Table 4

Excerpts from Theme 2, implications for undergraduate medical education

Excerpt 1“there would need to be a radical review then of the undergraduate curriculum … I- I've seen areas where F1s have made very, very serious mistakes … if they were registered they wouldn't have worked again” (Female EMP, ID180)
Excerpt 2“bringing registration and graduation together has a much, much bigger impact for medical schools, huge impact for medical schools, I think they… will have to significantly change their curricula and put much greater emphasis on that preparation for practice and having somebody who is ready on day one to do something as a foundation year one doctor and I think it will make the … national licensing exam all the more inevitable … that is quite a profound change for them and their curriculum and the way that they deliver the end product” (Male D_FP, ID80)
Excerpt 3“we have a reasonably good final year, there are about three or four what I call ‘fallow’ weeks, in other words they're weeks where there is nothing in particular in them. Especially in the first semester…they're called ‘self-learning’ weeks, ‘library’ weeks or ‘do-nothing’ weeks…if it comes to pass, I've got plans to re-jig the final year curriculum to use those weeks to give them more experience and more time in the wards, I've drawn up a plan for that and it's going through the various sub committees…there are a few hurdles to go through but if that does come to pass they'll have more time in general practice, more time in medicine and more time in surgery…I'm ahead of time in proposing that” (Male CE, ID06)
Excerpt 4“you would have to toughen up and be prepared to fail people earlier … but properly fail” (Male D_FP ID57)“the universities need to take that on. It used to … we always used to have people that didn’t pass, and now that's not acceptable…” (Female D_FP ID60)“because medical schools … if they have ten percent now who've failed, they would be seen as a failing medical school, and they need to get over that and realise that it isn’t a sign of failure, that’s a sign of robustness … it’s a sign of robustness in their assessment techniques …” (Female D_FP ID59)
Excerpt 5“to me, the key debate is whether you can do that, that within five years of medicine or whether you need a sixth year … that has been debated and they've come to the conclusion that five years is enough, and it makes me slightly anxious … that last year, I think, has to be absolutely practical and steeped in the wards… it needs to be patient contact as much as possible” (Male CE, ID96)
Excerpt 6“Well I think medical education is about trying to improve the quality of care for patients, I think it should be based in practice from the beginning and the more opportunities there are for medical students to practice being a doctor by practicing medicine is more effective they're going to learn and more effective they are going to be as doctors, so the sooner they can take on responsibility, from my perspective, the better. So the simple answer to the question that you've asked is I think it's a good idea as it gives them more responsibility and we can structure the learning better” (Male CE ID02)