Intercalated degrees, learning styles, and career preferences: prospective longitudinal study of UK medical students

"Excited When They See Their Name in Print": Research Outputs from an Australian Medical Program

To promote evidence-based practice, medical schools offer students opportunities to undertake either elective or mandatory research projects. One important measure of the research program success is student publication rates. In 2006, UNSW Medicine implemented a mandatory research program in the 4th year of the undergraduate medical education program. This study identified student publication rates and explored student and supervisor experiences with the publication process. A retrospective audit of student publications from the 2007, 2011, and 2015 cohorts was undertaken to look at trends over time. Data collected included type of publication and study methodology. Semi-structured interviews were conducted with a sample of undergraduate students (n = 11), medical graduates (n = 14), and supervisors (n = 25) and analysed thematically. Student publication rates increased significantly (P = 0.002) from 28% in 2007 to 50.2% in 2015. Students able to negotiate their own project were more likely to publish (P = 0.02). Students reported personal affirmation and development of research skills from publishing their research findings, while graduates noted improved career opportunities. Supervisors expected students to publish but identified the time to publications and student motivation as key factors in achieving publication(s). A high publication rate is possible in a mandatory research program where students can negotiate their own topic and are given protected time. Publications happen after the research project has finished. Critical factors in successful publication include supervisor support and student motivation. Given the importance of the supervisor's role, staff development and faculty support to train and develop a body of skilled supervisors is required.

Progress Testing in UK Medical Education: Evaluating Its Impact and Potential

This comprehensive review critically examines the UK medical curriculum, with a particular focus on progress testing as an innovative assessment strategy. The curriculum, evolving from foundational sciences to practical applications, is encapsulated in the integrated curriculum model (ICM). This model adeptly combines theoretical knowledge with clinical practice, fostering cognitive, affective, and psychomotor skills among medical students. Central to this review is an exploration of progress testing. This method, grounded in constructivist learning theories, emphasises continuous assessment and professional development. Progress testing's regular, comprehensive examinations are instrumental in guiding students through the progressive stages of competence, as outlined in Miller's pyramid, from foundational knowledge to clinical proficiency. The review also addresses the broader impacts of progress testing on teaching approaches, student feedback, academic and pastoral support, and quality assurance. By aligning with the dynamic requirements of 21st-century medical training, progress testing not only nurtures well-rounded professionals but also ensures compliance with regulatory bodies like the General Medical Council. Its emphasis on continuous evaluation aligns with the practical realities of a medical career, driving curricular innovation and aligning with regulatory standards. The implementation of progress testing marks a significant advancement in medical education. Its continuous, holistic nature benefits both students and educators, nurturing a more engaged learning attitude and meeting evolving medical needs. The adoption of this assessment strategy is seen as pivotal in shaping competent medical professionals, ready to face the challenges of modern medical practice.

Impact of the increase in tuition fees and demographic factors on medical student intercalation rates between 2006 and 2020

Introduction

No quantitative research has assessed the trends in English medical student intercalation. In addition, the impacts of the increase in tuition fees, introduced in 2012, and demographic factors on intercalation rates are unknown.

Methods

Freedom of information requests were sent to all UK universities. Regression analysis compared intercalation rates before (2006-2012) and after (2012-2020) the tuition fee increase. Student's t-tests compared demographics of medical students who intercalated. Questionnaires were sent to all UK universities to explore reasons for intercalating.

Results

In total, 101,085 students from seven universities responded. The intercalation rate increased from 4.70% to 10.53% (mean percentage difference (MPD) 5.84; 95% confidence interval (CI) 2.94-8.73). Intercalating students were more likely to be <25 years of age (MPD 33.36%; 95%CI 28.34-38.39), without a previous degree (MPD 8.56%; 95% CI 7.00-10.11) and without a disability (MPD 3.15%; 95% CI 0.88-5.42). In total, 389 completed questionnaires were received from 10 universities. Medical students believed an intercalated degree made them a better doctor.

Discussion

The proportion of students who intercalated was greater following the increase in tuition fees. This might be explained by the value medical that students placed on the skills and opportunities that accompany an intercalated degree.

An evaluation of Italian medical students attitudes and knowledge regarding forensic medicine

INTRODUCTION

This study aims to assess students' knowledge of forensic medicine concepts and their opinions regarding the course taught during the degree course in Medicine and Surgery in an Italian university. Consequently, the study aims to assess the impact of the course on the students' knowledge and attitude in choosing a medical residency.

MATERIALS AND METHODS

A cross-sectional study was conducted through an anonymous web-based survey of medical students at the Università Cattolica del Sacro Cuore. Descriptive and univariate analysis were conducted.

RESULTS

1166 students completed the survey. The forensic medicine course appears to be extremely important in providing training in the fundamental concepts of forensic medicine, especially professional liability, defensive medicine, and forensic pathology. Attending autopsies is important during the course, and their number should be more than ten. Additionally, univariate analysis demonstrates that students' awareness of forensic medicine topics, such as the function of the forensic physicians, professional liability, and defensive medicine, improves in the fifth or sixth year of the course. After the course, more students would choose to pursue a nonclinical and nonsurgical specialty, and forensic medicine specifically, for their residency.

CONCLUSIONS

The forensic medicine course has the task of defining the duties and responsibilities of forensic physicians, providing indispensable tools for future medical practitioners, regardless of their future specialisation, and limiting the increasing use of defensive medicine. In conclusion, we recommend further multicenter studies to evaluate the role and direct effect of undergraduate forensic medicine courses on students and on the quality of practice.

A national intercalated medical student research program - student perceptions, satisfaction, and factors associated with pursuing a PhD

BACKGROUND

To counteract a decreasing number of physician-scientists, a national intercalated Medical Student Research Programme (MSRP) was launched in Norway in 2002. We aimed to assess whether the students' favourable perceptions and satisfaction with the program had prevailed since the inception in 2002 and until 2015, and to identify factors associated with pursuing a PhD.

METHODS

The study was an incorporation of data from two previous national evaluations of the MSRP performed in 2007 and 2015. We used electronic questionnaires to explore demographic characteristics, area and type of research, student satisfaction, and future scientific goals. In 2007, questionnaires were sent to all 208 students, and 183 (88%) replied. In 2015, the corresponding numbers were 279, and 240 (86%). Categorical data were analysed using either Kruskal-Wallis or Pearson's chi square test. Differences between sample means were assessed with Student`s t-test while logistic regression was used to test associations between selected covariates and the students' ambitions to pursue a PhD degree.

RESULTS

Overall, the student satisfaction was 79%. However, more students in 2015 received less regular and less supervision time and expressed a need for more of it. Seventy-seven per cent expressed an ambition to pursue a PhD. Students were more likely to have a PhD ambition if they were satisfied with the program, had a supervisor with high expectations for them, or had already published some of their results. At both time points, students (86% vs. 89%) responded that the MSRP had a positive impact on their regular curriculum achievements.

CONCLUSIONS

The high degree of satisfaction with the national MSRP among undergraduate students has prevailed since the inception in 2002. By far, the program has also met its goal to increase the number of aspiring physician-scientists. However, to maintain that goal over time, adequate and personal supervision is a prerequisite.

Factors influencing medical students' approaches to learning in Qatar

BACKGROUND

This study investigated the relevance of the revised 2-factor study process questionnaire (R-SPQ-2F) for exploring medical students' approaches to learning in Qatar and identify how factors like gender, age, educational attainment, and prior experience with health care influence students' adoption of deep approaches to learning.

METHODS

The sample consisted of 108 medical students (44% male, 56% female) from all four years of medical school at Weill Cornell Medicine-Qatar (WCM-Q). Participants completed the 20-item R-SPQ-2F questionnaire to measure their learning approaches through a structural model contrasting deep and surface learning. Participants also completed a survey collecting demographic information.

RESULTS

Statistical analysis revealed significant differences in deep learning approaches across year levels for both men and women. Additionally, educational attainment played a significant role in students' approaches to learning.

CONCLUSIONS

Based on structural equation modeling, this cross-verification study supports the R-SPQ-2F instrument and offers additional evidence for its robustness and application to medical education. These findings may help educational and program leaders in Qatar better understand medical students' learning approaches to enhance their pedagogical practices.

Identifying and articulating the student experience in the Intercalated Enrichment Year

BACKGROUND

Benefits of intercalation during an undergraduate medical degree are well-recognized. The University of Hong Kong implemented a compulsory Enrichment Year (EY) in its Bachelor of Medicine and Bachelor of Surgery degree programme (MBBS) in 2016. In their third year of study, students could work on an area of interest in any of three programme categories (i) intercalation/ university exchange (IC); (ii) research (RA); (iii) service/ humanitarian work (SH). This study aimed to explore the barriers, enablers, and overall student learning experiences from the first cohort of EY students in order to inform future development of the EY.

METHODS

An exploratory sequential mixed-method study in 2019-20. Twenty students were purposively selected to attend three semi-structured focus group interviews. Conventional thematic analysis was employed and results assisted the design of a cross-sectional questionnaire. Sixty-three students completed the questionnaire. ANOVA or chi-square test was used to compare the difference in student's characteristics, barriers, enablers and perspectives on EY between programme categories. Adjusting student's characteristics, logistic regressions were conducted to identify the effect of programme categories on the EY experience.

RESULTS

Most students (95% in the questionnaire) agreed that EY was worthwhile and more rewarding than expected. EY was positively regarded for enhancing personal growth and interpersonal relationships. The main barriers were financial difficulties, scholarship issues and insufficient information beforehand. A few students had practical (i.e. accommodation, cultural adaptation) problems. Potential enablers included better financial support, more efficient information exchange and fewer assignments and preparation tasks. Similar barriers were encountered by students across all three categories of EY activities.

CONCLUSIONS

Personal growth was the most important benefit of the EY. Barriers were consistent with those identified in the literature except for cultural adaptation, which could be related to Hong Kong's unique historical context. Financial limitation was the most concerning barrier, as it could result in unequal access to educational opportunities. Better and timely access to scholarships and other funding sources need to be considered.

TRIAL REGISTRATION

Ethics approval was obtained from the local Institutional Review Board of The University of Hong Kong/Hospital Authority Hong Kong West Cluster (UW 19-585 ).

Black, White and Gray: Student Perspectives on Medical Humanities and Medical Education

ISSUE

In recent years, the value and relevance of humanities-based teaching in medical education have become more widely acknowledged. In many medical schools this has prompted additions to curricula that allow students to explore the gray-as opposed to the black and white-areas of medicine through arts, humanities, and social sciences. As curricula have expanded and diversified in this way, both medical educators and students have begun to ask: what is the best way to teach medical humanities?

EVIDENCE

In this article, five current medical students reflect on their experiences of medical humanities teaching through intercalated BSc programmes in the UK. What follows is a broad exploration of how the incorporation of medical humanities into students' time at university can improve clinical practice where the more rigid, objective-driven, model of medicine falls short.

IMPLICATIONS

This article reinforces the merit of moving beyond a purely biomedical model of medical education. Using the student voice as a vector for critique and discussion, we provide a starting point for uncovering the path toward true integration of humanities-style teaching into medical school curricula.

Virtual Interview, Real Anxiety: Prospective Evaluation of a Focused Teaching Programme on Confidence Levels Among Medical Students Applying for Academic Clinical Posts

BACKGROUND

In 2020, final year medical students applying for the United Kingdom's competitive academic training posts face an additional challenge because interviews are conducted online rather than in-person. We assessed how this new format influences anxiety and the impact of a targeted course on candidates' confidence levels.

METHODS

A mixed-methods national teaching programme including online bespoke mock interviews was delivered to prospective Academic Foundation Programme applicants. Pre- and post-interview questionnaires assessed anxiety levels subjectively and using a Measure of Anxiety in Selection Interviews (MASI) scores.

RESULTS

Individuals self-reported greater confidence, experience and preference for interviews delivered in-person as compared to online interviews. Post-course, there was an increase in self-reported confidence specific to online interviews (p = 0.009) and lower MASI scores in three of five domains, indicating reduced anxiety (social anxiety: p = 0.004, performance anxiety: p <0.001, behavioral anxiety: p = 0.003).

CONCLUSION

A structured course can increase confidence and reduce anxiety for online academic medicine interviews.

The impact of research intercalation during medical school on post-graduate career progression

BACKGROUND

Medical students at The University of Manchester have the option of research intercalation on the Master of Research programme. There is a paucity of evidence for the benefits of research intercalation. However, we hypothesised that research intercalation would accelerate post-graduate career progression and aimed to objectively measure the career enhancing impact, quantify the benefits and determine the alumni perception of research intercalation.

METHODS

Data was collected retrospectively by electronic questionnaire (in 2018) from those commencing research intercalation between 2005 and 2012.

RESULTS

Participants (n=52) returned questionnaires (68% response), demonstrating that the cohort had completed 67 postgraduate qualifications, published 304 manuscripts (median 3 publications per person (PP); range: 0-53) and made 430 presentations (median 7 PP; range: 0-37). Alumni had been awarded 49 research grants; funding disclosed on 43% totalled £823,000. Career progression of 73% of alumni had taken the minimum number of years; 27% took longer due to time spent working abroad or to gain additional experience prior to specialty training. Fifty-five publications and 71 presentations were directly related to MRes projects.

CONCLUSION

Research intercalation provides graduates with an opportunity to learn valuable transferrable skills, contribute to translational research, and objectively enhances medical career progression.

Students' Perceived Benefits of Integrating a BSc in Health Sciences within a Medical Degree at Sultan Qaboos University

Objectives

After completing the pre-clinical phase of a Doctor of Medicine (MD) curriculum, undergraduate medical students may choose to add a Bachelor of Science (BSc) degree in health sciences to their MD degree. Limited data exists on the motives behind students' decisions to undertake such intercalated degrees. Hence, this study aimed to identify the factors that influence students in making this choice.

Methods

Undergraduate students who chose the research-based academic track of the intercalated phase of the BSc programme at the College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman, between 2014-2018 were enrolled. A standardised and validated self-explanatory questionnaire examining motivations to join the intercalated phase was administered to all students in the first week of enrolment.

Results

Over a five-year period, out of 557 eligible students, 18 (3%) were enrolled in the intercalated phase and all completed the questionnaire. The mean age was 22 ± 1.5 years and the majority (83%) were female. Out of the 18 students, 10 (55%) had taken the university's foundation programme. A total of 45% of students chose to intercalate out of their own interest, regardless of career ambitions. The main reasons to intercalate were an opportunity to enhance research experience, alignment with long-term career goals and a chance to publish in indexed journals.

Conclusion

Despite the benefits of obtaining an additional degree, a relatively small proportion of MD students were attracted to the intercalated phase. A better presentation of the BSc degree is needed to help students make a more informed decision.

Effect of an intercalated research degree on general practice careers: a matched cohort study

INTRODUCTION Intercalated degrees are one of the most focused undergraduate research training activities offered to medical students worldwide. The effect of intercalating on actual career choices has not been previously investigated. AIM To examine the effect of obtaining an intercalated research degree on choosing general practice as a career. METHODS This was a retrospective, matched cohort study of intercalating students at the University of Otago, New Zealand (1995-2008). Medical students who completed the intercalated Bachelor of Medical Sciences with Honours, BMedSc(Hons), degree were retrospectively identified. Gender- and graduation year-matched controls were identified from a publicly available graduate database in a 1:1 ratio. MEDLINE® and Google Scholar-indexed publications resulting from BMedSc(Hons) projects were determined using standardised search criteria. Speciality choice was obtained from online lists of registered doctors. RESULTS Over the 14-year period, 99 (3.9%) students completed an intercalated degree with a publication rate of 36.4%. Of these, 42 (42.4%) were female and over two-thirds (68.7%) of projects were laboratory-based. The median follow-up period after graduation was 14 years (range 7.7-21.7 years). The congruence between students' BMedSc(Hons) research subject area and clinical speciality was 9.1%. Sixteen (16.2%) intercalating students chose general practice as a career, whereas 83 (83.8%) chose 19 different hospital-based specialties. Compared to controls, students who completed an intercalated degree were significantly less likely to pursue a career in general practice (odds ratio 0.37; 95% confidence interval=0.18 - 0.77; P=0.007). DISCUSSION The present study findings suggest that completing an intercalated degree is associated with lower odds of pursuing a career in general practice. Future research should explore reasons for this observation to help develop strategies to promote primary care and general practice careers among medical graduates, including those interested in research careers.

A 5-year retrospective evaluation of undergraduate dental research projects in a Nigerian University: Graduates' perceptions of their learning experiences

INTRODUCTION

Undergraduate research projects have never been evaluated despite six decades of dental training in Nigeria. This study evaluated dental graduates' perceptions of the research project from 2013 to 2017.

METHODS

A cohort of 93 graduates from a Nigerian University was investigated through the use of self-administered questionnaires on a Google form platform. Analysis was done using descriptive and analytical statistics on SPSS version 16. Statistical significant level was set at P < .05.

RESULTS

The cohort showed a very good understanding of research project objectives during their undergraduate training with more male and older students independently choosing their research topics (P > .05). Students' research topics were changed by supervisors in about one-quarter and one-tenth of the male and female students, respectively. About one-third of the students met set deadlines with no significant differences amongst gender and age groups (P > .05). However, only two-thirds of the students submitted their projects before the deadline due to other contending academic works. More males and older age group sought assistance from other academic staff for information on their projects. About one-half of the students reportedly acquired additional knowledge as a direct benefit from the project. Of all the variables associated with the research project, only the level of preparedness to undertake the project was highly statistically significant (P < .05) and this varied significantly amongst gender and age group (P < .05).

CONCLUSION

The students demonstrated a good understanding of research project. The perceived level of preparedness to undertake the project was low but significantly higher in male and older age groups.

To examine the associations between medical students' conceptions of learning, strategies to learning, and learning outcome in a medical humanities course

BACKGROUND

By learning medical humanities, medical students are expected to shift from handling the diseases only to seeing a whole sick person. Therefore, understanding medical students' learning process and outcomes of medical humanities becomes an essential issue of medical education. Few studies have been conducted to explore factors surrounding medical students' learning process and outcomes of medical humanities. The objectives were: (1) to investigate the relationships between medical students' conceptions of learning and strategies to learning; and (2) to examine the relationships between students' strategies to learning and learning outcomes for medical humanities.

METHODS

We used the modified Approaches to Learning Medicine (mALM) questionnaire and Conceptions of Learning Medicine (COLM) questionnaire to measure the medical students' strategies to learning and conceptions of learning respectively. The learning outcome of medical humanities was measured using students' weighted grade in a medical humanities course. The confirmatory factor analysis (CFA) was used to validate the COLM and mALM questionnaires, in which construct validity and reliability were assessed. Pearson's correlation was used to examine the relationships among the factors of COLM, mALM, and the weighted grade. Path analysis using structural equation modeling technique (SEM) was employed to estimate the structural relationships among the COLM, mALM, and the weighted grade.

RESULTS

Two hundred and seventy-five first-year medical students consented to participate in this study. The participants adopting surface strategies to learning were more likely to have unsatisfactory learning outcome (β = - 0.14, p = .04). The basic-level conception of "Preparing for Testing" was negatively (β = - 0.19, p < .01) associated with deep strategies of learning, and positively (β = 0.48, p < .01) associated with surface strategies of learning (β = 0.50, p < .01). The basic-level conception of "Skills Acquisition" was positively associated with deep strategies of learning (β = 0.23, p < .01).

CONCLUSION

Medical educators should wisely employ teaching strategies to increase students' engagement with deep and self-directed learning strategies, and to avoid using surface learning strategies in the medical humanities course in order to achieve better learning outcomes.

What difference can a year make? Findings from a survey exploring student, alumni and supervisor experiences of an intercalated degree in emergency care

BACKGROUND

One third of UK medical students undertake an intercalated degree, typically in traditional academic disciplines. It is less usual for students to undertake intercalated degrees that are directly aligned to a clinical speciality with longitudinal placements. This cross sectional survey aims to explore the self-reported experiences of students, alumni and supervisors associated with a clinically oriented intercalated degree in emergency care featuring a longitudinal placement in a hospital emergency department over a 9-month academic year. Themes for exploration include student clinical and academic development, effect on career choice, supervisor experience and the effect on host institutions.

METHODS

Current students, previous alumni, and clinical placement supervisors associated with a single intercalated degree programme in urgent and emergency care since 2005 were identified from records and using social media. Separate online surveys were then developed and distributed to current students/ previous alumni and consultant physician supervisors, between May and August 2016. Results are presented using basic descriptive statistics and selected free text comments.

RESULTS

Responses were obtained from 37 out of 46 contactable students, and 14 out of 24 supervisors (80 and 63%, respectively). Students self-reported increased confidence in across a range of clinical and procedural competencies. Supervisors rated student competence in clinical, inter-professional and academic writing skills to be commensurate with, or in many cases exceeding, the level expected of a final year medical student. Supervisors reported a range of benefits to their own professional and personal development from supervising students, which included improved teaching and mentoring skills, providing intellectual challenge, and helping with the completion of audits and service improvement projects.

CONCLUSIONS

Students report the acquisition of a range of clinical, academic, and inter-professional skills following their intercalated BSc year. A positive experience was reported by supervisors, extending to host institutions. Students reported feeling more enthusiastic about emergency medicine careers on completion. However, as students embarking on this degree naturally bring pre-existing interest in the area, it is not possible to attribute causation to these associations. Further investigation is also required to determine the longer term effect of clinically oriented intercalated degrees on career choice.

An Analysis of Medical Students' Attitude and Motivation in Pursuing an Intercalated MSc in Clinical Anatomy

OBJECTIVES

This study aimed to explore what factors influence and motivate medical students to undergo an intercalated degree and why they prefer to choose an intercalated MSc in Clinical Anatomy.

METHODS

The study consisted of 54 medical students enrolled in Queen's University Belfast which offers a range of intercalated degrees, including an iBSc in Medical Science and an iMSc in Clinical Anatomy. Five-point Likert scale survey was used to collect data, designed to discover what the influencing factors were in deciding to take an intercalating degree and if they have a desire to gain research experience. It measured the motivational features of their chosen courses.

RESULTS

In recent years, more students (68.5%, n = 54) opted for the iMSc rather than the iBSc. This difference in number of students was statistically significant (chi-square = 33.4, P < 0.0001). It was theorized that this was due to an interest in future surgical specialization; however, this study has shown that the prime reason 72.2% of students opt to take a year out of their medical degree to carry out an intercalated degree is simply to gain an extra qualification whilst 61.1% thought it would enhance their competitiveness in the job market. Ninety-four percent of the iMSc students recommended the intercalated degree to junior students in comparison to only 34.8% of the iBSc students. This difference in percentage was statistically significant (t = 2.78, P = 0.009).

CONCLUSION

The study shows no significant link to a desire to gain research experience in determining which intercalated programme to undertake. Students favoured iMSc more because they believed it will enhance their employability.

Dissemination of results from medical student public health research training and factors associated with publication

Purpose

To examine factors associated with successful publications resulting from mandatory public health research training attachment, the Trainee Intern Health Care Evaluation (TIHE) projects, at the University of Otago, Dunedin School of Medicine, New Zealand.

Methods

A total of 227 TIHE projects completed during the period from January 1985 to December 2013 were included in the study. In February 2016, Medline and Google Scholar databases were searched independently by both authors for publications using predefined search criteria.

Results

Overall, 25 (11.1%) out of 227 projects resulted in 19 articles, 3 conference presentations/abstracts and 4 cited report abstracts. Nineteen (8.4%) projects resulted in 22 peer-reviewed journal publications, the majority of which were original articles (86.4%). The number of projects commissioned by a client was independently associated with the likelihood of publication, conference abstract or citation of the project report (OR 1.40; P<0.01, 95% CI 1.14 to 1.71). The number of authors and the number of non-student authors were positively associated with publication in higher impact journals, while student first-authored articles were more likely to be published in lower impact journals. Projects completed in more recent years were more likely to be published.

Conclusions

Mandatory medical student research experiences promote tangible research output. These findings may help to influence policy around the introduction of required medical school research and facilitate encouraging academic careers among medical students. Future research could focus on examining how different student-related, supervisor-related and programme-related factors influence publication rates from mandatory medical student research attachments.

Dual Degrees in Medicine: Options for Medical Students

Increasingly, more universities are showing an interest in offering combined degrees (most commonly research-based) with their medical degree. Intercalated degrees often require the medical student to take time off their medical course in order to pursue the second degree full-time. Concurrent degrees, on the other hand, do not usually require taking additional time to complete; rather, they are integrated into the medical curriculum. Exposing medical students to the array of opportunities offered by their academic institutions will hopefully allow interested students to pursue studies in an area of their preference, at a pace of their own and for a cost (time and financial) they could afford. This article explores the different degrees offered around the world to students in combination with medical degrees.

Carry on shrinking: career intentions and attitudes to psychiatry of prospective medical students

Aims and Method

There is a shortage of doctors in the UK, particularly in psychiatry and pathology. Little is known about prospective medical students' career intentions or attitudes. This study aimed to report on the career intentions and attitudes to psychiatry of 819 attenders at a sixth-form conference for prospective medical students.

Results

A much higher proportion of students expressed favourable attitudes to psychiatry as a career than might have been expected. The most popular career was paediatrics and the least popular was genitourinary medicine.

IMPLICATIONS

Medical schools need to be proactive in providing information, career advice and positive role models. This may counteract negative propaganda and encourage career choice in tune with students' earlier feelings and patients' needs.

The influence of early research experience in medical school on the decision to intercalate and future career in clinical academia: a questionnaire study

BACKGROUND

Currently, only one in three UK medical students undertake an intercalated degree. This has often been implicated as a result of financial obstacles or a lack of interest in research due to inadequate exposure to academic medicine. The aims of this study were to determine whether exposure to research early in medical school, through the initiation of an early years clinical academic training programme has a positive influence on the decision-making related to intercalating and a career long interest in research. This study also aims to evaluate the perceived views of the recipients of such a scholarship programme.

METHODS

All previous recipients of the Aberdeen Summer Research Scholarship (ASRS) (n = 117) since its inception in 2010 until 2015 were invited via email in June 2016, to take part in the survey. Data were analysed using SPSS for quantitative data and a thematic approach was used to derive themes from free text.

RESULTS

The overall response rate was 56% (66/117). Of the respondents, seven received the scholarship twice. Seventy-three percent were still at medical school and 26% were foundation doctors. One respondent indicated that they were currently not in training. Seventy percent of respondents have continued to be involved in research since completing the scholarship. Fifty percent embarked on an intercalated degree following the ASRS. Furthermore, two thirds of the respondents who were undecided about undertaking an intercalated degree before the scholarship, chose to intercalate after completing the programme. ASRS was generally thought of as a positive, influential programme, yet the success of individual ASRS projects was dependent on the allocated supervisors and the resources available for specific projects.

CONCLUSIONS

Our findings indicate that early research exposure in medical school can provide students with a positive influence on involvement in research and allows students to make an informed decision about embarking on an intercalated degree. We therefore recommend the encouragement of similar programmes in medical schools to promote clinical academia at an early stage for medical students.

Student experiences and perceptions of compulsory research projects: a veterinary perspective

Background

Although research underpins clinical work, many students training to be clinicians are not inherently interested in developing research skills.

Aim

To characterise and understand veterinary student experiences and perceptions of compulsory research projects.

Methods

This was an explanatory sequential mixed-methods study, with a questionnaire survey of an entire cohort informing purposive selection for focus group discussions. Student views were triangulated with staff questionnaire data.

Results

About a third of the cohort felt that the project had not been worthwhile or had not fostered useful skills. Focus group data analysis identified fragility of motivation and lack of clear schemata for the research process as key themes. Students were easily demotivated by typical research challenges and lack of schemata contributed to a poor understanding of the rationale for the project, encouraging highly extrinsic forms of motivation. Triangulation with staff questionnaire data indicated that staff understood students’ challenges, but were more likely than students to consider it to be a valuable learning experience.

Conclusions

Findings support ongoing curriculum development and emphasise that, to optimise motivation, engagement and learning, students training to be clinicians need a clear rationale for research, based on development of critical inquiry skills as a core clinical competency.

Why apply for an intercalated research degree?

Intercalated degrees are commonly undertaken as part of the medical undergraduate course. In this article, we discuss the advantages and disadvantages of intercalation, along with alternatives that could be considered.

Research involvement among undergraduate health sciences students: a cross-sectional study

BACKGROUND

The development of research capacity among undergraduates is an important intervention in countering the documented decrease in medical and health sciences researchers. The literature on undergraduate research generally emanates from smaller scale studies that have been conducted in high income countries, with a focus on medical students. This cross-sectional study was conducted in a Sub-Saharan country, included a population of medical and allied health professions (AHP) students, and aimed to improve our understanding of the factors influencing undergraduate student research.

METHODS

A questionnaire was distributed to all students enrolled in an undergraduate programme at the Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa (including Medicine and four AHP programmes). Data was collected on a number of demographic characteristics and on 3 major outcome-themes: "voluntary research involvement", "self-perceived research competence" and "future research participation". Associations between characteristics and outcome themes were explored.

RESULTS

In total, 1815 students participated in the study (response rate 80.2%). Of all the demographic variables, discipline (AHP programmes vs. Medicine), male gender and prior undergraduate experience in a science degree were significantly associated with voluntary research involvement. Significantly higher levels of self-perceived research competence and greater interest in future research participation, were seen among participants from AHP programmes; males; and those with previous or current voluntary research involvement. Ethnicity and geographic background were not significantly associated with any of our outcomes.

CONCLUSIONS

Our results offer important new evidence in support of the imperative to diversify the research work-force, in Sub-Saharan Africa and globally. Enhanced efforts aimed at achieving better academic representation in terms of gender, ethnicity, geographical and socio-economic backgrounds are strengthened by the findings of this study. Potential student researchers represent an important group amenable to further intervention. Further research may be required to explore the factors that determine the progression from interest to future participation in research.

Medical research and audit skills training for undergraduates: an international analysis and student-focused needs assessment

INTRODUCTION

Interpreting, performing and applying research is a key part of evidence-based medical practice, however, incorporating these within curricula is challenging. This study aimed to explore current provision of research skills training within medical school curricula, provide a student-focused needs assessment and prioritise research competencies.

METHODS

A international, cross-sectional survey of final year UK and Irish medical students was disseminated at each participating university. The questionnaire investigated research experience, and confidence in the Medical Education in Europe (MEDINE) 2 consensus survey research competencies.

RESULTS

Fully completed responses were received from 521 final year medical students from 32 medical schools (43.4% male, mean age 24.3 years). Of these, 55.3% had an additional academic qualification (49.5% Bachelor's degree), and 38.8% had been a named author on an academic publication. Considering audit and research opportunities and teaching experience, 47.2% reported no formal audit training compared with 27.1% who reported no formal research training. As part of their medical school course, 53.4% had not performed an audit, compared with 29.9% who had not participated in any clinical or basic science research. Nearly a quarter of those who had participated in research reported doing so outside of their medical degree course. Low confidence areas included selecting and performing the appropriate statistical test, selecting the appropriate research method, and critical appraisal. Following adjustment, several factors were associated with increased confidence including previous clinical research experience (OR 4.21, 2.66 to 6.81, P<0.001), additional degrees (OR 2.34, 1.47 to 3.75, P<0.001), and male gender (OR 1.90, 1.25 to 2.09, P=0.003). Factors associated with an increase in perceived opportunities included formal research training in the curriculum (OR 1.66, 1.12 to 2.46, P=0.012), audit skills training in the curriculum (OR 1.52, 1.03 to 2.26, P= 0.036) and research methods taught in a student selected component (OR 1.75, 1.21 to 2.54, P=0.003).

DISCUSSION

Nearly one-third of students lacked formal training on undertaking research, and half of students lacked formal audit training and opportunities to undertake audit as part of their medical school course. The presence of research training in the cirriculum was associated with an increase in perceived opportunities to participate in MEDINE2 research competencies. Female gender and a lack of previous research experience were significant factors influencing confidence and participation in research.

Should an intercalated degree be compulsory for undergraduate medical students?

Undertaking an intercalated year whilst at medical school involves taking time out of the medicine undergraduate programme in order to pursue a separate but related degree. It is widely seen as a challenging but rewarding experience, with much to be gained from the independent project or research component of most additional degrees. However, whilst intercalating is encouraged at many universities and is incorporated into some undergraduate curricula, it is by no means compulsory for all students. The literature would suggest that those who have intercalated tend to do better academically, both for the remainder of medical school and after graduating. Despite this, the issue of making intercalation mandatory is one of considerable debate, with counter-arguments ranging from the detrimental effect time taken out of the course can have to the lack of options available to cater for all students. Nonetheless, the research skills developed during an intercalated year are invaluable and help students prepare for taking a critical evidence-based approach to medicine. If intercalated degrees were made compulsory for undergraduates, it would be a step in the right direction. It would mean the doctors of tomorrow would be better equipped to practise medicine in disciplines that are constantly evolving.

Medical Student Research: An Integrated Mixed-Methods Systematic Review and Meta-Analysis

Importance

Despite the rapidly declining number of physician-investigators, there is no consistent structure within medical education so far for involving medical students in research.

Objective

To conduct an integrated mixed-methods systematic review and meta-analysis of published studies about medical students' participation in research, and to evaluate the evidence in order to guide policy decision-making regarding this issue.

Evidence Review

We followed the PRISMA statement guidelines during the preparation of this review and meta-analysis. We searched various databases as well as the bibliographies of the included studies between March 2012 and September 2013. We identified all relevant quantitative and qualitative studies assessing the effect of medical student participation in research, without restrictions regarding study design or publication date. Prespecified outcome-specific quality criteria were used to judge the admission of each quantitative outcome into the meta-analysis. Initial screening of titles and abstracts resulted in the retrieval of 256 articles for full-text assessment. Eventually, 79 articles were included in our study, including eight qualitative studies. An integrated approach was used to combine quantitative and qualitative studies into a single synthesis. Once all included studies were identified, a data-driven thematic analysis was performed.

Findings and Conclusions

Medical student participation in research is associated with improved short- and long- term scientific productivity, more informed career choices and improved knowledge about-, interest in- and attitudes towards research. Financial worries, gender, having a higher degree (MSc or PhD) before matriculation and perceived competitiveness of the residency of choice are among the factors that affect the engagement of medical students in research and/or their scientific productivity. Intercalated BSc degrees, mandatory graduation theses and curricular research components may help in standardizing research education during medical school.

Promoting research and audit at medical school: evaluating the educational impact of participation in a student-led national collaborative study

BACKGROUND

Medical students often struggle to engage in extra-curricular research and audit. The Student Audit and Research in Surgery (STARSurg) network is a novel student-led, national research collaborative. Student collaborators contribute data to national, clinical studies while gaining an understanding of audit and research methodology and ethical principles. This study aimed to evaluate the educational impact of participation.

METHODS

Participation in the national, clinical project was supported with training interventions, including an academic training day, an online e-learning module, weekly discussion forums and YouTube® educational videos. A non-mandatory, online questionnaire assessed collaborators' self-reported confidence in performing key academic skills and their perceptions of audit and research prior to and following participation.

RESULTS

The group completed its first national clinical study ("STARSurgUK") with 273 student collaborators across 109 hospital centres. Ninety-seven paired pre- and post-study participation responses (35.5%) were received (male = 51.5%; median age = 23). Participation led to increased confidence in key academic domains including: communication with local research governance bodies (p < 0.001), approaching clinical staff to initiate local collaboration (p < 0.001), data collection in a clinical setting (p < 0.001) and presentation of scientific results (p < 0.013). Collaborators also reported an increased appreciation of research, audit and study design (p < 0.001).

CONCLUSIONS

Engagement with the STARSurg network empowered students to participate in a national clinical study, which increased their confidence and appreciation of academic principles and skills. Encouraging active participation in collaborative, student-led, national studies offers a novel approach for delivering essential academic training.

The Academic Backbone: longitudinal continuities in educational achievement from secondary school and medical school to MRCP(UK) and the specialist register in UK medical students and doctors

BACKGROUND

Selection of medical students in the UK is still largely based on prior academic achievement, although doubts have been expressed as to whether performance in earlier life is predictive of outcomes later in medical school or post-graduate education. This study analyses data from five longitudinal studies of UK medical students and doctors from the early 1970s until the early 2000s. Two of the studies used the AH5, a group test of general intelligence (that is, intellectual aptitude). Sex and ethnic differences were also analyzed in light of the changing demographics of medical students over the past decades.

METHODS

Data from five cohort studies were available: the Westminster Study (began clinical studies from 1975 to 1982), the 1980, 1985, and 1990 cohort studies (entered medical school in 1981, 1986, and 1991), and the University College London Medical School (UCLMS) Cohort Study (entered clinical studies in 2005 and 2006). Different studies had different outcome measures, but most had performance on basic medical sciences and clinical examinations at medical school, performance in Membership of the Royal Colleges of Physicians (MRCP(UK)) examinations, and being on the General Medical Council Specialist Register.

RESULTS

Correlation matrices and path analyses are presented. There were robust correlations across different years at medical school, and medical school performance also predicted MRCP(UK) performance and being on the GMC Specialist Register. A-levels correlated somewhat less with undergraduate and post-graduate performance, but there was restriction of range in entrants. General Certificate of Secondary Education (GCSE)/O-level results also predicted undergraduate and post-graduate outcomes, but less so than did A-level results, but there may be incremental validity for clinical and post-graduate performance. The AH5 had some significant correlations with outcome, but they were inconsistent. Sex and ethnicity also had predictive effects on measures of educational attainment, undergraduate, and post-graduate performance. Women performed better in assessments but were less likely to be on the Specialist Register. Non-white participants generally underperformed in undergraduate and post-graduate assessments, but were equally likely to be on the Specialist Register. There was a suggestion of smaller ethnicity effects in earlier studies.

CONCLUSIONS

The existence of the Academic Backbone concept is strongly supported, with attainment at secondary school predicting performance in undergraduate and post-graduate medical assessments, and the effects spanning many years. The Academic Backbone is conceptualized in terms of the development of more sophisticated underlying structures of knowledge ('cognitive capital' and 'medical capital'). The Academic Backbone provides strong support for using measures of educational attainment, particularly A-levels, in student selection.

Construct-level predictive validity of educational attainment and intellectual aptitude tests in medical student selection: meta-regression of six UK longitudinal studies

BACKGROUND

Measures used for medical student selection should predict future performance during training. A problem for any selection study is that predictor-outcome correlations are known only in those who have been selected, whereas selectors need to know how measures would predict in the entire pool of applicants. That problem of interpretation can be solved by calculating construct-level predictive validity, an estimate of true predictor-outcome correlation across the range of applicant abilities.

METHODS

Construct-level predictive validities were calculated in six cohort studies of medical student selection and training (student entry, 1972 to 2009) for a range of predictors, including A-levels, General Certificates of Secondary Education (GCSEs)/O-levels, and aptitude tests (AH5 and UK Clinical Aptitude Test (UKCAT)). Outcomes included undergraduate basic medical science and finals assessments, as well as postgraduate measures of Membership of the Royal Colleges of Physicians of the United Kingdom (MRCP(UK)) performance and entry in the Specialist Register. Construct-level predictive validity was calculated with the method of Hunter, Schmidt and Le (2006), adapted to correct for right-censorship of examination results due to grade inflation.

RESULTS

Meta-regression analyzed 57 separate predictor-outcome correlations (POCs) and construct-level predictive validities (CLPVs). Mean CLPVs are substantially higher (.450) than mean POCs (.171). Mean CLPVs for first-year examinations, were high for A-levels (.809; CI: .501 to .935), and lower for GCSEs/O-levels (.332; CI: .024 to .583) and UKCAT (mean = .245; CI: .207 to .276). A-levels had higher CLPVs for all undergraduate and postgraduate assessments than did GCSEs/O-levels and intellectual aptitude tests. CLPVs of educational attainment measures decline somewhat during training, but continue to predict postgraduate performance. Intellectual aptitude tests have lower CLPVs than A-levels or GCSEs/O-levels.

CONCLUSIONS

Educational attainment has strong CLPVs for undergraduate and postgraduate performance, accounting for perhaps 65% of true variance in first year performance. Such CLPVs justify the use of educational attainment measure in selection, but also raise a key theoretical question concerning the remaining 35% of variance (and measurement error, range restriction and right-censorship have been taken into account). Just as in astrophysics, 'dark matter' and 'dark energy' are posited to balance various theoretical equations, so medical student selection must also have its 'dark variance', whose nature is not yet properly characterized, but explains a third of the variation in performance during training. Some variance probably relates to factors which are unpredictable at selection, such as illness or other life events, but some is probably also associated with factors such as personality, motivation or study skills.

Construct-level predictive validity of educational attainment and intellectual aptitude tests in medical student selection: meta-regression of six UK longitudinal studies

BACKGROUND

Measures used for medical student selection should predict future performance during training. A problem for any selection study is that predictor-outcome correlations are known only in those who have been selected, whereas selectors need to know how measures would predict in the entire pool of applicants. That problem of interpretation can be solved by calculating construct-level predictive validity, an estimate of true predictor-outcome correlation across the range of applicant abilities.

METHODS

Construct-level predictive validities were calculated in six cohort studies of medical student selection and training (student entry, 1972 to 2009) for a range of predictors, including A-levels, General Certificates of Secondary Education (GCSEs)/O-levels, and aptitude tests (AH5 and UK Clinical Aptitude Test (UKCAT)). Outcomes included undergraduate basic medical science and finals assessments, as well as postgraduate measures of Membership of the Royal Colleges of Physicians of the United Kingdom (MRCP(UK)) performance and entry in the Specialist Register. Construct-level predictive validity was calculated with the method of Hunter, Schmidt and Le (2006), adapted to correct for right-censorship of examination results due to grade inflation.

RESULTS

Meta-regression analyzed 57 separate predictor-outcome correlations (POCs) and construct-level predictive validities (CLPVs). Mean CLPVs are substantially higher (.450) than mean POCs (.171). Mean CLPVs for first-year examinations, were high for A-levels (.809; CI: .501 to .935), and lower for GCSEs/O-levels (.332; CI: .024 to .583) and UKCAT (mean = .245; CI: .207 to .276). A-levels had higher CLPVs for all undergraduate and postgraduate assessments than did GCSEs/O-levels and intellectual aptitude tests. CLPVs of educational attainment measures decline somewhat during training, but continue to predict postgraduate performance. Intellectual aptitude tests have lower CLPVs than A-levels or GCSEs/O-levels.

CONCLUSIONS

Educational attainment has strong CLPVs for undergraduate and postgraduate performance, accounting for perhaps 65% of true variance in first year performance. Such CLPVs justify the use of educational attainment measure in selection, but also raise a key theoretical question concerning the remaining 35% of variance (and measurement error, range restriction and right-censorship have been taken into account). Just as in astrophysics, 'dark matter' and 'dark energy' are posited to balance various theoretical equations, so medical student selection must also have its 'dark variance', whose nature is not yet properly characterized, but explains a third of the variation in performance during training. Some variance probably relates to factors which are unpredictable at selection, such as illness or other life events, but some is probably also associated with factors such as personality, motivation or study skills.

The educational impact of assessment: a comparison of DOPS and MCQs

AIM

To evaluate the impact of two different assessment formats on the approaches to learning of final year veterinary students. The relationship between approach to learning and examination performance was also investigated.

METHOD

An 18-item version of the Study Process Questionnaire (SPQ) was sent to 87 final year students. Each student responded to the questionnaire with regards to DOPS (Direct Observation of Procedural Skills) and a Multiple Choice Examination (MCQ). Semi-structured interviews were conducted with 16 of the respondents to gain a deeper insight into the students' perception of assessment.

RESULTS

Students' adopted a deeper approach to learning for DOPS and a more surface approach with MCQs. There was a positive correlation between an achieving approach to learning and examination performance. Analysis of the qualitative data revealed that deep, surface and achieving approaches were reported by the students and seven major influences on their approaches to learning were identified: motivation, purpose, consequence, acceptability, feedback, time pressure and the individual difference of the students.

CONCLUSIONS

The format of DOPS has a positive influence on approaches to learning. There is a conflict for students between preparing for final examinations and preparing for clinical practice.

Impact of an intercalated BSc on medical student performance and careers: a BEME systematic review: BEME Guide No. 28

INTRODUCTION

Intercalated BScs (iBScs) are an optional part of undergraduate (UG) medicine courses in UK, Eire, Australia, New Zealand, the West Indies, Hong Kong, South Africa and Canada, consisting of advanced study into a particular field of medicine, often combined with research. They potentially improve students' skills and allow exploration of specific areas of interest. They are, however, expensive for institutions and students and delay workforce entry. There is conflicting evidence about their impact.

METHODS

A mixed-method systematic review (meta-analysis and critical interpretive synthesis) of the biomedical and educational literature, focusing on the impact of iBScs on UG performance, skills, and career choice, and to explore students' and other stakeholders' opinions about iBScs.

RESULTS

In the meta-analytic part of this review, we identified five studies which met our predetermined quality criteria. For UG performance, two studies using different methodologies report an improvement in UG performance; one study reported an Odds Ratio [OR] of 3.58 [95% CI 1.47-8.83] and the second reported a significant improvement in finals scores (1.27 points advantage 95% CI 0.52-2.02). One study reported a mixed result, while two studies showed no improvement. Regarding skills and attitudes, one paper suggested iBScs lead to the development of deeper learning styles. With regard to subsequent careers, two studies suggested that for those students undertaking an iBSc there is an increased chance following an academic career [ORs of 3.6 (2.3-5.8) to 5.94 (3.6-11.5)]. Seven of eight studies (with broader selection criteria) reported that iBSc students were less likely to pursue GP careers (ORs no effect to 0.17 [0.07-0.36]). Meta-analysis of the data was not possible. In the critical interpretative synthesis analysis, we identified 46 articles, from which three themes emerged; firstly, the decision to undertake an iBSc, with students receiving conflicting advice; secondly, the educational experience, with intellectual growth balanced against financial costs; finally, the ramifications of the iBSc, including some suggestion of improved employment prospects and the potential to nurture qualities that make "better" doctors.

CONCLUSION

Intercalated BScs may improve UG performance and increase the likelihood of pursuing academic careers, and are associated with a reduced likelihood of following a GP career. They help students to develop reflexivity and key skills, such as a better understanding of critical appraisal and research. The decision to undertake an iBSc is contentious; students feel ill-informed about the benefits. These findings could have implications for a variety of international enrichment programmes.

Assessing health care students' intentions and motivations for learning: the Healthcare Learning and Studying Inventory (HLSI)

Inventories that measure approaches to learning have revealed that certain approaches are associated with better academic performance. However, these inventories were developed primarily with higher education students on non-vocational courses and recent research shows they fail to capture the full range of healthcare students' intentions and motivations for learning. To develop a new inventory measuring approaches to learning that addresses these shortfalls and is relevant to students on vocational courses in healthcare. In depth interviews with healthcare students were performed to understand the full range of healthcare students' intentions and motivations. The data were used to create a draft inventory, which was reviewed by interview participants and then tested with medical students. The final inventory was piloted with 303 healthcare students across six disciplines. Exploratory factor analysis was used to identify groups of related items within the inventory. The research produced a 32 item scale based on rich qualitative data, with a four factor structure and good internal consistency. A desire to link theory and practice was a distinctive feature of healthcare students. The new inventory contains nuanced items that enable a better understanding of their common and distinctive intentions and motivations. This study suggests that healthcare student populations have some unique intentions and motivations for learning and therefore require a bespoke inventory to ensure that important aspects are not missed. It offers a new tool for meaningful future research, the Healthcare Learning and Studying Inventory (HLSI).

Twelve tips for teachers to encourage student engagement in academic medicine

BACKGROUND

Recruitment of trainees into clinical academic medicine remains an area of concern across the globe, with clinical academics making up a dwindling proportion of the medical workforce. To date, few approaches have emphasised early medical student research involvement as a solution to the decline of the clinician-scientist.

AIM AND METHOD

We identify 12 tips that all medical teachers can adopt to foster medical student participation in research and encourage student engagement with academic aspects of medicine throughout their time as an undergraduate. These recommendations are based on a comprehensive review of the international literature and our personal experience of research-focussed interventions and activities as medical students.

CONCLUSION

Through these 12 tips, we provide a practical framework for enhancing medical student exposure to research at medical school. This has the potential to inspire and maintain student interest in the varied role of the clinical academic and could contribute to reversing the downward trend that has occurred in this field over recent times.

Is it intelligent to intercalate? A two centre cross-sectional study exploring the value of intercalated degrees, and the possible effects of the recent tuition fee rise in England

AIMS AND OBJECTIVES

To explore the value of intercalated degrees, including student perceptions and academic sequelae. To gauge the likely effect of the recent tuition fee rise and to identify any differences in intercalated degrees between Bristol and Sheffield universities.

DESIGN

Cross-sectional study using questionnaires.

SETTING

Bristol and Sheffield Medical Schools, UK.

PARTICIPANTS

1484 medical students in their clinical years were e-mailed the questionnaire. 578 students responded: 291 from Bristol and 287 from Sheffield (n=578; mean age=22.41; SD 1.944; 38.9% male; 61.1% female). The response rate from previous intercalators was 52.5% from Bristol and 58.7% from Sheffield, while for non-intercalators it was 27.7% and 34.6%, respectively.

MAIN OUTCOME MEASURES

(1) Student preconceptions, opinions, results and academic sequelae from intercalated degrees at both centres. (2) Students' attitudes concerning the effect of the increase in tuition fees.

RESULTS

Those with clinical academic supervisors gained significantly more posters (p=0.0002) and publications (p<0.0001), and also showed a trend to gain more first class honours (p=0.055). Students at Sheffield had a significantly greater proportion of clinical academic supervisors than students at Bristol (p<0.0001). 89.2% said that an intercalated degree was the right decision for them; however, only 27.4% stated they would have intercalated if fees had been £9000 per annum.

CONCLUSIONS

Students clearly value intercalated degrees, feel they gained a substantial advantage over their peers as well as skills helpful for their future careers. The rise in tuition fees is likely to reduce the number of medical students opting to undertake an intercalated degree, and could result in a further reduction in numbers following an academic path. Sheffield University have more intercalating students supervised by clinical academics. Clinical academics appear more effective as supervisors for medical students undertaking an intercalated degree in terms of results and additional academic sequelae.

Extracurricular participation in research and audit by medical students: opportunities, obstacles, motivation and outcomes

BACKGROUND

Medical students should learn to critically evaluate research to inform future evidence-based practice. Participation in research and audit at medical school can help develop these skills whilst prompting interest in academic pursuits.

AIMS

We investigate medical student attitudes and participation in extracurricular research and audit focusing on their opportunities, obstacles, motivation and outcomes.

METHOD

A 60-item questionnaire was distributed to final-year medical students graduating from the University of Nottingham Medical School in the United Kingdom.

RESULTS

A total of 238 questionnaires were returned (response rate 75%). Of these, 86% felt research or audit experience was useful for medical students. The main driver for involvement was curriculum vitae (CV) improvement (51%). Male students and those involved in extracurricular research were more likely to agree that this experience should influence selection into training programmes (p = 0.017, p = 0.0036). Overall, 91 respondents (38%) had been involved in such activity with a mean number of projects undertaken of two (range one to four). Those interested in a surgical career were most likely to have undertaken projects (58%). Frequently cited obstacles to involvement were time constraints (74%) and a perceived lack of interest from potential supervisors (63%).

CONCLUSIONS

Despite significant CV motivation, many are enthusiastic regarding extracurricular research opportunities but frustrated by obstacles faced. Our study suggests there is scope for providing further opportunities to participate in such activities at medical school.

Twelve tips for introducing students to research and publishing: a medical student's perspective

BACKGROUND

Medical students claim to have inadequate opportunities to conduct research, whilst some do not know how to make the initial steps. There is a need for medical educators to not only direct students to research opportunities but also to counsel them on the attitudes required for the student's success in a research environment.

AIM

This article gives educators 12 tips on guidance that might help motivated medical students when starting their research careers. The various opportunities for students to participate in research are also identified.

METHOD

Tips were devised from personal experience and a review of the literature.

RESULTS

The 12 tips are: (1) Educate students on the benefits of research. (2) Encourage students to take the initiative to create opportunities for themselves. (3) Encourage students to undertake extracurricular research. (4) Encourage students to network with other researchers. (5) Encourage students to engage with student-selected components of their courses. (6) Encourage students to apply for summer research programmes. (7) Encourage students to attend scientific conferences. (8) Advise students to consider intercalated degrees. (9) Encourage students to do research during elective placements. (10) Make students aware of the MBPhD courses. (11) Emphasise research as a learning process and reduce focus on output. (12) Advise students to balance their academic and research interests.

CONCLUSIONS

The 12 tips highlight important attitudes for students to take in research as well as highlighting various opportunities for research.

The effect of an intercalated BSc on subsequent academic performance

BACKGROUND

The choice of whether to undertake an intercalated Bachelor of Science (BSc) degree is one of the most important decisions that students must make during their time at medical school. An effect on exam performance would improve a student's academic ranking, giving them a competitive edge when applying for foundation posts.

METHODS

Retrospective data analysis of anonymised student records. The effects of intercalating on final year exam results, Foundation Programme score, application form score (from white-space questions), quartile rank score, and success with securing Foundation School of choice were assessed using linear and ordered logistic regression models, adjusted for course type, year of graduation, graduate status and baseline (Year 1) performance.

RESULTS

The study included 1158 students, with 54% choosing to do an intercalated BSc, and 9.8% opting to do so at an external institution. Doing an intercalated BSc was significantly associated with improved outcome in Year 5 exams (P = 0.004). This was irrespective of the year students chose to intercalate, with no significant difference between those that intercalated after years 2, 3 and 4 (p = 0.3096). There were also higher foundation application scores (P < 0.0001), academic quartile scores (P = 0.0003) and resultant overall foundation scores (P < 0.0001) in intercalated students. These students also had improved success with securing their first choice Foundation School (p = 0.0220). Participants who remained at the institution to intercalate in general performed better than those that opted to intercalate elsewhere.

CONCLUSIONS

Doing an intercalated BSc leads to an improvement in subsequent exam results and develops the skills necessary to produce a strong foundation programme application. It also leads to greater success with securing preferred Foundation School posts in students. Differences between internally- and externally-intercalating students may be due to varying course structures or greater challenge in adjusting to a new study environment.

Vocation and avocation: leisure activities correlate with professional engagement, but not burnout, in a cross-sectional survey of UK doctors

BACKGROUND

Sir William Osler suggested in 1899 that avocations (leisure activities) in doctors are related to an increased sense of vocation (professional engagement) and a decreased level of burnout. This study evaluated those claims in a large group of doctors practicing in the UK while taking into account a wide range of background variables.

METHODS

A follow-up questionnaire was sent to 4,457 UK-qualified doctors who had been included in four previous studies of medical school selection and training, beginning in 1980, 1985, 1990 and 1989/1991. A total of 2,845 (63.8%) doctors returned the questionnaire. Questions particularly asked about work engagement, satisfaction with medicine as a career, and personal achievement (Vocation/engagement), stress, emotional exhaustion, and depersonalization (BurnedOut), and 29 different leisure activities (Avocation/Leisure), as well as questions on personality, empathy, work experience, and demography.

RESULTS

Doctors reporting more Avocation/Leisure activities tended to be women, to have older children, to be less surface-rational, more extravert, more open to experience, less agreeable, and to fantasize more. Doctors who were more BurnedOut tended to be men, to be more sleep-deprived, to report a greater workload and less choice and independence in their work, to have higher neuroticism, lower extraversion and lower agreeableness scores, and to have lower self-esteem. In contrast, doctors with a greater sense of Vocation/engagement, tended to see more patients, to have greater choice and independence at work, to have a deep approach to work, to have a more supportive-receptive work environment, to be more extravert and more conscientious, and to report greater self-esteem.Avocation/Leisure activities correlated significantly with Vocation/engagement, even after taking into account 25 background variables describing demography, work, and personality, whereas BurnedOut showed no significant correlation with Avocation/Leisure activities. Popular Culture and High Culture did not differ in their influence on Vocation/engagement, although there was a suggestion that Depersonalization was correlated with more interest in Popular Culture and less interest in High Culture.

CONCLUSION

In this cross-sectional study there is evidence, even after taking into account a wide range of individual difference measures, that doctors with greater Avocation/Leisure activities also have a greater sense of Vocation/Engagement. In contrast, being BurnedOut did not relate to Avocation/Leisure activities (but did relate to many other measures). Osler was probably correct in recommending to doctors that, 'While medicine is to be your vocation, or calling, see to it that you also have an avocation'.

Does undertaking an intercalated BSc influence first clinical year exam results at a London medical school?

BACKGROUND

Intercalated BScs (iBScs) are an optional part of the medical school curriculum in many Universities. Does undertaking an iBSc influence subsequent student performance? Previous studies addressing this question have been flawed by iBSc students being highly selected. This study looks at data from medical students where there is a compulsory iBSc for non-graduates. Our aim was to see whether there was any difference in performance between students who took an iBSc before or after their third year (first clinical year) exams.

METHODS

A multivariable analysis was performed to compare the third year results of students at one London medical school who had or had not completed their iBSc by the start of this year (n = 276). A general linear model was applied to adjust for differences between the two groups in terms of potential confounders (age, sex, nationality and baseline performance).

RESULTS

The results of third year summative exams for 276 students were analysed (184 students with an iBSc and 92 without). Unadjusted analysis showed students who took an iBSc before their third year achieved significantly higher end of year marks than those who did not with a mean score difference of 4.4 (0.9 to 7.9 95% CI, p = 0.01). (overall mean score 238.4 "completed iBSc" students versus 234.0 "not completed", range 145.2 - 272.3 out of 300). There was however a significant difference between the two groups in their prior second year exam marks with those choosing to intercalate before their third year having higher marks. Adjusting for this, the difference in overall exam scores was no longer significant with a mean score difference of 1.4 (-4.9 to +7.7 95% CI, p = 0.66). (overall mean score 238.0 " completed iBSc" students versus 236.5 "not completed").

CONCLUSIONS

Once possible confounders are controlled for (age, sex, previous academic performance) undertaking an iBSc does not influence third year exam results. One explanation for this confounding in unadjusted results is that students who do better in their second year exams are more likely to take an iBSc before their third year.