UCL Division of Medical Education
UCL School of Life and Medical Sciences
MBBS 2012:
An undergraduate education
for contemporary practice
Deborah Gill
MBBS Implementation Lead
Division of Medical Education
Why Change?
• Students, institutions,
curriculum guidance,
theory and evidence all
change over time
• Intervening only when
courses fail encourages a
regressive attitude
• Option for no change is
not an option
Why change?
• Changes to the
healthcare provider
landscape
• Changes in the
practice of medicine
• UCLP
• The institutional
mission of UCL
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
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’
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
– Early extended patient contact
– Focus on patient pathways
– Preparation for practice:
• Shadowing and assistantships
– 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:
• Portfolio of learning
• Exposure to a range of healthcare delivery venues
and practices
– Focus on contemporary practice and UCLP priorities:
• Leadership & professional practice
The UCL MBBS Programme 2012
PATIENT CENTRED
LEARNING, STUDENT
CENTRED LEARNING
VERTICALLY
ORGANISED MODULES
OVERARCHING
THEMES
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: Clinical care
Year 5: The life cycle
Year 6: The preparation for practice
NC 1 & 2
Year 1& 2: Fundamentals of clinical science
• Foundations module
• Systems based
• More vertical modules and integration (including
early patient contact)
• Post examination weeks
– Preparation for the following year
– Extended opportunities for early clinical practice
• Portfolio and end-of-year assessment
NC3
Integrated BSc
•
•
•
•
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 vertical modules
(portfolio and patient pathways)
NC4
Integrated clinical care
•
Three 12-week blocks, based at the three central sites
•
Focus on understanding and providing clinical care in the modern NHS
•
Provide comparable experience rather than uniformity of experience:
each site has a different ‘flavour’
•
Light touch central organisation, allowing sites to play to their strengths
but ensuring a core level of consistency & exposure
•
Modules link explicitly to the early years modules
•
Students maintain a portfolio of learning, including
workplace-based assessment (WPBA)
NC5
The life cycle
• Three12-week blocks, based in the three central sites,
rotating out to DGHs for placements
• Modules link to the lifecycle
• Child health and family health/primary care
• Women’s health: (also includes men’s health)
• Ageing and end of life care (plus specialist practice)
• Continue to maintain portfolio of learning, including WPBA
NC6
Preparation for practice
• Two blocks of 16 weeks, mainly at distant sites
• Focus on preparing for practice: student selected
components, elective, student assistantships, education
supervision and workplace based learning
• Students submit a portfolio of learning, including WPBA
• Finals earlier, allowing students the opportunity to re-sit
and still take up Foundation post
Vertical structures
– Key to students’ understanding of medicine as
an integrated whole
– Delivered through a range of activities
– Delivered both in centrally organised ‘peel-off’
activities and internally – module leads must
ensure aspects of the vertical modules topics are
addressed within the module and in workplace
based learning: everybody’s business
– Equivalent to approximately 1 day/week across
the programme
Vertical structures
1. Student centred learning, Patient
centred learning
–
–
–
–
Portfolios
Student selected components & elective
Patient Pathways (PPs)
Extended Patient Contact (EPC)
2. Vertically organised modules
–
Integrated Vertical Strands (IVS)
3. Overarching themes
–
–
–
Synthesis & professional practice
Mental health
Social determinants of health
Vertical structures: Student
centred learning, Patient
centred learning
– Authentic e-portfolio
– Mapping of SSCs: ensuring attainment of a
range of skills and outcomes
– Patient pathways (disease progression and
management & care pathways), core
presentations and extended patient contacts
Patient Pathways
•
In all years
•
Most include an Extended Patient
Contact
•
Relate to UCLP priorities
•
Link to Integrated Vertical Strands
and Synthesis
•
PP topics :
– Integrated/ community care
– Chronic diseases
– Cardio-metabolic disease
– Cancer
– Mental health
– Pregnancy & newborn/Women’s
health
Extended Patient Contact
• Throughout the programme, involving 3 to 5
contacts with one patient, supported by ongoing
small group work
• Topics:
–
–
–
–
–
Integrated /community care
Cardio-metabolic diseases
Cancer
Mental health
Mother and baby
Vertical structures: vertically
organised modules
Integrated Vertical Strands:
• Through all 6 years, linking to patient pathways
& portfolio
• Addressing factual knowledge connecting
science & clinical medicine:
–
–
–
–
–
Pathological sciences
Anatomy and imaging
Use of medicines
Use of Evidence
Clinical skills and practical proceedures
Vertical structures:
Overarching themes
– Synthesis & professional practice
– Mental health
– Social determinants of health
Synthesis & professional
practice
Delivered mainly through:
– Small group sessions
– Virtual learning environment
activities
– Some plenaries
– Case-of-the-month-type
activities
Addresses:
– Scholarship & critical thinking
– Professional skills
– Teamwork, leadership, safety
and quality of care
Mental Health
• An integrated vertical learning activity including
elements of patient pathways, extended patient
contact, integrated vertical strands and pockets of
protected time and placements, bringing together a
number of domains including:
–
–
–
–
–
–
Psychology
Social determinants of health
An extended patient project
Teaching on health and social care
Liaison psychiatry
Mental health problems in all horizontal modules and
attachments
– Dedicated short blocks of psychiatry experience in NC4&5
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 (mid May) to allow a
student to re-sit and graduate the same
year and take up their Foundation post
Countdown to MBBS 2012
• Less than 1 year to go!
• Period of transition: intensive work by
module leads and other lead teachers
• Communication, communication, communication
http://www.ucl.ac.uk/medicalschool/staff-students/mbbsnew-curriculum
• With learning oriented around patient pathways
and increase in vertical activities, need new ways
of thinking about teaching and careful thought
about the way learning experiences are organised
Implications for educators
•
•
•
•
•
•
•
•
•
Change needs careful management
Flexible timetables & placements must be designed
Staff development is crucial
Must work with a range of potential placements
providers
Web 2.0 and the VLE must be fully embraced
An integrated curriculum needs clear mapping
Ensuring patients are involved is vital
Student experience must be at the heart of all
decisions
Ongoing curriculum management and development
after 2012 must be ensured
MBBS 2012:
An undergraduate
education for
contemporary practice