National Organisations supporting medical education

The MEDEV Subject Centre

The Higher Education Academy Subject  Centre for Medicine, Dentistry and Veterinary Medicine MEDEV supports teaching and learning in medicine and related disciplines across all UK Higher Education. The Subject Centre's website provides a very  large amount of resources, including the findings and outputs of our mini-projects and workshop programmes  as well as a number of JISC related projects.

Other Medical Education Organisations

• The Association for the Study of Medical Education (ASME) is a very active community of medical educators which holds regular conferences and events and publishes a highly regarded journal Medical Education.

• That Academy of Medical Educators has done valuable work in developing standards for medical educators and provides a range of services to the sector.

• The Association for Medical Education in Europe (AMEE) holds a major annual conference and publishes its own very useful journal and range of guides and other publications

• The Best Evidence Medical Education (BEME) Collaboration which commissions and publishes the findings of extensive and carefully structured literature surveys on a range of medical education topics. 

3. Issues in curriculum design

Statutory Regulation of Medical Education

The core curriculum design requirements for medical education are statutorily determined by the General Medical Council (GMC).  

The GMCs main guidance for undergraduate medical education is in Tomorrows' Doctors  which describes in some detail the required learning outcomes and standards for medical schools to follow.

In this document the GMC sets the knowledge, skills and behaviours that medical students learn at UK medical schools: these are the outcomes that new UK graduates must be able to demonstrate. The GMC also sets standards for teaching, learning and assessment.

A full list of bodies providing medical degree can be found on the GMC website.

The GMC has completed a comprehensive review of Tomorrow's Doctors (2003). Following the review, they have produced Tomorrow's Doctors (2009) though for the time being, the 2003 edition continues to apply to courses in medicine. One of the key curriculum challenges for Medical schools at present is in preparing for application of the 2009 edition from 2011/12 onwards.

In addition to Tomorrows' Doctors the GMC also publishes supplementary advice for medical schools on how to help prepare medical students for clinical practice and the Foundation Programme. These are advisory documents to help medical schools implement the requirements in Tomorrow's Doctors (2009). They contain snapshot examples of local practice from UK medical schools. They also give an indication of the key issues and challenges for medical schools as seen by the GMC itself. The supplementary guidelines are as indicated below:

• Clinical placements for medical students (pdf) sets out what medical students can expect from their placements and Student Assistantships, in which they act as an assistant to a junior doctor during their final year. The advisory document also sets out what medical schools should do when organising placements.
• Assessment in undergraduate medical education (pdf) sets out the different methods a medical school could use to assess medical students and gives advice on setting standards and marking examinations.
• Patient and public involvement in undergraduate medical education (pdf) sets out the importance of patient and public involvement and ways in which medical schools can make it happen.
• Developing teachers and trainers in undergraduate medical education (pdf) sets out how medical schools can develop and support the teachers and trainers of medical students.

The GMC also publish a number of other curriculum related guidance documents and it is well worth exploring their website for these additional links. A key one which reflects an issue of current concern is Students fitness to practice.  

You can find out more about the GMCs quality assurance procedures by going to the Assuring Quality page on their website.

Transition to employment as a doctor - the Foundation Programme

There have been substantial changes to the post-graduate training and development process which have created a need for more explicit and detailed career guidance and support for students than was necessary in the past.  Two really useful sites are:

• The UK Foundation Programme site which has sections for medical students, foundation doctors and trainers
• And the NHS Careers site

Issues in curriculum delivery

Clinical teaching

One of the main curriculum delivery issues in medical education is the presence (and the wholly apropriate priority) of the patient in the clinical learning setting. This necessarily limits and constrains learning opportunities and all teaching and learning processes must take this fully into account. Similarly the clinical environment is focussed on providing treatment and care to patients and is not designed as a learning environment.

Nonetheless clinical experience and learning is central to the process of becoming a doctor and has become an increasing part of the medical undergraduate curriculum. artly in response to the constraints of the clinical environment most schools of medicine have introduced clinical skills labs to provide initial experience and skill development in a safe situation. Also a  wide range of simulators are now being used, some of a very high degree of sophistication. See for example the wikipedia entry (Yes I know this is the dreaded wikipedial but it does provide a useful overview and your students may well be accessing it all the time!?).

The Assessment and Learning in Practice Settings (ALPS) CETL has done really valuable work on the use of mobile technologies in the clinical environment.

Problem and case based learning

Because the capabilities required of medical graduates include the ability to reason and apply their knowledge to the diagnosis and management of clinical conditions, learning methodologies have been developed specifically designed to foster these reasoning and communication skills.

An interesting example is the use of Problem Based Learning (PBL) by some medical schools. Most schools have not chosen to go down the full PBL route but have developed a range of case-based strategies to develop these skills in their students.

Assessment

Because a medical degree leads into clinical practice and work in the NHS, it is vital that assessment is not only of academic knowledge but also of the wide range of clinical, communication and professional skills that are needed to practice as a doctor. One of the most distinctive assessment tools in medicine is the Objective Structured Clinical Examination (OSCE) which consists of a series of 'stations' which students move round and respond to the simulated clinical situation  at the station and are then assessed according to a checklist of key skills, knowledge etc. MEDEV has run a number of OSCE support workshops to support this process.

Clearly also it is essential that assessment of medical students should be a accurate as possible and MEDEV has run a number of workshops in the area of standardisation of assessment results.