New People, Old Systems – Re-imagining the Medical Elective
by Anna Harvey
It is an understatement to say that covid-19 has caused disruption to medical education. With final year students moved into the workforce early, a significant number of new doctors have missed out on the coveted medical elective – an experience that is touted from the beginning of medical school as something to look forward to; a reward for the hard work of five or six years of study. Many medical schools have advised this years’ fourth and final year students that their electives may be cut short, to accommodate catching up on skills or specialties missed during the spring and summer of 2020, and many students told UK electives are encouraged to prevent unnecessary international travel.
But it’s not just covid that concerns modern medical students about the traditional medical elective. When I recently Tweeted (1) that covid could be a time for the medical profession to take a pause and reflect on whether the current conventions around electives are really fit for purpose, there were some interesting replies. Students are concerned about the ethics surrounding short term placements in low and middle income countries; the environmental impact of air travel; and the often high costs of these placements, meaning students from widening access backgrounds are disadvantaged. Whilst experiencing another healthcare system and being immersed in another culture is still valued, there are some students for whom innovative solutions represent a welcome alternative. Innovation has penetrated other areas of the undergraduate medical curriculum, and yet the traditional elective placement has remained relatively static – extra sessions on cultural competency may have been added at some universities (my own included), but the bulk of the placements is assumed to be overseas, with many opportunities involving time in low and middle income countries.
The Virtual Elective programme at Medics.Academy was initially intended as a programme to plug the gap in elective placements for those whose electives had been disrupted by covid. The programme was developed using rapid iteration and deployment, meaning that intensive feedback was collected from our first two pilot cohorts and these changes were rapidly implemented by our small team of faculty. The four week programme guides students through a series of tasks enabling them to learn about technology enhanced medical education, and deliver a series of individual pieces of learning content, such as Tweetorials, leading up to a major group learning event, such as a live Virtual Clinical Placement session to be designed and run wholly by the students who have gone through the course, with the technical support of the Medics.Academy team.
The programme has received some excellent feedback from those who have gone through it, with Virtual Elective alumni saying:
“Taking part in the Virtual Elective has been one of the highlights of the quarantine period, learning about new ways in which technology can be applied to deliver effective medical education. I would definitely recommend the experience!”
“I have developed essential skills that I had not realised were so critical before. These skills will be very beneficial going forward. I have really enjoyed the programme, both in terms of its structure and design. I have met other medical students across the UK who I hope to stay in touch with – possible because I finally joined Twitter!”
The Virtual Elective programme is not intended to replace a clinical placement, especially for those who do wish to use their elective period to experience another culture. What the programme offers is an alternative or even complimentary experience for medical students who are looking for a low cost, more environmentally friendly experience that allows them to work on a project that allows them to gain skills outside of the clinical environment, but which will be transferable to whatever they do. Students so far have valued the experiences they have had through the programme and we will continue to enact their feedback to create the most robust, exciting and enjoyable experience possible.
After three iterations of the programme, our team were getting increasingly varied requests for different experiences based on the frameworks and student experiences were able to produce. The focus was not on the programme being virtual in the traditional sense, but really trying to understand the student or clinician experience and drive quality as a result. Medics.Academy has been at the forefront of this drive for quality learning experiences using technology since it’s inception. Previous programmes like the HLA Scholars programme have ensured that the team has learnt over four years of innovation how to build scalable transnational education programmes. With the Virtual Elective programme, we were able to rapidly solve a problem facing clinical medicine in a time of crisis. The next stage of development is to continue to adhere to the ethos of Medics.Academy and build further and faster to deliver even better learning experiences for clinicians and students across the globe.
Anna Harvey is a final year medical student and Medics.Academy Fellow. She is interested in women’s health, education and journalism. You can find her tweeting about writing, music and running at @a_c_harvey.