1. Exploring UK medical school differences: the MedDifs study of selection, teaching, student and F1 perceptions, postgraduate outcomes and fitness to practise
- Author
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Richard Nzewi, Luke Debenham, Calum MacMillan, Kiran Nadeem, Zoe Carrington, Omar Risk, Rebecca Razey, James Parkin, Sam Myers, Asanish Kalyanasundaram, Mark Awad, Zein Gowie, Julian Purdy, Simon E. V. Phillips, Zoe Wellbelove, Mike Jones, Priscilla Kirkland, Nadine Abbas, Oluseyi Adesalu, Roxanne Tajbakhsh, Oliver Shotton, Adele Heaney, Joseph Brandreth, Benjamin Human, Jamie Mac Donald Burrell, Benjamin Thompson, Wassim Merzougui, Chris Harlow, Matthew South, Angelos Mantelakis, Nora Sangvik Grandal, Samuel C. Barnes, Daniel Sims, Fady Sameh Anis, Hannah Lawrence-Smith, Thomas P. W. Cope, Farris Ziyada, Saad Majeed, Carmel Razzaghi, Jack Eldridge, Rachel Maguire, Amy Harrington, Simon Lubbock, Abdul Muiz Azri Yahaya, Roshan Ullah, Oliver P. Devine, Zoe Cashin, Usman Rasul, Daniel Tadross, Pranoy Sangal, Ngan Hong Ta, Ammar Ahmed, Mehar Chawla, Sarah Freeston, Hugo Layard Horsfall, Sohini Pawar, Eve Lancaster, Harriet Hunter, Richard Clough, Alex Eyre, Sonam Aojula, Prabhjot Singh Malhotra, Elliot Raymond-Taggert, Ciaran Grafton-Clarke, Abdelrahman Said, Katherine Aiken, Ryan Janjuha, Adam Sage, Wing Hang Serene Ho, Shree Vadera, Joyce Omatseye, Aninditya Salma Sopian, Daisy Bassey-Duke, Samuel Penrice, Tom Newman, Sarah Douglas, Helen Gilbert, Jia Jun Ang, Aisha Sooltangos, Leher Gumber, Raisa Ramjan, Nasreen Desai, Shaunak Chatterjee, Oloruntobi Rotimi, Shreya Badhrinarayanan, Chris Clements, Harriet Van Den Tooren, Bronwen Jacob-Ramsdale, Savraj Kalsi, Mrudula Utukuri, Soham Bandyopadhyay, Eleanor Houghton, Meron Esere, Sadhana Kalidindi, Chung Shen Chean, James Coultas, Emma Sanders, Jessica Coulthurst, Ahmed Ashraf, Nick Smith, Whitney General, Katherine Garnett, Emma L Howard, Joanna Rigbye, Rebecca Braine, Saba Houshangi, Christina Hood, Aadam Shah, Praveen Mahendran, Ifrah Hussain, Ben Phillips, Keshni Gudka, Alimatu Sadia Akeredolu, Reza Nasseri, Tobin Joseph, Vinay Mandagere, Charlotte Leeson, Jess Trevett, Anjola Mosuro, Othman Khaled Al-Othman, Thomas Hughes-Gooding, Eimear Reel, Vinnie Christine Daniels, Liora Wittner, Sophie Paddock, Verity Ford, Daniel Smith, Sara Venturini, Rahul Atul Shah, Martha Amy Smith, Matthew Tyler, Charlotte Boreham, Ratan Randhawa, Katie Smart, Richard Thomas Jackson-Taylor, Agnieszka Jakubowska, Andrew Christopher Harborne, Jessica Speller, Sophie Mustoe, Ibrahim Alam, Richard B. Anderson, Mohit Patel, Tess Marshall-Andon, Liam Curry, Elliot John Revell, Sami Hussain, Hassan Baig, Geoffrey Hong Kiat Yong, Emma Aspinall, Robert Spencer, Sajan Khullar, Ryan Samuels, Saleh Jawad, Oliver Jones, Ivan Aganin, Rebecca Davis, Hanelie De Waal, I. C. McManus, Ryan Clark, Adam Moxley, Charlie Caird, Ibrahim T. Fazmin, Natasha Benons, Rosalie Ogborne, Rishi K Gupta, Sahaj Kaur, Melanie Vine, Muzzamil Jelani, James Druce, Julius Elisabeth Richard Lenaerts, Anna Kane, Lucy Holloway, Lady Namera Ejamike, Tom Joseph Syer, Alena Ashby, Sophie McGovern, Simon Davies, Sophia Fitzgerald-Smith, Aradhya Vijayakumar, Stuart Pearce, Kerry Long, Joseph Beecham, Catherine Arthur, Qaisar Khan, Joshua William Kearsley, David Johnston, Ross McAllister, Hannah Douglas, Aamna Ali, McManus, I. C. [0000-0003-3510-4814], Harborne, Andrew Christopher [0000-0003-0937-1492], Horsfall, Hugo Layard [0000-0001-7848-5325], Joseph, Tobin [0000-0002-9283-9895], Smith, Daniel T. [0000-0003-1215-5811], Marshall-Andon, Tess [0000-0001-8909-1639], Samuels, Ryan [0000-0002-0886-7990], Abbas, Nadine [0000-0002-9116-2915], Baig, Hassan [0000-0001-8999-0474], Beecham, Joseph [0000-0002-4390-9164], Benons, Natasha [0000-0002-0750-6560], Caird, Charlie [0000-0001-7553-5585], Clark, Ryan [0000-0002-6143-9098], Cope, Thomas [0000-0003-0247-7411], Coultas, James [0000-0003-3381-8936], Debenham, Luke [0000-0002-3300-7802], Douglas, Sarah [0000-0003-3272-8154], Eldridge, Jack [0000-0001-6792-7714], Hughes-Gooding, Thomas [0000-0001-8483-5686], Jakubowska, Agnieszka [0000-0003-3153-8666], Jones, Oliver [0000-0003-4334-3567], Lancaster, Eve [0000-0001-5703-252X], MacMillan, Calum [0000-0002-8167-0051], McAllister, Ross [0000-0003-1686-1174], Merzougui, Wassim [0000-0001-7398-0095], Phillips, Ben [0000-0002-0489-6700], Risk, Omar [0000-0002-9226-9263], Sage, Adam [0000-0002-7763-404X], Sooltangos, Aisha [0000-0001-5675-1709], Spencer, Robert [0000-0001-9045-6260], Tajbakhsh, Roxanne [0000-0002-3753-6306], Adesalu, Oluseyi [0000-0001-8796-2701], Aganin, Ivan [0000-0002-3711-9430], Aiken, Katherine [0000-0002-3245-7772], Alam, Ibrahim [0000-0003-2853-623X], Ali, Aamna [0000-0003-1255-6113], Anderson, Richard [0000-0003-4734-0208], Anis, Fady Sameh [0000-0002-0950-3777], Arthur, Catherine [0000-0001-9551-6250], Ashraf, Ahmed [0000-0002-3921-8395], Aspinall, Emma [0000-0001-8307-1661], Awad, Mark [0000-0002-6570-010X], Yahaya, Abdul-Muiz Azri [0000-0002-7846-9322], Badhrinarayanan, Shreya [0000-0002-7159-098X], Bandyopadhyay, Soham [0000-0001-6553-3842], Barnes, Sam [0000-0001-6009-406X], Bassey-Duke, Daisy [0000-0002-0408-1042], Boreham, Charlotte [0000-0003-4828-0542], Braine, Rebecca [0000-0003-2751-3378], Brandreth, Joseph [0000-0002-6137-5928], Carrington, Zoe [0000-0002-0006-8334], Chawla, Mehar [0000-0003-0697-815X], Chean, Chung Shen [0000-0002-1625-4078], Clements, Chris [0000-0002-2567-5536], Clough, Richard [0000-0001-6941-7881], Coulthurst, Jessica [0000-0003-0714-9572], Curry, Liam [0000-0002-6906-5502], Daniels, Vinnie Christine [0000-0001-9461-8431], Davies, Simon [0000-0001-5556-7512], Davis, Rebecca [0000-0002-6960-5580], De Waal, Hanelie [0000-0002-9131-9521], Desai, Nasreen [0000-0003-4601-9084], Douglas, Hannah [0000-0001-8113-5465], Druce, James [0000-0001-6849-8560], Ejamike, Lady-Namera [0000-0001-6196-5584], Esere, Meron [0000-0002-1838-0756], Eyre, Alex [0000-0002-0474-5662], Fazmin, Ibrahim Talal [0000-0002-3300-6279], Ford, Verity [0000-0002-1364-8522], Freeston, Sarah [0000-0001-8768-5513], Garnett, Katherine [0000-0003-1135-6478], General, Whitney [0000-0002-9222-4233], Gilbert, Helen [0000-0002-5588-411X], Gowie, Zein [0000-0002-7597-7508], Grafton-Clarke, Ciaran [0000-0002-8537-0806], Gudka, Keshni [0000-0003-0880-6992], Gumber, Leher [0000-0003-0154-1207], Gupta, Rishi [0000-0003-3839-7982], Harlow, Chris [0000-0003-2912-0594], Heaney, Adele [0000-0002-0905-4342], Ho, Wing Hang Serene [0000-0002-2687-3198], Hood, Christina [0000-0001-6821-6324], Howard, Emma [0000-0001-8411-5734], Human, Benjamin [0000-0003-4445-0639], Hunter, Harriet [0000-0002-5204-2371], Hussain, Sami [0000-0002-8654-3617], Jackson-Taylor, Richard Thomas [0000-0002-6949-2977], Jacob-Ramsdale, Bronwen [0000-0001-6215-808X], Jawad, Saleh [0000-0001-8221-9871], Jelani, Muzzamil [0000-0003-3785-415X], Johnston, David [0000-0002-7078-7510], Kalidindi, Sadhana [0000-0002-4274-2913], Kalsi, Savraj [0000-0001-9103-5089], Kalyanasundaram, Asanish [0000-0003-4175-5998], Kane, Anna [0000-0002-6197-2511], Kaur, Sahaj [0000-0002-3446-6082], Al-Othman, Othman Khaled [0000-0001-5930-8593], Khan, Qaisar [0000-0002-5486-4205], Khullar, Sajan [0000-0001-6426-2892], Kirkland, Priscilla [0000-0003-2452-4207], Leeson, Charlotte [0000-0003-4735-2452], Lenaerts, Julius Elisabeth Richard [0000-0002-1626-7792], Long, Kerry [0000-0003-4546-5509], Burrell, Jamie Mac Donald [0000-0002-8175-3973], Maguire, Rachel [0000-0003-4855-5550], Mahendran, Praveen [0000-0002-4084-5222], Majeed, Saad [0000-0003-4289-5597], Malhotra, Prabhjot Singh [0000-0001-7463-3941], Mandagere, Vinay [0000-0002-2969-6457], Mantelakis, Angelos [0000-0001-7109-943X], McGovern, Sophie [0000-0002-6198-7553], Mosuro, Anjola [0000-0002-9013-9289], Moxley, Adam [0000-0001-9794-091X], Mustoe, Sophie [0000-0002-7870-1320], Myers, Sam [0000-0001-6050-4663], Nadeem, Kiran [0000-0001-5988-6780], Newman, Tom [0000-0002-7987-9948], Nzewi, Richard [0000-0002-8159-1302], Ogborne, Rosalie [0000-0003-3327-6030], Omatseye, Joyce [0000-0001-7472-4712], Parkin, James [0000-0002-1861-0822], Patel, Mohit [0000-0003-1168-2759], Pawar, Sohini [0000-0003-0224-5258], Pearce, Stuart [0000-0002-7482-0752], Penrice, Samuel [0000-0002-1142-6686], Ramjan, Raisa [0000-0002-2020-2123], Randhawa, Ratan [0000-0002-4749-4410], Rasul, Usman [0000-0001-5820-1313], Raymond-Taggert, Elliot [0000-0003-1514-6662], Razey, Rebecca [0000-0003-1971-3580], Razzaghi, Carmel [0000-0002-3264-8528], Revell, Elliot John [0000-0001-6025-094X], Rigbye, Joanna [0000-0003-4860-4084], Rotimi, Oloruntobi [0000-0002-1385-1993], Said, Abdelrahman [0000-0002-9801-4202], Sangal, Pranoy [0000-0001-5775-5859], Grandal, Nora Sangvik [0000-0002-2461-7852], Shah, Aadam [0000-0003-1841-5530], Shah, Rahul Atul [0000-0002-6981-7305], Shotton, Oliver [0000-0001-6684-3308], Sims, Daniel [0000-0002-6916-3719], Smith, Martha Amy [0000-0002-4652-3507], Smith, Nick [0000-0003-4478-2772], South, Matthew [0000-0003-2297-1089], Speller, Jessica [0000-0001-5503-4791], Ta, Ngan Hong [0000-0002-8747-5329], Tadross, Daniel [0000-0002-3593-0182], Thompson, Benjamin [0000-0002-2491-5235], Trevett, Jess [0000-0001-5008-1724], Ullah, Roshan [0000-0002-5140-6655], Utukuri, Mrudula [0000-0003-1510-469X], Vadera, Shree [0000-0001-9492-7541], Van Den Tooren, Harriet [0000-0001-9902-7147], Venturini, Sara [0000-0002-9541-0090], Vijayakumar, Aradhya [0000-0002-8702-1087], Vine, Melanie [0000-0002-7978-4375], Wittner, Liora [0000-0003-1271-4839], Yong, Geoffrey Hong Kiat [0000-0003-0103-5793], Ziyada, Farris [0000-0003-2117-7262], Devine, Oliver Patrick [0000-0001-7621-9699], Apollo - University of Cambridge Repository, McManus, IC [0000-0003-3510-4814], and Smith, Daniel T [0000-0003-1215-5811]
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Male ,Students, Medical ,020205 medical informatics ,Preparedness ,Problem-based learning ,media_common.quotation_subject ,education ,Specialty ,lcsh:Medicine ,02 engineering and technology ,National Training Study ,National Student Survey ,03 medical and health sciences ,Patient safety ,0302 clinical medicine ,Obstetrics and gynaecology ,Perception ,0202 electrical engineering, electronic engineering, information engineering ,Medicine ,Sanctions ,Humans ,Quality (business) ,030212 general & internal medicine ,Fitness to practise ,Schools, Medical ,GMC sanctions ,media_common ,Medical education ,Postgraduate qualifications ,business.industry ,lcsh:R ,Institutional histories ,General Medicine ,United Kingdom ,Female ,Medical school differences ,business ,Teaching styles ,Research Article - Abstract
BackgroundMedical schools differ, particularly in their teaching, but it is unclear whether such differences matter, although influential claims are often made. The Medical School Differences (MedDifs) study brings together a wide range of measures of UK medical schools, including postgraduate performance, fitness to practise issues, specialty choice, preparedness, satisfaction, teaching styles, entry criteria and institutional factors.MethodAggregated data were collected for 50 measures across 29 UK medical schools. Data includeinstitutional history(e.g. rate of production of hospital and GP specialists in the past),curricular influences(e.g. PBL schools, spend per student, staff-student ratio), selection measures(e.g. entry grades),teaching and assessment(e.g. traditional vs PBL, specialty teaching, self-regulated learning), student satisfaction, Foundation selection scores,Foundation satisfaction,postgraduate examination performance andfitness to practise(postgraduate progression, GMC sanctions). Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail.ResultsMedical school differences are stable across time (median alpha = 0.835). The 50 measures were highly correlated, 395 (32.2%) of 1225 correlations being significant withp p Problem-based learning (PBL) schools differ on many measures, including lower performance on postgraduate assessments. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reportedgreaterstudent satisfaction with feedback also showedlowerperformance at postgraduate examinations.More medical school teaching of psychiatry, surgery and anaesthetics did not result in more specialist trainees. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs.Postgraduate exam outcomes were also higher in schools with more self-regulated learning, but lower in larger medical schools.A path model for 29 measures found a complex causal nexus, most measures causing or being caused by other measures. Postgraduate exam performance was influenced by earlier attainment, at entry to Foundation and entry to medical school (the so-called academic backbone), and by self-regulated learning.Foundation measures of satisfaction, including preparedness, had no subsequent influence on outcomes. Fitness to practise issues were more frequent in schools producing more male graduates and more GPs.ConclusionsMedical schools differ in large numbers of ways that are causally interconnected. Differences between schools in postgraduate examination performance, training problems and GMC sanctions have important implications for the quality of patient care and patient safety.
- Published
- 2020