Community Based Medicine

Everyone who has qualified with MBChB from Birmingham since 2000 will have experienced teaching in Community Based Medicine (CBM) throughout all five years of the course (previously called Firm 1). Do you remember how influential this teaching was on your career choice? If you are a GP in the West Midlands area now, some of you will be in teaching practices and teaching tomorrow’s doctors already.

We know how difficult some practices are finding recruitment of new partners as colleagues retire or relocate, and so it is very important that we maintain the level of Primary Care input into the curriculum to enthuse our student population to consider this wonderful career, especially as the Government is supporting an increase in GPs being trained. I am looking to recruit practices who aren’t teaching yet (or those who have taught before but stopped several years ago and would like to come back).

So why do GPs who are already very busy, take on student teaching? I have spoken to Dr Jonathan Fox (JF) from Feldon Lane Surgery, Halesowen, who, with partner Dr Mohit Mandiratta have started teaching this academic year. Also, why do GPs keep teaching and what are the benefits? To answer this, I have interviewed Dr Pat Clarke (MPC), Dr Keith Wright (KW) and Dr Mindie Mostert (MM) from the Hawthorns Surgery, Sutton Coldfield, a practice who have been teaching our undergraduates since 1996.

MPC: Having qualified in 1979, I had no exposure to patients until going on the wards in year 3, and no GP experience until year 5. Our practice thought it was a novel idea to teach students in practices from the first year, and so we got involved from 1996. We had had several registrars who had changed career path from orthopaedics and O & G, and we felt that doctors should want to do General Practice as a first choice not as second best when the first choice failed. So having early exposure to General Practice was a great idea.

KW: We were all enthusiastic about this new way of teaching, as we had all done a lot of hospital medicine and seen General Practice from the other side, and we really wanted to promote it to students and junior doctors, for them to see that it is a great career and it is exciting, varied and interesting.

JF: The CBM content at Birmingham attracted me to apply to the course here, and I really enjoyed the early patient contact in years 1 and 2. In years 3 -5, the student surgeries in CBM improved my skills, and the CBM course was pivotal in my choice of career. Having qualified in 2010,  I now have the opportunity to ‘give back’ to Birmingham by teaching the students.

JF: It has been a steep learning curve, but I am finding it stimulating, and am really enjoying teaching the practical and clinical skills. It has given me a chance to brush up on my clinical skills too.

MM: I have just started teaching year 1, having taught final year students before. I am really enjoying it. They seem rather fixated on the assessment but I am helping them deal with that.

JF: The patients really enjoy talking to the students and are happy to spend an hour talking to them about their conditions. The practice staff find it refreshing to have a new set of people in the building and everyone thinks it has been a positive decision.

JF:  Not really. Everything I needed is provided in the detailed workbook of resources, and there is support from the Medical School if necessary.

MM: I had some anxieties, but they soon passed once the students had arrived.  Teaching the day’s programme to two groups on consecutive weeks means the second time around I am more relaxed.

KW: It is so rewarding and the students really love CBM. Watching their progress from year to year makes it worthwhile. It is so stimulating and keeps me interested in General Practice. Over the years, CBM has changed with the times and curriculum updates which happen every few years motivate me as there are new challenges with each one.

MPC: I think that teaching is a great way to avoid ‘burnout’. Teaching days bring a change to the working week which is beneficial for me. I taught year 1 for almost twenty years then changed to year 4 and that has been a new challenge which has been very worthwhile. Students attend here in groups of 4-6 for 10 days per year and we get to know them as people a lot more than our Medical School and hospital colleagues. They feel part of a group and they talk to us on many topics and we are a pastoral support too, which is fulfilling.

KW: I would be sad. I am very proud that our Practice teaches medical students.

MPC: I would feel I was losing a skill, and that we were missing out on something good. Some of the students we have taught are now qualified doctors and quite a number are going into General Practice and that needs to continue.

JF: I would say “go for it”. You do need a certain amount of confidence, but most doctors who are GPs can do it. Also, it is of paramount importance that CBM continues in all five years of the MBChB course, so get some more information and sign up.

KW: Jump in – you won’t regret it. If you are worried, support from the Medical School is great.

MPC: Go for it – teaching rekindles the reason I went into General Practice. It is a win-win situation and the proof is we are still doing it after 23 years.

If you would like to find out more about teaching medical students at Birmingham, visit our dedicated site or email gpteaching@contacts.bham.ac.uk for details.