It’s good to talk

UK medical students are living in interesting times. The Modernising Medical Careers programme has thrown career prospects into doubt. The cost of gaining a UK medical degree continues to rise. And rising numbers of medical students on the wards puts more and more pressure on clinical teaching time and funding. Medical students need to make their concerns known, but the recent history of interaction between the government and medical students and doctors has shown that this can be difficult.

But the government may be about to listen more carefully to students. As part of Gordon Brown’s project of listening to the people, the government has created a National Student Forum, which will allow students to present their ideas and concerns direct to government. The forum will consist of between 15 and 20 students from different higher education bodies such as the National Union of Students and the Mature Students Union. The delegates will produce an annual report to which ministers will have to respond. It is hoped that the students will raise questions that ministers have not previously considered. In the run-up to Christmas, five student juries were convened to examine matters such as student finance, widening participation, and learning support. And ministers visited universities throughout the country to listen to students’ worries.

Best placed

At the programme’s launch in October, the minister for students, Lord Triesman, said, “Students are among the best placed to tell government what’s going right in the system and what needs to be done better.” There will not necessarily be any medical student representation on the panel, however, because students are not allocated by subject matter. When asked whether the panel would consider matters such as the future of undergraduate and postgraduate medical training, Emma Griffiths of the Department for Innovation, Universities, and Skills said, “Hopefully that will be an issue that they will consider important and that they will want to discuss.”

Will this programme make a difference for medical students? Reg Jordan, dean of undergraduate medicine at Newcastle University, is not sure what the new forum will add. He says that medical students already have ample opportunity to offer comment on their experiences of their studies “perhaps not at a national level, but more locally. In fact, some students may even feel overwhelmed by the number of feedback forms they have to fill in.” Ian Noble, chairman of the BMA Medical Students Committee has different concerns: “My fear is that like a lot of the government’s higher education policies this will be set up for the three year undergraduate student without considering the unique needs and requirements of medical students.”

There are different ways for medical students to make their voices heard. The National Student Survey offers them the opportunity to comment on their experiences of their university. The survey is sent to every undergraduate in their final year, and the results are displayed at www.unistats.com as a resource when choosing where to study.

The BMA’s Medical Students Committee represents medical students nationally. Mr Noble explained the range of influence that this BMA committee has, “We deal with and have seats on committees and boards of the Medical Schools Council; the General Medical Council; and the UK Foundation Programme Office, including its group that sets the rules for the application process. And we lobby government through the Department of Health and the Department for Innovation, Universities, and Skills.”

Quality assurance

Medical students can also raise important matters through the external regulator of undergraduate medical education, the GMC. The GMC’s Quality Assurance of Basic Medical Education (QABME) programme monitors how well medical schools are following the guidance for undergraduate education in Tomorrow’s Doctors (www.gmc-uk.org/education/undergraduate/GMC_tomorrows_doctors.pdf). Teams visit medical schools in rotation and use questionnaires, meetings with staff, site visits, and student forums to assess performance. Kirsty White, quality assurance programme manager at the GMC, thinks that the programme allows students to raise important matters beyond the confines of their medical school: “There is evidence of students asking very meaningful questions, and they feel quite comfortable talking about what’s important to them.” Ms White noted that “one of the challenges is to reach a range of students and we are working on ways to raise the profile of the QABME visits and let students know about the opportunities to contribute.”

Faced with so many ways to discuss their experiences, UK medical students might be forgiven for complaining of feedback fatigue. This may be less true internationally. At the faculty of medicine of the University of Khartoum in Sudan, students fill in only one evaluation paper at the end of their course and attend small conferences on educational development two or three times during their course. Medical education is nevertheless developing fast. Abubekr Tamim, president of the Student Support Society in the faculty, said, “There have been many changes to the course, with the introduction of objective structured clinical examinations, and courses related to medicine, such as communication skills. The faculty is looking at new and different ways to involve students by involving them in research, as well as training courses and workshops in medical education.”

Competing interests: The author is a student visitor on one of the QABME teams this year, which is a paid position.

Provenance and peer review: Commissioned; not peer reviewed.

      

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