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

The views of European students on the inclusion of research in undergraduate Oral Health Professional curricula

INTRODUCTION

The education of Oral Health Professionals (OHPs) is variable across Europe and consequently, there is concern that research skills are not consistently or optimally integrated into European OHP curricula. The aim of this study is to investigate the perspectives of European OHP students regarding the inclusion of research in the undergraduate curriculum.

MATERIALS AND METHODS

A 21-question online survey was administered to dental, dental hygiene, and dental hygiene and therapy students across Europe. Informed consent was obtained from participants and all responses remained confidential. Quantitative and qualitative methods were used to analyse the data.

RESULTS

A total of 825 student responses to the survey from 33 European countries were eligible for inclusion. The results demonstrated that OHP students recognise the importance of research in the dental field and value the inclusion of research in the curriculum. Although students indicated that they are interested to learn more about research, the survey results also showed that students had neutral opinions towards the existing curriculum providing enough training about research.

CONCLUSION

European OHP students agree on the need for an open and explicit research curriculum in OHP education. The development of a research domain within an open curriculum framework would help to harmonise the teaching and assessment of OHP research skills across Europe and ultimately improve graduating OHP's research skills.

Differential Attainment Within the Specialised Foundation Programme: Creating an Accessible Mentorship Scheme to Increase Diversity Within Academic Medicine

The Specialised Foundation Programme (SFP), formerly the Academic Foundation Programme, is a highly competitive pathway into academic medicine. There is minimal information available on the demographics of those who apply to the programme, how it scores its applicants and who is successful, making it difficult to assess whether the application process is accessible to all students and promotes a diverse workforce. There are varying levels of support available with coaching, either geographically ring-fenced by universities or available through paid courses. As a result, there is a risk of differential attainment between students who have financial constraints or attend universities where the SFP is less promoted. The aim of the study was to assess student opinion on barriers to the SFP and academic medicine and the demand for the creation of a national, free-to-access SFP mentorship programme to reduce differential attainment amongst student cohorts. Students in the programme received mentorship, peer learning and scheduled teaching events over a six-month period. Surveys were distributed pre- and post-course, and qualitative and quantitative analysis was conducted. Of the respondents, 76% felt that medical schools provided insufficient information on SFP, 31% did not feel financially stable at university and 53% stated that they would not enrol if a cost was present. Applicants were tested on pre- and post-course confidence, all of which showed an increase in mean Likert (1-5) scoring post-mentorship. Financial, institutional and geographical barriers to students applying to the programme were identified. Whilst further research is required to better understand the barriers to academic medicine, national, free-to-access mentorship may effectively reduce differential attainment and improve accessibility amongst students.

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.

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.

Impact of Intercalated Degree on Post-graduate Career Progression and Academic Development in the UK: A Rapid Review of the Literature

An intercalated degree offers medical students an avenue to explore their interests and become competent in scientific literacy. Although intercalating can pose a financial burden and time commitment, they do provide competitive academic and speciality training applications. The aim of this review was to explore academic development and subsequent outcomes of career progression. Medline and EMBASE were systematically searched using keywords. After the removal of duplicates, the studies were screened against the inclusion criteria. For the five studies included in this review, a narrative synthesis was performed. The two main themes were academic development and career progression. All studies showed a plethora of academic achievements during and after intercalation. Two studies showed that students are more likely to enter a career in academic medicine. A further two studies have shown that the transferable skills of academia have allowed alumni to make more competitive applications for foundation year and speciality training. The results have shown a correlation between academic achievements and an increase in competitiveness in foundation programmes and speciality applications. There are clear discrepancies in the success of academic careers depending on the institution and type of intercalated degree. Current literature suggests a master’s degree results in more academic success compared to a bachelor’s degree. Due to the sheer diversity of intercalated degrees offered to medical students in the UK, there is limited literature on post-graduate career progression. More research should be undertaken to look at the implications of intercalation on post-graduate career progression.

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.

Understanding UK medical students' perspectives on a career in cardiothoracic surgery

Objectives

The UK postgraduate training program in cardiothoracic surgery is challenging and competitive, with trainees choosing the field for different reasons. This study aims to identify factors that influence medical students in pursuing a career within cardiothoracic surgery.

Methods

A cross-sectional study was carried out in which a questionnaire was anonymously filled out by medical students across 17 medical schools in the United Kingdom. An online survey platform was used for survey distribution and analysis. A mixed-methods approach was employed to gather quantitative and qualitative data. Data collection consisted of a series of closed questions and 1 open-ended question. The questions focused on the attitudes toward, knowledge of, and exposure to cardiothoracic surgery.

Results

The survey yielded 265 responses. Interest in cardiothoracic surgery was seen in 45.3% of participants, with the leading factor for pursuing this career being lifestyle factors (50%), closely followed by the career opportunities (42.9%) and the aid of mentors (31%). Some discouraging factors were: Difficulty of learning material (37.7%), length of the training program (27.4%), competition in the field (26%), stress (24.3%), and lifestyle factors (22.1%).

Conclusions

Whilst UK medical schools try to provide an introduction to specialties like cardiothoracic surgery, there remains a proportion of medical students who do not have access to opportunities needed to make a balanced career decision. Additionally, individual circumstances and aspirations tend to change from students' first year of study to their final year, which can alter their perceptions about the field.

Portuguese Medical Students' Interest for Science and Research Declines after Freshman Year

The integration of scientific research into medical curricula remains insufficient despite its advantages for medical students' professional development and the advancement of medicine. This study aimed to evaluate the impact of first-year medical course attendance on medical students' attitudes and perceptions towards scientific research and clinical practice, while also assessing the contribution of sociodemographic and academic factors. Two hundred and thirteen medical students self-administrated a questionnaire at the beginning and at the end of the first school year. Their responses were compared and two regression models were calculated to assess factors influencing students' attitudes and perceptions. After freshman year, students displayed significantly lower positive attitudes towards science and research. Their motivation to perform research and to integrate it into the curriculum also decreased, while the importance attributed to research skills for clinical practice increased. Motivation to perform research and negative attitudes were positively and negatively associated with grade point average (GPA), respectively. Female students and those who attended public secondary schools attributed greater importance to communication skills. This study reinforces the need to early develop research skills and positive attitudes in medical students, motivating them to become physician-scientists. Additional follow-up studies may offer further contributions to the integration of research into medical curricula.

Curriculum initiatives to enhance research skills acquisition by medical students: a scoping review

BACKGROUND

Although it is accepted that providing medical students with opportunities to engage in research activity is beneficial, little data has been collated on how medical degree curricula may address this issue. This review aims to address this knowledge gap by conducting a scoping review examining curriculum initiatives that seek to enhance research experience for medical students.

METHODS

This review looks to specifically look at 'doing research' as defined by the MEDINE 2 consensus rather than 'using research' for the bachelor component of the Bologna Cycle. The framework developed by Arksey & O'Malley was utilised and a consultation with stakeholders was incorporated to clarify and enhance the framework.

RESULTS

A total of 120 articles were included in this scoping review; 26 related to intercalated degree options and 94 to non-intercalated degree options. Research initiatives from the United States were most common (53/120 articles). For non-intercalated research options, mandatory and elective research projects predominated. The included studies were heterogeneous in their methodology. The main outcomes reported were student research output, description of curriculum initiative(s) and self-reported research skills acquisition. For intercalated degree options, the three main findings were descriptions of more 'novel' intercalated degree options than the traditional BSc, student perspectives on intercalating and the effect of intercalating on medical student performance and careers.

CONCLUSIONS

There are several options available to faculty involved in planning medical degree programmes but further research is needed to determine whether research activity should be optional or mandatory. For now, flexibility is probably appropriate depending on a medical school's resources, curriculum, educational culture and population needs.

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.

Teaching, reflecting, and learning: The value of an intercalated medical education programme

Objectives: Teaching programmes within medicine focus primarily on pathways of a shorter length with little regard to teaching lasting longer than a month. This study is different from other studies as it examines the benefits of a nine month-long medical education degree programme and its impact beyond graduation. This study set out to explore the impact of a medical education intercalated degree programme for its graduates and their careers.Methods: A small scale, exploratory qualitative case study was conducted with 10 graduates of an intercalated degree programme.Results: The findings highlight the longer term value of an intercalated degree programme with particular emphasis on academic and personal skills; research and teaching skills; independence and confidence; its impact on future practice and the notion that 'student as teacher' programmes are a valuable asset to medical education as a whole. Participants advocated more teaching opportunities as a core longitudinal teaching component in preparation for the teaching responsibilities in their working lives.Conclusions: The programme enables the development of a range of academic and personal skills, with particular emphasis on research and teaching skills, independence and confidence.

Stimulating Intrinsic Motivation in Millennial Students: A New Generation, a New Approach

There has been a fundamental change in health care pedagogy to address the demands and challenges posed by the present generation of millennial students. There is also a growing recognition of the role of intrinsic motivation as a catalyst in a positive learning experience. The term intrinsic motivation refers to energizing behavior that comes from within an individual and develops due to an inherent interest in the activity at hand. However, stimulating intrinsic motivation in the present generation of millennial health care students is a daunting task, considering their diverse and disparate nature. In addition, the inherent generational differences between educators and students, and an increasing emphasis on technological tools have resulted in a dichotomy in the educational environment leading to the development of a greater incidence of burnouts among students. Hence, numerous innovative techniques have been introduced in health care education to enhance the levels of intrinsic motivation in these students. Unfortunately, most of these approaches have only been moderately successful due to their limited ability to address the unique educational expectations of millennial students. The cumulative evidence suggests that specific approaches to stimulate intrinsic motivation should aim at nurturing the learning efforts of students, bridging the generational barriers between educators and students, and ameliorating the stress associated with health care education. Hence, the specific aim of this narrative review is to suggest empirically proven curricular strategies and institutional reforms to enhance intrinsic motivation in health care students belonging to the Millennial Generation.

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.

Examining the readiness of best evidence in medical education guides for integration into educational practice: A meta-synthesis

BACKGROUND

To support evidence-informed education, health professions education (HPE) stakeholders encourage the creation and use of knowledge syntheses or reviews. However, it is unclear if these knowledge syntheses are ready for translation into educational practice. Without understanding the readiness, defined by three criteria-quality, accessibility and relevance-we risk translating weak evidence into practice and/or providing information that is not useful to educators.

METHODS

A librarian searched Web of Science for knowledge syntheses, specifically Best Evidence in Medical Education (BEME) Guides. This meta-synthesis focuses on BEME Guides because of their explicit goal to inform educational practice and policy. Two authors extracted data from all Guides, guided by the 25-item STructured apprOach to the Reporting In healthcare education of Evidence Synthesis (STORIES).

RESULTS

Forty-two Guides published in Medical Teacher between 1999 and 2017 were analyzed. No Guide met all STORIES criteria, but all included structured summaries and most described their literature search (n = 39) and study inclusion/exclusion (n = 40) procedures. Eleven Guides reported the presence of theory and/or educational principles, and eight consulted with external subject matter experts. Accessibility to each Guide's full-text and supplemental materials was variable.

DISCUSSION

For a subset of HPE knowledge syntheses, BEME Guides, this meta-synthesis identifies factors that support readiness and indicates potential areas of improvement, such as consistent access to Guides and inclusion of external subject matter experts on the review team. This analysis is useful for understanding the current readiness of HPE knowledge syntheses and informing future reviews to evolve so they can catalyze translation of evidence into educational practice.

Optimizing engagement of undergraduate students in medical education research: The eMERG training network

Background

The practice of evidence-based medicine and critical appraisal are essential for the modern doctor. Early engagement of medical students in research methodology is considered as a rising need for most medical school curricula; however, few peer-reviewed initiatives have been reported so far. We developed a Medical Education Research Group (eMERG) as part of a novel undergraduate surgical masterclass, which aimed to train undergraduate students on basic research methodology, as well as to motivate them to pursue a clinical and academic career in surgical specialties.

Methods: eMERG consists of an international structured network of senior academics, consultant-level clinicians, senior and junior trainees who support undergraduate trainees. Students are selected from a competitive pool of applicants. Several small prospective studies in skills-based education, as well as systematic reviews on similar topics, have run under the umbrella of this framework, in the form of scholarship awards. Structured feedback questionnaires were distributed to evaluate the experience of the first three years.

Results

12 students have participated in this pilot initiative. 11 manuscripts have been submitted for publication and 8 were accepted following peer-review in MEDLINE-indexed journals. Delegates perceived this experience as an excellent training opportunity which improved their research productivity. Delegates also stated engagement in research developed interest in the relevant surgical speciality, impacting their career aspirations.

Conclusions

eMERG is one of the first reported European educational research networks for undergraduates. Research outcomes and students' perceptions conclude that eMERG enhances engagement with research methodology and motivation towards a career in surgery.

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eMERG is a pilot international research training network where medical students receive support to conduct research in Medical Education.

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eMERG structure can serve as a novel model to convey research experience from one generation to another, and in the same time, motivate and aspire students to develop leadership skills.

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eMERG was developed in a financial crisis environment with promising research outputs and positive students' feedback.

Clinician-scientist MB/PhD training in the UK: a nationwide survey of medical school policy

OBJECTIVE

This study surveyed all UK medical schools regarding their Bachelor of Medicine (MB), Doctor of Philosophy (PhD) (MB/PhD) training policy in order to map the current training landscape and to provide evidence for further research and policy development.

SETTING

Deans of all UK medical schools registered with the Medical Schools Council were invited to participate in this survey electronically.

PRIMARY

The number of medical schools that operate institutional MB/PhD programmes or permit self-directed student PhD intercalation.

SECONDARY

Medical school recruitment procedures and attitudes to policy guidance.

FINDINGS

27 of 33 (81%) registered UK medical schools responded. Four (14%) offer an institutional MB/PhD programme. However, of those without institutional programmes, 17 (73%) permit study interruption and PhD intercalation: two do not (one of whom had discontinued their programme in 2013), three were unsure and one failed to answer the question. Regarding student eligibility, respondents cited high academic achievement in medical studies and a bachelor's or master's degree. Of the Medical schools without institutional MB/PhD programmes, 5 (21%) have intentions to establish a programme, 8 (34%) do not and 3 were unsure, seven did not answer. 19 medical schools (70%) considered national guidelines are needed for future MB/PhD programme development.

CONCLUSIONS

We report the first national survey of MB/PhD training in the UK. Four medical schools have operational institutional MB/PhD programmes, with a further five intending to establish one. Most medical schools permit study interruption and PhD intercalation. The total number MB/PhD students yet to graduate from medical school could exceed 150, with 30 graduating per year. A majority of medical school respondents to this survey believe national guidelines are required for MB/PhD programme development and implementation. Further research should focus on the MB/PhD student experience. Discussion regarding local and national MB/PhD policies between medical schools and academic stakeholders are needed.

Self-reported extracurricular activity, academic success, and quality of life in UK medical students

OBJECTIVES

To explore the relationship between academic performance, extracurricular activity, and quality of life at medical school in the UK to aid our understanding of students' work-life balance.

METHODS

A cross-sectional study, using an electronic questionnaire distributed to UK final year medical students across 20 medical schools (4478 students). Participants reported the hours of self-regulated learning and extracurricular activities undertaken each year at medical school; along with their academic decile (1 = highest, 10 = lowest). Self-reported quality of life (QoL) was assessed using an established screening tool (7 = highest, 1 = lowest).

RESULTS

Seven hundred responses were obtained, across 20 participating medical schools, response rate 16% (700/4478). Factors associated with higher academic achievement were: graduate entry course students (2 deciles higher, p < 0.0001), more hours academic study during term and revision periods (rho=-0.1, p < 0.01), and involvement in teaching or research. Increased hours of study was associated with lower QoL (rho = -0.13, p < 0.01).

CONCLUSIONS

Study skills may be more important than duration spent studying, for academic achievement and QoL. Graduate-entry students attain higher decile scores despite similar self-reported duration of study.

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.

Demographic characteristics of doctors who intend to follow clinical academic careers: UK national questionnaire surveys

Objectives

It is well recognised that women are underrepresented in clinical academic posts. Our aim was to determine which of a number of characteristics—notably gender, but also ethnicity, possession of an intercalated degree, medical school attended, choice of specialty—were predictive of doctors’ intentions to follow clinical academic careers.

Design

Questionnaires to all UK-trained medical graduates of 2005 sent in 2006 and again in 2010, graduates of 2009 in 2010 and graduates of 2012 in 2013.

Results

At the end of their first year of medical work, 13.5% (368/2732) of men and 7.3% (358/4891) of women specified that they intended to apply for a clinical academic training post; and 6.0% (172/2873) of men and 2.2% (111/5044) of women specified that they intended to pursue clinical academic medicine as their eventual career. A higher percentage of Asian (4.8%) than White doctors (3.3%) wanted a long-term career as a clinical academic, as did a higher percentage of doctors who did an intercalated degree (5.6%) than others (2.2%) and a higher percentage of Oxbridge graduates (8.1%) than others (2.8%). Of the graduates of 2005, only 30% of those who in 2006 intended a clinical medicine career also did so when re-surveyed in 2010 (men 44%, women 12%).

Conclusions

There are noteworthy differences by gender and other demographic factors in doctors’ intentions to pursue academic training and careers. The gap between men and women in aspirations for a clinical academic career is present as early as the first year after qualification.

General Practice in the United Kingdom – A training evolution

This article will outline the current state of training for UK General Practice, specifying some of the steps that must be taken in order to qualify, the challenges that trainees often face, and the career opportunities that may await them once completed. A historical perspective will be used to demonstrate the extent to which General Practice has evolved during the last sixty years. A few of the examples and explanations used in this article are by necessity simplistic, designed to highlight key areas of UK general practice in a bid to encourage readers to explore further if they wish to do so.