How prepared are medical graduates to begin practice? A comparison of three diverse UK medical schools

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Abstract

Background
Previous work has suggested that many medical graduates feel unprepared to start work, and
that preparedness varies substantially between medical schools.
Aim
The present study aimed to explore the extent to which different medical schools prepare their
graduates for the workplace.
Methods
This was a multi-method, prospective, cross-sectional study. The primary research sample was
drawn from new graduates of three medical schools with differing curricula and cohorts:
Newcastle (systems-based, integrated curriculum); Warwick (graduate entry) and Glasgow
(problem-based learning or PBL).
This sample was stratified on the basis of academic MTAS (Medical Training Application
System) score, with five students from each school initially sampled from each MTAS quartile.
Purposive substitution was then made if necessary, to ensure representation of the
demographic range of students, in terms of age, sex, ethnicity and disability. Focus groups held
at each site with Foundation Programme doctors fed into the development of interview
schedules. Sixty five of the primary sample graduates were then interviewed before starting
their first placement as part of Foundation Year 1 (F1). Fifty five were re-interviewed at the end
of their first placement, and forty six again at the end of the F1 year. A cohort questionnaire to
assess perceptions of preparedness was devised and administered to each university cohort
during the shadowing period before starting F1.
Qualitative triangulating data was collected from nearly 100 clinicians (undergraduate tutors,
educational supervisors, key managers and members of clinical teams) to provide another
perspective on preparedness. Some of these interviews informed a triangulating questionnaire
completed by members of clinical teams who work with F1s.
Secondary data was examined in the form of assessment data from learning portfolios at the
end of the first placement, to identify procedures on which new F1s chose to be assessed
early. Newcastle and Warwick F1s also completed a safe prescribing assessment during F1.

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