GP recruitment: could an undergraduate apprenticeship create the generalists the NHS needs?BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4408 (Published 22 October 2018) Cite this as: BMJ 2018;363:k4408
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Other schools and specialities should learn from the Imperial College London integrated clinical apprenticeship
Imperial College London is to be congratulated for setting up the integrated clinical apprenticeship.<1> Their director Kumar correctly stated that "medical students don’t want to sit in a lecture or the back of a GP surgery." Similarly, patients do not want to simply interact with "learners" who do not contribute to their care in a stretched NHS. Students are an invaluable resource that can help physicians to take complete histories from patients and perform various duties.<2> Moreover, physicians are often criticised for running late and interrupting patients.<3><4> Students can help in building rapport with patients that offsets the work shortage in the NHS. It does not mean students would be abused as free labour. By easing the workload of physicians, students have more teaching from physicians that further enhances their learning. That is the education model in various medical schools in North America.
When I was a student in a British medical school, my classmates and I were usually sent to take histories from stable patients who were waiting to be discharged. At times, patients questioned us, "Why are you here? What could you do for me?" We could be scheduled to go to a clinic on one day, and then watch a procedure the other day. We lacked opportunities to learn about teamwork, continuity of care, and overall management of patients. The consultants barely knew us, and struggled to give us constructive feedback. Although we all completed portfolios to document our clinical activities, some viewed this as a tick box exercise to collect clinicians' signatures.
We have heard enough about junior doctors' lack of readiness to practice.<5><6> Regardless of what specialities students want to pursue, all medical schools should adopt this undergraduate apprenticeship to enhance our future physician experience and quality of patient care.
1. Wilkinson E. GP recruitment: could an undergraduate apprenticeship create the generalists the NHS needs? BMJ. 2018;363:k4408.
2. Medical students: The most underutilised resource in the NHS. London, UK: British Journal of General Practice; 2018 Mar 4; cited [Jul 12, 2018]. Available from: http://bjgp.org/content/medical-students-most-underutilised-resource-nhs.
3. McCartney M. Margaret McCartney: Why GPs are always running late. BMJ. 2017;358:j3955.
4. Singh Ospina N, Phillips KA, Rodriguez-Gutierrez R, Castaneda-Guarderas A, Gionfriddo MR, Branda ME, et al. Eliciting the Patient's Agenda- Secondary Analysis of Recorded Clinical Encounters. J Gen Intern Med. 2018:https://doi.org/10.1007/s11606-018-4540-5.
5. Glass J. Is herd thinking in medical training leading us astray? BMJ. 2017;358:j4297.
6. Yeung EYH. How are junior doctors supposed to learn without the opportunity? BMJ. 2017;359:j5057.
Competing interests: I have been paid for working as a physician, but not for writing this letter.