Table 2.

Recommendations for improving prescribing education for medical students and junior doctors (adapted, in part, from reference 35)

Undergraduate

1.Prescribing and therapeutics should be identified as an important vertical theme that is visible throughout the medical curriculum, integrating with and identifiable within relevant horizontal modules.

2.Students' core learning objectives should be clearly identified, including knowledge and understanding about drugs, skills related to the prescribing of drugs, and attitudes towards drug therapy.

3.The factual burden imposed by the large numbers of medicines that are encountered should be eased by prioritizing learning around a core list of around 100 commonly used drugs (a student formulary).

4.There should be an identifiable and robust assessment that tests whether the knowledge and skills outcomes identified above have been achieved; although this might form part of an integrated assessment, it should never be possible to compensate for a poor performance in prescribing by a good performance in other items.

5.Each medical school should identify an individual teacher to oversee this area of the curriculum, who will champion the importance of prescribing as a clinical skill and will ensure that the relevant opportunities are available to allow the relevant learning outcomes to be met.

Postgraduate

1.Prescribers should have protected time to update and reflect on their prescribing practices; dedicated training events should be provided at least once a year.

2.Prescribers should get feedback in the form of quality markers of prescribing relevant to their area of clinical practice.

3.Prescribers should, in the first year after graduation, receive genuine supervision that allows them to discuss problems and seek advice in a non-judgemental way.

4.Prescribers should not be pressurized into prescribing medicines of which they have little experience or understanding.

5.Whenever possible, errors that are identified should be drawn to the attention of the individuals concerned to afford a blame-free learning opportunity; all clinical units, including junior and senior doctors, should review and discuss prescribing incidents at regular intervals.

6.eLearning resources should be made available to support continuing professional development for prescribers at all levels.

7.Prescribing champions should be present in all large healthcare organizations to oversee the processes outlined above.