Present:
PAPER 13/FP/1
THE UNIVERSITY OF EDINBURGH
COLLEGE OF MEDICINE AND VETERINARY MEDICINE
FOUNDATION PROGRAMME COMMITTEE
Minutes of Meeting held on 20 May 2013
Professor W Reid, Dean of Postgraduate Medicine (Convenor)
Dr D Henderson, Associate Postgraduate Dean (Foundation Programmes)
Professor A N Turner, Director, Undergraduate Learning & Teaching
2
Professor R W Parks, Convenor, Fitness to Practise Committee
Dr G Birnie, Medical Director, Fife
Dr A Jaap, Year 5 Deputy Director
Dr M Cullen, Convenor, Professional Development Committee
Dr H Monaghan, Consultant representative (Lothian)
Dr R Gill, ST Grade representative
Dr T Carter, F2 representative
In Attendance:
1
Mrs C Tomlinson, College Office (M&VM)
WELCOME AND APOLOGIES
Professor Reid welcomed members, who introduced themselves to the meeting.
Apologies were presented from Dr A Mowbray, Dr D Thomson, Dr H Cameron and Mrs M
McGill.
MINUTES OF MEETING OF 19 NOVEMBER 2012 Paper 12/FP/7
Professor Reid took members through the minutes.
Matters arising:
UKFPO/SFAS allocation scheme 2013 – Dr D Henderson Paper 12/FP/8
Dr Henderson referred members to the above paper and it was noted that this year the
Foundation Programme was oversubscribed by 1,000 applicants.
The over-subscription rule was applied, whereby non-UK medical school/non-EU applicants were excluded from the
Primary Allocation. 7242 applicants were allocated in the primary list, with 89% percent of applicants being allocated to one of their top five foundation schools. 95.8% of Edinburgh students were allocated to a top five preference. 295 applicants (including 238 UK graduates) were placed on the reserve list to be allocated in batches to vacancies arising from withdrawals and failed finals. Such allocations were scheduled to take place on 30 April, 29
May, 26 June and 24 July.
Tables comparing the national average of all medical schools and results by Foundation
School were also considered. Edinburgh scored an average of 81.7%.
The table of SJT results by medical school were also considered. The SJTs had not produced the spread of marks hoped for. It was noted that Edinburgh was the third highest scoring University for SJTs after Oxbridge but below average for the academic score. It was felt that Edinburgh students were disadvantaged by the way that score was calculated (ie the majority of students do not have a degree before commencing Medicine) have a first degree.
This requires to be considered. Dr Cullen, who had attended a national meeting, reported that
UKFPO were considering the issue of degrees.

3
There were also marking issues surrounding the SJTs and medical schools were tasked with manually checking the papers/scores awarded.
Eleven students throughout the UK were excluded from the Foundation Programme allocation process on the grounds of their SJT answers, which has caused concern in a number of universities. Should these students successfully pass Finals, they would possess a medical degree but no GMC licence to practise. After the Appeals process relating to this situation, these students were informed that they can apply, and be interviewed, for any August vacancies in their local Foundation School.
The minutes were approved.
REPORT ON F1/F2 - Dr D Henderson Paper 12/FP/9
Dr Henderson informed the Committee of new Foundation Programme Director appointments as follows:
S1 – Dr David Mitchell, Consultant Paediatric Gastroenterologist, RHSC (replacing Dr Angela
Thomas)
S12 – Dr Alistair Milne, Consultant Anaesthetist, RIE (replacing Dr Kirsty Dundas)
F1
Three (one Edinburgh) Special Circumstances applications to South-East Scotland Deanery for August 2013 intake were successful this year.
One F1 had performance issues and will now progress to F2 after an additional F1 year. One
F1 has had their training delayed due to physical health issues. One F1 had to be transferred to a supernumerary post for their 2 nd block due to performance issues. Having improved, they have now returned to a standard training post. One F1 had a recurrence of mental health issues and will re-commence F1 in August.
A previously satisfactory Unit had a number of issues which led to significant stresses on the
F1 doctors for the first 2 blocks of this F1 year. Considerable input has been required to improve the situation on the Service side and this has paralleled the pastoral care required for the trainees. Focus groups were planned for the end of June. A new rota had been put in place but any further problems should be reported to the Deanery.
Tragically, two F1 doctors have died this year - one in a climbing accident and one in a car accident. Both Professor Reid and Dr Henderson expressed their thanks to all those involved in supporting the F1s’ friends and relatives both in Fife and in Edinburgh.
F2
One F2 required to repeat a block, which led to visa issues. One F2 was convicted of assault in Spain. The GMC did not feel that the doctor had any case to answer as they felt that there were issues with the Spanish legal process. The doctor is appealing the conviction at a
European level and has received excellent support from both his/her FPD and University staff throughout the appeal process.
One F2 has successfully returned to work after previous health issues.
There are currently two vacancies at F1 level. There were 7 vacancies at F2 from August
2013. The one-year F2 LAT posts were all filled after interview as part of the Scottish recruitment process.
Scottish Foundation Allocation Scheme (SFAS) – August 2013 intake
Paper 12/FP/8 details the current issues around oversubscription for the August 2013 intake.

4
Scottish Foundation Allocation Scheme (SFAS) – August 2014 intake
Dr Henderson and Dr Steve Cunningham (FPD, Academic Foundation Programme) hosted a recruitment presentation for Year 4 on 10 May and Powerpoint presentations have been uploaded to EEMeC. It is thought likely that the level of oversubscription will be even higher in 2014.
Foundation Programme UK Reviews
Health Education England (HEE) has set up a Better Training, Better Care Taskforce, which includes Scottish representation, to assist in implementation of a number of the recommendations from the Collins Review of the Foundation Programme.
One of the main challenges outstanding is the increase in Community placements. Scotland currently has 24% of Foundation trainees experiencing a Psychiatry post and 28% of trainees rotating through General Practice. There has been an SHA directive in England to increase psychiatry posts in Foundation.
It is hoped to increase Community exposure by using the additional posts funded by the
Scottish Government as part of the oversubscription issue. Forty-five additional F1 posts have been funded in Scotland for the August 2013 intake (12 in SE Scotland). Additional posts have also been provided in England and Wales. It is unclear whether an F2 year will be funded for these posts or what will happen around oversubscription in August 2014.
The new formalised Transfer of Information (ToI) form was referred to. Dr Margaret Cullen
(Senior Tutor for the Personal Tutor scheme) had interviewed students who had been seen by the Professional Development Committee (PDC) or who had issues surrounding academic performance/health, etc, in connection with the completion of the ToI forms.
It would be useful for Fitness to Practise statistics and Final Year students who have had issues to be brought to this Committee. Action: RWP
2013 ARCP Process
In a move to harmonise PG medical training, the ARCP process is being introduced to
Foundation for 2013. The F1s are already signed off for Full GMC Registration and F2s for their Foundation Achievement of Competencies Document (FACD). It is therefore hoped that the ARCP process will build on the existing processes and not be a significant administrative burden.
Shadowing Week
Four days of Shadowing Week (a 7-day programme in Scotland) is now funded, an increase on the single day that was previously funded. Fife, Lothian and Borders have improved the content of the week year on year and have introduced innovative practice such as simulation and the production of a passport valid across the three Health Boards. This has been put forward on a Scottish level as an example of best practice and will be presented to the
Scottish Foundation Day on 30 May.
SE SCOTLAND DEANERY – QUALITY MANAGEMENT REVIEWS - Dr D Henderson
(Paper 12/FP/9)
Dr Henderson summarised the recommendations (Rs1-6) based on the reviews of the following units:

5
Queen Margaret Hospital – Surgery (29 August 2012)
R1 Ongoing Dignity at Work issues are still being reported by trainees pertaining to one consultant , although they did comment that the consultant’s management of patients was excellent. The Deanery expects the Management team to investigate this further, monitor closely and keep the Deanery informed.
R2 There is still evidence that Foundation trainees are uncertain of Medical Escalation
Procedures. It is recognised that there is a clear policy already in place so steps are required to ensure that all trainees are aware of these.
R3 There needs to be clear guidance to allow cross cover between teams to restructure the workload between teams.
R4 There needs to be clear guidance and increased utilisation of critical incident reporting.
R5 The facilities need to be New Deal compliant.
R6 SPAs in Job Plans - this should be addressed with the divisional Medical Director NHS
Fife to ensure that all the trainers have their educational activities in their Job Plan.
St John’s Hospital – Psychiatry (21 September 2012)
R1 Improve clinical supervision in clinics so clinics become training clinics.
R2 Improve clinical supervision both for on calls (24 hours/day) but also for handover, aiming for consistency from all senior staff involved.
R3 Continue communication for ROTA management including study and annual leave.
R4 Formalise the inducti on of Royal Edinburgh trainees on the St John’s site.
R5 To review medical nursing input in the old age psychiatry unit to reduce the workload on junior doctors.
R6 Review admission processes so patients are assessed in a timely manner.
A number of visit reports are currently pending.
PREPAREDNESS FOR PRACTICE F1 SURVEY (Paper 12/FP/10)
Feedback on a Preparedness for Practise survey of both F1 trainees and trainers, conducted by
Severn Foundation School, was presented. Only English Foundation Schools were surveyed and therefore Scotland was not involved. Dr Henderson undertook to speak to Clare van
Hamel, the Lead Investigator, to request Scottish involvement in any future study.
Action: DH
Twenty-three out of 26 Foundation Schools participated, with 1,829 respondents giving an overall response rate of 31%. Survey results were from weeks 1-4 from start of F1.
The trainer survey led to 1,145 responses from clinical and educations supervisors. However the denominator is not clear as supervisors may have more than one role per F1 trainee they supervise. These results were from weeks 8-12 from the start date.
Professor Turner remarked that a considerable amount of work was being undertaken around this and he would endeavour to gather information regarding what was happening in Scotland.
Action: ANT

7
6 GMC FITNESS TO PRACTISE AND PROVISIONAL REGISTRATION (Paper 12/FP/11)
Members were referred to the above paper, a letter from the General Medical Council (GMC) stressing the importance of medical schools only graduating medical students who are fit to become doctors.
The letter states that medical schools and parent universities “have a responsibility to the public, to employers and to the profession to ensure that only those students who are fit to practise as doctors are allowed to complete the curriculum and gain provisional registration with a licence to practise.”
The GMC can only register those whose fitness to practise is not impaired. By graduating a medical student, the university is declaring to the GMC, as the regulator, that it considers a student is fit to practise medicine. Therefore, if the university is not of that view, it must not allow that student to graduate with a medical degree.
The GMC is planning to revisit its current guidance “Medical students: professional behaviour and fitness to practise” and to promote the importance of professionalism with students.
Professor Turner suggested that perhaps the law required to be changed so that a licence to practise was awarded with a medical degree which was the case up until WWII.
As regarded professionalism of students, Professor Reid was encouraged that the medical school was moving in the right direction, with early prevention being the key and individuals were becoming more confident about flagging this up.
ANY OTHER COMPETENT BUSINESS
7.1 Prescribing Skills Assessment pilot
It was noted that the Prescribing Skills Assessment had be run on a pilot basis this year with
Edinburgh students performing very well by national comparison. The students felt the test to
be authentic and relevant to clinical practise. Professor Turner did not think there would be a
national rule regarding its implementation in its current form in the near future. The proposal had been that students who did not pass the test at medical school must take this sometime during their F1 year and this would incur a fee.
Consideration should be given to how Edinburgh tests prescribing in the MBChB programme.
Action: ANT
7.2 Medic Insight/Workplace experience
It had been unclear at the last meeting regarding whether all school pupils had the opportunity to take up this experience. Dr Monaghan undertook to speak to Human Resources at St
John’s Hospital regarding this. She had now spoken to Neil Murray, R&D Manager, Human
Resources, SE Lothian, who assured her that this was open to all S5 pupils and placements was administered by his team at St John’s Hospital.
Dr Monaghan undertook to obtain further information from Mr Murray. Action: HM
Mr Murray advised that Medic Insight is a model that is run both in Edinburgh and Dundee, running two weeks each year and was open to all pupils in S5 and the online application process is via the following website: http://www.medicinsight.com/index.php/our-programmes/edinburgh
The following is an extract from the above webpage:

8
"Medic Insight, a voluntary organisation set up and run by medical students and doctors, is looking for students to join our team and help in the running of the programme. Medic Insight organises careers events, school talks and a work experience programme for secondary school pupils in the Edinburgh area who are interested in pursuing a career in medicine. We have a variety of roles available including working in teams to organise the events; fundraising and sponsorship; liaising with schools to carry out talks etc.
”
Final year medical students assess the applications and shortlist successful candidates who are sent the paperwork by Mr Murray’s team. He is unsure how the applications are assessed.
Scott James (scott.james@medicinsight.com) is the General Manager for Medic Insight and could probably answer any specific questions.
Mr Murray was unable to answer the question regarding whether pupils at private schools were favoured over others. However, his team runs twice-yearly careers fairs in East and
West Lothian and in Edinburgh and he informs all pupils that if they are interested in becoming a doctor, to look at the above website and apply.
Marion McGill
The Committee recorded its thanks to Marion McGill, who was due to retire in mid-June, for her valued contribution over a number of years. She would be sadly missed.
DATE OF NEXT MEETING
The next meeting will be held at 4.30 pm on Monday, 18 November 2013 in the Board
Room, Chancellor’s Building, Little France.
Professor Reid thanked everyone for attending, particularly Dr Tom Carter for whom this was his last meeting as the F2 representative.