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Rapid response to:


Subscribe to thrive: paid subscriptions to online medical education materials should be included with tuition fees

BMJ 2021; 375 doi: (Published 01 December 2021) Cite this as: BMJ 2021;375:n2970

Rapid Response:

Re: Subscribe to thrive: paid subscriptions to online medical education materials should be included with tuition fees

Dear Editor,

I read with interest the article by Katharine Lynch-Kelly covering the inclusion of online subscriptions to medical educational materials within undergraduate tuition fees. There has been a significant shift in the nature of undergraduate medical education over recent years, with increased utilisation of online learning materials, this accelerated by the Covid-19 pandemic. The author argues that educational institutions--namely, UK medical schools--need to recognise this change and that access to online educational resources should be provided free at the point of use for students to support curriculum delivery.

There is evidence that many UK medical schools have recognised this change in the educational needs of their students. As the author alludes to, a number of bespoke medical school online initiatives have been developed and some schools will also financially support student access to selected commercial online educational providers.

An important and ongoing initiative is CAPSULE (Clinical and Professional Unique Learning Enviroment), a bespoke, mobile/tablet optimised, digital learning resource originally designed on a not for profit basis by Brighton and Sussex Medical School (BSMS) together with a commercial technology partner (Ocasta Studios). CAPSULE was developed over a period of years using a multiple-choice case-based format with emphasis on formative learning and case feedback, originally designed to support senior BSMS students during regional rotations. By early 2020 CAPSULE contained nearly 700 cases and over 3500 questions and 500 images, cases written by senior medical school faculty, supported by an editorial board and covering all medical specialties.

With the onset of the Covid-19 pandemic in early 2020 and resulting loss of face to face teaching opportunities for medical students there was a pressing need, as recognised by UK medical schools and the Medical Schools Council (MSC), to support students with access to learning materials and course content during this period.

Following discussions and with the support of the MSC and a team of medical school editors from across the UK, CAPSULE was peer-reviewed and then made available free at the point of use in May 2020 to every UK medical student and to all UK medical schools and faculty. Thirty-three UK medical schools registered their interest and over 41,000 medical students and 3200 faculty were uploaded. MSC support was provided until September 2021 and during the first 12 months of use c. 1.5 million cases were completed by UK medical students with overall excellent feedback received from both students and faculty. The process of CAPSULE development and UK wide distribution is covered in a recent publication (1).

From September 2021 UK medical schools have been able to continue with their CAPSULE subscription, this process is evolving, but currently around two thirds of UK medical schools have elected to continue with CAPSULE, thereby providing free access to core curriculum content for their students, content aligning to the General Medical Council Medical Licensing Assessment content map. It is hoped that other UK medical schools may also wish to continue their involvement and that increasing cross school collaboration will develop with formation of a UK- wide editorial board and blending of CAPSULE content into other course delivery. There is no doubt however that UK medical schools and the MSC are alerted to the changes occurring within medical education and strategies are being put in place to support the learning needs of their students.

(1) Karunaratne. D et al. An Online Teaching Resource to Support UK Medical Student Education During the Covd-19 Pandemic- a Descriptive Account. Advances in Medical Education and Practice. 2021; 12; 1317-1327. DOI

Competing interests: No competing interests

06 December 2021
Consultant Radiologist and Honorary Clinical Professor (Brighton and Sussex Medical School)
East Sussex Healthcare NHS Trust
Radiology Department, Eastbourne DGH, Kings Drive, Eastbourne, BN21 2UD