Leeds School Of Medicine

Summary of curriculum developments

What You Study

The medical curriculum at Leeds has recently undergone the most extensive and far-reaching reforms in its 166 year history. This is in response to both the changing demands on future doctors and the recent recommendations the General

Medical Council published as a pamphlet entitled “Tomorrow’s Doctors”.  The changes have made the scientific foundation more clinically relevant and has introduced clinical contact and cases earlier in the course. The first year of the new systems-based, integrated curriculum, introduced in October 1999 was built on the existing course which had evolved over the previous decade through the inclusion of such subjects as communication skills, information technology and special study modules.

As the diagram below indicates, the structure of the new medical course has three key phases, and they are:- Phase I  “Fundamentals for clinical practice”, Phase II “Clinical practice in context” and Phase III “Becoming a doctor: enhancing professional competence”.  In addition, the School has identified five themes which will reoccur throughout all five years of the course.  These themes are communication skills, ethics, health and prevention of disease, community-based medicine and medical information management.

A further strand running through the curriculum are the Special Study Modules, which occur in each year of the course. During these periods, you will be able to make a choice from a wide variety of disciplines or related topics that interest you.  Topics are drawn from all areas of medical science, clinical practice and related subjects. The purpose of the Special Study Modules is to assist in the development of professional, transferable skills for life-long learning in medicine.

The broad framework for the new course is as follows (see diagram).  Years 1,2 & 3 form the basis of Phase 1 and consist of a series of integrated core units (or ICUs) comprising Biomedical Science, Personal & Professional Development, Individuals & Populations, Transport Systems of the Body, Nutrition & Energy, Life Cycle, Patient Evaluation and Clinical Laboratory Science. Phase II is Year 4 of the curriculum and covers teaching in Primary Care, Psychiatry & Public Health Medicine; Medical & Surgical Specialities; Obstetrics & Gynaecology and Paediatrics & Child Health.

Phase III blends together Year 5, the final year of the course  which leads to the award of the degree of MB ChB and the Pre-Registration House Officer year, the first year of postgraduate medical education and training.

Selection and Admissions Procedure

The annual intake into the School is 258 which includes 15 overseas and a small number (up to 20) of graduate and mature applicants, 40 places are available to students who have successfully complete either an Access or Foundation Course at the University of Bradford.  Successful applicants need to fulfil a combination of academic, personal and health requirements.  All applications must be made via UCAS.  The Admissions Office consists of 5 Sub-Deans who are all medically qualified and appointed by the Dean of the School of Medicine from senior university staff, including consultants from the hospitals which are involved in teaching medical students.

UCAS forms are assessed independently by 2 Sub-Deans, and on the basis of the assessments candidates may be made an offer, rejected, or called for interview.  Candidates to whom offers are  made without interview are invited to visit the Medical School.  Around 200 applicants are interviewed each year for good academic attainments, Leeds also takes into account personal qualities which include communication skills, awareness of society, motivation towards a medical career, areas of responsibility, and non-academic achievements.

Groups responsible for organising/monitoring the curriculum

The body responsible for the management of change in the curriculum is the MBChB Sub-Committee which is chaired by Professor Trudie Roberts.  Recommendations for changes and improvements to the curriculum are submitted for formal approval to the Learning & Teaching Committee (Chairman, Professor David Cottrell), a committee of the Faculty of  Medicine, Dentistry & Health.  These Committees meet twice per term. The membership of each consists of representation from University clinical academics (Professorial, Senior Lecturer and Lecturer), NHS members of staff (Consultant & Junior staff),  members of staff from departments of the School of Biological Sciences that contribute to the undergraduate teaching and representatives of the MSRC (Medical Students Representative Council).

Quality Management and Enhancement

The School is committed to quality assurance and an annual review of the MB ChB curriculum is undertaken.  In 1999/2000 the School Learning & Teaching Committee successfully implemented a new Quality Management & Enhancement Review methodology for all taught programmes. The MB ChB Sub-Committee is responsible for the organisation of the annual QM&E Review of the MB ChB Curriculum.  Each course is provided with a nominated reviewer from another to undertake the evaluation.   This process of peer review was commended by the Faculty Learning and Teaching Committee and the University's Quality Management and Enhancement Unit and has been maintained for future reviews.

Special Study Modules

The Special Study Module (SSM) programme in Leeds is well established with planned further development.    The SSM co-ordinator compiles the SSM portfolio, assists the students with their selection and remains contactable by the  students during the SSM module for any problems.  Every SSM has a dedicated supervisor who has received guidance/training from the SSM co-ordinator.  In addition, students are provided with an SSM Guide. In Year 4 the  SSM project selection is provided by the Course Management Teams themselves and every project again has dedicated supervisors.  The SSM co-ordinator maintains surveillance by contact with Academic Units and via the SSM monitoring forms returned by the students.  In addition, students are provided with a Year 4 SSM Guide.  The Year 5 Electives have named supervisors at the host institution who are responsible for the students whilst attached to their practice.

Assessment Criteria, and contribution to course assessment

Phase I: All students are assessed individually using standardised proforma.  Equal weighting is placed on acquisition of defined transferable skills as to the final piece of work.  The assessment form is entered into the students record.  In Phase III projects are marked by the individual ICUs, using standardised proforma.  The SSM mark is incorporated into  their final mark in that discipline.

Phase III:  Elective supervisors are asked to complete a report on the students.

Students will be expected to compile an SSM portfolio which reflects their overall SSM experience.  When SSM’s are introduced across the entire curriculum, submission of a satisfactory portfolio will be a requirement of final qualification.

Learning Methods

A wide variety of learning methods are used during the course including: lectures, seminars, demonstrations, laboratory

experiments, individual and group presentations, project work, video-based consultation, training in the clinical skills centre, computer-based learning, computer-based access to information technology and coursework production, bedside activities, case conferences, clinical log-book monitoring and group and individual feedback on many of the in-course assessments (see assessment section).  The particular mix of methods is the choice of the individual course management teams.

Students start early in the course with access to computer technology.  Computer facilities including on-line packages, printing, e-mail, scanning and access to other peripherals including over 200 workstations, 5 printers, a colour scanner and 1 data printer.  All students achieve basic computer literacy by the end of Year 2.  There is a wide range of software

available.  For example, in addition to stand alone packages available in the Clinical Skills Centre, such as Prime Practice, ABC Clinical cases, Harrisons Textbook,  Moseby Multimedia, and Heart Sounds and Murmurs, the School of Biomedical Sciences, amongst others, has developed the PILS (Pharmacology Integrated Lecture Support) system which provides lecture summaries available for downloading and the opportunity to view slides shown in lectures. Further software is available through the School’s web access.  The Nathan Boding Building is a virtual learning environment which provides additional learning support, including lecture notes and on-line tests for students.   Each student has their own e-mail address and access to the Internet.  Most computers have access to CD ROM drives and software is  available on the NET for both use and evaluation by students through the LIME (Leeds Interactive Medical Education) project.

The Clinical Skills Learning Centre operates at the Clinical Sciences Building at St James’s University Hospital, and at the

Leeds General Infirmary. In the new curriculum (see diagram) all years have Skills Centre activities.  Three 200 plus seat lecture theatres are equipped with large screen video projection and connection to the computer network.  Medical students also have access to the anatomy dissection room and museum and the pathology museum and teaching collection.  The Medical and Dental Library in the Worsley Building and at St James’s University Hospital provides a full service for medical students and staff.  Medline is available on-line to all students, and there is self-access to special collections of teaching resources and books.

Assessment

The School has a series of assessments for which responsibility is devolved to course management teams.  These are both formative and summative and a few examinations perform a dual function.  These usually comprise a hurdle that has to be surmounted before proceeding to qualification, and examinations are staggered so that the weight of assessment at any one time is not too onerous.

Some courses use posters, presentation sessions, video-feedback, and OSCE style assessments to encourage critical analysis, independent learning and a focus on clinical skills and decision-making.  SSMs uniformly feature in-depth study, usually in the context of clinical activity, and research skills of varying complexity, and are assessed by a project report which contributes towards a student’s academic record.  In addition, a move towards a portfolio or record of achievement is being explored.

In Phase I there is an integrated summative examination at the end of each session which must be passed before progression to the next year is permitted.  Resits in August are permitted for those who fail at the first attempt.   In Phase II each of the three ICU rotations has a final summative examination which must be satisfied before progression to Year 5 is permitted.  In Phase III all students are examined by SSMs, clinical placements case presentations, an integrated medicine and surgery examination and an OSCE. 

Internet address:   http://www.leeds.ac.uk/medicine