Transitioning from university to postgraduate medical training: A narrative review of work readiness of medical graduates

Objective To investigate trainee doctors’ and trainers’ perceptions of the validity of the Annual Review of Competence Progression (ARCP) using Messick’s conceptualisation of construct validity. Design Qualitative semi-structured focus groups and interviews with trainees and trainers. Setting Postgraduate medical training in London, Kent Surrey and Sussex, Yorkshire and Humber, and Wales in November/December 2015. Part of a larger study about the fairness of postgraduate medical training. Participants Ninety-six trainees and 41 trainers, comprising UK and international medical graduates from Foundation, General Practice, Medicine, Obstetrics and Gynaecology, Psychiatry, Radiology, and Surgery, at all levels of training. Main outcome measures Trainee and trainer perceptions of the validity of the ARCP as an assessment tool. Results Participants recognised the need for assessment, but were generally dissatisfied with ARCPs, especially UK graduate trainees. Participants criticised the perceived tick-box nature of ARCPs as measuring clerical rather than clinical ability, and which they found detrimental to learning. Trainees described being able to populate their e-portfolios with just positive feedback; they also experienced difficulty getting assessments signed off by supervisors. ARCPs were perceived as poor at identifying struggling trainees and/or as discouraging excellence by focussing on minimal competency. Positive experiences of ARCPs arose when trainees could discuss their progress with interested supervisors. Conclusions Trainee and trainer criticisms of ARCPs can be conceptualised as evidence that ARCPs lack validity as an assessment tool. Ongoing reforms to workplace-based assessments could address negative perceptions of the ‘tick-box’ elements, encourage constructive input from seniors and allow trainees to demonstrate excellence as well as minimal competency, while keeping patients safe.

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Exploration of Academic Postgraduate Medical Training System in the Context of "Internet plus"

E3S Web of Conferences ◽

10.1051/e3sconf/202127103073 ◽

2021 ◽

Vol 271 ◽

pp. 03073

Author(s):

Xiaoshan Huang ◽

Longwu Yin ◽

Bilan Zhou ◽

Zhifang Liu ◽

Meihua Bao

Keyword(s):

Higher Education ◽

Evaluation System ◽

Medical Training ◽

Training System ◽

Innovation Capability ◽

New Era ◽

Postgraduate Medical Training ◽

Medical Graduates ◽

Global Quality ◽

Higher Education In China

Higher education in China has entered a new era of global quality improvement and innovation. The cultivation of innovative talents is crucial for the development of our higher education. Within the framework of "Internet plus", the culture of university medical graduates must deeply integrate information technology. In the present study, an "Internet plus" academic medical postgraduate training system was discussed. This system includes the establishment of the curriculum system, innovation capability training system and quality evaluation system. By making full use of modern informatics technology, the “Internet plus” system improved the the innovation capability and quality of postgraduates significantly.

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Implicit gender-career bias in postgraduate medical training still exists, mainly in residents and in females

BMC Medical Education ◽

10.1186/s12909-021-02694-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Maud Kramer ◽

Ide C. Heyligers ◽

Karen D. Könings

Keyword(s):

Gender Bias ◽

Medical Training ◽

Leadership Positions ◽

Medical Field ◽

Online Questionnaire ◽

Surgical Specialty ◽

Postgraduate Medical Training ◽

Career Ambition ◽

The Mean ◽

Attending Physicians

Abstract Background More and more female residents enter postgraduate medical training (PGMT). Meanwhile, women are still underrepresented in academic medicine, in leadership positions and in most surgical specialties. This suggests that female residents’ career development may still be negatively impacted by subtle, often unconscious stereotype associations regarding gender and career-ambition, called implicit gender-career bias. This study explored the existence and strength of implicit gender-career bias in doctors who currently work in PGMT, i.e. in attending physicians who act as clinical trainers and in their residents. Methods We tested implicit gender-career bias in doctors working in PGMT by means of an online questionnaire and an online Implicit Association Test (IAT). We used standard IAT analysis to calculate participants’ IAT D scores, which indicate the direction and strength of bias. Linear regression analyses were used to test whether the strength of bias was related to gender, position (resident or clinical trainer) or specialty (non-surgical or surgical specialty). Results The mean IAT D score among 403 participants significantly differed from zero (D-score = 0.36 (SD = 0.39), indicating bias associating male with career and female with family. Stronger gender-career bias was found in women (βfemale =0 .11; CI 0.02; 0.19; p = 0.01) and in residents (βresident 0.12; CI 0.01; 0.23; p = 0.03). Conclusions This study may provide a solid basis for explicitly addressing implicit gender-career bias in PGMT. The general understanding in the medical field is that gender bias is strongest among male doctors’ in male-dominated surgical specialties. Contrary to this view, this study demonstrated that the strongest bias is held by females themselves and by residents, independently of their specialty. Apparently, the influx of female doctors in the medical field has not yet reduced implicit gender-career bias in the next generation of doctors, i.e. in today’s residents, and in females.

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Factors relating to working hours restriction that have impacted the professional identity of trainees in the last decade

British Journal of Hospital Medicine ◽

10.12968/hmed.2020.0355 ◽

2021 ◽

Vol 82 (3) ◽

pp. 1-10

Author(s):

Soumya Mukherjee ◽

James Meacock ◽

Eleanor Kissane ◽

Debasish Pal

Keyword(s):

Identity Development ◽

Professional Identity ◽

Medical Training ◽

Working Hours ◽

Junior Doctors ◽

Clinical Experiences ◽

Postgraduate Medical Training ◽

European Working ◽

Working Time Directive ◽

The Impact

Ever-developing changes to the working hours of junior doctors by the European Working Time Directive, the junior doctor contract of 2019 and most recently the COVID-19 pandemic have impacted the professional identity of doctors. There has been little investigation into its influence on the multifaceted aspects of postgraduate medical training, which feeds into how trainees consider themselves professionally and the concept of professional identity or ‘being a doctor’. A review of the medical, socio-political and educational literature reveals that the impact on the professional identity development of trainees is influenced by several perspectives from the trainee, trainer and the public. Gross reduction in working hours has no doubt decreased the raw volume of clinical experiences. However, to counteract this, smarter learning processes have evolved, including narrative reflection, supervised learning events, and a greater awareness of coaching and training among trainers.

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Teamwork of clinical teachers in postgraduate medical training

Perspectives on Medical Education ◽

10.1007/s40037-016-0286-0 ◽

2016 ◽

Vol 5 (4) ◽

pp. 253-256 ◽

Cited By ~ 1

Author(s):

Irene Arida Slootweg

Keyword(s):

Medical Training ◽

Clinical Teachers ◽

Postgraduate Medical Training

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Medical Training Initiative for UK hospitals and international medical graduates

British Journal of Hospital Medicine ◽

10.12968/hmed.2011.72.2.66 ◽

2011 ◽

Vol 72 (2) ◽

pp. 66-67

Author(s):

Morgan Bailey ◽

Peter Trewby

Keyword(s):

Medical Training ◽

International Medical ◽

International Medical Graduates ◽

Medical Graduates ◽

Training Initiative

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The European Working Time Directive and Postgraduate Medical Training: challenge or opportunity?

Medical Education and Training ◽

10.1093/med/9780199234219.003.0015 ◽

2008 ◽

pp. 211-224

Author(s):

Michael J Bannon

Keyword(s):

Medical Training ◽

Working Time ◽

European Working Time Directive ◽

Postgraduate Medical Training ◽

European Working ◽

Working Time Directive

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International medical graduates' reflections on facilitators and barriers to undertaking the Australian Medical Council examination

Australian Health Review ◽

10.1071/ah11082 ◽

2012 ◽

Vol 36 (3) ◽

pp. 296 ◽

Cited By ~ 3

Author(s):

Pam McGrath ◽

Saras Henderson ◽

Hamish A. Holewa ◽

David Henderson ◽

John Tamargo

Keyword(s):

Medical Training ◽

Study Groups ◽

International Medical ◽

International Medical Graduates ◽

Medical Council ◽

Or Education ◽

Program Coordinators ◽

Australian Health ◽

Medical Graduates ◽

Facilitators And Barriers

Objective. In Australia, 25% of international medical graduates (IMGs) make up the medical workforce. Concern is expressed in the literature about the lack of awareness and knowledge of issues that impinge on IMGs’ education. Although there is literature alluding to difficulties IMGs face with undertaking the Australian Medical Council (AMC) examination, there is little research detailing this experience. We therefore explored IMGs’ reflections on facilitators and barriers in undertaking the AMC examination. Methods. After ethics approval, in-depth telephone interviews were conducted with 30 IMGs selected from a hospital in Queensland. Data were coded and analysed using thematic analysis principles. Results. Two facilitating themes were identified: ability to sit for the first part of the examination in country of origin; and having access to resources such as bridging courses and study groups. Three themes represented barriers: not understanding procedural steps; financial issues; and lack of information on examination content and standards. Conclusion. The themes provide new insights and add depth to existing literature that can be used to improve procedural processes and education for IMGs towards successful outcomes in the AMC examination. What is known about the topic? There is concern expressed in the literature about the lack of awareness and knowledge of issues that impinge on IMGs education. The Australian work that is available only depicts educational experience of fellowships or education and training strategies after IMGs have passed their AMC examination. What does this paper add? The findings indicate that the process of sitting for the AMC examination is perceived as one of the major difficulties associated with entering and integrating into the Australian health system. The findings indicate a range of practical, financial and resource problems faced by IMGs attempting to sit for the AMC examination. What are the implications for practitioners? The detailed accounts from IMGs about their experience with undertaking the AMC examination will provide up-skilling program coordinators with the information they need to better assist IMGs to prepare for the examination. The provision of appropriate medical training and educational support will contribute to more effective integration of IMGs into the healthcare system.

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