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- Page navigation anchor for The disparity in GP placements: Teaching quality and student engagementThe disparity in GP placements: Teaching quality and student engagement
We read with great interest the paper written by Cottrell et al and found it to be incredibly relevant to our current curricula.1 As fourth year medical students, we would like to offer our perspective on this topic.
Having completed a 10-week GP placement, we strongly agree that having a long placement in the community was critical in developing our history-taking skills and applying our knowledge in a clinical setting. However, we have found that the discrepancy between practice allocation has led to enormous variations in experience and perceptions of general practice as a career, a view shared by Nicholson et al .2 The opportunities to take active roles in our learning and receive immediate feedback on our progress was entirely dependent on our GP lead’s engagement and what was available to us.
Another point we would like to raise is that our written assessments have been heavily focussed on specialties and this is reflected in the profiles of the academic societies in our university; our GP society does not have as wide of a reach as speciality-focussed societies. Not only do these societies provide tutorials, mock examinations and specific assessment assistance, they also provide sources for careers guidance, mentoring and research opportunities. We believe that having a smaller outreach and a lower priority in written assessments can reduce engagement amongst medical students with their GP placements. Th...
Show MoreCompeting Interests: None declared. - Page navigation anchor for The forgetting curve: The importance of distribution as well as quantity of general practice teachingThe forgetting curve: The importance of distribution as well as quantity of general practice teachingAs third year medical students, some of whom have an interest in becoming general practitioners (GP), reading the article: ‘Revealing the reality of undergraduate GP teaching in UK medical curricula: a cross-sectional questionnaire study’1 it was clear to see that there is widespread variation and an overall reduction in the exposure of medical students to general practice.From our own experience, a possible reason for the decline in GP teaching for older medical schools compared to an increase in teaching for newly established medical schools could be related to the distribution of GP teaching within the curriculum. In our firm, we are a mix of Aston (who are the first medical students for this university) and University of Birmingham (UOB) medical school students. The UOB students have GP teaching once a fortnight, interspersed with hospital placements, whereas the Aston students have a full 12-week semester of only GP teaching. This is a common theme in the Aston medical school curriculum: in year 4 there is a 5-week teaching block dedicated to community medicine and in the fifth year of study students are allocated a 6-week block of GP teaching.2 It is important to consider the distribution of GP teaching, as well as the quantity of the teaching. According to the ‘forgetting curve’,3 spaced repetition of teaching can help to reinforce and improve the memory of the...Show MoreCompeting Interests: None declared.
- Page navigation anchor for Quality Over Quantity to Reveal the Reality of Undergraduate GP Teaching in the UK- Clinical Years Medical Student PerspectiveQuality Over Quantity to Reveal the Reality of Undergraduate GP Teaching in the UK- Clinical Years Medical Student PerspectiveAs students studying at the University of Manchester in United Kingdom, in their clinical years of study, we found the article by Cottrell et al1 to be of great interest to us. Although we appreciate that your paper shows a clear decline in percentage of GP teaching sessions (9.2% from 13%), we believe that the emphasis on quality rather than quantity of GP session is a component that needs to be further explored.As students we understand the importance of adequate exposure to GP practice to be of paramount importance given the shortfall of GP’s across the UK.2 In order to achieve this goal, your research concludes that it is necessary that ‘minimum quantity of GP teaching is mandated across all regions of the UK’.Based on personal experience of having GP teaching weeks particularly in our clinical year 3-5, we would like to bring it to your attention that a lack of structured and meaningful involvement of us while on GP placements has been a far more important factor in determining a meaningful outcome. Talking to peers it was interesting for us to compare how varied each one’s experience at the GP teaching had been. While some of us were allocated our own rooms in the surgeries where we took histories from patients and devised management plans to later discuss with the GP’s, other students spent most of the time observing consultations. Fu...Competing Interests: None declared.
- Page navigation anchor for A University GP Society’s perspective on the reality of undergraduate GP teaching in UK medical curriculaA University GP Society’s perspective on the reality of undergraduate GP teaching in UK medical curriculaAs committee members of The University of Manchester’s GP (general practice) society, we found the article by Cottrell et al1 to be an insightful read. It brings to attention the current challenges facing GP recruitment in the NHS (National Health Service).2 However, the study does not consider the importance of University GP Societies and the extra-curricular teaching that they deliver. Therefore, we wanted to add our perspective as we have organised a virtual clinical lecture series, delivered by doctors, regarding common GP presentations. Our aim is to educate medical students whilst promoting GP as a specialty.Alberti et al found a significant correlation between the number of GP placements at medical school and the uptake of GP training by their medical students.3 Feedback from our clinical lecture series demonstrated a similar trend. A 10% increase in the likelihood of pursuing GP as a career was observed when students were asked before and after our talks. Furthermore, feedback included requests for further teaching not extensively covered by medical school curricula. Despite undergraduate GP teaching having plateaued1, we were pleased to note that our lecture series was attended by students globally. The use of online platforms creates opportunity for more uniformed teaching within primary care. Going forward, we hope to deliver on student’s requests for additional GP-focused t...Show MoreCompeting Interests: None declared.
- Page navigation anchor for The reality of undergraduate GP teaching - A medical students’ perspectiveThe reality of undergraduate GP teaching - A medical students’ perspectiveWe read with great interest the paper written by Cottrell and colleagues, which attempted to quantify the average time allocated to GP teaching across UK medical schools.1 We acknowledge the importance of identifying strategies to increase interest in general practice and would like to highlight the importance of a positive student experience in achieving this goal.When quantifying total GP teaching time, this study did not differentiate between lectures and clinical experience, based on the assumption that it is the quantity of GP teaching which correlates to an increased percentage of GP graduates. Although this assumption is supported by other data within this field, it is important to note that evidence has shown that this correlation is only statistically significant for clinical based teaching which allows patient contact.2 This correlation is not observed when accounting for total GP teaching time, including lectures and small group tutorial work. Further data collection which makes the distinction between clinical and non-clinical experience would not only assess the quantity of effective GP teaching but also ensure that medical schools are appropriately informed about the type of improvements required to enhance interest in general practice.Additionally, although this paper recognises that students’ perceptions are further influenced by their overall exper...Competing Interests: None declared.
- Page navigation anchor for Revealing the reality of undergraduate GP teaching in UK medical curricula: a cross-sectional questionnaire studyRevealing the reality of undergraduate GP teaching in UK medical curricula: a cross-sectional questionnaire studyWe read the article by Cottrell et al with interest and commend them on their endeavours to quantify general practice teaching within UK medical schools.1 As medical students, we wished to share our perspective.Quantification of teaching can be misrepresentative if learning outside of the general practice (GP) environment is not taken into consideration. As students, we are acutely aware of the value of implicit versus explicit teaching, with the former in GP occurring alongside teaching of other primary care-based topics, such as psychiatry or infectious disease. It would also be fruitful to compare curricula coverage of other specialties to general practice; for example, dermatology, which is undertaught in UK medical schools.2 The authors also failed to address post-graduate GP training; specifically, whether a correlation exists between the quantity of undergraduate GP teaching and subsequent GP trainees. Accordingly, we would have liked to have seen inclusion of the student/trainee perspective, specifically focusing on how we rate the current value of GP education within our degree and whether we perceive there to be any shortcomings.Additionally, we observed gaps in the authors’ statistical analyses. Four medical schools were excluded from analysis; constituting nearly 10% of the initial sample, this represents a considerable data gap, thereby affecti...Show MoreCompeting Interests: None declared.
- Page navigation anchor for Inadequate primary care tariffInadequate primary care tariff
Thank you for publishing our article ‘Revealing the reality of undergraduate GP teaching in UK medical curricula’ in which we highlighted the longstanding problem of under-investment in general practice teaching in the UK.1 One of our key recommendations was for “an adequate primary care tariff which reflects the cost of teaching and simplifies current payment mechanisms”. We are pleased to report that since writing this paper the Department of Health and Social Care (DHSC) in England has for the first time introduced a national minimum tariff for medical student placements in general practice.2 We of course welcome this development as a step in the right direction. However, the new minimum tariff of £28,000 per full time equivalent (FTE) placement per year still falls significantly short of the current tariff for secondary care undergraduate medical placements set at £33,286.3 A primary care payment of £28,000 per FTE is also significantly lower than the actual cost of undergraduate teaching in general practice, identified by a national study in England as £41,700 per FTE.4
Whilst there is no doubt that the health economy will be struggling in the wake of the COVID-19 pandemic, recent events surely present yet further evidence of the need to provide all future doctors with high quality experience in general practice and primary care. We strongly urge...
Show MoreCompeting Interests: None declared.