Q&A April 2011
Why is change happening at Cardiff Medical School?
The General Medical Council (GMC) is the UK’s independent medical regulator. It decides whether medical schools are entitled to award medical degrees. To do this, it sets out standards that medical schools must meet in teaching and assessing medical students. In 2009, the GMC produced new guidance to all UK medical schools which will require them to make some fundamental changes to their curricula. Cardiff is at the vanguard of this process; in the autumn of 2011, the GMC’s quality assurance experts will visit us to inspect us and report on how we are performing against the new guidance. We intend to comply with the GMC’s requirements, and then over time to exceed them, setting a new standard for medical education both in the UK and internationally.
To see the GMC guidance for medical schools, Tomorrow’s Doctors 2009, click on the following link:
What is happening?
All medical schools modify their courses constantly, sometimes in quite small ways. Periodically, however, a more fundamental overhaul is found to be necessary. What’s happening at Cardiff is a very large project which will review the existing MB BCh course against the GMC’s latest guidance and modify it to ensure compliance. The result will be a reformed curriculum that is ready to meet the challenges of training doctors for the future.
What is its scope and who is involved?
Put simply, just about everyone who is involved in or affected by teaching and learning medicine at Cardiff! The project is all-encompassing and covers every level of management. It is taking place under the overall leadership of Professor Paul Morgan, Dean of Medicine and Professor John Bligh, Dean of Medical Education. Together with a group of specially appointed project managers and academic leads to monitor and control the project as it progresses, Professors Morgan and Bligh are working in partnership with individuals and representatives of various interested parties including: students, clinicians and teachers, University staff, specialist experts, patients, the Welsh Assembly Government, NHS employers including Trusts and the Wales Deanery, and researchers and colleagues from other UK and international medical schools.
For more information on the project and to find out who is involved and how to contact them, click on the following link
Why does the project have to be so big?
Because it is responding to big challenges, and because it has big aims. Medical schools are required by the GMC to train doctors who are properly qualified and licensed to practise, who can practise safely, ethically and independently and provide outstanding patient care, and who will serve as good colleagues and employees within the modern NHS. Cardiff University is embracing these challenges with vigour and enthusiasm. Our vision is to develop the values of teaching excellence, service, science, scholarship and patient safety into a world leading medical programme that will attract, train and retain the very best doctors for Wales by providing high quality teaching and an inspiring learning experience based around increased clinical contact with strong emphasis on the relevant science base.
How do you plan to meet these objectives?
For a project as big as this to succeed, there needs to be a clear focus on what we are actually aiming to accomplish. We will achieve our overall vision through the completion of five main, multi-stranded projects, all of which are carefully managed to a set timescale with specified outcomes. More detail on the projects and how they fit together is available on the 'C21 Projects' section of this website.
The key to the whole project is, of course, the drive, vision, involvement and skills of everyone involved. We are therefore ensuring that this focus on people runs through every part of the project by an emphasis on: making sure all interested parties are represented and their views consulted; continuous review of our administration and quality processes; communication; team work; and staff development and training.
I teach on the current MB BCh course. How will the changes to the curriculum affect me?
Over the next two years:
(a) you will be offered increased opportunities to contribute suggestions as to how your subject or discipline should develop;
(b) you will be invited to take part in discussions about the core learning outcomes for your subject or discipline (see link below for further information on these groups);
(c) as a consequence of your feedback and involvement you will notice structural changes accompanied by improvements to the course.
You may not need to change your personal teaching practice as the changes come into effect, although you will probably find that you wish to take advantage of increased opportunities to learn new skills and new ways of teaching and assessing students. In addition, you should find that opportunities for staff development will increase and that the existing recognition and reward structure for medical educators is strengthened.
These changes will be introduced in stages and we will ensure that they will be flagged up well in advance and will feature in the C21 newsletter, Inform.
As a medical teacher I would like to get more involved, but where will I find the time?
Many of our medical teachers across the country are already doing an outstanding job and we appreciate their dedication and enthusiasm. We are delighted that so many of you want to play a further part in developing the curriculum, but where any increased involvement will be over and above your current commitment, you will need to seek the approval of your line manager or clinical director.
If you’d like to get further involved in the programme, contact
I am a current medical student. How will the changes affect me?
To meet the GMC’s required outcomes, all medical schools are expected to develop students who are (1) scholars and scientists, (2) practitioners and (3) professionals. As these requirements start to come into effect within the Cardiff course, you will notice a refocusing of your teaching and learning, particularly towards a stronger understanding of disease and repair mechanisms, the science underlying diagnosis and therapy, patient care, patient safety and professional clinical practice.
The result of this re-focusing on the actual skills and knowledge you’ll need as a doctor is that we’ll be introducing increasing variety in your course over time. There will be a wider range of learning opportunities, teaching and assessment methods; more opportunities to study particular areas of interest in depth; opportunities to learn more about professional skills including teaching and learning in medicine, research methods, leadership; and a chance to develop an extended range of clinical, academic and scientific skills as well as a focus on population and global health.
Among the practical effects of this for all students will be that, at whatever stage you are in the course, you’ll soon begin to experience:
- More and better opportunities for clinical skills practice;
- An enhanced emphasis on science relevant to current as well as future clinical practice;
- Opportunities for dissection later in the course;
- Changes to the assessment system so that you can measure your progress in a more realistic and authentic way;
- Changes to the assessment cycle to allow longer placement periods;
- Opportunities for increasing amounts of clinical experience, starting earlier in the course;
- A continuing emphasis on science and, especially, on learning science in a clinical context
I’m a first year medical student and came to Cardiff because I liked the course – but it will have changed a lot by the time I graduate, won’t it?
The GMC’s previous inspection reports show that there is much about the current Cardiff course that is extremely good; that will not change. Cardiff has been producing some of the best doctors in the UK for many years and will continue to do so. But in common with all the best medical school courses, Cardiff’s course is constantly evolving. No medical school’s course could (or indeed should) remain static for the five or six years it takes a student to progress through it, and Cardiff’s course is no exception.
It is, however, true to say that we are planning to speed up the pace of development over the coming years. In particular, there will be one major organisational change in 2013 that will affect all students who are currently in year 2 and below – but evidence from elsewhere suggests that you’ll like it and will benefit from it. By 2013 we expect that all year 4 students will, as they progress into their final undergraduate year, have made accelerated progress on achieving the skills and competencies required by the GMC thanks to more intensive clinical skills teaching in the new educational facilities. Because of this, we will achieve a better alignment between year 5 undergraduate medical training and FY1 postgraduate training to ensure that all our medical students are really well prepared for their medical careers.
So will there still be finals in year 5?
The practical effect of accelerating your clinical skills learning and assessing it earlier will be that instead of having to focus on the dreaded ‘finals’, anyone who is expecting to graduate in 2014 or later will have greater opportunities to develop their skills as a doctor in the final undergraduate year through community and hospital placements, student assistantships and FY1 shadowing and induction.
There will still be assessments in year 5 that you must pass in order to progress to the next stage of training, but the emphasis will be increasingly on continuous assessment in clinical skills suites and in real world settings such as clinical placements, so that your progress towards independent practice as a doctor can be monitored in a more authentic and realistic way.
I am a third year medical student and will have graduated by 2013. Will I really notice any difference?
As I explained above, Cardiff’s course has been evolving every year since the medical school began, and you will already have noticed many changes since your first year. We are constantly introducing improvements to the course; some have been fairly recently introduced, some are in progress, and some are already at an advanced stage of development. Some areas where change is currently underway or imminent include, for example: the introduction of portfolios, appraisal, changes to assessments, electives, and the introduction of the final year clinical skills log.
The pace of change is likely to increase over the next couple of years; but we are with you every step of the way and can promise you that any changes you do experience will take place in clear stages, be well signposted and, wherever possible, you will be involved in any consultations.
Will the new course be based on problem based learning?
No, it won’t. Problem based learning is a particular method of teaching that has been superseded by other, more effective methods that place more emphasis on learning theoretical and clinical science in context.
There will certainly be a decrease in the number of large lectures. This is because the evidence clearly shows that a more active approach to learning medicine results in doctors who are better able to use science to make diagnostic and treatment decisions. As a result there will be increased learning in small groups in the first two years of the course; these sessions will be structured around clinical trigger cases designed to build on and integrate with the learning outcomes for each block. Each small group will be led by tutors with training and expertise, not just in the subject and content of the learning module but also in the skills and processes involved in facilitating this type of learning.
So will we students just be learning in small groups all the time?
No, not at all. We will be offering a much wider range of support materials and learning modalities, designed to offer the best possible learning mix. Some you will be familiar with; some may be new to you. They will include:
- Tutorials by subject experts and specialists aimed at developing an in depth understanding of the syllabus relating to the learning outcomes of the module
- Technology enhanced learning that includes electronic resources
- Lectures, dissection sessions, clinical demonstrations, lab work
- More choice of optional components for study: the GMC requires that at least 10 percent of the course should be selected by the student
- Regular sessions in the new clinical skills and simulation centres being built for Cardiff.
Even so, doesn’t this sound a bit like what all the other new medical schools are offering?
Yes and no. Yes, it will in some respects look similar to other medical schools’ programmes. After all, it would be strange indeed if we refused to use the very best methods just because another medical school is also using them. We have a responsibility to make use of the latest evidence about the best ways to educate medical students – and so, of course, do other medical schools. So naturally we have drawn on examples of best practice from medical schools not just in the UK but also in Australia, New Zealand, North America and Canada and mainland Europe.
And no, it will be quite unique in the sense that this curriculum is very much Cardiff’s own product. Medical school curricula don’t come ready made: they are developed in a particular context for a particular purpose. Our purpose is to produce, attract and retain the very best doctors for Wales, which is why we have consulted so widely within Wales and why we have ensured local and regional representation at every level of management of the project. We want to take full advantage of the opportunities and challenges this project presents to develop a new and world-leading curriculum that draws on the finest traditions and culture of medicine in Wales, that brings into play the best strengths of medical education in Wales and in Cardiff, and that can take it forward and develop it further for the future health needs of our nation.
Are you really interested in what students think about the project?
Yes, yes and yes! We are in regular touch with MedSoc, and we get feedback on your views through the Staff Student Consultation and through the BMA Cymru Wales Medical Students’ Committee. There are student representatives on the various project groups involved in the curriculum changes, and your elected year representatives are there to act as interfaces between the student body and the project team members. You'll also find lots of information on this website plus contact details for key members of the team who will be happy to talk to you further.