Undergraduate medical training: students' perspective and medical school policy

OBJECTIVES: Student attendance to lectures in French medical schools is oft en poor. We surveyed undergraduate medical students in our medical school, repeating a similar survey conducted ten years earlier. The results are pre sented with the conclusions of the faculty seminar that followed this surve y. METHODS: A closed item questionnaire was distributed in June, 1998, through the hospital wards where the students were posted. After two reminders, th e final response rate was 71% (247/348). RESULTS: Overall, 71% of the students declared that they never, or only occ asionally, attended lectures in the medical school. Reasons included lack o f time (75%), the curriculum diverging from the program of the selective ex amination that gives access to graduate specialization programs (59%), or i nsufficient practical clinical content (36%); 46% believed that this teachi ng prepared them to practice family medicine (11% some specialy), and 92% t hat the way it was organized was not compatible with preparing for the sele ctive examination. On the other hand, 75% of the students in the final two years of the curriculum declared that attending regularly special preparati on seminars for the selective examination, to succeed at this test (91%), b ut also to prepare for family practice (25%). Respectively 75%, 68% and 66% declared that undergraduate medical courses should, ideally, prepare them for the selective examination, but also for the practice of family medicine , and for graduate medical education. CONCLUSIONS: These results echoed the difficulties of the faculty of the me dical school to reconcile preparing students both for their future medical practice and for the selective examination. Two working groups were asked t o identify independently appropriate educational objectives according to ea ch perspective. their conclusions appeared to be quite compatible. Based on these conclusions, institutional objectives were ratified to guide the edu cational policy of our medical school, including the following. to reinforc e the consistency and progressiveness of the curriculum; to promote active and autonomous student learning approaches; to develop faculty teaching ski lls, curriculum evaluation and recognition of teaching activities. (C) 2000 , Masson, Paris.