UNIVERSITY OF LIVERPOOL

The Undergraduate Medical Curriculum
Updated : 30 April 2002

AIMS

The general aim of the Liverpool course is to produce a good doctor defined as a doctor who possesses :

• Clinical reasoning skills
• Communication skills
• Competence in science
• Continuing self-motivated learning

The learning objectives that would facilitate the achievement of these aims are identified under the headings of knowledge, skills and attitudes.

STRUCTURE

The Liverpool course is divided into three Phases. Phase 1 (first year) is an introduction to the Science and Practice of Medicine. Phase 2 (years 2-4) covers the Human Life Cycle twice - the first time concentrating on normality, the second emphasising disease and pathology. Phase 3 (fifth year) is an intensive clinical experience, preparing the student for independent clinical practice.

METHODS

The learning of the theoretical aspects of the course is facilitated by Problem-Based Learning tutorials that are loosely patterned on the Maastricht model. The tutorials span the first four years of the course and are organised into a series of modules, each of which lasts 2 weeks and is based on an unfolding clinical case. The students generate learning objectives during the tutorials and research them outside the groups. Learning is supported by resources developed by the Faculty, including computer packages, library materials, practicals and demonstrations.

During their Problem-Based Learning tutorials, students generate learning objectives categorised under four curriculum themes for each module:

• Structure and Function
• Individuals, Groups and Society
• Population Perspective
• Professional Values and Personal Development

In addition to theoretical learning, the students learn Clinical Skills (see below) and Communication Skills. The teaching of Communication Skills starts with tutorials in first year and continues in the clinical environment throughout the remaining years of the course with an emphasis on facilitated reflection on real encounters that the student has had with patients.

CLINICAL LEARNING.

Clinical training in the first year is entirely in the Clinical Skills Resource Centre where the students practice their clinical skills with models and on each other.

Community attachments.

The first contact with real patients is at the beginning of second year, and takes place contemporaneously in general practice and in hospital. Over the entire course, approximately 30% of clinical contact time will be in a primary care setting. In addition, students have the opportunity to experience other aspects of health care in the community with attachments to Community Clinicians, Health Authorities and Community Health Councils, and a variety of voluntary organisations.

Hospital Attachments

The initial hospital attachments in second and third year consist of medical and surgical firms based in the two major teaching hospitals in Liverpool. There are also hospital attachments in Reproductive Health and Child Health.

In the 4th year, each student spends the entire year in one locality. The student is attached to a general practitioner (GP) and spends at least one day a week with that GP. At the same time, they spend a minimum of two days a week in the hospital rotating through Medicine, Surgery, Child Health, Obstetrics & Gynaecology, Geriatric Medicine, Psychiatry and Palliative Care. The design of this facilitates students encountering the same patient in both the primary and secondary care setting, encouraging an understanding of continuity of care.

The final year of the course prepares students for clinical practice and consists of five eight week rotations. These include Community and Accident and Emergency attachments and two attachments of the student's own choice. The fifth attachment is a period of PRHO shadowing within the hospital where the student will be working as a House Officer.

CONTENT

In common with other UK medical schools, and in line with the recommendations of Tomorrow's Doctors, we have structured the content of the course into Core plus Special Studies. The Core is taken by all the students and Special Studies are organised into 6 modules spread over the first four years of the course.

Identification of Core

We have chosen to define core in terms of cases rather than facts. The development of core is an iterative process. A Working Group - drawn from all branches of medicine - met to decide which cases should form the core. The results of these were sent to a wide range of colleagues within the Mersey Region for their comment and opinion and further refinement was based on their replies.

The resulting core cases have formed the basis of the PBL modules and act as a definition of the clinical core knowledge that all students are expected to be familiar with. The identification of the real core of the medical course is an ongoing task and is constantly being reviewed.

Special Study Modules

The Special Study Modules (SSMs) may be selected by the students from a menu drawn up by Faculty or, in the later years, be student-led. SSMs offer a wide range of modules from laboratory-based scientific studies through to surveys and systematic literature reviews to the experience of complementary therapies.

ASSESSMENT

Assessment takes place within three domains :

• Knowledge
• Clinical and Communication Skills
• Critical Thinking

Knowledge is assessed by MCQs, EMIs and clinical diagnosis and management questions. Formative papers are offered at the end of each semester. Currently, summative assessment takes place at the end of the 1st year, in the middle of the 3rd year and at the end of the 4th year. Clinical and communication skills are tested in an OSCE format.

Critical thinking is assessed at each examination but in addition there is a specific critical thinking module in the 3rd year for which students are expected to write an application for a research grant and then to peer review one another's efforts.

MANAGEMENT

A major change has been the transfer of responsibility for the detailed management of the curriculum from individual departments to the Faculty. The Curriculum Executive Group is chaired by the Director of Medical Studies (Professor Anne Garden), who is responsible to the Dean and the Board of Faculty for the delivery of the course. In addition, there is a Deputy Director responsible for Assessment and a Deputy Director responsible for Quality Enhancement of the curriculum. Day to day management rests with the Phase Directors for each part of the curriculum. Assessment for each Phase is managed by a Board of Examiners for that Phase.

STUDENT INVOLVEMENT

Student participation in the management of the course is regarded as essential. All committees associated with the course have student members. In addition, there is a Student Parliament with elected members representing each component of the course. This meets with senior members of the course management team to discuss problems and their potential solutions.

CONTACTS

For information about Admissions, contact :

Ms Karen Hornby, Admissions Officer
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Miss Clare McCormick, Admissions Assistant
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Tel: 0151 706 4266
Fax: 0151 706 5667

An Admissions Day is held in April each year, and Karen or Clare should be contacted for further information.

Futher information about the Liverpool course can be found on http://www.liv.ac.uk/FacultyMedicine