Fellowships in medical educationBMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c5697 (Published 30 October 2010) Cite this as: BMJ 2010;341:c5697
Ronny Cheung gives a rough guide to the short term posts
The value of developing a practical interest in areas such as medical education, management, and leadership is increasingly being recognised. Many “out of programme experience” posts now exist for doctors in training, which allow trainees to “deep dive” and gain a greater understanding of these areas.
For the past year, I have been able to take time out of my training programme in general paediatrics to take up one such post: a fellowship in medical education at Great Ormond Street Hospital in London. This experience has helped me to hone my teaching skills, learn about higher education theory (through a masters programme), and develop strategic plans for training in the trust. My projects have included developing supervision, teaching, and assessment skills for consultants and registrars; setting up multidisciplinary simulation training; developing e-learning packages; and setting up mentoring and support schemes for international medical graduates. Through these projects, my interest and expertise in education have increased, and I have been able to enhance my academic experience by doing research, presentations, and peer reviewed publications. All this and no on-call commitments for a year.
Why should I consider a fellowship in medical education?
More than a decade ago, the General Medical Council published The Doctor as Teacher, which laid down guidance on the educational duties of all medical practitioners, whether or not they are formally employed in a role with specific responsibility for education.1 Part of our duty as practitioners and advocates is to ensure that the next generation of healthcare professionals is trained to the highest standard, for the benefit of our patients. After all, the word “doctor” is derived from the Latin docere, meaning “to teach.”
Many of us believe that teaching is not merely a duty, but is a rewarding and exhilarating experience in its own right. Within the constraints of our clinical training, however, teaching can often take a back seat, especially now, where with rota shortages and the spectre of the European Working Time Directive’s regulations there are more service delivery issues than ever before.
If you are not currently in a training programme, then taking on a fellowship in medical education post can be a real string to your bow when it comes to personal and professional development and improving your chances of successful application to a training scheme. If you are already in a training programme, taking six months or a year out may seem a hefty investment, even if your long term career plans involve taking on formal educational responsibilities. The experiences and learning you will gain during this time, however, are impossible to attain elsewhere. If you wish, you will be able to immerse yourself in academic educational theory, while surrounded by a group of like-minded educators to foster your enthusiasm and skills. You will be able to deliver frequent, regular teaching to a diverse range of learners, and there may well be opportunities to develop your own courses or teaching materials, or to do educational research, under the supervision of an experienced clinical educator. Moreover, a post such as this, away from the pressures of service delivery and the emphasis on developing purely clinical skills, provides the scope for learning generic, transferable skills—such as leadership, working in teams, networking project management, and managing multiple work streams—that fulfil many competencies in our leadership and management training as junior doctors.2
What does a fellowship in medical education post involve, and how can I pick a programme most suited to me?
There is a great deal of variation in the available fellowship in medical education posts, and care must be taken to read the job description thoroughly to be sure that the duties of the post suit your own expectations and learning needs. There will be an element of regular teaching in all posts, of course, but the volume, variety, target audience, and the methods used will be different in every post. The emphasis of the post may also vary and can run the gamut from being predominantly focused on the delivery of established teaching programmes to a much more strategic role in helping to steer the direction of medical education in the trust. Academic educational research based posts also exist.
Bearing in mind the variation listed, a “typical” week in my post, where the emphasis has been on improving the educational environment, might involve three to four hours of teaching about membership examinations to specialty trainees years 1-3 in paediatrics; delivering a training course in teaching skills; facilitating a multidisciplinary simulation session for two to three hours; attending meetings with consultants and managers to discuss new training programmes; planning and preparation for future courses with my supervisor; and writing draft business bids for training and equipment. Finally, my contract allows me to spend one day a week in clinical work, although again this will vary from post to post.
When should I apply?
This will very much depend not only on your own interests and career pathway, but also on the specific post that interests you. As such, there is no correct time to pursue a fellowship in medical education post. Take a careful look at the person specifications as well as the job descriptions for each post to check that your skills and qualifications fit the bill.
Chances are, if you are planning on applying for a fellowship in medical education post, you will already have had some practical experience of teaching. How much experience you need in order to secure a post can vary widely and will depend on the particular job requirements and the other applicants with whom you will be competing. Above all, your curriculum vitae should reflect your interest and commitment to medical education—the precise nature of your experience will often be much less of an issue than your enthusiasm and drive.
If you are thinking about applying for a post, and you are in a training programme, contact your deanery training programme lead as soon as possible to tell them about your application—if you wait until you are successfully appointed you may find the deadline to apply for out of programme experience has passed you by. If you can argue the merits of the particular post for which you are applying, complete all the correct forms, and get appropriate signatures on time, you will find the process relatively straightforward.
How can I build on the experience I gain?
You may wish to use the opportunity of having dedicated time away from clinical work to develop your theoretical knowledge through various accredited higher qualification programmes (box). Of course, you do not have to wait until the job starts—many clinicians already do this in their own time, and if you are applying for a post then having started on a postgraduate certificate in medical education will certainly enhance your application.
How you build on the experience gained in the post will depend on your ultimate career aims, as well as on how much the experience of the post has altered the direction of these aims. Most people will go back into clinical work with some full time teaching experience under their belts, which will stand them in good stead for a career as a practising clinician with an active role in education within their department. Others will be emboldened to look towards a career in education management, as a director of medical education or at a regional or national level within deaneries, royal colleges, or medical schools. I know of one or two who have decided to take up academia as a full time career on the basis of the skills and experience gained during their out of programme experience.
Higher qualifications in medical education
Many higher education institutions and hospitals across the country offer accredited qualification programmes in medical education. Choosing one can be a bit of a minefield, and most people will decide on the basis of geography more than anything else. Careful consideration of their individual merits can pay off, however, as each programme is delivered in different ways, with a variety of assessment methods and emphasis on different topics within medical education. There are also programmes tailored for specific areas of medical education, whether they are specialty based (with specific programmes for surgeons, anaesthetists, and physicians, among others) or based on educational modalities (such as management in education, simulation, and education and technology). A synopsis of available programmes was compiled in 2005, but others have since been developed.3
Perhaps the first question to ask is whether you intend to complete a postgraduate certificate, a diploma, or a masters programme. The answer will depend on your personal circumstances and career direction. If you are unsure at the outset, you may wish to start with a certificate or diploma programme—if so, make sure you check whether the credits you gain from those are recognised for transfer should you wish to progress on to a masters programme later.
The other major choice is whether to do a face to face taught programme or a distance learning programme. The University of Dundee and the University of Cardiff, among others, run well established distance learning programmes, which give you flexibility over start and finish dates as well as choice in when you wish to study and undergo self assessment. However, this type of study may not suit individuals who require a certain level of external motivation to perform. The advantage of a face to face course is in the structure of the teaching programme, and especially in the added peer and supervisor support which that entails. The requirements for attendance are necessarily more restrictive, however, which may not be practical for everyone.
Whatever the ultimate career pathway, I do not know of a single person in a fellowship in medical education post, past or present, who has regretted taking the post, or felt that the time spent out of training was detrimental to their clinical careers. The Academy of Medical Educators (www.medicaleducators.org), a national body for educators in all areas of clinical practice, is currently undergoing an information gathering process to map out careers in medical education in order to inform the process of streamlining career pathways as well as to provide guidance for aspiring medical educators. Look out for their report, which should be available in the near future.
Whether you see yourself as a clinician with an interest in the continuing education of colleagues and juniors or whether you see teaching opportunities as a springboard to educational leadership at a higher level, a fellowship in medical education post can give you the opportunity to develop a deeper and more nuanced understanding of training delivery. In addition, the responsibilities and work patterns of the post offer the opportunity to develop generic skills and attributes that you may otherwise find difficult to attain and that you can transfer to all aspects of your future professional life.
Competing interests: None declared.