Dear Sir
Clinical anaesthetics rotations during medical school offer several benefits to medical students, including opportunities to practice procedural skills under close supervision, develop a strong foundation in applied physiology and gain early exposure to the specialty to inform future career choices. It is therefore important to monitor the provision of anaesthetics training to ensure that standards are consistent at a national level.
We present the key findings of a preliminary cross-sectional evaluation of clinical anaesthetics training in fifteen medical schools throughout the United Kingdom. We adopted a mixed methods approach using a standardised questionnaire and semi-structured interviews of clinical medical students (n = 65). The response rate was 86.7%. Where appropriate, we corroborated information using collateral sources, such as curriculum maps, logbooks and any learning materials provided.
Two out of the fifteen medical schools (13%) did not provide compulsory anaesthetics training, and only offered rotations as part of student selected modules. Within the remaining thirteen institutions, there was significant variation in the length of rotations (median: 2 weeks, range: 2 days–6 weeks). Typically, rotations were integrated into either surgical or acute specialty blocks. Activities during these rotations were unanimously centred around perioperative anaesthestics, with optional on-call, pain clinic and ITU attendance. Ten institutions (67%) consistently provided students with learning objectives, which universally focused on: airway equipment and management, principles of applied physiology, anaesthetic management of the surgical patient and anaesthetic pharmacology. Students from seven medical schools (47%) were directly assessed on their competencies in procedural and clinical skills, through either Direct Observation of Procedural Skills (DOPS) or Clinical Evaluation Exercises (mini-CEX). Common examples of skills performed included peripheral intravenous cannulation and airway management. Only two institutions (13%), however, have formalised these assessments as an essential requirement to successfully complete the rotation. Students at three medical schools (20%) cited specific concerns regarding the variation in experiences between hospital sites, which ranged from the length of the rotation itself to a lack of structure in their timetables.
Based on our preliminary results, we advocate that the General Medical Council acts to standardise undergraduate anaesthetics training across the UK. In particular, we recommend that: (1) A minimum length for clinical rotations is established to ensure adequate exposure; (2) Assessment of procedural and clinical skills is formalised to facilitate student learning; and (3) Institutions aim to minimise variation in experiences across hospital sites.
Declaration of interest: The authors report no conflicts of interest.