Covid-19: medical schools are urged to fast-track final year students

UK medical schools have been urged to fast-track final year medical students into the workforce in the wake of severe disruptions to teaching programmes caused by the covid-19 outbreak.

The Medical Schools Council said that universities should waive requirements for clinical exams and draw on alternative methods of assessment to ensure that doctors are registered as quickly as possible.

Guidance issued by the council to medical schools on 13 March said: “It is important that medical schools do not delay qualification and so prevent new doctors joining the workforce in the summer. We advise that final year qualifying exams are prioritised where they have not yet taken place. Additional opportunities to take finals as a first sit should be provided where necessary. We suggest that finals are simplified as far as possible consistent with testing necessary learning objectives. We suggest patients are not used in final clinical exams.”1

The guidance added: “The GMC [General Medical Council] has confirmed that if a final year student is deemed by the university to have met the GMC’s required outcomes and has graduated, then subject to fitness to practise the GMC will provisionally register that doctor.”

The move comes amid fears that disruptions to final year exams could prevent newly qualified doctors from joining the workforce at a time when the NHS urgently requires extra staffing capacity.

Last week, the University of Cambridge School of Clinical Medicine said that it was being forced to suspend examinations because of the outbreak, including the final two clinical exams (SCEE and OSCE) for sixth year medical students next month. In an email to students, seen by The BMJ, Diana Wood, clinical dean of the school, wrote: “I am afraid that we have had to make some extremely difficult decisions based on the principle that students going in and out of clinical environments could be an unnecessary source of virus transmission, they may be putting their patients and themselves at greater risk and there may be too few staff available to deliver formal clinical teaching, either through pressure of work or illness.”

The Medical Schools Council guidance said that, if medical schools were unable to deliver formal clinical exams in the current climate, they could review alternative methods of assessment such as previous exam results or placement grades. “Where credit bearing modules and attendances other than exams are required for qualification, we encourage universities to look carefully to see whether these could be modified or waived,” it said. “Where this is not possible, we encourage universities and partner placement providers to enable such activity where possible, with the proviso that this must not compromise safety.”

King’s College London told The BMJ that it had suspended clinical placements for its medical students from 13 March to free up clinicians to focus on delivering care. It said it would review this on a weekly basis. And a University of Glasgow spokesperson told The BMJ that, after consultation with all stakeholders including the GMC, its clinical exams would be “adjusted and truncated” in response to the current situation.

In a statement, Colin Melville, medical director and director of education and standards at the GMC said: “We recognise these are exceptional circumstances, and medical schools may have to make adjustments. The decision to graduate a student is a matter for the university, but we must be satisfied they meet our requirements. We’ll continue to work closely with medical schools to ensure students have the right skills and knowledge before they receive their degree.”