Consistency of teaching in parallel surgical firms: an audit of student experience at one medical school

Background Traditional clinical clerkships have been based on the apprentic eship model of learning, with opportunistic teaching by doctors on presenti ng patients. Students at King's College School of Medicine, London had expr essed concern that they were receiving inequitable experiences in different clerkships. This had become more apparent since the introduction of a scho ol-wide end-of-year skills assessment. We decided to assess the consistency of delivery of the surgical syllabus. Method A multistage questionnaire survey was undertaken with third-year (fi rst clinical year) undergraduate medical students on surgical clerkships. T he questionnaire required students to record topics about which they had be en taught, and practical skills on which they had been supervised, from the surgical syllabus pertaining at the time. Results 194 (46.4%) questionnaires were returned. A low level of consistenc y was reported in the teaching of theoretical topics and practical skills a cross surgical clerkships in eight different locations. There were substant ial differences, both in overall coverage of the syllabus and in the priori ty given to different topics. There were no overall differences between tea ching hospital- and district general hospital-based clerkships. Discussion Students in so called 'parallel' clerkships did not receive comp arable teaching. The traditional opportunistic nature of clinical teaching led, in effect, to individual curricula within each clerkship. The General Medical Council has called for a core curriculum to be delivered across dif ferent clinical sites within each medical school. To achieve this, medical schools may need to introduce guidelines to direct teaching in the same way that clinical protocols have been developed to achieve greater standardiza tion in clinical practice.