UK medical schools have been urged to fast-track qualifications for final-year medical students, waiving requirements for clinical exams and using alternative assessments to enable them to be quickly registered as doctors in order to help tackle the coronavirus outbreak.
Medical schools and departments at universities across Britain are facing the prospect of releasing their staff and students to help the NHS cope with the developing crisis.
The leadership of the Medical Schools Council (MSC) has advised the UK’s 42 medical schools that they should prioritize qualifying final -year students even if they have missed clinical exams, so they can be provisionally registered by the General Medical Council (GMC) to begin working as doctors as soon as possible.
“It is important that medical schools do not delay qualification and so prevent new doctors joining the workforce in the summer,” the letter from the MSC’s co-chairs and chief executive said.
“We suggest that finals are simplified as far as possible, consistent with testing necessary learning objectives. We suggest patients are not used in final clinical exams. Ultimately it may not be possible to deliver any meaningful formal clinical exams, in which case the medical school should review the alternative methods of assessment that are available to them (previous exam results, placement grades etc). ”
Clinical teaching and exams using live patients are a crucial part of a medical student’s education, and the fear is that if clinical work was suspended then this year cohort of final-year students would face delays in qualifying as doctors, at a crucial time for an NHS already facing staff shortages.
Students at the University of Cambridge were told last week that the school’s clinical teaching would end, and that the university had sought approval from the GMC to cancel clinical exams. A spokesperson said the exams would have tied up more than 200 hospital doctors and GPs for more than two weeks, as well as students mingling with large numbers of patients, potentially exposing them to Covid – 90 infection.
“I am afraid that we have had to make some extremely difficult decisions, based on the principle that students going in and out of clinical environments could be an unnecessary source of virus transmission, they may be putting their patients and themselves at greater risk, and there may be too few staff available to deliver formal clinical teaching, either through pressure of work or illness, ”students were told in an email from Prof Patrick Maxwell, the head of Cambridge’s school of clinical medicine.
The university said the students have already completed their final written examinations and been assessed on clinical competence in previous exams and placements.
Prof Louise Richardson, vice-chancellor of the University of Oxford, has also told staff in an email: “The medical science division is cancelling all clinical teaching until further notice in order to release clinical teachers to the wards.”
Meanwhile, University College London has said it will release all clinical academics from their university roles if they want to help the NHS during the coronavirus crisis.
“Many of our clinical academics may shortly be asked to support clinical services as the NHS faces increased pressure during the coronavirus outbreak. We have taken the decision to release colleagues from their UCL responsibilities to enable them to take a decision on this, ”said Prof David Lomas, the university’s vice provost for health.
The MSC said current students should be enabled to work in the NHS during the crisis, by working as call handlers for the NHS’s 111 telephone service or taking over other non-critical roles to relieve staff.
“We predict that many medical students who have already passed finals will want to volunteer to work in the NHS and we encourage this. Important principles are that it must be their own decision, they should not be allowed to work beyond their competencies, they should be given full necessary personal protection and full instruction in its use, and they should be fully supervised with clear governance arrangements, ”the letter states.
“Opportunities may be available for post-finals medical students to assist in clinical services other than those dealing directly with patients with coronavirus infection. For example, helping in fracture clinics that are repurposed to deal with patients with minor injuries away from the emergency department environment. ”