MBBS PROGRAMME OVERVIEW & CURRICLUM MAP INTRODUCTION Educating doctors is a complex process. An MBBS programme needs to deliver an under- graduate education and also to induct students into the profession. As a professional programme, a significant proportion of the learning is workplace based. Students need to learn the knowledge and skills of the practice of medicine, and to develop the orientations and attributes appropriate for practice as a doctor. This document provides an overview of the structure of the MBBS programme at UCL, the outcomes for graduates and some of the ways in which these outcomes are addressed through learning and teaching activities. It also maps the programme activities and learning opportunities to the expected outcomes for graduates as defined by the GMC in Tomorrows Doctors 2009. As a professional programme and one where a significant proportion of the programme is workplace based, students are expected to take responsibility for their learning and, with support, to learn to make the best use of all learning opportunities, whenever and wherever they arise. This curriculum map therefore demonstrates some of the foci of planned learning opportunities whilst acknowledging the unique richness of clinical placements and workplace based learning, in relation to achieving the outcomes of the curriculum overall. PROGRAMME STRUCTURE The MBBS at UCL is a six year integrated programme of study. The themes of each year are: Year 1: Fundamentals of Clinical Science 1 Year 2: Fundamentals of Clinical Science 2 Year 3: Integrated BSc 1
Year 4: Integrated Clinical Care Year 5: The Life Cycle and Specialist Practice Year 6: Preparation for Practice Running through the six year programme are the Vertical modules: The Integrated Vertical Strands: o Anatomy and imaging o Clinical skills and practical procedures o Pathological sciences o Use of evidence o Use of medicines The Overarching Themes: o Mental health o Social determinants of heath o Synthesis and professional practice Student Centred Learning, Patient Centred Learning: o The portfolio o The student selected components o The patient pathways
1 Students who are already graduates are exempt from the integrated BSc and move directly from year 2 to year 4 UCLMS MBBS curriculum map July 2012
Elements of choice for students within the programme include: Student selected components (SSCs) in years 1, 2 and 6 The integrated BSc in year 3 The elective period in year 6 The SSCs cover four broad domains to allow students to pursue special interests and develop a range of generic skills: Clinical/vocational Underpinning science (clinical or basic sciences) Research oriented/library projects Arts/humanities/social sciences. Students are permitted an eight week elective period of study in a subject and geographical area of their own choice. Some project work is expected from the students during this time. The integrated BSc provides a whole year of selective study and includes a research project. SSC and the elective period are required course work and must be completed to a satisfactory standard in order to progress. EDUCATIONAL AIMS OF THE PROGRAMME Overarching aim: The MBBS programme aspires to educate the UCL Doctor: a highly competent and scientifically literate clinician, equipped to practise patient-centred medicine in a constantly changing modern world, with a foundation in the basic, medical and social sciences.
Outcomes for graduates: The overall aims of the MBBS 2012 Programme at UCL are for graduates to: Demonstrate a genuine understanding of the fundamentals of clinical science and how science underpins medical practice Demonstrate competence in a range of professional skills necessary for patient care, including history taking and consultation skills, examination skills and clinical reasoning skills Diagnose and manage, under supervision, a range of common and important clinical problems Understand the basic ethical, professional and legal issues related to clinical practice Understand the epidemiological, environmental, psychological and sociological aspects of health and illness and their application for both the treatment and prevention of disease Consider how knowledge of disease pathology is applied in care and prevention Be able to assess patients healthcare needs, taking into account their physical and mental health and personal and social circumstances, and apply their knowledge and skills to synthesise information from a variety of sources in order to reach the best available diagnosis and understanding of the patients problem UCLMS MBBS curriculum map July 2012
Demonstrate an appreciation of the determinants of health: how health behaviours and outcomes are affected by the diversity of the patient population and how, from a global perspective, health, disease and variations in health care delivery and medical practice are determined and interact Employ a patient centred approach to practice Deliver the most appropriate care by considered and careful use of limited resources Demonstrate the attitudes and behaviours appropriate to being a good doctor by their behaviour with patients, relatives and colleagues Appreciate the nature of contemporary practice including an understanding of: the modern NHS; the need to work in teams to ensure patient safety and improve healthcare; providing leadership and advocacy; and being able to adapt to the changing landscape of medical knowledge and healthcare delivery and transnational challenges to global health Be well prepared to enter the Foundation Programme Be prepared to fulfil a lifelong commitment to requirements of the GMC enshrined in Good Medical Practice (GMC 2012) including a commitment to reflective practice, and working continually to improve their own performance UCLMS MBBS curriculum map July 2012
CURRICULUM MAP 1. ACHIEVING THE UCL MBBS OUTCOMES Below is a brief outline of how each of these outcomes is addressed within the programme 2 : Demonstrate a genuine understanding of the fundamentals of clinical science and how science underpins medical practice In year 1 and 2, this includes the basic medical and social sciences to a degree sufficient primarily to inform students clinical studies but also to prepare students to undertake an integrated BSc (Hons) degree in a clinical domain or one of the medical or social sciences allied to medicine In years 4-6, this includes further developing this understanding in the context of providing good clinical care and clinically focused teaching Some SSC choices further develop learning that addresses this objective Throughout the course, students are exposed to cutting edge clinical and biomedical scientists, as teachers, project supervisors and personal tutors Demonstrate competence in a range of professional skills necessary for patient care, including history taking and consultation skills, examination skills and clinical reasoning skills The foundations of these skills are developed within the vertical modules Synthesis and professional practice and Clinical skills and practical procedures. Practice-based and patient-based learning apply this learning, further developing the students expertise in this domain Throughout the course, students will work with clinical staff who are professional role models, demonstrating through their own practice, the professional skills the students are expected to develop Diagnose and manage, under supervision, a range of common and important clinical problems In year 1 and 2, the vast majority of teaching and learning opportunities are based around the core conditions and presentations, and the top 100 drugs formulary. The underpinning scientific principles in diagnosis and management are emphasised. The patient pathways in community and integrated care and in cardiometablic illness address chronic disease diagnosis and management Learning In years 4-6, which builds on knowledge and principles developed in years 1- 3, involves development of this understanding in the context of clinical care. Again, the vast majority of teaching and learning opportunities are based around the core conditions and presentations and the top 100 drugs formulary but they will also include other patient presentations during the course of clinical placements The SSCs and elective period in year 6 provide further opportunities to develop this knowledge and understanding All clinical placements provide opportunities to observe and discuss clinical diagnosis and management in action Understand the basic ethical, professional and legal issues related to clinical practice In years 1,2,4,5 and 6, this includes teaching within the vertical module Synthesis and professional practice, through the patient-based and practice-based experiences and
2 The exact choice of BSc will determine the extent to which some objectives are addressed in year 3 UCLMS MBBS curriculum map July 2012
placements and through Case of the Month. Some SSC choices further develop learning that addresses this objective Throughout the course, in clinical placements, students are exposed to observation of, and discussion related to, authentic clinical, professional, legal and ethical dilemmas Understand the epidemiological, environmental, psychological and sociological aspects of health and illness and their application for both the treatment and prevention of disease In years 1,2,4,5 and 6, this includes teaching within the vertical modules Use of evidence, Social determinants of health, Mental health and Synthesis and professional practice, and through patient-based and practice-based experiences and placements All clinical teachers and firm leads are expected to emphasise this aspect of healthcare as being everybodys business The elective period further extends learning in this domain Some SSC choices further develop learning that addresses this objective Consider how knowledge of disease pathology is applied in care and prevention In years 1,2,4,5 and 6, this includes teaching within the vertical modules Pathological sciences, Anatomy and imaging, Mental health (to some extent), in the health promotion aspects of Social determinants of health and in horizontal module based teaching, particularly in years 1 and 2 but also in years 4-6. This knowledge is also developed through the patient-based and practice-based experiences in clinical settings The elective period, particularly if carried out abroad, further extends learning in this domain Some SSC choices further develop learning that addresses this objective Be able to assess patients healthcare needs, taking into account their physical and mental health and personal and social circumstances, and apply their knowledge and skills to synthesise information from a variety of sources in order to reach the best available diagnosis and understanding of the patients problem The foundations of these skills are developed within the vertical modules Synthesis and professional practice, Mental health, Social determinants of health and the Patient pathways. Practice-based and patient-based learning then applies this learning to further develop students expertise in this domain The complex nature of healthcare needs is emphasised in all clinical placements, especially in year 4 and in primary care placements Demonstrate an appreciation of the determinants of health: how health behaviours and outcomes are affected by the diversity of the patient population and how, from a global perspective, health, disease and variations in health care delivery and medical practice are determined and interact This is both a knowledge-based and attitudinal objective which is emphasised throughout the course, but highlighted in specific teaching as illustrated below In years 1,2,4,5 and 6, this includes teaching within the vertical modules Social determinants of health, Mental health (to some extent) and Synthesis and professional practice and through patient-based and practice-based experiences and placements, particularly the Patient pathways and the elective period Some SSC choices further develop learning that addresses this objective UCLMS MBBS curriculum map July 2012
Employ a patient centred approach to practice This competency requires knowledge, know-how, clinical skills and professional skills, as well as attitudinal development. It is a fundamental component of all patient related teaching across all years As the MBBS is a vocational course, this preparation begins in year 1 and becomes the increasing focus of learning until year 6 when it becomes the main focus of the year. Learning opportunities occur in every year and every module; horizontal and vertical, but particularly in workplace based learning and in the vertical modules Patient pathways, Synthesis and professional practice, Mental health and Social determinants of health Deliver the most appropriate care by considered and careful use of limited resources In years 1,2,4,5,& 6, this includes teaching within the vertical modules Use of evidence, Social determinants of health, Use of medicines and Synthesis and professional practice and through the patient-based and practice-based experiences and placements Some SSC choices further develop learning that addresses this objective The elective period further extends learning in this domain Clinical placements in NHS environments with serious resource constraints allow students to observe and discuss the difficult decisions being made in practice Demonstrate the attitudes and behaviours appropriate to being a good doctor by their behaviour with patients, relatives and colleagues This competency requires knowledge, know-how, clinical skills and professional skills as well as attitudinal development As the MBBS is a vocational course, this preparation begins in year 1, and continues until year 6. Learning opportunities occur particularly in workplace based learning and in the vertical modules: Patient pathways and Synthesis and professional practice Students have the opportunity to observe and reflect upon the professional behaviours healthcare professionals in all clinical placements: from year 1 to year 6 Appreciate the nature of contemporary practice including: an understanding of the modern NHS; the need to work in teams to ensure patient safety and improve healthcare; providing leadership and advocacy; and being able to adapt to the changing landscape of medical knowledge and healthcare delivery and transnational challenges to global health This is both a knowledge-based and attitudinal objective which will become clear during clinical placements. All NHS Trusts that provide placements for students have developed sophisticated policies and procedures in these areas, which we encourage our students to engage with and learn from In years 1,2,4,5 and 6, this experiential learning is supported by additional teaching within the vertical modules, particularly Synthesis and professional practice but also in Use of evidence, Social determinants of health, Use of medicines and through patient- based and practice-based experiences and placements Some SSC choices further develop learning that addresses this objective The elective period further extends learning in this domain Be well prepared to enter the Foundation Programme This competency requires knowledge, know-how, understanding, intellectual skills, clinical skills, professional skills and attitudinal development UCLMS MBBS curriculum map July 2012
As the MBBS is a vocational course, this preparation begins in year 1 and becomes the increasing focus of learning until year 6 when it becomes the main focus of the year Learning opportunities occur in every year and every module, horizontal and vertical Year 6 concentrates on embedding of the skills required to be a foundation doctor. The whole academic year encourages shadowing opportunities, and the chance of learning by observation of, and contribution to, clinical practice in a variety of settings Be prepared to fulfil a lifelong commitment to requirements of the GMC enshrined in Good Medical Practice (GMC 2012) including a commitment to reflective practice, and working continually to improve their own performance Students are informed of the work of the GMC at many stages of the programme and asked to reflect on their performance in relation to Good Medical Practice as part of the portfolio Learning opportunities occur particularly in relation to workplace based learning, maintenance of the portfolio, reflective writing and in the vertical modules Patient pathways and Synthesis and professional practice 2. ACHIEVING THE OUTCOMES FOR GRADUATES DESCRIBED IN THE GMC DOCUMENT TOMORROWS DOCTORS 2009 The course structure, assessments, and outcomes for graduates are based on the curricula recommendations outlined in the General Medical Councils document Tomorrows Doctors (2009). The following table maps the MBBS programme at UCL to these expected outcomes, outlining how and when these outcomes are achieved across the programme.