Context Resource allocation and manpower planning in the clinical faculty of a UK medical school.Purpose To design a model, which is perceived to be fair, to determine indicative undergraduate teaching budgets to departments within the school from university resources and to specialty care groups of the main university hospital from service increment for teaching (SIFT) resources, and to aid manpower planning.Method The student load for each department is measured in full-time-equivalent student numbers (FTEs) for each specialty and compared with the total load for the whole curriculum to derive each department's percentage share of available undergraduate teaching resources. Data on staff numbers available for teaching, both from the school and NHS, are also included. Student load and teaching capacity are then compared.Result Undergraduate teaching resources relate to student load in the resource allocation process, and changes to the course are automatically re¯ected. Staff data, when compared with student load, facilitate rational planning of establishment levels to meet the teaching needs of the undergraduate curriculum. Of the respondents to a survey of heads of departments and the faculty's management board, 88% agreed that it was a better approach to resource allocation than the previous historical basis.Present limitations and scope for development Data are currently entered manually but will be transmitted electronically in the future via the Web. Further consideration will be given to the possible inclusion in the model of weighting factors for different types of teaching and to how appropriate measures of quality may be incorporated into the resource allocation process.Conclusion The model, despite some limitations, is a cost-effective and pragmatic management tool.
Members of the Student Clinical Ethics Committee discussed the ethical and legal issues arising in a case referred for consideration -the family of a very elderly non-English speaking Asian lady did not want her to be informed that she had incurable lymphoma. The case study summarises the reflections of the Committee and focusses on: the role of cultural norms in healthcare decision making; the extent to which the views of the family about what is best for the patient should be respected, whether the patient should have been informed of her terminal diagnosis and the role of the clinician in navigating complex family dynamics.
Members of the Student Clinical Ethics Committee discussed the ethical and legal issues arising in a case referred for consideration – a female patient in her mid-60s, who had a very long history of multiple sclerosis, withdrew her previous consent to treatment following discussion with her son. The case study summarises the reflections of the Committee and focusses on: the meaning and practical application of respect for patient autonomy; whether a refusal of clinically indicated treatment may challenge the notion of capacity; the role of others in the process of decision-making; if the current decision to refuse treatment was the patient’s own and whether, in the circumstances, it should be respected.
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