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Undergraduate Medical Education at
Central Manchester Foundation Trust
Professor Ray McMahon Hospital Dean
CMFT Medical Educators ConferenceApril 2014
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Undergraduate Medical Education
• What do we do?
• Who actually does it?
• How is it changing?
• What do we need to do next?
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One of the largest teachingteaching hospitals in Europe
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Central Manchester Trust
Long established teaching hospital
First linked with Medical School
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The Manchester Curriculum
Phase 1 (Y1+2) Laying foundationsEssential Skills – Sem 1 Life cycle (including ECE) – Sem 1Cardio/Resp (including ECE) - Sem 2Mind and Movement – Sem 3Nutrition & Metabolism - Sem 4
Phase 2 (Y3+4) Developing clinical competenceY4Mind and Movement Families & Children Portfolio; Project Option Y3Introduction to Clinical Learning (ICL)Heart, Lungs & Blood Nutrition, Metabolism & Excretion
Phase 3 (Y5) Consolidation - preparation for practiceTeaching Hospitals & DGH; CommunityElectives; Portfolio
Foundation years - Starting a career
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The Undergraduate Centre provides • 3 floors of educational space• Undergraduate facilities• IT suite• 2 large Lecture theatres• Seminar rooms• Skills labs• Simulation centre• Common Room
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Central Manchester Trust
• Year 3: 135 students in clinical pairs, 20 firms, based at MRI or NMGH, 1 day a week in community
• Year 4: 140 students, based at MRI, Salford and Park House (M&M) or SMH, RMCH, Tameside, Oldham and NMGH (F&C), 1 day a week in community
• Year 5: 140 students, 8 blocks of 4 weeks each
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• Introduction to Clinical Learning• Groups of 6-8 students (3-4 x clinical
partners) in 4 blocks of 7 weeks• Structured teaching programme: linked to
clinical activity of firm (NME or HLB)• Supplemented by PBL and sessions in
skills lab and communications• Portfolio
Central Manchester TrustYear 3
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20 clinical firms distributed across the specialties:
• Acute medicine (A&E, MAU, Respiratory)• Specialist medicine (e.g. renal, haematology,
cardiology, gastroenterology)• Surgery (general, vascular, transplant)• Clinical support services (anaesthetics,
radiology, pathology)• NMGH
Central Manchester TrustYear 3
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Clinical Placement Model• Placements will provide opportunities for
timetabled clinical teaching (at least 3/week) and time on wards
• With community day, 60% of time in patient contact
• PBL facilitation by no more than 2 tutors• Monitored as part of QA with MMS
Central Manchester TrustYears 3 and 4
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Mind and MovementOrthopaedics and Rheumatology at MRINeurology at Salford and MRIPsychiatry at Park House
Families and ChildrenPaediatrics at RMCH, Tameside, Oldham and
NMGHO&G at SMH, Tameside, Oldham and NMGH
Central Manchester TrustYear 4
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New Specialty Blocks
(replacing SSCs in August 2014) •Ophthalmology (M&M at MREH)•ENT (M&M at MRI)•Geriatrics (M&M at MRI, Trafford and Comm)•Breast (F&C at UHSM)•Dermatology (F&C at Salford)•Infectious disease (F&C at NMGH and UHSM)•Public health (F&C at Stopford Building)
Central Manchester TrustYear 4
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Pre-exempting Exam• Teaching Hospital: MRI, NMGH• District Hospital: Tameside, Oldham,
Wrexham, Glan Clywd, Nobles (IOM)• Community: GP, paeds, psych• OSS: oncology (Christie), simulation,
(prescribing) skills
Central Manchester TrustYear 5
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Post-exempting Exam• Student Assistantship: 4 weeks• Clinical placement: 4 weeks• StEP (subject to endorsement placement: elective):
2 x 4 weeks• Portfolio• uPSAs (undergraduate practical skills assessments)• uCMD (undergraduate clinical management
discussion)• uCEX (undergraduate clinical examinations)
Central Manchester TrustYear 5
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Central Manchester Trust Hospital Dean supported by
Associate Hospital Deans
AHD Student Welfare & Professionalism AHD Curriculum Quality & Performance AHD Feedback & Year 5 Programme Lead
AHD Specialist Medicine AHD Acute Medicine AHD Surgery AHD CSS Division AHD St Mary’s Division AHD Childrens’ Division AHD Royal Eye Hospital Division
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Central Manchester Trust
Administration
Head of Undergraduate Education (+deputy)
Year Leads
SWAP
OSCE
Portfolio/Academic Advisors
Clinical Skills
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Central Manchester Trust
Clinical Skills
Introduction to clinical learning (Y3)
Frequent timetabled sessions through Y3
Tailored Y4 teaching (M&M, F&C)
Simulation sessions, especially Y5
OSCE preparation
Innovation
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Central Manchester Trust
Student Welfare and Professionalism (SWAP)
Transfer of Information (ToI) from Phase 1 and St Andrew’s
Identification of issues requiring support, especially health
Monitoring of conduct and professionalism
Liaison with MMS at Stopford Building
ToI pre-graduation for Foundation Programme
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Personal Excellence Paths (PEP)
•Wide range of PEP and Project Option (PO) placements in CMFT, including pan-sector options in specialist areas
•PEPs recent change from SSCs: now related to quality improvement/clinical governance
•Leading research centre with opportunities for excellence
Central Manchester Trust
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Portfolio
•All students allocated an Academic Advisor from CMFT
•Formative reviews in Y3 and first Y4
•Summative review at end of Y4 (progression issue)
•Training provided
Central Manchester Trust
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Drivers for change
• Specialties Block
• Placement standards for Phase 3
• New curriculum
• Department of Health costing exercise
• Commissioning
• Loss of SIFT income to the Trust
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Year 5 Placement Standards
• Formal induction
• Weekly timetable
• More structured teaching whilst on placement 3 programmed sessions per week
More monitoring of placements to ensure they meet minimum standards
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Proposed new Curriculum 2015Year 3
Generic clinical skills
M&M or F&C
& Specialty block
PEP
Year 4
M&M or F&C
& Specialty block
Project Option
4 weeks each TH/ DGH/
Community/
OSS block
Exempting exam moved to end of Year 4
Year 5
Preparation
for Practice
Student Assistantship
Student
AssistantshipElective
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Central Manchester TrustTeaching Service Level Agreements
• Response to MPET review with reduction in funding to CMFT
• Allocation of funding to individual divisions• Baseline calculations of activities: clinical firms,
bedside teaching, PBL, OSCE, comms skills, PEPs, POs, AA
• Based on student week: £34k/42 = £850 (same for all hospitals; recharge being negotiated for ‘teaching hospital’ roles such as exams, skills, student support)
• QA process to monitor activity
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Central Manchester TrustTeaching Service Level Agreements
• Increased activity should result in increased funding (and vice versa)
• Potential for CMFT to increase income through PEPs and POs and some Year 4 specialty blocks
• Threat to income from community, district hospitals and other Year 4 specialty blocks
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Central Manchester TrustGMC and Accreditation of Undergraduate
Trainers• From 2016, all those involved in undergraduate
education must demonstrate their training is appropriate and up to date (similar to the current situation for postgraduate trainers)
• Equiniti is being modified to recognise UG activities such as PBL, OSCE, comms skills and AA
• Those signed off at PG level as ES/CS will be recognised equally at UG level as firm leads
• MMS also require sign off on their e-learning module for clinical tutors (unique to MMS)
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Undergraduate Medical Education
• What do we do? A LOT!
• Who actually does it? LOTS OF PEOPLE
• How is it changing? FUNDING, Y4, PEPs
• What do we need to do next? ACCREDITATION
• Why do we do it?
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We do our best to help students become good and happy doctors