Medical students will be ordered out of the lecture theatre and into the wards, gaining more “hands-on” experience treating patients in hospitals and doctors’ surgeries, new guidance from the medical regulator says.
New standards for “tomorrow’s doctors” from the General Medical Council (GMC) says that all medical students should be able to administer a local anaesthetic, take blood from patients and undertake other medical procedures under supervision, before they graduate from university.
The guidance, seen by The Times before its publication this week, updates standards for undergraduate medical training first published in 1993. It follows concerns that some skills, such as prescribing multiple drugs at the correct dosage, are being overlooked by some medical schools.
A survey of 2,400 medical students and junior doctors last year found that three quarters felt that they put patients at risk because they had not been trained to prescribe drugs properly.
Sir Graeme Catto, a former chairman of the GMC, has said that while students were generally content with their higher education, they complained about the lack of “bedside manner” teaching.
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“The old-fashioned teaching ward round has been lost. It is much easier to organise speaking to 300 students all at once in a lecture than to grapple with the logistical nightmare of sending them to GP surgeries or wards,” he said.
The latest Tomorrow’s Doctors guidance will standardise curriculums for more than 30 medical schools around the country, requiring them to organise “student assistantships”, where undergraduates can become involved in dealing with patients under the supervision of a registered doctor. At present, only some offer such placements.
Jim McKillop, Professor of Medicine at the University of Glasgow and chair of the GMC’s undergraduate board, said that the new placements were designed to provide all final-year students with “intense clinical experience in the workplace”.
“While at university students will practise taking blood on mannequins or doing simulated procedures, it is not the same as seeing real patients.”
Other tasks that students are expected to have carried out before they graduate include filling in a prescription form, ordering a blood sample, taking swabs and learning correct techniques for moving and handling patients.
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Professor McKillop said that there was no hard evidence that prescribing errors, which contribute to 40,000 adverse reactions to medicine every year, could be directly linked to lapses in medical training.
But the GMC would send inspection teams made up of practising doctors, academics and the public to medical schools to make sure its guidance was being implemented, he added.
“There are more drugs, they are more powerful, and there are potentially more interactions between drugs that can occur,” he said. “In the last 20 years medical training has moved on enormously and current graduates are much better prepared to perform clinical tasks than we were in the past but we are trying to improve even further, and make sure they have the appropriate grounding on a broad base of science.”
The GMC is due to take over the regulation of post-graduate medical training from April, as the former training board is phased out.Professor Tony Weetman, chair of the Medical Schools Council, said that he welcomed the greater emphasis on hands-on experience for undergraduate students. “We recognise that collaboration between the Medical Schools and Teaching Hospitals will be essential to the successful implementation of Student Assistantships,” he said. “I am sure that the changes made will have a long-lasting and beneficial impact on the way that doctors are educated in the UK.”