The Undergraduate Medical Curriculum

Introduction

Throughout its modern history the Medical School has enjoyed a reputation for innovation in medical education. The excellence of our programmes, was confirmed by the GMC and the Quality Assurance Agency for Higher Education (QAA) at their most recent visitations. The current integrated, systems-based approach was first introduced in 1962 and revised in 1976 and 1994. In this curriculum, traditional discipline-oriented teaching, associated with specific Departments operating as autonomous academic units, was replaced by modular courses of study based largely upon organ systems of the body. In 1987, the need for further change was recognised, and a major review and gradual re-orientation of the undergraduate programme commenced. In 1994, informed by Tomorrow's Doctors, the curriculum was once again modified. The most recent review began in 2000 to incorporate the successful bids for expansion, and the partnership with Durham University. The 'new' curriculum takes account of 'standards' as well as 'benchmarks, and is case-led. It concentrates on 'outcome-based' education that focuses on the 'end-product', and defines what the learner is accountable for.

Selection and Admissions Procedures

The admissions process is supervised by the Senior Admissions Tutor for Medicine. In 2000/01 there were over 2500 applications for 340 places of which 220 places were available on the five year programme at Newcastle (14 of these places were for overseas students). Ninety five places were available at the University of Durham, Stockton Campus. The remaining 25 places were available on the four year accelerated programme offered by Newcastle. This programme was recently introduced for graduates and health care professionals with the relevant post registration professional qualifications. The school continues to provide a pre-medical year for a small number of students with non-science 'A' levels or equivalent vocational qualifications.

The Recruitment and Admissions Executive Committee ensures that the Admissions Policy is applied consistently across all entry routes and takes into account the views of external bodies such as the GMC and the QAA. The Admissions Policy is renewed annually in the light of previous experience and changing national needs.

Every candidate is considered on the basis of their application form. Attention is paid not only to academic performance but also to non-academic attributes such as communication skills and whether a candidate has shown a commitment to a career in Medicine and evidence of concern for the welfare of others. No candidate will be made an offer without attending for interview.

The school continues to provide a pre-medical year for a small number of students with non-science 'A' levels or equivalent vocational qualifications.

There is a fixed quota or 14 places for overseas students.

The Medical School recently introduced an accelerated four year degree programme for graduates and health care professionals with the relevant post registration professional qualifications.

Description of the group responsible for organising and monitoring the curriculum

The Board of Medical Studies oversees the undergraduate degree programme, and has ultimate responsibility for all aspects of curriculum management. It comprises an executive group overarching two Co-ordinating Committees, one for Phase I (comprising Stage 1, Stage 2 and the Accelerated Programme introduced from September 2003), and the other for Phase II (comprising Stages 3 and 4). Membership of the Executive includes academic and clinical staff, the Dean, student members and a lay representative. The sub-ordinate Co-ordinating Committees comprise Course and Module Directors responsible for delivering the curriculum in the respective Phase. In addition the Board has several sub-committees and/or working groups which report to it on a regular basis, each having specific responsibilities for particular areas e.g. clinical skills, personal and professional development, student support, SSM's.

The type of specialist medical education resource within the school

The medical education unit has existed 'virtually' since 1993. However, in December 2000 the 'unit' moved into a new home, and comprises a Professor of Medical Education, a group of academics and administrative staff with a special interest and expertise in medical education and staff development, many of whom have a major role in the curriculum management process. The 'unit' also comprises the Faculty of Medicine Computing Centre who liaise closely with the Board of Medical Studies in the educational research and development arena. From 1 May 2002 the 'unit' will become the 'School of Medical Education Development' within the Faculty of Medical Sciences.

There are strong links with the NHS, medical education specialists, and interested academics in the Postgraduate Institute of Medicine and Dentistry, the University's Quality Enhancement Unit, and national networks including the LTSN for which this University was awarded the Subject Centre for Medicine, Dentistry and Veterinary Science.

The general framework and structure of the curriculum

Briefly, the new core curriculum is built around the development of clinical competence. The training in clinical medicine starts in the first year, and the programme is case-led dealing essentially with normal and abnormal structure, function and behaviour. Clinical relevance is emphasised throughout. Early clinical experience is provided in the context of this programme in the form of laboratory-based teaching and learning of basic clinical skills, contextual visits to primary care centres and hospitals as well as project work. People as 'patients' play an active role in teaching and learning.

The development of clinical competence is complemented by education in the sciences basic to medicine delivered in parallel through the first three and a half years of the programme. This provision comprises eight Subject Strands that are mapped to each of the four Stages of the curriculum, seven of which are 'core' and the eighth comprises Student Selected Choice, which now incorporates an early SSM in the second year. These are delivered in a series of linked, vertically integrated modular units; a 'constructivist' approach to learning has been adopted, in which knowledge and understanding is built upon prior experience gained in preceding stages of the programme and delivered within a spiral' model of curriculum design.

The Accelerated Programme

In September 2002, twenty five students will begin the four year accelerated degree programme. These students will complete a three-semester programme of study that incorporates teaching from the first two years of the standard programme. On successful completion of Year 1, students will join the mainstream students to begin third year, and will continue to follow the same programme of study until graduation.

The Base-Units

At the beginning of third year, those students who studied Phase I at Stockton will be integrated with those students who studied Phase I at Newcastle, and to accommodate the increase in student numbers, students will be allocated to one of four regional 'base-units' for their third year. Allocation to a Base Unit will be randomised so as to ensure that a broad experience of health care delivery systems throughout the region is gained.

Base Unit attachments begin with a comprehensive 15-week clinical practice introduction where the key clinical skills of history taking and examination will be further developed, and early experience in medicine and surgery both in hospital and general practice settings will be gained.

The 'Foundations of Clinical Practice' course is followed by a series of Essential Junior Rotations that emphasise the importance of hospital, primary care and community medicine, and address the overall theme of Health and Disease. Students will gain relevant experience by rotating through the various hospitals, practices and community facilities associated with the Base Unit. Following the end of the Base Unit Attachment, students will undertake a 12-week course in the clinical sciences and investigative medicine, to be delivered at the Medical School and hospitals in Newcastle.

The scope and structure of Special Study Modules/Option

Student choice is one of the major principles of the curriculum, and runs as a theme through the five years. A wide range of learning resources is provided to allow a student to select those most suited to him/her in helping to meet programme-wide and individual learning objectives. Throughout Phase I and Phase 2, students are also given the opportunity to study topics of their own choice.

In Stage 1 and 2, students undertake a series of assignments that allow them to develop their skills of communication, critical thinking and information and data handling. These skills are subsequently used in the first SSM, in which students choose a topic that focuses on a particular aspect of a patient's condition and produce a review of the literature and critically appraise selected articles relating to that topic.

In Phase II, the main block of student selected work is in the fourth Year. The philosophy underlying this concentration of elective study is that students by this stage will have a full range of experience so as to fully inform their choice. The focus for the Stage 4 Special Study Modules is on consolidation of critical and analytic skills developed earlier in the course, on integration of knowledge and on continuing development of professional skills and attitudes. The SSM's allow students the opportunity to study a variety of subjects of their own choice in depth, in order to develop a particular interest, explore a new subject, or study a topic with a view to a potential career. The students undertake three 7 week modules in sequence, selecting one from each of the three 'menus' under the following headings: community-based/mental health; hospital-based; and laboratory/investigative-based. A wide range of academic departments, clinical units, extra-mural organisations and individuals offers the modules. Currently, there are over 300 topics available ranging from clinical research to the history of medicine, problem-based learning in general practice to working with para-medics, and from specialist hospital clinical attachments to holistic medicine. Students are also afforded the opportunity of arranging a 'private' SSM both inside and outside the Northern Region where a particular topic, or specialist subject is not 'offered'. Student choice of SSM's is carried out using World Wide Web based 'Options selection' software.

The theme of student choice continues with a 9-week period of elective study.

During Final Year, students are attached to hospital units and general practices in Newcastle and throughout the Northern Deanery for periods of whole-time clinical work. The Essential Senior Rotations address the theme of Care and Management.

Following the final examination, there is a 2-week preparatory course to ease the transition from final year student to Pre-registration House Office, providing a period of time to 'shadow' the outgoing House Officer.

The outcome-based, case-led approach ensures integration with multidisciplinary sessions to allow the students to see how each component of the teaching fits together to provide an overall picture of diagnosis, treatment and care that includes ethics, primary health care, pharmacology and pathology.

The current major review will continue until the first cohort to undertake the 'new' curriculum graduates in June 2006. However, the Newcastle undergraduate medical curriculum will continue being refined and amended to ensure that it meets the needs of an ever-changing Health Service.

Publications for prospective medical students:

UCAS (Universities and Colleges Admissions Service)

’A Student’s Guide to Entry to Medicine’ short booklet
£6.00  (Please make cheque out to UCAS Enterprises Ltd)
Available from:
Distribution Dept
UCAS Enterprises Ltd
PO Box 130
Fulton House
Jessup Avenue
Cheltenham
Glos, GL50 3SH
Telephone:  01242 227788

Sixthformer’s guide to visiting universities and Colleges in 1998. And Opportunities in the Gap Year.  Published by ISCO.   Both published by ISCO.  Cover all subjects, but relevant to medicine.  To order copies telephone 01276 21188, or fax 01276 691833.

‘Getting Into Medical School’ by Joe Ruston
Price £7.99, published by Trotman & Co Ltd, ISBN 085660 3724
Telephone number 0181 940 5668.

The New Learning Medicine, by Peter Richards and Simon Stockill, 14th Edition, BMJ Publishing Group, Tavistock Square, London.  Price £10.95, 168 pages.  ISBN 0 7279 1155 4.  This updated version gives the lowdown on everything you need to know, from entry requirements, choosing a medical school, being interviewed and course content, to being a house officer, choosing  a specialty, and coping with doubt.

‘Choosing Tomorrow’s Doctors’ produced by the Policy Studies Institute and St George’s Hospital Medical School, available from:
Grantham Book Services Ltd
Isaac Newton Way
Alma Park Industrial Estate
Grantham
Lincs NG31 9SD
Tel:  01476 541081
Fax:  01476 541061.

Introductory courses for prospective medical students:

The Medical Careers Forum, recently established, organises one-day courses for sixth formers on how to apply for medicine, UCAS, selection processes, requirements, and interviews.
For more information and details of the next event contact:
Dr H A Mann
Medical Careers Forum
Alcombe House
11 Hanson Street
London W1P 7LL
Telephone:  0171 436 2656
Fax:  0171 436 2552.
 
‘Insight Into Medicine’ Courses at MPW
These are a series of one-day courses aiming to provide would-be doctors with a practical introduction to an important area of medicine.  It is organised by Mander Portman Woodward (MPW) Sixth Form colleges, in conjunction with Ealing Hospital, London.  The course provides applicants to medical school with material for section 10 of their UCAS form and topics for discussion at interview.  The course is held by permission of a consultant cardiologist in the cardiology department, wards and lecture theatre of Ealing Hospital, Uxbridge Road, Southall, London.  Student s learn about hear disease through lectures, practical investigations and a ward round, using modern diagnostic equipment on volunteer patients.
For further information contact:   Jackie Brown on 0171 581 7941, or send a fax on 0171 591 0167.  The next course will take place on Saturday 28 March 1998.
 
Annual Medical Schools Admissions Seminars - UCAS
Organised by UCAS for admissions tutors for Higher Education Courses in Medicine, teachers, tutors and advisory staff from schools, further education sector colleges and careers services.

Seminars provide an opportunity for those concerned with the recruitment of students to Medical Schools to meet and discuss relevant issues.

Cost:  £85.00 plus VAT
Contact Irene Kirkman, Head of Information Services, UCAS,
Telephone:  01242 544864, Fax:  01242 255725.