Jump to comment:

• Response to Clinical specialty training in UK undergraduate medical schools: a retrospective observational study
  Shujhat H Khan, Taha H Shiwani, Areeb A Mian and Ali Omar
  Published on: 2 August 2019

• Published on: 2 August 2019

  Response to Clinical specialty training in UK undergraduate medical schools: a retrospective observational study

  • Shujhat H Khan, Medical student Imperial College London
  • Other Contributors:
    • Taha H Shiwani, Medical student
    • Areeb A Mian, Medical student
    • Ali Omar, Medical student

  Dear Editor,

  In contrast with prior literature - which only focused on a limited number of specialties - HJ Vaidya et al (1) demonstrated that medical students who have a longer placement period in a particular speciality are no more likely to pursue a career in that speciality. The study has important implications, and the authors should be commended, as it suggests that increasing exposure to clinical specialties during medical school will not solve current recruitment pressures.

  Interestingly, the authors chose to incorporate specialties such as clinical radiology and public health within the statistical analysis. However we question the reliability of the subsequent results, given the small number of medical schools that offered placements in those specialities.

  By using the number of weeks allocated to a particular speciality by each medical school, the authors created a useful, objective metric that could be used for statistical analysis. However, upon reading, we noted that it may not wholly reflect a student’s exposure to that speciality during their placement. In our experience as medical students, we feel that due consideration must be given to the quality of a clinical placement as well as it’s duration. The hospital in which a student is based, the medical team that they shadow, and the student’s experience are but some of the factors that may influence the degree of a student’s involvement on a particular firm, thereby influencing their e...

  Show More

  Dear Editor,

  In contrast with prior literature - which only focused on a limited number of specialties - HJ Vaidya et al (1) demonstrated that medical students who have a longer placement period in a particular speciality are no more likely to pursue a career in that speciality. The study has important implications, and the authors should be commended, as it suggests that increasing exposure to clinical specialties during medical school will not solve current recruitment pressures.

  Interestingly, the authors chose to incorporate specialties such as clinical radiology and public health within the statistical analysis. However we question the reliability of the subsequent results, given the small number of medical schools that offered placements in those specialities.

  By using the number of weeks allocated to a particular speciality by each medical school, the authors created a useful, objective metric that could be used for statistical analysis. However, upon reading, we noted that it may not wholly reflect a student’s exposure to that speciality during their placement. In our experience as medical students, we feel that due consideration must be given to the quality of a clinical placement as well as it’s duration. The hospital in which a student is based, the medical team that they shadow, and the student’s experience are but some of the factors that may influence the degree of a student’s involvement on a particular firm, thereby influencing their exposure to the speciality. It also allows positive relationships to develop between the trainee and mentor – a feature that should be further exploited in undergraduate education (2).

  It is likely that exposure to a speciality is an important, but not the deciding factor, in determining career choice. Take for example students looking to enter a career in surgery. There is an increased cost for surgical training through regular attendance of surgical training courses and conferences, and undertaking higher degrees to increase the likelihood of obtaining competitive posts. Additionally, membership and medical defence fees often leads to surgical trainees having to spend over £130,000 in total (3). Many would also perceive surgery as being a more stressful specialty and this can deter students who are looking for a better work-life balance (4).

  Based on this study and prior literature, it may be beneficial for future studies to combine the use of subjective measures and objective metrics to define the quality and quantity of exposure to a particular speciality, as well as surveys to understand the ultimate reasons for final career choices. Additionally, it would be interesting to see the effects of foundation year placements on future career choices.

  Conflicts of interest- none declared

  1. Vaidya HJ, Emery AW, Alexander EC, McDonnell AJ, Burford C, Bulsara MK. Clinical specialty training in UK undergraduate medical schools: a retrospective observational study. BMJ Open. 2019;9(7):e025403.
  2. Hagopian TM, Vitiello GA, Hart AM, Perez SD, Pettitt BJ, Sweeney JF. Do medical students in the operating room affect patient care? An analysis of one institution's experience over the past five years. J Surg Educ. 2014;71(6):817-24.
  3. Pereira EA, Dean BJ. British surgeons' experiences of mandatory online workplace-based assessment. J R Soc Med. 2009;102(7):287-93.
  4. Rich A, Viney R, Needleman S, Griffin A, Woolf K. ‘You can't be a person and a doctor’: the work–life balance of doctors in training—a qualitative study. BMJ Open. 2016;6(12).

  Show Less

  Conflict of Interest:
  None declared.

  • Back to top