How well prepared are medical students for their first year as doctors? The views of consultants and specialist registrars in two teaching hospitals

Abstract

Objective: To evaluate (1) the extent to which first year doctors (foundation year 1 doctors, F1s) in two teaching hospitals in the Trent Deanery were rated by specialist registrars (SpRs) and consultants as being well prepared for practice; (2) the importance ascribed by SpRs and consultants to the various items of core knowledge, skills and attitudes outlined in the publication of the General Medical Council, Tomorrow's Doctors. Method: SpRs and consultants were asked to rate: how well prepared F1s were in a range of items of core knowledge, skills and attitudes that a new medical graduate must possess as outlined in Tomorrow's Doctors; the importance for a new doctor of each item of core knowledge, skills and attitudes; and how well the medical school had prepared F1s in respect of key generic issues related to their practice. Results: In most of the items of core knowledge, skills and attitudes covering 8 of the 11 topic areas of Tomorrow's Doctors, F1s were seen as not prepared for starting work, especially in regard to clinical and practical skills and the more challenging communication skills. They were best prepared in asking for help and in basic communication skills. Conclusions: Overall, F1s in the study were not well prepared either to perform the tasks that await them or in terms of most of the specific background knowledge and skills necessary for the successful execution of those tasks. The level of preparedness raises important issues about medical training and transition from medical graduate to first year doctor. Further research is needed to determine whether this situation exists in other regions of the UK.

Junior doctors prescribing: enhancing their learning in practice

“…All sources of data reported here indicated that preparedness for prescribing was a weakness.This suggests that the often questioned validity of self reports [24] is less of a problem in this study, although preparation in this case is mostly related to confidence rather than prediction or assessment of performance [25,26]. Similar findings that prescribing is an area of weakness have been reported elsewhere [4,6,7,10,13,27,28].…”

“…From being unable to prescribe by law as medical students, new doctors have the responsibility for prescribing powerful,potentially high risk drugs [1].Often it is junior doctors who prescribe most drugs in hospital [2] and their ability to do this safely and effectively is a concern both in the UK [3] and internationally [4]. A number of previous studies have found that new doctors are not as well prepared for prescribing as they might be [4][5][6][7][8][9][10][11][12][13]. A study carried out on behalf of the General Medical Council checked 124 260 medical orders across 19 hospitals in the UK.…”

‘August is always a nightmare': results of the Royal College of Physicians of Edinburgh and Society of Acute Medicine August transition survey

“…The frustrations and anxiety of the transition can be ameliorated by rapid integration of juniors into teams, clear delineation of roles and early constructive feedback from senior colleagues. [9][10][11] While the temptation may be to use consultant staff to fill gaps left in the rota or save costs on locum staff, there is a much stronger case to be made for clear and consistent clinical leadership in the early part of the transition. With regard to the better preparedness of medical students, shadowing was strongly supported by respondents, who also advocated for longer periods of shadowing, rather than just the first one or two days of the August transition week.…”

“…This strongly mirrors the views of medical students and junior doctors, who almost uniformly find shadowing to be more useful than the taught curriculum with regard to preparing for the real world of clinical practice, 10 particularly when the shadowing is undertaken in the hospital where they later work as a house officer or when the student is allowed to effectively function as a junior doctor, rather than just clerking patients. [9][10][11] Despite the General Medical Council (GMC) making shadowing a requirement of the final year of medical school, 12 only a minority do so in their place of later employment. 11 The GMC also recommends that shadowing students should be 'protected' from the 'business' of being a junior doctor, which the evidence suggests may be counterproductive.…”

What do clinical pharmacologists do? A questionnaire survey of senior UK clinical pharmacologists

“…Furthermore, they and their senior colleagues believe that new graduates are not well prepared to prescribe. Some of the evidence comes from studies by clinical pharmacologists [16][17][18], but independent investigators have concurred [19][20][21].…”