Re: Medical training at breaking point: will an increase in learners push the system over the edge?
Dear Editor
This report is long on problems but short on solutions; the response from NHSE lacks detail.
It is evident that additional clinical teachers are not going to be available in the short term, so we need to think about efficiency. For undergraduate learning and teaching (those are not the same) finance is not the issue; the Tariff is sufficient, it is time that is lacking. Osler said ‘it is a safe rule to have no teaching without a patient for a text, and the best teaching is that taught by the patient himself’. The NHS lacks many things but not patients. Two suggestions, both about enabling students to become self-directed learners, follow from this. Write competency-based learning outcomes at a sufficient granularity that students know what they have to do. Concentrate the teaching on the observation and feedback on the consultation skills of communication, examination and clinical reasoning, thus equipping the student with the ‘bag of tools’ that they can use to educate themselves.
Where are the patients? The article by Rammya Mathew in the same issue (p 189) suggests that they are in the community. Community trusts and community hospitals are rarely used for teaching but look after many of the patients with the long term problems faced by modern medicine.
Rapid Response:
Re: Medical training at breaking point: will an increase in learners push the system over the edge?
Dear Editor
This report is long on problems but short on solutions; the response from NHSE lacks detail.
It is evident that additional clinical teachers are not going to be available in the short term, so we need to think about efficiency. For undergraduate learning and teaching (those are not the same) finance is not the issue; the Tariff is sufficient, it is time that is lacking. Osler said ‘it is a safe rule to have no teaching without a patient for a text, and the best teaching is that taught by the patient himself’. The NHS lacks many things but not patients. Two suggestions, both about enabling students to become self-directed learners, follow from this. Write competency-based learning outcomes at a sufficient granularity that students know what they have to do. Concentrate the teaching on the observation and feedback on the consultation skills of communication, examination and clinical reasoning, thus equipping the student with the ‘bag of tools’ that they can use to educate themselves.
Where are the patients? The article by Rammya Mathew in the same issue (p 189) suggests that they are in the community. Community trusts and community hospitals are rarely used for teaching but look after many of the patients with the long term problems faced by modern medicine.
Competing interests: No competing interests