Reform of Undergraduate Medical Teaching in the United Kingdom : A Triumph of Evangelism over Common Sense
Dear Sir
Re: "Reform of Undergraduate Medical Teaching in the United Kingdom :
A Triumph of Evangelism over Common Sense”
Authors: Gareth Williams and Alice Lau. BMJ volume 329 p92-94 10 July 2004
I write as a product of a pioneering new style undergraduate medical
education course dating from the 1970’s at the University of Nottingham.
Gareth Williams has expressed a view that educational revision of
undergraduate medical teaching in the UK has swung to a level where the
priority of teaching attitudes amongst educationalists has reached a point
where they overshadow the importance of teaching clinical knowledge and
skills for those training to be doctors in the United Kingdom.
As a graduate of the University of Nottingham Medical Faculty in
1977, I was one of a group of students who were subjected to the
experience of an educationally driven new course based upon novel
principles of education at that time. The course identified themes, the
cell, man and community, used a diverse range of educational techniques,
lectures, seminars, tutorials, problem based learning, early clinical
teaching, integrated courses, programme text learning, streamlined
practical classes, continual assessment and formative assessment with the
aim of producing an educated and highly trained House Officer capable of
taking their professional training further within their personal ambitions
for the rest of their lives. The central component of the course was to
include training in research, with every student undertaking an
individualised research project with appropriate supervision and achieving
a BMedSci degree within the 5 year time slot.
At the time of graduating as a Houseman and working around the
country amongst others from the more traditional courses, it was apparent
that there was an emphasis in my training that meant that I had a reduced
body of clinical knowledge compared to my colleagues from other Faculties.
However, I had a comparable level of scientific knowledge and a higher
level of research and communication skills training compared with my
colleagues from other Faculties.
This contrast in the late 1970s was noticeable and the lack of
clinical knowledge, in particular, did impact, to some degree, upon my
ability to achieve in postgraduate training in medicine and paediatrics.
This has not proved insurmountable as I now work as an academic in
paediatric oncology.
It is my view that the problems identified by Williams and Lau are an
exaggeration of the same situation that I found myself in in the late
1970s with the more extreme forms of educational course being experimented
upon in the new Faculties that are springing up around the country. The
difference is that they are, in general, not laying emphasis upon the
importance of research training as an integrated skill for the modern
doctor.
As a multi-system specialist physician working with children, I would
challenge the wisdom of down playing the importance of basic science in an
undergraduate education and I would also challenge the safety of too
greater emphasis being placed upon a limited core of knowledge with
disregard to its breadth.
It is impossible as an undergraduate to predict your future career
course. The end of your medical training is a time when you have acquired
your metaphorical set of basic tools for the rest of your career. To have
a bag of tools that are so light in basic science and clinical knowledge
that you need to buy new tools throughout your professional training, does
mean that the choices open to you will be unacceptably constrained before
you have even earned your first salary.
I would therefore, support Williams's and Lau’s view that extremes of
educational fervor in the area of problem based learning, and an excessive
focus on attitude is to our disadvantage. Modern clinical practice
cannot disregard the importance of scientific, as well as clinical
training, if this highly valued national workforce with the country’s
health service budget at their disposal is to meet the expectations of
their patients and employers.
Yours sincerely
Dr David A Walker BMedSci.BM.BS.FRCP.FRCPCH
Reader in Paediatric Oncology / Honorary Consultant
Rapid Response:
Reform of Undergraduate Medical Teaching in the United Kingdom : A Triumph of Evangelism over Common Sense
Dear Sir
Re: "Reform of Undergraduate Medical Teaching in the United Kingdom :
A Triumph of Evangelism over Common Sense”
Authors: Gareth Williams and Alice Lau. BMJ volume 329 p92-94 10 July 2004
I write as a product of a pioneering new style undergraduate medical
education course dating from the 1970’s at the University of Nottingham.
Gareth Williams has expressed a view that educational revision of
undergraduate medical teaching in the UK has swung to a level where the
priority of teaching attitudes amongst educationalists has reached a point
where they overshadow the importance of teaching clinical knowledge and
skills for those training to be doctors in the United Kingdom.
As a graduate of the University of Nottingham Medical Faculty in
1977, I was one of a group of students who were subjected to the
experience of an educationally driven new course based upon novel
principles of education at that time. The course identified themes, the
cell, man and community, used a diverse range of educational techniques,
lectures, seminars, tutorials, problem based learning, early clinical
teaching, integrated courses, programme text learning, streamlined
practical classes, continual assessment and formative assessment with the
aim of producing an educated and highly trained House Officer capable of
taking their professional training further within their personal ambitions
for the rest of their lives. The central component of the course was to
include training in research, with every student undertaking an
individualised research project with appropriate supervision and achieving
a BMedSci degree within the 5 year time slot.
At the time of graduating as a Houseman and working around the
country amongst others from the more traditional courses, it was apparent
that there was an emphasis in my training that meant that I had a reduced
body of clinical knowledge compared to my colleagues from other Faculties.
However, I had a comparable level of scientific knowledge and a higher
level of research and communication skills training compared with my
colleagues from other Faculties.
This contrast in the late 1970s was noticeable and the lack of
clinical knowledge, in particular, did impact, to some degree, upon my
ability to achieve in postgraduate training in medicine and paediatrics.
This has not proved insurmountable as I now work as an academic in
paediatric oncology.
It is my view that the problems identified by Williams and Lau are an
exaggeration of the same situation that I found myself in in the late
1970s with the more extreme forms of educational course being experimented
upon in the new Faculties that are springing up around the country. The
difference is that they are, in general, not laying emphasis upon the
importance of research training as an integrated skill for the modern
doctor.
As a multi-system specialist physician working with children, I would
challenge the wisdom of down playing the importance of basic science in an
undergraduate education and I would also challenge the safety of too
greater emphasis being placed upon a limited core of knowledge with
disregard to its breadth.
It is impossible as an undergraduate to predict your future career
course. The end of your medical training is a time when you have acquired
your metaphorical set of basic tools for the rest of your career. To have
a bag of tools that are so light in basic science and clinical knowledge
that you need to buy new tools throughout your professional training, does
mean that the choices open to you will be unacceptably constrained before
you have even earned your first salary.
I would therefore, support Williams's and Lau’s view that extremes of
educational fervor in the area of problem based learning, and an excessive
focus on attitude is to our disadvantage. Modern clinical practice
cannot disregard the importance of scientific, as well as clinical
training, if this highly valued national workforce with the country’s
health service budget at their disposal is to meet the expectations of
their patients and employers.
Yours sincerely
Dr David A Walker BMedSci.BM.BS.FRCP.FRCPCH
Reader in Paediatric Oncology / Honorary Consultant
Competing interests:
None declared
Competing interests: No competing interests