Episode Transcript
[00:00:00] Cheryl: Welcome to the first podcast of Cambridge University Medical Education Group, or CUMEG, for short. For our listeners who may not be aware of CUMEG, we are a team of world-leading medical doctors, scientists, and academics based at the University of Cambridge. We provide bespoke advice and expertise to organizations, government departments, and other universities on a range of topics, including curriculum design and support, faculty and professional development, quality assurance frameworks, training on assessment, as well as assisting with developing new medical schools or helping to change or enrich an existing medical school. In addition, we will be offering some online webinars and short courses.
[00:01:00] I’m your host, Cheryl France, head of CUMEG. My background is in public health, and I've worked in the UK National Health Service or NHS for short, the Department of Health, as well as running my own business. The podcast has been developed to share some knowledge and insight on a range of topics. We will be interviewing various people throughout the year and hope that you will enjoy listening and learning from the experts.
Today. I will be introducing Dr Diana Wood. Diana is the Emeritus Clinical Dean from the University of Cambridge School of Clinical Medicine. Diana has been instrumental in the development of CUMEG and will help us to frame the upcoming podcast and tell us more about educating the doctors of our future. Hello, Diana. We're so pleased to have you with us today.
[00:01:50] Diana: Hello.
[00:01:55] Cheryl: Will you please tell us more about your background and about the University of Cambridge Clinical School?
[00:02:00] Diana: Thank you Cheryl and thank you for asking me to do this. So, I qualified as a doctor and did my early training in medicine and was following a career in academic medicine as an endocrinologist when I moved to work at St. Mary's hospital in London, as a lecturer in medicine. And it was there that I became interested in medical education, which was just beginning to develop as a subject on the background of the first General Medical Council publication 'Tomorrow's Doctors', which was published in 1992.
[00:02:32] So at St Mary's, I started getting involved with student admissions and with teaching clinical communication skills, just as it was getting to be recognized as an important subject. I did a masters in higher education and then moved to The Royal London Hospital, which subsequently merged with Barts Health NHS Trust, as a senior lecturer and consultant physician with a particular interest in medical education.
[00:02:55] I moved to Cambridge in 2003 when I was appointed as the first full-time Clinical Dean here. Interestingly, Cambridge Clinical School is actually quite a new medical school. Medicine has been taught in Cambridge since the 16th century, but the clinical school was only established in 1976. And at that time, the pre-clinical and clinical medical courses were quite separate.
[00:03:20] And we took 50 clinical students that came from a pre-clinical intake of about 200. And that really hadn't changed much up until 2003, but over the last 19 years, we've increased that so that we now take all the Cambridge pre-clinical students onto the Cambridge clinical course.
[00:03:42] So it is now all one course, but it wasn't prior to 2014. Before then, you studied preclinical medicine and then you went to one of seven different clinical schools, either to Oxford or to one of the London medical schools or to Cambridge. We finally negotiated our position so that from 2014, all the students coming into year one in Cambridge stayed on the single Cambridge course.
[00:04:07] Cheryl So that's how it is today, is that correct?
[00:04:11] Diana: That's right. So, the standard course is a six-year course, which includes an intercalated bachelor's degree, the Cambridge BA, and students’ study across a wide range of subjects in the third year, they can study virtually anything they want to, although the majority do some form of biomedical sciences, as what's called their part two. This is what would be regarded as an intercalated degree in other universities.
[00:04:39] And then we have two other programmes; Cambridge was the first UK medical school to offer an MBPhd programme, this is based loosely on the American and MDPhd programme. We started in 1999 and essentially those students do the six years of medicine and also intercalate a three-year PhD.
[00:05:00] Currently that's between years four and five of the standard curriculum. So, it makes a course nine-years long, which is a long time to be a student and it's also short time to complete a PhD, so it is quite challenging. But those students obviously will do a PhD in the broadest possible terms in a medically related subject.
[00:05:25] The other programme that we run is the Cambridge graduate course in medicine, that we just mentioned. This was established in 2001 and at the time took 20 students, and this was increased to the 41 that I mentioned, in 2018 there was a round of national medical student increases. So overall, as we said, there are 272 students on the standard course and 41 on the graduate.
[00:05:53] The graduate course is very hard work. We take students with a first degree in any subject, not just a biomedical science. So, we've had engineers and accountants and linguists, all sorts of people coming through. In the first two years, students follow the same course as the standard core students, but in the long vacations, they do clinical medicine.
[00:06:17] And then at the end of the first two years, they obviously skip the intercalated degree year because they've already got a degree. And then the final two years are integrated with the final two years of the six-year programme. So, it's quite an intense course.
[00:06:38] But I'm pleased to say that, and what's been really interesting for us is that our arts and humanities graduates and graduates from different non-biomedical science degrees actually do just as well as the students who come to us with a science degree. And in fact, when we last looked at the data, they actually did slightly better in some parts of the course than the students who came with the first degree in science, particularly in clinical communications skills.
Cheryl: [00:07:06] That's really interesting because that is quite intense, the graduate programme. I know that from having witnessed some of the students going through it, but also what you've said; particularly if you've come from a different background is a lot to come up to speed with. And I think says a lot about the students coming onto the course, if those that were not in a science background, have done just as well as those that have come from a science background. So that's really interesting. And I think it's really interesting to pick up the PhD programme as well and how long a student may be studying for. But as you say, if you're doing a PhD, it's not as long as somebody else who may be going off to do a PhD.
[00:07:51] So it's interesting to know the different options. So, you've got your regular route into medicine, so the six-year course, you've got the graduate programme and, as well, this additional PhD programme that you can do.
[00:08:02] Diana: That's right. Yep.
[00:08:04] Cheryl: Fascinating and quite a lot to keep hold of as a Clinical Dean, I imagine.
[00:08:10] Diana: Yes, it is, but it's very interesting and it's very helpful, particularly with the MBPhD programme, to get the right students into the MBPhD programme.
[00:08:18] And we've had some astonishingly successful young people going through that, who've been, for example, publishing papers in nature when they're still a medical student and that's really quite outstanding. And the outcomes from the MBPhD programme are quite gratifying and they show that a much higher percentage of our MBPhD graduates do indeed end up in academic medicine than from the standard programme. So, it seems to do what we set out to make it do.
[00:09:00] Cheryl: Which is good, that's exactly what you want and fantastic that you're training future academics, as well as future doctors who can do both. Diana, you were instrumental in starting CUMEG within the clinical school. Could you tell me more about the purpose of Cambridge University Medical Education Group?
[00:09:21] Diana: So, for a few years now, I've been talking about how we might assist other institutions that requested help to do various projects in medical education. And over the time I've been here, I've put a lot of effort and encouragement into getting team members who are interested in education to develop their skills through various forms of staff development up to and including a master's programme in medical education that we set up in Cambridge.
[00:09:52] So we've developed a cohort of staff who are very skilled, and this is an opportunity for us to expand that and to take that team and their expertise sort of out into the wider world as it were. So, CUMEG itself was started with funding from the university and it's very much a university activity with a view to bring assistance to people, either wanting to set up new medical schools or wanting assistance in various bits of the medical education programme, or indeed looking for staff development themselves, and so on.
[00:10:25] Cheryl: Thank you, that's interesting. And I'm grateful that you started that because I've really enjoyed being a part of the university and looking at opportunities to help others to grow and expand. So, I think it's a wonderful opportunity, not only for other organizations who may be interested in having support but also for the university to help others that are starting out or need just specific assistance. And I think it's a win-win for different reasons. So, thank you for starting that. So, I wanted to ask your thoughts about medical education in the future.
[00:11:07] What do we need to be thinking about to ensure that our doctors are ready for the future? And I'm thinking about this in terms of we've had a pandemic, we are in a situation where there's unrest in different countries, there's lots of things happening in the world, but that aside we need good doctors who are ready to help in all sorts of situations in the future. How do we prepare for that?
[00:11:30] Diana: So, I think ensuring our students and graduates are fit for the future, that's a huge question. And I think it's really important for people to understand that the time that you're a medical student is only the start of your medical education. All doctors go on to post-graduate training and then on to continuous professional development of one sort or another. So, we're learning all our working lives and I think that's a very important thing to bear in mind.
[00:11:49] So, thinking about the future, there's a tension developing quite clearly between the technological advances that are happening in medicine right across from diagnostics, imaging, therapeutics, genomics, et cetera, huge advances, which we've seen accelerated in some areas, obviously over the course of the pandemic. So, on the one hand, there's all the technological advances. On the other hand, we've got an aging population. We've got increased evidence of chronic illness. We've got the well-known problems related to social care and how health relates into and interacts with the social care system.
[00:12:27] And then also on a broader scale, as you mentioned, the problems of global health. So those two sets of things could be set to be in opposition, and I think we have to, as doctors to look at both and try and bring the skills from one into caring for patients in the other group, and that I think is a two-way thing.
[00:12:47] So I suppose the most important thing we can give our medical students is the skill of dealing with the unexpected. And that's always been the case. And I think that's what distinguishes doctors from other health professionals, it's an ability to take decisions when things aren't necessarily following a pattern and to have the underlying knowledge and skills and abilities to make those different decisions.
[00:13:10] To get there; there are quite a lot of things we have to do. The first thing is selection of medical students, and it's very important that we look to select the best people for medicine. That's a huge area in itself, and people have very different views on what that means.
Irrespective of what we think we're looking for in our admissions processes, I think we all recognize there’s a minimum academic achievement level and that's really quite high across the board. But beyond that, we're looking for all sorts of interpersonal skills and the potential for developing those interpersonal skills. So, selection is the first thing.
[00:13:50] Then in order to ensure our doctors are ready for future for the future, the other thing we have to do is have really clear, well-defined graduate outcomes so that we know exactly what we're setting out to do. So those graduate outcomes need to be regularly reviewed and, if necessary, changed in order to take on board the advances and developments that are happening in healthcare and in medicine.
[00:14:19] One of the other things that can sometimes sort of prevent that graduate comes approach from being approved is people say, okay, there’s the graduate outcomes and they turn your medical students into first year doctors. But it's really important that we're not just taking a bunch of people and training them to be first-year doctors, that's not the point. We're also looking to broaden their minds and to give students abilities to develop their reasoning skills. And the whole range of other skills that go with that, so that they can develop that core skill of dealing with the unexpected.
[00:15:05] Cheryl: I think that's really helpful to understand. So, I think breaking it down in that way of talking about the selections being really important in the fact that it's not just about the brightest students coming through, but about personable skills. And I know we'll be interviewing people later in this podcast series where we'll be talking about the need for some of that. So, it’s good that you’ve highlighted that now and I think every individual that has been to a doctor would say they would like them to be more personable so it’s not just wanting them bright and having that knowledge that was really important to bring out, thank you for that.
[00:15:38] And the graduate outcomes is also really helpful to understand. So, it's about saying what you want to achieve at the end and that's really useful and something that I think we don't always consider in all sorts of things in life, but actually thinking about what our end results is going to be and how we're going to get there so important.
[00:15:55] So that's useful to have brought that out and also the broadening minds and reasoning is interesting in itself. So, thank you for that. I think the other thing I'd like to just touch on is this pandemic. I know you mentioned that it's not just about bringing doctors out, but we have to think about wider issues that can be brought upon us.
[00:16:22] The pandemic provided a swift shift to online learning, which meant some creative learning and assessment methods being deployed as well as online medical consultations. Do you think all of this is here to stay?
[00:16:38] Diana: So, I think the start of the pandemic in terms of education, basically necessity was the mother of invention and colleagues in the IT and the online learning group initiative for the clinical school just did an amazing job as to get it turned around and delivered, essentially over a weekend, which was fantastic. And I think there are always positives that you can take from things. Initially, a lot of the factual information content was quite easy to convert and deliver online.
[00:17:12] And we were grateful because we were able to get something up and running. And I think the students were grateful for anything at that time and not just for the academic content, but also for the contact with the medical school and the fact that they still felt that they were medical students.
[00:17:30] Over time, they've obviously become more critical of our skills and delivering online learning and that is interesting and we can all learn from that. Ultimately there will be things from that, that we can learn and take with us into the future.
[00:17:43] However, I do think that some of the knowledge base can be delivered successfully online for students and in particular it helps for them to be able to look and go back over material in their own time. And I think that's a huge advantage of the online learning system. Funnily enough, the other thing that's proved to be quite successful and popular online is the student support the welfare system, which that was a surprise to me.
[00:18:07] But in fact, a lot of things that students come to the welfare team with can actually be sorted out quite straightforwardly. And I think because students are used to communicating electronically perhaps more than we were at the time, they're happy to do that. So that was a really interesting output from that time.
[00:18:27] The other thing that people obviously think about is assessment. And again, written in terms of written exams, I think they should increasingly be delivered in online formats. There are huge advantages to doing that, to be honest, post-graduate exams are going that way, and it gives students an opportunity to experience the format before they're faced with those post-graduate issues.
[00:18:51] However, I'm pretty, obviously what's missing from an online programme. And what we found most difficult to reproduce online is anything that involves contact with patients and patient-centred education and that of course, core to everything. So, I think there's a real advantage to be gained in terms of the underpinning knowledge and how we deliver underpinning knowledge.
[00:19:17] That should free up time and availability for students to do the patient-centred education and simulation activities which there's a sort of core to that, to the profession. And then you mentioned online consultations and however, you do them online consultations are different from real-life consultations.
[00:19:42] So, there's online consultations or telephone consultations, and there's no question that those will continue in healthcare delivery. And clearly, there's a big debate that's gone on over the last few months about the amount of patient contact versus online and telephone contact with GPs. So, in terms of education, we need to be teaching our students how to do online and telephone conversation consultations better than we do them at the moment, which we do they're okay. But they're not very good and I think we could improve on them. For some people, both doctors and patients, the pandemic was the first time they've ever encountered an online consultation or a video consultation, and people were learning as they went along.
[00:20:38] They're obviously going to continue, but there are other consultations that absolutely need to happen in person. And there are issues where you get more out of a consultation in real life than you do on the telephone. For example, it's much easier to pick up on nonverbal communication in real life.
[00:21:02] And again, there's been a lot of. It came out recently about how people interact on zoom and who they're looking at. Is it themselves? Is it the other people what they're doing? So, so it is different. The other thing that bothered me when I was doing telephone consultations in the pandemic was that you couldn't follow up anything that wasn't directly related to what that consultation was set up to do.
[00:21:27] So you might be on. On the phone with a patient to give them the results of some blood tests, or this is what we need to do next I'll order your scan or anything like that. And the patient says, yes, that's fine. But can I tell you about the tingling in my right foot? And the tingling in my right foot is nothing to do with what that consultation was set up to do, or even one’s own specialty.
[00:21:49] And so, in real life, you'd have a look at the patient's right foot, get them up, and examine them. And if necessary, make some referrals and investigate what's wrong with their right foot. In the pandemic, all you could say was you need to go and talk to your GP about that because I really can't do anything on the end of this phone.
[00:22:07] And that was unsatisfactory for both parties. So, I think there's definitely a place for online and telephone consultations. But that they're not a replacement for real life. Having said that, that specialty, that surprised me most with friends of colleagues of mine who had dermatologists and they were really concerned about not being able to see people with skin lesions and that photo and video consultations wouldn't be good enough quality for them to make diagnosis.
[00:22:47] And as it turned out, even photo sent on mobile phones were actually pretty good. And they were able to use that as a sort of triage. So, they were able to look at things that really didn't need the patient to come up for a biopsy, for example, from those who did. So, it turned up some very interesting issues and we’ll have to take all of that on board and think about it in terms of specialties and what the telephone or online consultation can offer. So, I think really, it's about getting it right for different, the implications for different specialties and getting it right for different specialties. And that's probably something that we should start thinking about in the undergraduate student medical curriculum.
[00:23:40] Cheryl: I think that's a good point too, to try to bring out some of those issues and talk about the differences and the pros and cons and perhaps even letting students try the different consultations and when would they see that as beneficial to just have the online versus having somebody come in person, because as you said, it's pros and cons in lots of different ways.
[00:24:03] So for dermatology, you can triage much quicker, see the patients you absolutely need to see in clinic, but from your example, there may be a whole host of things going on and having that patient in front of you means you could look at those different things. They may be related; they may not, but by having that patient there, you're able to look at that, discuss it, and take it forward. So that's really interesting.
There's been a lot there that you talked about. The assessment, I think you're right; I think things are moving online and in loads different fields. So, it's interesting that's one way that we're going. The student support online; I thought that was interesting too.
[00:24:41] As you said, students these days prefer texts or emails, perhaps more than actually having to go and speak to somebody. So, I think that could be a good way in the future. So, wow, that was a lot to cover but thank you for that. It's really interesting.
[00:25:00] Thinking about the various diseases and wider determinants of health that have implications for patients. The curriculum must be huge. How do you break that down so that students can take it all in?
[00:25:14] Diana: So that's a really good question and curriculum overload is a problem that has existed in medical education for a very long time. You can find a really good description of it and Flaubert’s novel Madame Bovary, which was actually published in 1857.
[00:25:31] So the book is about Emma Bovary, and she's really become a literary heroine. But her husband is a doctor, a sort of not a particularly successful provincial doctor, right at the beginning of the book, it describes him being a medical student. I'm just going to read a little bit from this because it just identifies that in the middle of the 19th century, the same problems existed.
[00:26:00] So here we go: “The syllabus you saw on the notice board stunned him. Lectures on anatomy, lectures on pathology, lectures on physiology, lectures on pharmacy, on chemistry and botany, on diagnosis and therapy, not to mention hygiene and Materia Medica, all names of unknown import to him. Doors into so many sanctuaries filled with an august obscurity.
[00:26:27] He didn't understand a word of it. Couldn't grasp it, however hard he listened. Nevertheless, he worked, he possessed bound notebooks, he attended all the lectures, and never missed around at the hospital. He performed his daily little task, like a mill horse tramping around blindfold, grinding away at what he knows not.”
[00:26:50] And a little later: “He grew lean and lanky, and his face took on a doleful sort of expression that made it almost interesting. Devoid of enthusiasm, he came naturally to absolve himself from all the good resolutions he had made. One day he cut the hospital round, the next his lectures. Savouring the choice of idleness, he gradually dropped the whole thing.”
[00:27:14] I think that we can all recognize medical education in the last 150 years in that in that section from a book published, just let me say that again, published in 1857.
[00:27:30] Cheryl: That was an interesting quote. Thank you for bringing that out. I think it is fascinating that you can take something from so long ago. And when you were mentioning some of the topics, I was thinking that feels like overload, but it sounds a lot like what we're doing now.
[00:27:45] Diana: Absolutely. Right. Absolutely. Right. And also. That he, his mental health was suffering. He became lean and lanky. It's really fascinating. No student support system, of course, in 1857.
[00:28:00] And really that went on and on and on and up until the middle of the 20th century, there was an attempt in the UK to revise the curriculum in the 1950s, but nothing came of that, and another attempt was made in the late 1960s. And there some changes were made at that time had a partial impact, but it really wasn't until the 1980s that people started to look at this in enough detail.
[00:28:29] And that work is what led to the publication of Tomorrow's Doctors in 1992. So, what we're looking for really in terms of curriculum overload is to absolutely sit down and identify; based on those graduate outcomes that you've developed at the start of the process. Identify exactly what should go into your curriculum.
[00:28:55] And it's really tricky because. Anybody who goes into a clinical specialty, thinks their specialty is fantastic and much more important to much more interesting than anybody else's. So that's something you have to be prepared to deal with. So, it is important for medical educators just to step back and say, what are the key things that our doctors need to learn and how can they learn them?
[00:29:17] In a generic way, rather than saying that every single medical student needs to do two weeks of this and two weeks of that, or two weeks of the other. So being a medical student, not about becoming a specialist in say, urological surgery. That's not going to happen, and it shouldn't happen, but what urological surgery can offer, is what the subjects like in its broader sense, but also what generic skills can be learned by spending time with a urological surgeon.
[00:29:50] So that really is the origin of the concept of the core curriculum. And then you can identify the generic knowledge, skills, attitudes, and so on, that students can learn across a whole range of specialties.
[00:30:05] And then, once you've got your core curriculum identified and you've got your outcomes and you're making sure that it's delivered. You can then look at other parts of the curriculum, which can be students selected so that students have the opportunity to pick up something that might not feature very much in the core curriculum, but to pursue a specialty that they really want to do it.
[00:30:30] So you've got to be firm, you've got to keep reminding people that we're talking about medical students, not specialty trainees. And the way to do that, I can't say often enough, is to set very careful, realistic, and achievable goals. And then in the selected part of the curriculum selected study modules, electives, and so on, students can pursue other things that they may or may not find interesting.
[00:30:56] And it's really important that they understand that they may pick a selected study module that is a subject that they really want to do, and they come out of it thinking, yeah, that's great, I really want to be a urological surgeon or whatever it is. On the other hand, and equally importantly, they might come out of it thinking, yeah, I had a good time clinically, but that's not the specialty for me.
[00:31:19] And that's just as important to, for them to realize. The other things that they can do on the elective parts of the curriculum are some research, they can get publications; they can do all sorts of things that stretches them intellectually. So, I think that's how you can put together a curriculum that covers the core things, but that also allows a bit of interest and challenge for the students as they move through the course.
[00:31:55] And then beyond that, there's a whole set of things that run through every specialty and people have tried various ways to integrate these. So public health being a good example of what we here call a curriculum theme. Something that runs through all parts of these through every specialty, essentially.
[00:32:16] So you can't study for example, paediatrics, or obstetrics and gynaecology or orthopaedic surgery without having an understanding the public health that relates to it. So that can be threaded through the curriculum. And what we've tended to do is a sort of spiral pattern, so that students revisit different parts of the theme curriculum throughout the whole course.
[00:32:47] So if you like, the curriculum themes form spiral core, if you can have a spiral core, that works through the whole six years of the course. It allows students to come back and revisit key concepts in a theme related to the different clinical specialties that they're studying at that time.
[00:33:09] Cheryl: That's really useful to understand. So, the spiral, I like the way you've described that. So, it's one of those things that will be revisited year after year or even within a year. Is that correct?
[00:33:22] Diana: That's correct. Yes.
[00:33:24] Cheryl: Okay. And I like the idea of public health as well, because as you said for different specialties, that could be touched upon for different reasons.
[00:33:33] So, okay. The pandemics one, but there are also. Totally different issues that are affected from a public health perspective, whether it be from tummy bugs, from children that is a public health issue. Why are we having them? What, where does that relate? So, I think that's useful to understand how a theme could be revisited and that spiral.
[00:33:54] I also think it was really useful for you to talk about how you can consolidate that learning, because I think that is really important when you’ve got six years of learning different range of topics and how students can break that down and use that spiral to continue their learning.
[00:34:17] So, we've got the core that everybody has to learn, and we make sure that they understand that core by being able to take some selected topics they can pick and choose and see what topics might interest them, which I think is, as you said, is really helpful because it gives them the opportunity to say what they really do like, but also what they may not like and can walk away from that.
[00:34:42] So that's a nice way of students being able to learn and understand. As part of developing this podcast, we were thinking about all the different topics that we could touch on, not just in terms of the themes or what medical students are learning, but also how medical schools are developed and what issues they may be addressing.
[00:35:03] So as part of that, we are not just focusing on the curriculum but the whole range of topics. So, in thinking about that, you’ve looked at the topics that we will be touching on and I thought it would be helpful if you could talk about some of the themes we will be talking about in this podcast and why you think they are important.
[00:35:23] Diana: So, I think overall the way I would look at where we are at the moment is that the future needs a different type of doctor doing a different type of medical practice. In different healthcare environments and everything is changing at the moment and I think we need to focus ourselves on what's likely to happen and how we can get those core values instilled into our students in their undergraduate medical education programme.
[00:35:57] For example, it's likely that they will be clinical specialties in the future, that our first-year medical students might end up practicing, which actually don't exist at the moment and that we don't know anything about that's a genuine possibility. So, the whole thing is about the core knowledge, skills, attitudes, behaviours, all those things, giving the students a solid basis that can be adapted and transferred into different specialties.
[00:36:22] So some of the things we were talking about in the podcasts, some of those core themes such as clinical communication skills, how to manage patients who are dying, medical, ethics, knowledge, and a whole range of generic and universal skills in these podcasts, we can look at some of how those core skills are developed.
[00:36:48] I think skills teaching is probably the thing that's changed most in the course of my career in medical education. So nowadays nobody would dream of asking a medical student to do a procedure on a patient without having previously learned how to do it in a simulated setting. So, simulation has become standard.
[00:37:12] And communication skills as a form of simulation have really helped in terms of students approaching difficult consultations after they graduate. And they've never, they've never had that opportunity before. So, when I qualified, we learned how to have difficult conversations as a junior doctor, and very often from senior nursing staff and senior doctors, actually on the job as it were. Really difficult, and so to have had the opportunity as a medical student to practice those in a simulated environment is really important. So, on top of that, I think we need to, within the podcast, think about things that are changing and we're going to try and do a number of podcasts that are picking up on current issues.
[00:38:02] So for example, there are some real issues related to racism in medical education at the moment, which you've come to the floor quite dramatically across the world, stimulated by the Black Lives Matter movement, but we're actually bubbling under before then. And it's a really important thing for our students to consider.
[00:38:25] It's a multifaceted issue. It's not just about students encountering. racism in the profession in terms of progression and progress being impeded, it also occurs on a day-to-day basis. Patients may make racist comments to medical students and doctors, patients to other patients and so on. So that's one example of an issue which has come to the fore more recently and which we'll hope to include in that podcast series.
[00:38:57] Another obvious thing is thinking about emerging technologies and how those are going to affect medical practice. And again, at what level medical students need to know about them there's a lot going on and they do need to know something about them because they will go to different specialty clinics where doctors might be using different forms of imaging or different forms of diagnostics.
[00:39:22] So it really helps medical students if they've got a basic understanding of what's going on. So, there's a whole range of other topics that we might want to discuss, but there's this combination of really important core topics.
[00:39:37] Cheryl: I think that's really useful to help set the scene. Thank you for that, I do appreciate you helping to set up what our next series of podcasts could entail.
[00:39:47] I think you're right to bring up those topics that medical schools are dealing with at the moment, and students are interested in learning more about as well or having changes within the medical school. So, thank you for doing that. The other thing I'd like to pull out of what you said is I thought it was interesting when we talked about simulation. That is something that is becoming far more used in teaching and in the hospital setting itself; recently heard some of the students had some simulation in one of the hospital training settings and they said, ‘we loved it; can we have more please?’ So that is the way that things are going forward.
[00:40:30] So, it's interesting to pull that out and to say that maybe we do need to look at that in a bit more detail. I appreciate you setting the scene and helping us to think of what we'll be doing in the future. I'm going to kind of put you on the spot now; you've talked about such a range of topics today and thinking about how students learn here at the University of Cambridge and what that education entails, but also this whole method of the spiral. You've talked about so many different topics. Can you give us some of the top three takeaways from today please?
[00:41:04] Diana: I don't know if there'll be top three, but I think the takeaway message is probably more straightforward than you might think it is. It's all about maintaining core values. So those might be patient centred education and education that offers knowledge, skills, attitudes, and behaviours, and that allows students to undertake clinical learning in different clinical and changing clinical environments.
[00:41:32] And that is really that last one is really important because the way that healthcare is delivered changes constantly. So, it is quite easy for a medical curriculum to fall into an atmosphere of it's always been like this. This is what it was like when I was a medical student. So that must be what it should be like now, and that doing a ward round, going to an outpatient clinic, that's how you do it.
[00:41:58] But actually, a lot of care is now being delivered in other places and students may not be seeing where the majority of care for certain clinical specialties is being delivered completely in the community for example. So, so we need to watch for that and be continuously reviewing and updating the curriculum and the graduate outcomes.
[00:42:29] So the core values, I think that's the first thing and that has to happen within a framework and the framework is a bigger thing that would involve patient safety and would include professionalism and ultimately fitness to practice.
[00:42:49] Cheryl: Thank you. You've summed that up beautifully. I appreciate you being here with us today. Thank you, Dr Diana. We've really enjoyed having you kickstart this podcast series.
[00:43:00] Diana: Thank you.
[00:43:03] Cheryl: If listeners are interested in learning more about Cambridge University Medical Education Group, please contact us via the CUMEG website. You also find other podcasts on the website at www.CUMEG.cam.ac.uk, or look for us wherever you get your podcast.
[00:43:35] We are grateful to you, our listeners. Thank you for taking the time out of your busy schedules to listen to us today. If you would like to hear more from our series, please like, and subscribe to our podcast.
Next time, we will be speaking with Dr Fiona Cooke, who will be speaking to us about student welfare and support within the clinical school. We look forward to you joining us next time.
