UCL School of Life and Medical Sciences
UCL Medical School
MBBS 2012
An undergraduate education
for contemporary practice
UCL Medical School
Developing & managing the MBBS
programme at UCLMS
• There has been an MBBS programme at UCL for a very long
time
• UCLMS represents the merger of three smaller medical
schools each with their own traditions, programmes,
practices
• UK undergraduate medical programmes are overseen by
the GMC (Tomorrow’s Doctors)
• Medical curricula
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make complex demands of students and staff
address complex learning
are complexly organised, delivered , governed and assessed
Are high stakes
Influences
GMC
Patients
UCLP
Local
healthcare
provider
landscape
UCL MBBS
programme
Education
theory and
research
NHS
workforce
planning
UCL
MBBS 2012:The starting point..the UCL
doctor
A highly competent and scientifically
literate clinician, equipped to practise
patient-centred medicine in a constantly
changing modern world, with a foundation
in the basic medical and social sciences.
MBBS 2012: The Vision
• Provide the best possible student experience
• Reflect the needs of today’s and tomorrow’s patients
• Create 21st century doctors able to thrive in modern
healthcare environments
• Maximise the benefits of learning medicine at UCL
Countdown to a new MBBS
programme
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MBBS review: 2007 (600 stakeholders)
Phase 1 implementation: 2008 (structural changes)
Phase 2 review and recommendations: 2009/10
Phase 2 implementation project: March 2010 –September 2012
– Set-up of working groups and governance group; appointment of project
manager; outline planning, etc.
• External review: October 2010 & February 2011, October 2011:
– Reviewed of plans, reports of working groups and recommendations generation
of further recommendations, initiation of ‘mini work groups’
• Final year : September 2011-2012
– Initiation implementation groups for detailed planning & timetabling
– Pilot projects and prototype testing
– Extensive communication & staff development
• September 2012
– Roll out in all 6 years
– Implementation groups become management and review groups
– Detailed evaluation
Features of the New MBBS
Programme
• The best possible student experience
– More integration of the basic and clinical sciences
– More small group work and use of the virtual learning
environment, with a focus on synthesis of learning
– BSc integrated into the MBBS programme
– Attention to vertical themes throughout all years
– Longer, more generic, clinical attachments
– Contemporary assessments that are fair, relevant and help
to prepare for practice and life long learning
Features of the New MBBS
Programme
• The needs of today’s and tomorrow’s patients
– Focus on patient pathways
– Early extended patient contact
– Preparation for practice:
• Shadowing and assistantships
• Preparation for practice year
– Focus on contemporary practice and UCLP priorities:
• Social determinants of health
• Mental health
• Patient safety and quality improvement
Features of the New MBBS
Programme
• Create 21st century doctors, able to thrive in
modern healthcare environments
– Preparation for practice:
• E-Portfolio
• Exposure to a range of healthcare delivery venues and practices
• Blended learning
– Focus on contemporary practice:
• Leadership & professional practice
• Anatomy and Imaging
• Use of evidence
Features of the New MBBS
Programme
• Maximising the benefits of studying medicine at
UCL
• Learning within an academic health sciences centre environment
• Maintaining a strong, focused basis in the fundamentals of
underpinning science
• A focus on contemporary practice and UCLP priorities
• An integrated BSc embedded in the MBBS course, providing a
year of scientific study in depth
• Creating opportunities to learn within the world famous
UCL partners
• Attention to the global health agenda
The UCL MBBS Programme
PATIENT PATHWAYS
VERTICAL THEMES
PORTFOLIO
PROGRESSION
Year 1 - Fundamentals of clinical science 1
Assessment
Year 2 - Fundamentals of clinical science 2
Assessment
Year 3 - Scientific method in depth ( iBSc )
Assessment
Year 4 – Integrated clinical care
Assessment
Year 5 - Life cycle
Assessment
Year 6 - Preparation for practice
Assessment
Foundation Programme
Horizontal Structures
Year 1: Fundamentals of clinical science 1
Year 2: Fundamentals of clinical science 2
Year 3: Integrated BSc
Year 4: Integrated clinical care
Year 5: The life cycle
Year 6: The preparation for practice
Year 1 & 2
Year 1& 2: Fundamentals of clinical science
• Foundations module
• systems based modules
• Vertical modules activity every week including
meaningful early patient contact
• Post examination weeks
– Year 1: extended opportunities for early clinical practice
– Year 2: Doctor as scientist and scholar
• Portfolio and end-of-year assessment
Year 3
Integrated BSc
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Integrated, not intercalated:
enhances learning on MBBS
Taken by all students in year 3
Consistency across the courses with
orientation to the practice of medicine
Continued attention to medical learning (via
portfolio)
Year 4
the vision
Integrated clinical care
• Three 12-week blocks, based mainly at the three central sites & in
primary care
• Focus on foundation skills and understanding and providing clinical
care in the modern NHS
• Sites provide comparable experience rather than uniformity of
experience: each site has a different ‘flavour’
• Students maintain an e-portfolio of learning, including
workplace-based assessment (WPBA)
• Extensive use of GP placements
• Vertical modules learning is ‘everybody’s
business’
Integrated clinical care
Module A
• Includes learning in acute admission : ED and the AAU,
medical and mental health problems
Module B
• Includes movement (medical and surgical) and digestive
health (medical and surgical)
• Includes time dedicated to operative care led by anaesthetists
Module C
• Includes metabolic medicine, neurology (medical and
surgical), infectious diseases and haematology
Year 5
the vision
The life cycle
• Three 12-week blocks
• based in the three central sites but more extensive use of district
general hospitals and community providers for placements to increase
the exposure to both case load and service delivery models
• Sites provide comparable experience rather than uniformity of
experience: each site has a different ‘flavour’
• Students maintain an e-portfolio of learning, including
workplace-based assessment (WPBA)
• Significant use of GP placements
• Vertical modules learning is ‘everybody’s business’
The Life Cycle
Module D
• addresses women’s and men’s health
Module E
• addresses child and family health
Module F
• Includes ageing and palliative care and specialist
practice (in patient psychiatry, eyes, ears, cancer)
Year 6
Preparation for practice
• Two blocks of 16 weeks, mainly at distant sites and
general practice
• Elective and SSCs including post exams SSC
• Focus on preparing for practice: student selected
components, elective, student assistantships, education
supervision and workplace based learning
• Students submit a portfolio of learning
• Finals early May allowing students the opportunity to resit and still take up Foundation post
Vertical Modules
– Key to students’ understanding of medicine as an
integrated whole
– Delivered through a range of activities
– Delivered both in centrally organised activities
everybody’s business: module leads ensure aspects
of the vertical modules topics are addressed within
the module and in workplace based learning:
– Equivalent to approximately one day per week across
the programme
Vertical Modules
1. Vertically organised modules: the integrated
vertical strands
2. Student centred learning, Patient centred
learning
1. Overarching themes
Vertical Modules: integrated vertical
strands
• Through all 6 years
• Addressing factual knowledge and skills connecting
science & clinical medicine:
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Pathological sciences
Anatomy and imaging
Use of medicines
Use of Evidence
Clinical skills and practical procedures
Vertical Modules: Student centred
learning, Patient centred learning
– Authentic e-portfolio
– Student selected components: mapped to ensure
attainment of a range of skills and outcomes
– Patient Pathways (disease progression and
management & care pathways; focus on the patient
experience)
Vertical Modules: Overarching
themes
– Synthesis & Professional Practice
– Mental Health
– Social Determinants of Health
Teaching methods
Assessment
Cohesive strategy:
– All years have in-course assessment managed via
the portfolio and end-of-year progression tests
– ‘Basket’ of assessments to ensure reliability and
feasibility
– Re-sits at key times: years 1, (2) and finals
– Finals early enough to allow a student to re-sit and
graduate the same year and take up their
Foundation post
MBBS 2012
• A time of great change for us
• Need to evaluate and
continue to modify
• An ever changing healthcare
provider landscape needs to
be part of the vision
• Teachers need to ensure a
consistent message with the
overall vision
• GMC visit in 2013 was
successful so good first
measure
MBBS 2012: a review of the journey
so far
Deborah Gill
Lead for the MBBS programme
We have lift off….
• Pilots and prototypes in 2010/11 and 2011/12
• Year 1,2, 3 ,4 and 6 in new curriculum format
• Year 5 in transition for full implementation in
2013/14
Successes
• Lots of different rockets launched!
• Year 1,2, 3 ,4 and 6 in new curriculum format
• Year 5 integrated assessment
• E-portfolio
• New personal tutor system
• New vertical modules introducing integrated mental
health, social determinants of health, patient
centredness and patient pathways, anatomy and
imaging
• New formative assessments in years 1 and 2
• Programme design seems to tolerate health service
reconfiguration
Issues arising…
• Failure to launch
• Poor trajectory/design faults
• Unhappy crew/action denounced as hostile
…….but no crashes (yet!)
GMC review (a problem focused
review)
The School has recently reviewed its curriculum and the
new curriculum became fully operational in September
2012. While we found some initial problems with the roll
out of the new curriculum, we also found that the School
was acting to address these concerns, for example, by
rectifying timetable clashes and updating student guidance
documents. [j1]
Failure to launch
• No patient pathways in
mental health or mother
and baby
• Little in way of vertical
modules seen as
everybody’s business
• Limited integration of BSc
• Very limited use of the
community (where care is
being delivered) beyond GP
teaching
Poor trajectory/design faults
• Some rather last minute design
leading to poorer quality product in
first iteration
• Menu of activity seen as ‘clashes’
• Integrated module management
and administration is problematic
• Moodle as currently used is not
fully supportive of the curriculum
• Differences between sites seen as
unfair
Unhappy crew/action denounced
as hostile
• Integrated module make for confused and disgruntled
teachers, administrators and students – especially in the
first iteration
• Episodes of non-engagement by senior teachers (doing it
the old way or no shows)
• Game of ‘trumps‘ with what activities are most important
• Some marginalisation of VMs and GP teaching as ‘taking
up too much curriculum space’
• Move to VLE seen as ‘taking away our teaching’: with
informal curriculum emerging
• Change in finals and within year re-sits not supported by
UCL
The ongoing mission..
• Important to not loose
momentum now the exciting
launch is over
• Curricula evolve and so new
changes will be needed in the
bedding down period
• Need to take staff and students
with us and ensure moving
forward feels safe and the right
thing to do
• Review structural issues that
impede delivery
New for 2013/14
New year 6
Launch of mother a baby patient pathway
Extension of e-portfolio to years 4-6
Changes to formative and summative assessments in
years 1 and 2
• Preparation for movement of finals to Easter term
• Some evaluation outcomes….watch this space
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