Those who can, teach

Jack Amiry is Honorary Clinical Lecturer and Co-chair of the EDI Clinical Working, Oxford Medical School.

With contributions from:

David McCartney – Director of Graduate Entry Medicine, Oxford Medical School.

Richard Harrington – Associate Director of Graduate Entry Medicine, Oxford Medical School.

For GPs who enjoy teaching there are numerous opportunities to get involved – not just with medical students and specialty trainees but with those allied healthcare professionals working alongside us. It is increasingly likely for patients to see a nurse practitioner, physician associate, pharmacist, or paramedic and GPs are more likely than ever to be involved in interprofessional education, which associated with improved quality of care for patients.¹

Despite this key responsibility, few GP trainees have the opportunity to pursue formal training in education unless choosing to do so off their own back, and even then usually years after completing their training.

Medical Education Fellowships

Medical education fellowships (MEFs) originated within Family Medicine in the U.S.A. in the 1970s² but are gaining prominence in the U.K, where they are sometimes called Clinical Teaching Fellowships.

There is very little available data for the number of MEFs available specifically to those within GP training but speaking to educators at other universities as well as those working within GP schemes, they appear to be far from common. At the time of writing this article – July 2021 – there were 10 education or teaching fellow posts on NHS Jobs, none aimed specifically at GP trainees, and only two that were open to anyone including GP trainees.

Part of the Solution

Perhaps most pertinently given the current recruitment crisis in General Practice³ is the well-established correlation between exposure to “role models” and students’ future career choice.⁴ Undergraduates view primary care more favourably if there is credible representation of primary care academics and educators within their institutions⁵ and we know positive authentic experiences on their GP placements make undergraduates more likely to pursue GP training later on.⁶

Representation matters, and if the next generation of doctors associate GPs and GP trainees with academic credibility, it may mean those who see themselves as “high-flyers” are less likely to think of General Practice as a back-up.

I had several students tell me in careers meetings that seeing GPs in educational leadership positions within Oxford made them strongly consider whether General Practice was something they wanted to pursue. Even if these students ultimately end up practicing in hospitals, they are likely to have a greater level of respect for General Practice and those who operate within it, which can only be beneficial for the relationship between primary and secondary care in the future.

If GP trainees are not given the chance to experience what a job in higher education is really like – not to mention to opportunity to form working relationships within those institutions – it would hardly be surprising those interested in education were dissuaded from pursuing their ambitions.

I undertook a MEF last year. The post ran throughout my ST3 year and was two sessions per week, taking the place of two clinical sessions, with the ST3 ‘year’ subsequently extended by three months to make up for this.

I was encouraged to experience myriad educational activities; not just face-to-face teaching (though these were the most rewarding) but also student pastoral meetings, assisting with the setting and marking of assessments and attending departmental meetings.

Gaining an insight into the way a university is organised behind the scenes was invaluable. In the same way you need to sift through an inbox of bloods, referrals, letters and prescriptions to grasp what it is like to be a GP, it was only when I had an appreciation for the different facets of medical education that I felt I could truly commit to pursuing it as a career.

While it may well not be true for everyone who undertakes one, I don’t think it’s an exaggeration to say that my MEF will fundamentally shape the path of my future career.

References

1. Barnsteiner JH, Disch JM, Hall L, Mayer D, Moore SM. Promoting interprofessional education. Nurs Outlook. 2007 May-Jun;55(3): 144-50.
2. Coates WC, Runde DP, Yarris LM, Rougas S, Guth TA, Santen SA, Miller J, Jordan J. Creating a Cadre of Fellowship-Trained Medical Educators: A Qualitative Study of Faculty Development Program Leaders’ Perspectives and Advice. Acad Med. 2016 Dec; 91(12): 1696-1704
3. Lawson E, Kumar S. The Wass Report: Moving Forward 3 Years On. BJGP. 2020; 70 (693): 164-165.
4. Wright, S., Wong, A. & Newill, C. The Impact of Role Models on Medical Students. J Gen Intern Med 1997, 12 53–56.
5. Bland, C. et al. “Determinants of primary care specialty choice: a non‐statistical meta‐analysis of the literature.” Acad Med 1995: 70, 620–41.
6. Alberti H, Randles H, Harding A, McKinley R. Exposure of undergraduates to authentic GP teaching and subsequent entry to GP training: a quantitative study of UK medical schools. BJGP. 2017; 67 (657)

Featured photo by Sidharth Bhatia on Unsplash