Undergraduate preparation for prescribing: the views of 2413 UK medical students and recent graduates

Abstract

Aims: To gather opinions from UK medical students and recent graduates about their undergraduate training to prescribe and their confidence about meeting the relevant competencies identified by the General Medical Council (GMC).

Methods: We designed a web-based survey that was distributed to UK medical students and first year Foundation doctors (graduation years 2006-2008) via medical schools and postgraduate networks.

Results: Analysis was restricted to 2413 responses from students graduating in 2006-2008 from the 25 UK medical schools (mean 96.5 per school) with a complete undergraduate curriculum. Distinct courses and assessments in 'clinical pharmacology & therapeutics (or equivalent)' were identified by 17% and 13%, respectively, with mode of learning described most commonly as 'opportunistic learning during clinical attachments' (41%). Only 38% felt 'confident' about prescription writing and only a minority (35%) had filled in a hospital prescription chart more than three times during training. The majority (74%) felt that the amount of teaching in this area was 'too little' or 'far too little', and most tended to disagree or disagreed that their assessment 'thoroughly tested knowledge and skills' (56%). When asked if they were confident that they would be able to achieve the prescribing competencies set out by the GMC, 42% disagreed or tended to disagree, whereas only 29% agreed or tended to agree.

Conclusions: Many respondents clearly perceived a lack of learning opportunities and assessment related to the safe and effective use of drugs and had little confidence that they would meet the competencies identified by the GMC. There is an urgent need to review undergraduate training in this area.

Figure 1

Learning style for ‘basic pharmacology’ (a) and ‘clinical pharmacology & therapeutics’ (b)

Figure 2

Responses to the statement ‘I feel that the amount of teaching in Pharmacology, Therapeutics & Prescribing during my course is (was) …’ by year of graduation (Far Too Much, (); Too Much, (); Just About Right, (); Too Little, (); Far Too Little, ())

Figure 3

Responses to the statement ‘I feel that my assessment(s) in pharmacology, therapeutics and prescribing thoroughly tested my knowledge and skills in this area’ (Agree, (); Tend to Agree, (); Neutral, (); Tend to Disagree, (); Disagree, ())

Figure 4

Responses to the statement ‘I feel confident that my training will enable me to achieve the prescribing competencies set out by the GMC’ by year of graduation (a) and by medical school (b)