Which common clinical conditions should medical students be able to manage by graduation? A perspective from Australian interns

Abstract

The objectives of the study were to report the development of a core curriculum that details the clinical conditions medical students should be able to manage upon graduation; and to canvass the opinion of interns (first-year postgraduate doctors) regarding their perceptions of the level of skill required to manage each condition. Literature relating to core curriculum development and training of junior medical officers was reviewed and stakeholders in the education and training of medical students and junior doctors in the state of New South Wales, Australia (intern supervisors, academics, registrars, nurses and interns) were consulted. The final curriculum spanned 106 conditions, 77 'differentiated' and 29 'undifferentiated'. Four levels of skill at which conditions should potentially be managed were also identified: 'Theoretical knowledge only'; 'Recognize symptoms and signs without supervision'; Initiate preliminary investigations, management and/or treatment without supervision'; and 'Total investigation, management and/or treatment without supervision'. The list of conditions in the curriculum was converted to a survey format and a one-in-two random sample of interns (n = 193) practising in New South Wales who graduated from the state's three medical schools were surveyed regarding the level of skill required for managing each clinical condition at graduation. A total of 51.3% of interns responded to the survey. Interns felt they should be able to initiate preliminary investigation, management and/or treatment for most conditions in the curriculum, with more than half acknowledging this level of management for 53 of the differentiated and 28 of the undifferentiated conditions. It is concluded that developing core curricula in medical education can involve multiple stakeholders, including junior doctors as the consumers of educational experiences. The data gathered may be useful to medical schools revising their curricula.

Improving the transition from medical school to internship – evaluation of a preparation for internship course

“…The difficult nature of the transition from medical school to internship is well documented, as is the lack of intern preparedness as reported by students and their supervisors’ [14,18,19]. To improve the transition from medical school to internship, UNSW developed a PRINT course that was first implemented in 2007 for students who had learned within a traditional content-based curriculum, and continued for subsequent student cohorts who had enrolled in a new outcomes-based program, that places importance on development of generic as well as clinical capabilities [6,24].…”

Factors influencing the development of practical skills of interns working in regional hospitals of the Western Cape province of South Africa

“…It was also found that the level at which interns functioned in these hospitals was very high when compared to other countries. 7,13,24 This implies that, with sufficient support and supervision, the combination of university training and an internship year is adequately preparing junior doctors for independent practice in this region. It may be of interest to repeat this exercise in a couple of years, when all universities will follow a new format of teaching with greater focus on practical skills.…”

“…An exploration of the barriers and difficulties involved in the learning of clinical skills will be made. 22,23,24,25,26,27,28,29,30,31,32,33,34,35 Method…”

The content of undergraduate health professional courses: a topic largely ignored?

“…A recent survey of 400 Australian interns suggests that they are able to nominate and prioritise areas that they feel are required for intern practice (Rolfe et al, 2000). However, they may not be aware of the tasks that will confront them as clinicians.…”