Does performance at the intercollegiate Membership of the Royal Colleges of Surgeons (MRCS) examination vary according to UK medical school and course type? A retrospective cohort study

ObjectivesThe knowledge, skills and behaviours required of new UK medical graduates are the same but how these are achieved differs given medical schools vary in their mission, curricula and pedagogy. Medical school differences seem to influence performance on postgraduate assessments. To date, the relationship between medical schools, course types and performance at the Membership of the Royal Colleges of Surgeons examination (MRCS) has not been investigated. Understanding this relationship is vital to achieving alignment across undergraduate and postgraduate training, learning and assessment values.Design and participantsA retrospective longitudinal cohort study of UK medical graduates who attempted MRCS Part A (n=9730) and MRCS Part B (n=4645) between 2007 and 2017, using individual-level linked sociodemographic and prior academic attainment data from the UK Medical Education Database.MethodsWe studied MRCS performance across all UK medical schools and examined relationships between potential predictors and MRCS performance using χ2 analysis. Multivariate logistic regression models identified independent predictors of MRCS success at first attempt.ResultsMRCS pass rates differed significantly between individual medical schools (p<0.001) but not after adjusting for prior A-Level performance. Candidates from courses other than those described as problem-based learning (PBL) were 53% more likely to pass MRCS Part A (OR 1.53 (95% CI 1.25 to 1.87) and 54% more likely to pass Part B (OR 1.54 (1.05 to 2.25)) at first attempt after adjusting for prior academic performance. Attending a Standard-Entry 5-year medicine programme, having no prior degree and attending a Russell Group university were independent predictors of MRCS success in regression models (p<0.05).ConclusionsThere are significant differences in MRCS performance between medical schools. However, this variation is largely due to individual factors such as academic ability, rather than medical school factors. This study also highlights group level attainment differences that warrant further investigation to ensure equity within medical training.

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BJS.02Graduates from different medical schools vary in their performance on the Intercollegiate Membership of the Royal College of Surgeons (MRCS) Examinations

British Journal of Surgery ◽

10.1093/bjs/znab310.004 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Ricky Ellis ◽

Duncan Scrimgeour ◽

Jennifer Cleland ◽

Amanda Lee ◽

Peter Brennan

Keyword(s):

Medical School ◽

Royal College ◽

Univariate Analysis ◽

Medical Schools ◽

Sociodemographic Factors ◽

Pass Rates ◽

Medical Graduates ◽

Surgical Trainees ◽

Socio Demographic Factors ◽

The Uk

Abstract Aims UK medical schools vary in their mission, curricula and pedagogy, but little is known of the effect of this on postgraduate examination performance. We explored differences in outcomes at the Membership of the Royal College of Surgeons examination (MRCS) between medical schools, course types, national ranking and candidate sociodemographic factors. Methods A retrospective longitudinal study of all UK medical graduates who attempted MRCS Part A (n = 9730) and MRCS Part B (n = 4645) between 2007 and 2017, utilising the UK Medical Education Database (https://www.ukmed.ac.uk). We examined the relationship between medical school and success at first attempt of the MRCS using univariate analysis. Logistic regression modelling was used to identify independent predictors of MRCS success. Results MRCS pass rates differed significantly between medical schools (P < 0.001). Russell Group graduates were more likely to pass MRCS Part A (Odds Ratio (OR) 1.79 [95% Confidence Interval (CI) 1.56-2.05]) and Part B (OR 1.24 [1.03-1.49])). Trainees from Standard-Entry 5-year programmes were more likely to pass MRCS at first attempt compared to those from extended (Gateway) courses, Part A OR 3.72 [2.69-5.15]; Part B (OR 1.67 [1.02-2.76]. Non-graduates entering medical school were more likely to pass Part A (OR 1.40 [1.19-1.64]) and Part B (OR 1.66 [1.24-2.24]) than graduate-entrants. Conclusion Medical school, course type and socio-demographic factors are associated with success on the MRCS. This information will help to identify surgical trainees at risk of failing the MRCS in order for schools of surgery to redistribute resources to those in need.

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Radiology and the medical student: do increased hours of teaching translate to more radiologists?

BJR|Open ◽

10.1259/bjro.20210074 ◽

2021 ◽

Author(s):

Cindy Chew ◽

Patrick J O'Dwyer ◽

David Young

Keyword(s):

Medical Students ◽

Medical School ◽

General Medical Council ◽

Medical Schools ◽

Medical Council ◽

Chi Square ◽

Medical Graduates ◽

Increasing Demand ◽

Radiology Teaching ◽

The Uk

Objectives: The UK has a shortage of Radiologists to meet the increasing demand for radiologic examinations. To encourage more medical students to consider Radiology as a career, increased exposure at undergraduate level has been advocated. The aim of this study was to evaluate if formal Radiology teaching hours at medical school had any association with the number of qualified Radiologists joining the General Medical Council Specialist Register. Methods: Total number of doctors joining the GMC Specialist Register as Clinical Radiologists, and those with a primary medical qualifications awarded in Scotland, was obtained from the GMC (2010–2020). Graduate numbers from all 4 Scottish Medical Schools (2000–2011) were also obtained. Hours of Radiology teaching for medical schools in Scotland were obtained from validated AToMS study. Results: Two hundred and twenty three (6.6%) of 3347 Radiologists added to the GMC Specialist Register between 2010 and 2020 received their primary medical qualification (PMQ) from Scottish Universities. The number of Radiologists from Scottish Universities joining the GMC specialist register was 2.6% of the total number of Scottish Medical Graduates. There was no association between the number of hours (Range 1–30) Radiology was taught to medical students and the number that joined the specialist register as Radiologists (p = 0.54 chi square trend). Conclusion: Increased exposure to Radiology teaching does not influence medical students’ decision to take up Radiology as a career. While continued Radiology exposure remains important, other strategies are required in both the short and long term to ensure radiology services are maintained without detriment to patients. Advances in knowledge: Increased hours of Radiology teaching in medical school was not associated with increased radiologists joining the profession.

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Prevalence and predictors of US medical graduates’ federal F32, mentored-K, and R01 awards: a national cohort study

Journal of Investigative Medicine ◽

10.1136/jim-2017-000515 ◽

2017 ◽

Vol 66 (2) ◽

pp. 340-350 ◽

Cited By ~ 8

Author(s):

Donna B Jeffe ◽

Dorothy A Andriole

Keyword(s):

Cohort Study ◽

Medical School ◽

Logistic Regression Models ◽

Medical Graduates ◽

Medical Licensing ◽

School Research ◽

National Cohort ◽

Experiential Interventions ◽

Research Workforce ◽

To Receive

The size and diversity of the physician-scientist workforce are issues of national concern. In this retrospective, national cohort study of US medical school matriculants who graduated in 1997–2004, we describe the prevalence and predictors of federal F32, mentored-K, and R01 awards among physicians. In multivariable logistic regression models, we identified demographic, educational, and professional development variables independently associated with each award through August 2014, reporting adjusted odds ratios and 95% confidence intervals (AOR (95% CI)). Among 117,119 graduates with complete data (97.7% of 119,906 graduates in 1997–2004), 509 (0.4%) received F32, 1740 (1.5%) received mentored-K, and 597 (0.5%) received R01 awards. Adjusting for all variables except US Medical Licensing Examination Step 1 scores, black (vs white) graduates were less likely to receive F32 (0.48 (0.28–0.82)), mentored-K (0.56 (0.43–0.72)), and R01 (0.48 (0.28–0.82)) awards; Hispanic graduates were less likely to receive mentored-K awards (0.68 (0.52–0.88)), and women less likely to receive F32 (0.81 (0.67–0.98)) and R01 (0.59 (0.49–0.71)) awards. After adding Step 1 scores, these race/ethnicity effects were not significant, but women (0.62 (0.51–0.75)) were still less likely to receive R01 awards. Graduates reporting both (vs neither) medical school research elective and authorship were more likely to receive F32 (1.89 (1.45–2.48)), mentored-K (2.48 (2.13–2.88)), and R01 (2.00 (1.54–2.60)) awards. Prior F32 (2.17 (1.46–3.21)) and mentored-K (28.08 (22.94–34.38)) awardees more likely received R01 awards. Findings highlight the need for research-experiential interventions along the medical education continuum to promote greater participation and diversity of US medical graduates in the federally funded, biomedical research workforce.

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A survey of ENT undergraduate teaching in the UK

The Journal of Laryngology & Otology ◽

10.1017/s0022215120000936 ◽

2020 ◽

Vol 134 (6) ◽

pp. 553-557

Author(s):

A W Mayer ◽

K A Smith ◽

S Carrie ◽

Keyword(s):

Medical School ◽

Learning Outcomes ◽

Undergraduate Curriculum ◽

Medical Schools ◽

School Curriculum ◽

Careful Consideration ◽

Undergraduate Teaching ◽

Medical Graduates ◽

Wide Variability ◽

The Uk

AbstractBackgroundENT presentations are prevalent in clinical practice but feature little in undergraduate curricula. Consequently, most medical graduates are not confident managing common ENT conditions. In 2014, the first evidence-based ENT undergraduate curriculum was published to guide medical schools.ObjectiveTo assess the extent that current UK medical school learning outcomes correlate with the syllabus of the ENT undergraduate curriculum.MethodTwo students from each participating medical school independently reviewed all ENT-related curriculum documents to determine whether learning outcomes from the suggested curriculum were met.ResultsSixteen of 34 curricula were reviewed. Only a minority of medical schools delivered teaching on laryngectomy or tracheostomy, nasal packing or cautery, and ENT medications or surgical procedures.ConclusionThere is wide variability in ENT undergraduate education in UK medical schools. Careful consideration of which topics are prioritised, and the teaching modalities utilised, is essential. In addition, ENT learning opportunities for undergraduates outside of the medical school curriculum should be augmented.

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Bullying in UK cardiology: a systemic problem requiring systemic solutions

Heart ◽

10.1136/heartjnl-2021-319882 ◽

2021 ◽

pp. heartjnl-2021-319882 ◽

Cited By ~ 1

Author(s):

Christian Fielder Camm ◽

Abhishek Joshi ◽

Abigail Moore ◽

Hannah C Sinclair ◽

Mark Westwood ◽

...

Keyword(s):

Medical School ◽

Regression Models ◽

Medical Schools ◽

European Economic Area ◽

Medical Specialties ◽

Logistic Regression Models ◽

Annual Survey ◽

Economic Area ◽

Sexist Language ◽

Being Bullied

ObjectivesBullying of trainee doctors has been shown to be associated with detrimental outcomes for both doctors and patients. However, there is limited evidence regarding the level of bullying of trainees within medical specialties.MethodsAn annual survey of UK cardiology trainees was conducted through the British Junior Cardiologists’ Association between 2017 and 2020 and asked questions about experiencing and witnessing bullying, and exposure to inappropriate language/behaviour in cardiology departments. Fisher’s exact tests and univariable logistic regression models were used to describe associations between trainee characteristics, and reports of bullying and inappropriate language/behaviour.ResultsOf 1358 trainees, bullying was reported by 152 (11%). Women had 55% higher odds of reporting being bullied (OR: 1.55 95% CI (1.08 to 2.21)). Non-UK medical school graduates were substantially more likely to be bullied (European Economic Area (EEA) OR: 2.22 (1.31 to 3.76), non-EEA/UK OR: 3.16 (2.13 to 4.68)) compared with those graduating from UK-based medical schools. Women were more likely than men to report sexist language (14% vs 4%, p<0.001). Non-UK medical school graduates were more likely to experience racist language (UK 1.5%, EEA 6%, other locations 7%, p=0.006). One-third of trainees (33%) reported at least one inappropriate behaviour with 8% reporting being shouted at or targeted with spontaneous anger. Consultants in cardiology (82%) and other specialties (70%) were most commonly implicated by those reporting bullying.DiscussionBullying and inappropriate language are commonly experienced by cardiology trainees and disproportionately affect women and those who attended non-UK medical schools. Consultants both in cardiology and other specialties are the most commonly reported perpetrators.

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Risk factors for mortality, ICU admission and bacteremia in patients suspected of sepsis at the Emergency department. A prospective cohort study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa594 ◽

2020 ◽

Author(s):

Valentino D’Onofrio ◽

Agnes Meersman ◽

Sara Vijgen ◽

Reinoud Cartuyvels ◽

Peter Messiaen ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Regression Models ◽

Serum Lactate ◽

Suspected Sepsis ◽

Logistic Regression Models ◽

Icu Admission ◽

Observational Cohort ◽

Independent Risk Factors ◽

Prediction Of Prognosis

Abstract Background There is a clear need for a better assessment of independent risk factors for in-hospital mortality, ICU admission, and bacteremia in patients presenting with suspected sepsis at the ED. Methods A prospective observational cohort study including 1690 patients was performed. Two multivariable logistic regression models were used to identify independent risk factors. Results SOFA score of ≥2 and serum lactate of ≥2mmol/L were associated with all outcomes. Other independent risk factors were individual SOFA variables and SIRS variables but varied per outcome. MAP<70 mmHg negatively impacted all outcomes. Conclusion These readily available measurements can help with early risk stratification and prediction of prognosis.

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Work-life balance predicted work ability two years later: a cohort study of employees in the Swedish energy and water sector

BMC Public Health ◽

10.1186/s12889-021-11235-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Erik Berglund ◽

Ingrid Anderzén ◽

Åsa Andersén ◽

Per Lindberg

Keyword(s):

Logistic Regression ◽

Cohort Study ◽

Work Ability ◽

Regression Models ◽

Work Life ◽

Personal Life ◽

Life Balance ◽

Logistic Regression Models ◽

Mental Demands ◽

Longitudinal Associations

Abstract Background Work-life balance (WLB) is the extent to which individual’s multiple life roles and demands carry over between each role. WLB can be divided into work interference with personal life (WIPL) and personal life interference with work (PLIW). This study aimed to investigate longitudinal associations between WIPL, PLIW and work ability outcomes. Methods In this cohort study, 224 employees in the energy and water sector in Sweden were followed-up over 2 years. Three questions derived from the Work Ability Index were used for measuring work ability outcome: current work ability compared with lifetime best; work ability regarding physical; and mental demands. Logistic regression models were used to analyse longitudinal associations between work ability and WIPL and WIPL respectively, controlling for workplace (company), position at work, experience of leadership quality, demographics, and work ability. Results Work ability compared to lifetime best were associated with WIPL in the adjusted logistic regression models (odds ratio (OR) 1.77, 95% confidence interval (CI) 1.15–2.73), and PLIW (OR 3.34, 95% CI 1.66–6.74). Work ability regarding physical demands was associated with WIPL (OR 1.60, 95% CI 1.07–2.40). Work ability regarding mental demands was associated with WIPL (OR 1.59, 95% CI 1.03–2.44) and PLIW (OR 2.88, 95% CI 1.31–6.32). Conclusion In this two-year longitudinal study, lower WIPL predicted good/excellent overall work ability compared with lifetime best, higher work ability regarding physical and mental demands, and lower PLIW predicted good/excellent overall work ability compared with lifetime best and higher work ability regarding and mental demands.

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The Consequences of Divorce and Splitting up for Spatial Mobility in the UK

Comparative Population Studies ◽

10.12765/cpos-2013-10 ◽

2013 ◽

Vol 38 (2) ◽

Author(s):

Peteke Feijten ◽

Maarten Van Ham

Keyword(s):

Residential Mobility ◽

Regression Models ◽

Disruptive Effect ◽

British Household Panel Survey ◽

Union Dissolution ◽

Panel Survey ◽

Housing Situation ◽

Spatial Mobility ◽

Logistic Regression Models ◽

The Uk

Union dissolution is well known to have a disruptive effect on the housing situation of those involved, and often leads to downward moves on the “housing ladder”. Much less is known about the geographies of residential mobility after union dissolution. There are, however, reasons to expect that those who experienced a union dissolution have a different likelihood of moving over longer distances than those who stay in a union, because of different moving motives. This study contributes to the existing literature by investigating the occurrences of moves, distances moved and the destinations of moves after union dissolution. The paper also contributes to the literature by investigating the effect on mobility not only of divorce, but also of splitting up and repartnering. Using longitudinal data from the British Household Panel Survey (BHPS), and logistic regression models, we found that union dissolution has a significant effect on the occurrence of moves and on moving distances.

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Differences in Sickness Allowance Receipt between Swedish Speakers and Finnish Speakers in Finland

Finnish Yearbook of Population Research ◽

10.23979/fypr.66598 ◽

2017 ◽

Vol 52 ◽

pp. 43-58 ◽

Cited By ~ 3

Author(s):

Kaarina S. Reini ◽

Jan Saarela

Keyword(s):

Regression Models ◽

Health Condition ◽

Logistic Regression Models ◽

Individual Level ◽

Objective Health ◽

Language Groups ◽

Health Measure ◽

All Cause Mortality ◽

The Difference ◽

The Individual

Previous research has documented lower disability retirement and mortality rates of Swedish speakers as compared with Finnish speakers in Finland. This paper is the first to compare the two language groups with regard to the receipt of sickness allowance, which is an objective health measure that reflects a less severe poor health condition. Register-based data covering the years 1988-2011 are used. We estimate logistic regression models with generalized estimating equations to account for repeated observations at the individual level. We find that Swedish-speaking men have approximately 30 percent lower odds of receiving sickness allowance than Finnish-speaking men, whereas the difference in women is about 15 percent. In correspondence with previous research on all-cause mortality at working ages, we find no language-group difference in sickness allowance receipt in the socially most successful subgroup of the population.

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Does UK medical education provide doctors with sufficient skills and knowledge to manage patients with eating disorders safely?

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2018-135658 ◽

2018 ◽

Vol 94 (1113) ◽

pp. 374-380 ◽

Cited By ~ 7

Author(s):

Agnes Ayton ◽

Ali Ibrahim

Keyword(s):

Eating Disorders ◽

Patient Safety ◽

Eating Disorder ◽

Postgraduate Training ◽

Medical Training ◽

Improve Patient Safety ◽

Medical Schools ◽

Junior Doctors ◽

The Uk ◽

Improve Patient

BackgroundEating disorders affect 1%–4% of the population and they are associated with an increased rate of mortality and multimorbidity. Following the avoidable deaths of three people the parliamentary ombudsman called for a review of training for all junior doctors to improve patient safety.ObjectiveTo review the teaching and assessment relating to eating disorders at all levels of medical training in the UK.MethodWe surveyed all the UK medical schools about their curricula, teaching and examinations related to eating disorders in 2017. Furthermore, we reviewed curricula and requirements for annual progression (Annual Review of Competence Progression (ARCP)) for all relevant postgraduate training programmes, including foundation training, general practice and 33 specialties.Main outcome measuresInclusion of eating disorders in curricula, time dedicated to teaching, assessment methods and ARCP requirements.ResultsThe medical school response rate was 93%. The total number of hours spent on eating disorder teaching in medical schools is <2 hours. Postgraduate training adds little more, with the exception of child and adolescent psychiatry. The majority of doctors are never assessed on their knowledge of eating disorders during their entire training, and only a few medical students and trainees have the opportunity to choose a specialist placement to develop their clinical skills.ConclusionsEating disorder teaching is minimal during the 10–16 years of undergraduate and postgraduate medical training in the UK. Given the risk of mortality and multimorbidity associated with these disorders, this needs to be urgently reviewed to improve patient safety.

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