Medical students are to be tested on prescribing

BMJ 2009; 339 doi: (Published 16 December 2009) Cite this as: BMJ 2009;339:b5504
  1. Jacqui Wise
  1. 1London

    Medical students are to be given more training and testing in prescribing so as to reduce doctors’ medication errors.

    The British Pharmacological Society is developing an online prescribing simulator that will give medical students more opportunities to practise filling in drug charts. It is also working with the Medical Schools Council to develop a national prescribing assessment for medical students in their final year. An early version will be piloted this summer, and it is expected to be part of the final year’s assessment for medical students in 2012.

    The society, in conjunction with the Medical Schools Council and the Department of Health, is also developing a national e-learning portal (, which will be available free to all prescribers. The site will contain both interactive learning sessions and background information covering pharmacology, clinical pharmacology and therapeutics. The site will be piloted next summer and be in place by 2012.

    Jeff Aronson, president of the British Pharmacological Society, said, “Medical students are not being taught enough about prescribing. They are not being assessed on their prescribing skills and are ill prepared to prescribe. The evidence has mounted up over the past few years, and now we are looking at solutions to the problem.” He was speaking on the eve of the society’s conference, Delivering Safe Prescribing in the NHS, which started on 15 December.

    Simon Maxwell, chairman of the society’s prescribing committee, said that medical students may have filled out a hospital prescription sheet only five or six times before qualifying, and once in hospital they have to do 50 or 60 in a day.

    “It is important that medical students get to do dry runs regularly and are tested on this,” said Professor Maxwell. The online prescribing simulator will give imaginary scenarios to doctors in training, who will then fill out the practice form and be given immediate feedback and scoring.

    The society welcomed the General Medical Council’s recent report highlighting the high rate of prescribing errors made by all grades of hospital doctor (BMJ 2009;339:b5328, 7 Dec, doi:10.1136/bmj.b5328). But it criticised the GMC for blaming the errors on the complex working environment and not on inadequacies in the undergraduate medical curriculum.

    The society also supported the GMC in its call for a national prescribing form but said that on its own it would not be enough.

    Professor Maxwell said, “Everyone is in agreement that we need to provide more education and training for those who prescribe drugs, at all stages of their careers. This has to be combined with changes to the systems in which they work, including better supervision and team work, improved documentation, and easier access to detailed drug information when it is needed.”

    The society developed the medical student curriculum for prescribing that has now become part of the GMC guidance Tomorrow’s Doctors. “We are happy it is now included, but we regret it took so long to get it there,” said Professor Maxwell.

    He added: “The good news is that the corner has been turned after years of indifference and, even, denial. Everyone now accepts that standards of prescribing must be improved.”

    At the conference the society launched Ten Principles of Good Prescribing to underpin the safe and effective use of drugs. This document is aimed at all NHS prescribers and can be found at


    Cite this as: BMJ 2009;339:b5504

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