GTAs and a lack of uniform formal assessment may mean that the competency of newly qualifying medical students in basic gynaecological examination is compromised.

Assessing medical student knowledge and attitudes about shared decision making across the curriculum: protocol for an international online survey and stakeholder analysis

IntroductionShared decision making (SDM) is a goal of modern medicine; however, it is not currently embedded in routine care. Barriers include clinicians’ attitudes, lack of knowledge and training and time...

Piloting the United Kingdom 'Prescribing Safety Assessment' with pharmacist prescribers in Scotland.

Prescribing is a complex task requiring considerable knowledge and skills. The Prescribing Safety Assessment (PSA) was developed by the British Pharmacological Society and the United Kingdom (UK) Medical Schools Council. Between February and June 2014, over 7000 final year medical students undertook the PSA, with an overall pass rate of 94%. Independent prescribing for suitably trained pharmacists was introduced in the UK in 2006. To date there has been little focus on any objective measures of prescribing safety. To determine the PSA performance of a pilot group of pharmacist prescribers in Scotland relative to medical students and to test the feasibility and acceptability of running the PSA. A group of 59 pharmacist prescribers took part in ten events. The PSA consisted of 30 questions to be completed over 60min. All questions had been used in the 2014 assessments for final year medical students. The PSA was undertaken online under invigilated conditions, mirroring the medical student assessment. One month later, participants were invited to complete an online evaluation questionnaire. The mean overall PSA scores (±SD) were 87.5%±8.7 (range 52-98) compared to a 88.5% for medical students. Based on an Angoff passmark of 76.0%, 53 pharmacists (89.8%) passed compared to an overall pass rate in PSA 2014 of 94%. Pharmacists performed equivalently to medical students in all assessment areas, with a slightly lower performance in the prescribing, drug monitoring and data interpretation questions offset by better performance in prescription review and adverse drug reactions. Feedback was positive in relation to appropriateness, relevance and level of difficulty of the PSA although several commented that they were practicing in very specific clinical areas. These pilot events have benchmarked the PSA performance of pharmacist prescribers with final year medical students, and feedback confirmed feasibility and acceptability.

Peer-assisted learning: filling the gaps in basic science education for preclinical medical students.

In contrast to peer-assisted learning (PAL) in clinical training, there is scant literature on the efficacy of PAL during basic medical sciences teaching for preclinical students. A group of senior medical students aimed to design and deliver clinically oriented small-group tutorials after every module in the preclinical curriculum at a United Kingdom medical school. Twenty tutorials were delivered by senior students throughout the year to first- and second-year students. A baseline questionnaire was delivered to inform the development of the program followed by an end-point questionnaire the next year (n = 122). Quizzes were administered before and after five separate tutorials to assess changes in mean student scores. Additionally, each tutorial was evaluated via a questionnaire for participants (n = 949). All five posttutorial quizzes showed a significant improvement in mean student score (P < 0.05). Questionnaires showed students found the program to be relevant and useful for revision purposes and appreciated how tutorials contextualized basic science to clinical medicine. Students appreciated the interactive nature of the sessions and found receiving personalized feedback about their learning and consolidating information with someone familiar with the material to be useful. With the inclusion of the program, students felt there were now an adequate number of tutorials during the year. In conclusion, this study shows that senior medical students can design and deliver a program that adds value to the mostly lecture-based formal preclinical curriculum. We hope that our study can prompt further work to explore the effect of PAL on the teaching of basic sciences during preclinical studies.

Assessment at UK medical schools varies substantially in volume, type and intensity and correlates with postgraduate attainment.

BackgroundIn the United Kingdom (UK), medical schools are free to develop local systems and policies that govern student assessment and progression. Successful completion of an undergraduate medical degree results in the automatic award of a provisional licence to practice medicine by the General Medical Council (GMC). Such a licensing process relies heavily on the assumption that individual schools develop similarly rigorous assessment policies. Little work has evaluated variability of undergraduate medical assessment between medical schools. That absence is important in the light of the GMC’s recent announcement of the introduction of the UKMLA (UK Medical Licensing Assessment) for all doctors who wish to practise in the UK. The present study aimed to quantify and compare the volume, type and intensity of summative assessment across medicine (A100) courses in the United Kingdom, and to assess whether intensity of assessment correlates with the postgraduate attainment of doctors from these schools.MethodsLocally knowledgeable students in each school were approached to take part in guided-questionnaire interviews via telephone or SkypeTM. Their understanding of assessment at their medical school was probed, and later validated with the assessment department of the respective medical school. We gathered data for 25 of 27 A100 programmes in the UK and compared volume, type and intensity of assessment between schools. We then correlated these data with the mean first-attempt score of graduates sitting MRCGP and MRCP(UK), as well as with UKFPO selection measures.ResultsThe median written assessment volume across all schools was 2000 min (mean = 2027, SD = 586, LQ = 1500, UQ = 2500, range = 1000–3200) and 1400 marks (mean = 1555, SD = 463, LQ = 1200, UQ = 1800, range = 1100–2800). The median practical assessment volume was 400 min (mean = 472, SD = 207, LQ = 400, UQ = 600, range = 200–1000). The median intensity (minutes per mark ratio) of summative written assessment was 1.24 min per mark (mean = 1.28, SD = 0.30, LQ = 1.11, UQ = 1.37, range = 0.85–2.08). An exploratory analysis suggested a significant correlation of total assessment time with mean first-attempt score on both the knowledge and the clinical assessments of MRCGP and of MRCP(UK).ConclusionsThere are substantial differences in the volume, format and intensity of undergraduate assessment between UK medical schools. These findings suggest a potential for differences in the reliability of detecting poorly performing students, or differences in identifying and stratifying academically equivalent students for ranking in the Foundation Programme Application System (FPAS). Furthermore, these differences appear to directly correlate with performance in postgraduate examinations. Taken together, our findings highlight highly variable local assessment procedures that warrant further investigation to establish their potential impact on students.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-015-0428-9) contains supplementary material, which is available to authorized users.

P084 Feasibility study to examine underlying mechanisms for “Chemo Fog”

P084 Feasibility study to examine underlying mechanisms for “Chemo Fog” V. Jenkins *, H. Harder, M. Cercingani, H. Whiteley-Jones, R. Thwaites, L. Mullen, N. Harrison, K. Davies, C. Zammit, S. Sacre. SHORE-C Brighton & Sussex Medical School, University of Sussex, Brighton, United Kingdom, CISC Brighton & Sussex Medical School, University of Sussex, Brighton, United Kingdom, Brighton & Sussex Medical School, University of Sussex, Brighton, United Kingdom, Breast Surgery, Brighton & Sussex University Hospitals, Brighton, United Kingdom

P085 Acupuncture for musculoskeletal symptoms induced by aromatase inhibitors: a single centre experience

P084 Feasibility study to examine underlying mechanisms for “Chemo Fog” V. Jenkins *, H. Harder, M. Cercingani, H. Whiteley-Jones, R. Thwaites, L. Mullen, N. Harrison, K. Davies, C. Zammit, S. Sacre. SHORE-C Brighton & Sussex Medical School, University of Sussex, Brighton, United Kingdom, CISC Brighton & Sussex Medical School, University of Sussex, Brighton, United Kingdom, Brighton & Sussex Medical School, University of Sussex, Brighton, United Kingdom, Breast Surgery, Brighton & Sussex University Hospitals, Brighton, United Kingdom

National survey of clinical communication assessment in medical education in the United Kingdom (UK)

BackgroundAll medical schools in the UK are required to be able to provide evidence of competence in clinical communication in their graduates. This is usually provided by summative assessment of clinical communication, but there is considerable variation in how this is carried out. This study aimed to gain insight into the current assessment of clinical communication in UK medical schools.MethodsThe survey was sent via e-mail to communication leads who then were asked to consult with all staff within their medical school involved in the assessment of communication.ResultsResults were obtained from 27 out of 33 schools (response rate 82%) and a total of 34 courses. The average number of assessments per year was 2.4 (minimum 0, maximum 10). The Objective Structured Clinical Exam (OSCE) was the most commonly used method of assessment (53%). Other assessments included MCQ and workplace based assessments. Only nine courses used a single method of assessment. Issues raised included, logistics and costs of assessing mainly by OSCE, the robustness and reliability of such exams and integration with other clinical skills.ConclusionsIt is encouraging that a variety of assessment methods are being used within UK medical schools and that these methods target different components of clinical communication skills acquisition.

How do United Kingdom (UK) medical schools identify and support undergraduate medical students who ‘fail’ communication assessments? A national survey

BackgroundThe doctor’s ability to communicate effectively (with patients, relatives, advocates and healthcare colleagues) relates directly to health outcomes, and so is core to clinical practice. The remediation of medical students’ clinical communication ability is rarely addressed in medical education literature. There is nothing in the current literature reporting a contemporary national picture of how communication difficulties are managed, and the level of consequence (progression implications) for students of performing poorly. This survey aimed to consolidate practices for identifying and processes for managing students who ‘fail’ communication assessments across all UK medical schools.MethodsData were collected via an email survey to all leads for clinical communication in all UK Medical Schools for the UK Council for Clinical Communication in Undergraduate Medical Education.ResultsAll but two participating Schools reported some means of support and/or remediation in communication. There was diversity of approach, and variance in the level of systemisation adopted. Variables such as individuality of curricula, resourcing issues, student cohort size and methodological preferences were implicated as explaining diversity. Support is relatively ad hoc, and often in the hands of a particular dedicated individual or team with an interest in communication delivery with few Schools reporting robust, centralised, school level processes.ConclusionsThis survey has demonstrated that few Medical Schools have no identifiable system of managing their students’ clinical communication difficulties. However, some Schools reported ad hoc approaches and only a small number had a centralised programme. There is scope for discussion and benchmarking of best practice across all Schools with allocation of appropriate resources to support this.

PTU-011 A Survey on Provision of Teaching for Nasogastric Tube Placement as part of the Curricula of UK Medical Schools: Abstract PTU-011 Table 1

<h3>Introduction</h3> Nasogastric tube (NGT) insertion for enteral feeding is common practise, but is associated with the risk of tube misplacement or malposition in both the immediate and subsequent time points.¹ Between 2005 to 2010, 21 deaths and 79 other cases of harm have been reported on the updated National Patient Safety Agency (NPSA) Alert (2011), “Reducing harm caused by nasogastric feeding tubes”. In 45% of cases, misinterpretation of the chest X-ray was directly responsible for the harm inflicted. The General Medical Council’s (GMC) guidance for undergraduate education, “Tomorrow’s Doctors (2009)” does not specify NGT placement as a core competency for a graduate or Foundation Trainee.² The purpose of this survey was to ascertain the number of medical schools in the United Kingdom (UK) which provide specific teaching on NGT placement and correct identification of tube position (using either pH method or clinical interpretation of a plain chest X-ray film). Furthermore, the authors sought to identify whether these medical schools included formative or summative assessment of the respective methods. <h3>Methods</h3> All 30 GMC recognised Medical Schools within the UK were invited to participate by means of a standardised survey proforma. This proforma was emailed to relevant staff members who were either responsible for course development or were personnel within the clinical skills faculty. <h3>Results</h3> To date, there has been a 57% (17/30) response rate (<i>Table 1</i>). Of the 10 medical schools that provide formal teaching on NGT insertion, 8 of them required formative assessment for both the practical technique and the interpretation of correct tube position. Of the 7 medical schools that do not to provide formal teaching of NGT insertion, 6 of them stated that this was due to the GMC’s “Tomorrow’s Doctors” guidance not including NGT placement as a mandatory proficiency for a graduate. <h3>Conclusion</h3> This survey found that 59% (10/17) of the participating UK medical schools provide formal teaching on NGT placement and correct identification of tube position. There is variable emphasis on NGT procedure proficiency in undergraduate medical education. Given the risks highlighted by the 2011 NPSA report, we would suggest that NGT placement instruction and training should be facilitated at the undergraduate level. <h3>Disclosure of Interest</h3> None Declared <h3>References</h3> National Patient Safety Alert (PSA 002): Reducing the harm caused by misplaced nasogastric feeding tubes in adults, children and infants; Mar 2011. URL: http://www.nrls.npsa.nhs.uk/alerts/?entryid45 = 129640 General Medical Council (GMC) Tomorrow’s Doctors 2009; URL: http://www .gmc-uk.org/TomorrowsDoctors_2009.pdf_39260971.pdf

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.