Medical students to be immersed in rural and semi-rural GP practices

Longitudinal Integrated Clerkship students alongside doctors and other healthcare professionals

Hull York Medical School have introduced a new education initiative which will see fourth year medicine students immersed in rural and semi-rural GP practices around Northallerton - working alongside doctors and other healthcare professionals and delivering care to patients within a community setting.

The Longitudinal Integrated Clerkship or LIC is one of the first of its kind in England. It will provide medicine students with the opportunity to develop their knowledge and skills, building on what they have learnt so far in their academic programme and further developing their clinical and communication skills. They will also have the chance to follow selected patients on their healthcare journeys, from GP to hospital clinic and admissions – deepening their understanding of medical conditions and the factors that can influence health through learning centred around individual healthcare journeys.

Dr Kevin Anderson, Director of Primary Care Education and a GP himself, believes the LIC will provide students with a first class learning experience. He says: ‘We believe that embedding students in a clinical environment for an extended period of time will enable them to enhance their learning and build their confidence as clinicians. Their experience during the year will make them more patient centred and more aware of the socio economic factors that can impact on health.’

For Emily Iliadis, a fourth year medicine student at the Medical School, the LIC offers a unique opportunity to learn. She says:  ‘I think doing the LIC will give me lots of opportunities to improve my GP consultation skills and gain knowledge and confidence which will help me during my final year of study and throughout my career. I am keen to live in a rural location and I’m really looking forward to becoming a team member at my GP surgery and taking advantage of opportunities available at both the hospital and in the local area.’

The Medical School already offers medicine students early and sustained clinical experience from week 3 of their undergraduate programme, and the new LIC will build on this with an increased focus on primary care. Students undertaking the LIC will be based in Northallerton and will spend three days per week in a primary care setting at a rural or semi-rural GP surgery, and 1-2 days per week at the Friarage Hospital in Northallerton, part of South Tees Hospitals NHS Foundation Trust.

Longitudinal Integrated Clerkships (LICs) were first developed in Australia, South Africa and North America with the aim of facilitating continuity and relationships between students, patients and physicians as means of enhancing learning and the student experience.   They allow students to participate in the comprehensive care of patients over time. Recent research indicates that students undertaking this type of placement perform as well or better in examinations than their peers, are perceived as more work ready, are more patient-centred and have greater confidence in dealing with uncertainty – being reflective and self-directed.

There is also evidence to suggest that students undertaking this type of placements are more likely to return to work in their area of training, something which has proved beneficial to under doctored rural areas in Canada and Australia. Within the UK this type of placement is an initiative which offers one solution to the GP and wider medical recruitment difficulties that many parts of the country face, particularly rural areas. And there is evidence to suggest that doctors involved in the delivery of LIC programmes also benefit in terms of professional satisfaction, and increased ownership of students learning and development.

Dr Duncan Rogers GP at Mowbray House Surgery, Northallerton is looking forward to welcoming a Hull York medicine student to his practice. ‘We have a growing proportion of the population living longer - often with multiple, chronic conditions. The majority of these cases are managed in primary care so it is important that future doctors, whatever specialist route they choose, have an understanding of primary care. We hope that as well as increasing their understanding of primary care, that students are inspired to work within our area after their training. Myself and my colleagues are very much looking forward to working with Hull York Medical School and welcoming our first medicine student.’

Hull York Medical School is the joint medical school of the universities of Hull and York. It works in partnership with regional NHS Trusts and community healthcare providers to ensure it responds to local workforce needs and provides its students with the knowledge and skills to deliver exceptional care to patients. Since the school was established it has offered an innovative medicine programme centred on problem based learning, clinical and communication skills and early and sustained clinical exposure. It has also placed significant importance on primary care teaching, with 21% of its curriculum being delivered in a primary care and community care setting, compared to a national average of 13%. It has recently established an Academy of Primary Care with the aim of developing research and interventions to drive excellence in primary care.

Dr Joanne Reeve, Director of Research for the Academy of Primary Care, believes that to work in the NHS you need a thorough understanding and experience of primary care. She says: ‘90% of NHS consultations happen in primary care. It is where referrals are started, where care is continued post discharge and where 90% of the work is delivered. By giving our students the opportunity to experience primary care we are providing them with the best opportunity to meet and understand patients (a skill they will need whatever their speciality), to meet and understand the clinicians they work with on a day to day basis, to experience some of the most challenging medical problems, and ultimately to work as part of a team to truly make a difference to patients.’

Since Hull York Medical School was established in 2003, it has trained over 1600 doctors who are now working within the region and beyond - as GPs, Psychiatrists and Consultants. As a result of the School’s commitment to delivering exceptional medical education and its focus on widening participation, it was awarded an additional 90 undergraduate medicine places and in 2019 will welcome its largest ever cohort of medicine students. This year the School will also welcome its first students on the Medicine with a Gateway Year Programme – a widening participation initiative designed to support local students interested in pursuing a career in medicine.

Further information about the Longitudinal Integrated Clerkship (LIC) visit our LIC web page.

To hear from Hull York Medicine students about their experience on the LIC visit the LIC blog.