Graduate students are more challenging, demanding, and questioning -- McCrorie 325 (7366): 676 Data Supplement

Graduate students are more challenging, demanding, and questioning
Peter McCrorie
is director of the graduate entry programme at St George’s Hospital Medical School Are good doctors born or made?

Both, just like good communicators. Some have a natural gift (or acquire it during their upbringing) that can serve as a grounding for focused training, others can be nurtured and developed into good doctors, and some will never make good doctors no matter how people try to help them.

What do you look for when selecting students?

We look for:

understanding about what being a good doctor entails, from both the profession’s point of view and the patient’s point of view
significant meaningful experience of working in a healthcare environment or with disabled or disadvantaged people
understanding of the importance of research in medicine and awareness of the ethical issues associated with medical research
understanding and experience of how teams work
good oral communication skills
flexible and critical thinking
awareness of the range of careers available in medicine, and
awareness of the need for doctors to have a strategy for dealing with stress.

Are graduate medical students any different from non-graduate students?

Definitely, although there may be less of a difference between graduates and mature (that is, older, with life experience) non-graduates. They are highly motivated, committed, prepared to work long hours, much more self directed, challenging, demanding, questioning, and—as alluded to above—mature. Graduates also come with a good deal of content knowledge, although that knowledge will vary widely according to the degree taken. They can therefore help each other in their learning—ideal for problem based learning.

Does undertaking medical training as a graduate have any bearing on being a good doctor?

Difficult one this. I’d say that if the course they undertake is little or no different from the school leaver course, in the end it would make little difference. However, if the graduate programme is tailormade specifically for graduates, and it builds upon their strengths, motivation, and prior learning, then it will make a difference. Also, if the pool of students is widened to include non-science graduates, then that will influence the end product of the medical school through broadening of the intake. I believe that mature students, whether graduates or not, are better able to handle the responsibilities which a doctor is required to undertake, sooner and more successfully—simply because they are more ready for it than 18 year olds, many of whom don’t begin to understand what being a doctor is really about.

Do you think that medical education needs to be altered in any way, and if so how?

Yes. I’m going to stick my neck out and say that, from 30 years’ experience of teaching both school leavers and graduates, medicine (and more importantly patients) would be better served by doctors entering medical school at a more mature age (22 and over). Entrance to medical school should be by a specially designed entrance examination (a European equivalent of the Australian GAMSAT?) testing reasoning, rather than factual recall. Indeed, all medical school assessments thereafter should test reasoning rather than factual recall, even skill based assessments. It follows that learning should also be through reasoning and logic rather than by rote. It should be self directed, student centred, patient centred, and contextualised.