We agree with Nazir et al. (Citation2014) that the MAU provides an ideal context for teaching, as long as adequate clinical and educational governance arrangements are in place. The reported findings concur with our local experience as Clinical Teaching Fellows: student attachments that receive the best feedback are usually those where substantial effort has gone into planning, delivery and accountability.
MAUs could be perceived by students as chaotic, overwhelming environments. In our view, however, this disadvantage is outweighed by the significant positive benefit of exposure to complex patients with multiple-organ pathologies. The busy nature of MAUs is also balanced by the omnipresence of senior clinicians. Integrating an educational role into acute physician job plans may improve job satisfaction (Gerrity et al. Citation1997) while meeting the need for consultant-led undergraduate teaching. MAU may prove to be an effective context in which to see elderly patients. Student exposure to Care of the Elderly (CoE) Medicine is often limited, and many MAUs now operate with multi-disciplinary acute CoE teams. Furthermore, MAU provides ample experience of several non-clinical aspects of medical practice, including the need for effective communication, time-management and team-working.
Our own attempts to integrate MAU teaching into medical student places have been met with mixed success thus far. Specific barriers have included varied expectations of students from different medical schools, management concerns over the operational impact of hosting students within MAU, and individual clinicians’ doubts as to the efficacy of the ad-hoc teaching delivered there.
Rewarding teaching is an excellent incentive for participation and involvement, but runs the risk of being about quantity rather than quality. We wonder if the firms are encouraging quality assurance of the teachers by providing training or supervision for them in addition to students?
We welcome Nazir et al.’s paper and hope it will catalyse our own efforts to improve our students’ exposure to, and enjoyment of, the MAU and other acute clinical areas.
Declaration of interest: The authors report no conflicts of interest.
References
- Gerrity MS, Pathman DE, Linzer M, Steiner BD, Winterbottom LM, Sharp MC; The Society of General Internal Medicine Career Satisfaction Study Group. 1997. Career satisfaction and clinician-educators. J Gen Intern Med 12:90–97
- Nazir T, Wallis S, Higham J, Newton K, Pugh M, Woywodt A. 2014. How we established a new undergraduate firm on a medical admissions unit. Med Teach 36(11):940–944