Retaining graduates of non-metropolitan medical schools for practice in the local area: the importance of locally based postgraduate training pathways in Australia and Canada

Does UK medical education provide doctors with sufficient skills and knowledge to manage patients with eating disorders safely?

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2018-135658 ◽

2018 ◽

Vol 94 (1113) ◽

pp. 374-380 ◽

Cited By ~ 7

Author(s):

Agnes Ayton ◽

Ali Ibrahim

Keyword(s):

Eating Disorders ◽

Patient Safety ◽

Eating Disorder ◽

Postgraduate Training ◽

Medical Training ◽

Improve Patient Safety ◽

Medical Schools ◽

Junior Doctors ◽

The Uk ◽

Improve Patient

BackgroundEating disorders affect 1%–4% of the population and they are associated with an increased rate of mortality and multimorbidity. Following the avoidable deaths of three people the parliamentary ombudsman called for a review of training for all junior doctors to improve patient safety.ObjectiveTo review the teaching and assessment relating to eating disorders at all levels of medical training in the UK.MethodWe surveyed all the UK medical schools about their curricula, teaching and examinations related to eating disorders in 2017. Furthermore, we reviewed curricula and requirements for annual progression (Annual Review of Competence Progression (ARCP)) for all relevant postgraduate training programmes, including foundation training, general practice and 33 specialties.Main outcome measuresInclusion of eating disorders in curricula, time dedicated to teaching, assessment methods and ARCP requirements.ResultsThe medical school response rate was 93%. The total number of hours spent on eating disorder teaching in medical schools is <2 hours. Postgraduate training adds little more, with the exception of child and adolescent psychiatry. The majority of doctors are never assessed on their knowledge of eating disorders during their entire training, and only a few medical students and trainees have the opportunity to choose a specialist placement to develop their clinical skills.ConclusionsEating disorder teaching is minimal during the 10–16 years of undergraduate and postgraduate medical training in the UK. Given the risk of mortality and multimorbidity associated with these disorders, this needs to be urgently reviewed to improve patient safety.

Download Full-text

Effectiveness of regional medical schools in attracting and retaining students for early‐career practice in the local area: The James Cook University experience

Australian Journal of Rural Health ◽

10.1111/ajr.12498 ◽

2019 ◽

Vol 27 (2) ◽

pp. 125-131 ◽

Cited By ~ 2

Author(s):

Torres Woolley ◽

Robin Adelle Ray

Keyword(s):

Medical Schools ◽

Local Area ◽

Early Career ◽

James Cook ◽

Regional Medical ◽

University Experience ◽

Career Practice

Download Full-text

Just the diagnosis is never enough!

Indian Journal of Medical Ethics ◽

10.20529/ijme.2021.091 ◽

2021 ◽

pp. 01-02

Author(s):

William Wilson

Keyword(s):

Patient Care ◽

Postgraduate Training ◽

Medical Schools ◽

Patient Communication ◽

High Time

Medical schools train us to be brilliant academicians and diagnosticians. But as physicians, we must never belittle patient communication nor be inconsiderate in our approach to patient care. Communication as a skill gets neglected in postgraduate training as young doctors chase procedural and diagnostic excellence. It is high time we make amends.

Download Full-text

Calculated grades, predicted grades, forecasted grades and actual A-level grades: Reliability, correlations and predictive validity in medical school applicants, undergraduates, and postgraduates in a time of COVID-19

10.1101/2020.06.02.20116830 ◽

2020 ◽

Cited By ~ 2

Author(s):

Ian Christopher McManus ◽

Katherine Woolf ◽

Dave Harrison ◽

Paul Tiffin ◽

Lewis Paton ◽

...

Keyword(s):

Medical School ◽

Predictive Validity ◽

Large Scale ◽

Postgraduate Training ◽

Predictive Ability ◽

Medical Schools ◽

Research Literature ◽

Administrative Dataset ◽

The Uk ◽

General Studies

Calculated A-level grades will replace actual, attained A-levels and other Key Stage 5 qualifications in 2020 in the UK as a result of the COVID 19 pandemic. This paper assesses the likely consequences for medical schools in particular, beginning with an overview of the research literature on predicted grades, concluding that calculated grades are likely to correlate strongly with the predicted grades that schools currently provide on UCAS applications. A notable absence from the literature is evidence on whether predicted grades are better or worse than actual grades in predicting university outcomes. This paper provides such evidence on the reduced predictive validity of predicted A-level grades in comparison with actual A-level grades. The present study analyses the extensive data on predicted and actual grades which are available in UKMED (United Kingdom Medical Education Database), a large-scale administrative dataset containing longitudinal data from medical school application, through undergraduate and then postgraduate training. In particular, predicted A-level grades as well as actual A-level grades are available, along with undergraduate outcomes and postgraduate outcomes which can be used to assess predictive validity of measures collected at selection. This study looks at two UKMED datasets. In the first dataset we compare actual and predicted A-level grades in 237,030 A-levels taken by medical school applicants between 2010 and 2018. 48.8% of predicted grades were accurate, grades were over-predicted in 44.7% of cases and under-predicted in 6.5% of cases. Some A-level subjects, General Studies in particular, showed a higher degree of over-estimation. Similar over-prediction was found for Extended Project Qualifications, and for SQA Advanced Highers. The second dataset considered 22,150 18-year old applicants to medical school in 2010 to 2014, who had both predicted and actual A-level grades. 12,600 students entered medical school and had final year outcomes available. In addition there were postgraduate outcomes for 1,340 doctors. Undergraduate outcomes are predicted significantly better by actual, attained A-level grades than by predicted A-level grades, as is also the case for postgraduate outcomes. Modelling the effect of selecting only on calculated grades suggests that because of the lesser predictive ability of predicted grades, medical school cohorts for the 2020 entry year are likely to under-attain, with 13% more gaining the equivalent of the current lowest decile of performance, and 16% fewer gaining the equivalent of the current top decile, effects which are then likely to follow through into postgraduate training. The problems of predicted/calculated grades can to some extent, although not entirely, be ameliorated, by taking U(K)CAT, BMAT, and perhaps other measures into account to supplement calculated grades. Medical schools will probably also need to consider whether additional teaching is needed for entrants who are struggling, or might have missed out on important aspects of A-level teaching, with extra support being needed, so that standards are maintained.

Download Full-text

Predictive validity of A-level grades and teacher-predicted grades in UK medical school applicants: a retrospective analysis of administrative data in a time of COVID-19

BMJ Open ◽

10.1136/bmjopen-2020-047354 ◽

2021 ◽

Vol 11 (12) ◽

pp. e047354

Author(s):

I C McManus ◽

Katherine Woolf ◽

David Harrison ◽

Paul A Tiffin ◽

Lewis W Paton ◽

...

Keyword(s):

Medical Education ◽

Medical Students ◽

Medical School ◽

Predictive Validity ◽

Postgraduate Training ◽

Medical Schools ◽

Longitudinal Observational Study ◽

Medical Education And Training ◽

Future Consequences ◽

And Training

ObjectivesTo compare in UK medical students the predictive validity of attained A-level grades and teacher-predicted A levels for undergraduate and postgraduate outcomes. Teacher-predicted A-level grades are a plausible proxy for the teacher-estimated grades that replaced UK examinations in 2020 as a result of the COVID-19 pandemic. The study also models the likely future consequences for UK medical schools of replacing public A-level examination grades with teacher-predicted grades.DesignLongitudinal observational study using UK Medical Education Database data.SettingUK medical education and training.ParticipantsDataset 1: 81 202 medical school applicants in 2010–2018 with predicted and attained A-level grades. Dataset 2: 22 150 18-year-old medical school applicants in 2010–2014 with predicted and attained A-level grades, of whom 12 600 had medical school assessment outcomes and 1340 had postgraduate outcomes available.Outcome measuresUndergraduate and postgraduate medical examination results in relation to attained and teacher-predicted A-level results.ResultsDataset 1: teacher-predicted grades were accurate for 48.8% of A levels, overpredicted in 44.7% of cases and underpredicted in 6.5% of cases. Dataset 2: undergraduate and postgraduate outcomes correlated significantly better with attained than with teacher-predicted A-level grades. Modelling suggests that using teacher-estimated grades instead of attained grades will mean that 2020 entrants are more likely to underattain compared with previous years, 13% more gaining the equivalent of the lowest performance decile and 16% fewer reaching the equivalent of the current top decile, with knock-on effects for postgraduate training.ConclusionsThe replacement of attained A-level examination grades with teacher-estimated grades as a result of the COVID-19 pandemic may result in 2020 medical school entrants having somewhat lower academic performance compared with previous years. Medical schools may need to consider additional teaching for entrants who are struggling or who might need extra support for missed aspects of A-level teaching.

Download Full-text