Educating tomorrow’s doctorsBMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e3689 (Published 29 May 2012) Cite this as: BMJ 2012;344:e3689
In spring 1992, Student BMJ was launched as one of the first international peer reviewed journals written by and for medical students.1 The journal was created as a place for students and junior doctors to find out about developments in medical education, career planning, and research, and to access education and opinion on matters that might not be comprehensively taught at medical school.
Twenty years on, much has changed. For example, in 1993 British universities adopted undergraduate core curriculums to standardise medical education. And in 2009, implementation of the European Working Time Directive (EWTD) restricted junior doctors’ hours of work across the European Union to 48 hours a week. At the BMJ our aim has been to help students and educators keep abreast of these changes and to understand what they mean for curriculums and careers. With a monthly print readership of 21 000, 24 000 unique visitors each month online from around the world, and growing opportunities for interactivity, we have been in a position not only to support our readers but to learn from them.
We have learnt that, although trainees recognise that evidence based medicine is important in clinical training and when dealing with patients,2 they rarely read research papers. So Student BMJ has had to change the way it presents original research. Where initially we used to republish selected studies as they appeared in the BMJ, we now offer a breakdown and analysis of just one study in our “Research explained” section.
We’ve also learnt that trainees want to know “how” and “why.” They tend to be good at memorising facts and figures to pass assessments but less good at retaining the information.3 TheEWTD , and similar legislation in North America, has added time constraints, cutting down on useful clinical exposure for learning on the job.4 Educators must adapt their teaching methods, to answer “how” and “why” even more efficiently than before. Student BMJ’s education section has adapted too. Initiatives such as our interpretation series aim to help students reinforce their knowledge of a core topic, such as reading radiographs or understanding arterial blood gases, by using case based discussion.5 6
Finally, we’ve learnt that trainees and teachers have different priorities when it comes to education and career development. Last month, we polled BMJ and Student BMJ readers to ask what they thought was the most important change to medical education in the past 20 years. Teaching methods and resources (40%) topped clinicians’ and educators’ list, whereas students and junior doctors felt that competition for jobs when qualified (24%) and quality of teaching (21%) were the main challenges to their education. Student debt and competition to get into medical school featured for both groups.
It’s no surprise that debt looms high on the list of concerns for trainees. This year, UK university tuition fees hit an all time high of up to £9000 a year ( €11 000; $14 000). Similar spikes have occurred in the United States7 and Canada8, where students pay $20 000 more a year on average for tuition than they did in 1995.
As for competition, the reasons for concern are not so clear. Although applications to medical schools have increased (23 000 this year in the UK compared with 14 000 in 1996), competition ratios to enter UK medical schools have remained stable at about 2.3 applications for each place. This figure is much the same as in the United States, with 2.19 applications per place.9
One thing on which trainees and educators also agree is the value they place on good educational content. In 2010, an online survey of Student BMJ readers gave their highest rating to our education section, composed of clinical reviews and picture quizzes. This is an aspect of the journal we will continue to focus on, with the help of expert co-authors who liaise with students to produce articles of high relevance to other trainees.
We’ve come a long way, but we want to go further. As we look forward to the next 20 years, we anticipate constant changes to the medical curriculum, workforce planning, clinical practice, and student life.10 We want to find new ways to support tomorrow’s doctors, so that they learn to make rational decisions about diagnosis and treatment, to design and manage high quality systems of care as well as treating individual patients, and above all, to practise medicine with integrity and compassion. We welcome suggestions and feedback on what you think tomorrow’s doctors need to know, and how we can best serve their needs.
Cite this as: BMJ 2012;344:e3689
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
Provenance and peer review: Commissioned, not externally peer reviewed.