Monday, 14 July 2008

Reflections On 5 Years

This post is so long it needs a contents page so you can skip to the relevant part if you can't be bothered with all of it.
CONTENTS:
Part 1 - Introduction
Part 2 - The first few years
Part 3 - The Preston fiasco
Part 4 - Other complaints
Part 5 - Graduation disaster
Part 6 - Disclaimer to potential students
Part 7 - Conclusion


If I'd learnt anywhere near as much about medicine as I have about life in the past 5 years I'd be a genius. Had I coasted through medical school without a single problem I'd still be as naive as I was 5 years ago. Maybe I should be grateful then that Manchester have 'taught' me so well. Ha. I am bitter about my time at medical school, but by being so I believe I'm far more prepared to be disappointed in the real world. It might not make much sense as I write about it but believe me, I'm a much harder person now, and hopefully, based on my experience will be far more able to accept the incompetencies of other institutions and organisations (*cough* NHS *cough*)

Just one worry, what will I have left to blog about?

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I was 16 when I started looking at medical schools and only just 17 when I submitted my application. I was young and naive, perhaps even bordering on stupid. I based my university choices mainly on where I thought I was most likely to get in, that was my first, and probably biggest mistake. The first thing I always tell potential applicants is to apply to where they want to go, not to where they think they're most likely to be offered a place. The second thing I tell them is not to touch Manchester with a barge pole!

The first time I visited Manchester was for my interview and even though it was raining torrentially, it was the city, rather than the medical school that inspired me. Although I now harbor a passionate hatred towards the university, the city itself is move vibrant than ever and inspires me even more than it did 5 years ago. Maybe it was my expectations of what to expect from the whole university experience that were wrong to begin with. Maybe I would have been just as unhappy elsewhere, grass is always greener and all that. I've heard plenty about problems with other medical schools too so I don't expect that Manchester is unique in its inadequacy.

Had I been blogging in first year I would have had very little to write about, it went by with very little fuss. There were always rumblings of administrative incompetency from others but I was happy in my own little world. Without warning, problem based learning was thrust upon us. Fresh from spoon-fed A-Levels it was quite a shock to have to learn everything yourself. There were of course 6 or so supplementary lectures, although these were often irrelevant or cancelled, It was clear early on that PBL is little more than a synonym for DIY.

I made some great friends from all over the world in my first year and on the whole I really enjoyed myself. Despite the learning style, I even enjoyed the work, I found it interesting and was reassured I'd made the right choice of course, if not university. All that was about to change in what was a pivotal moment in my university years. I've written about this before and it may be a little bit boring so apologies if you're falling asleep already.

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It was time to choose our hospitals for clinical years. I never imagined how important this would be. This process seems to vary from school to school, At Manchester, for the last 3 years, you're based at one of 5 hospitals, 3 of which are in Manchester, one being Keele (40 miles away) and the other being 40 miles in the opposite direction in a wonderful city called Preston often referred to as depreston. At the end of first year we ranked in order of preference those 5 hospitals and we were assured that the allocation process would be random and fair. If you don't know, I'm sure you can guess what happened next. I fell foul of this 'random' allocation and was allocated to Preston. The day after finding out, I handed my appeal letter in personally. Naively again, I didn't for one minute think my appeal would be unsuccessful and spent the rest of the summer safe in the knowledge that of course I wouldn't actually end in Preston, unfortunately the other 40 students allocated to Preston had exactly the same idea.

If my biggest mistake was choosing Manchester then my second biggest mistake was not having a clinical partner for this allocation process, i.e. a friend with whom you made a joint application to a hospital preference. At first I did have one but we wanted different first choices so in the end we applied alone. In my appeal letter I clearly stated that the process had been unfair. We had been told that whether or not you had a clinical partner you were equally as likely to be allocated a place at your first choice. When the allocation results were published this was clearly not the case. As sad as I am I used my basic knowledge of statistics to analyse the results and it was clearly skewed in favour of those who had clinical partners. To put this simply the algorithm used had clearly given a group of two students the same priority as a single student which is obviously unfair on the single student.

I complained and complained but to no avail. I know of at least one person who had their allocation altered on the strength of a falsified official letter. The vast majority of appeals were unsuccessful, after all, they can't just have an empty hospital. It wasn't until the end of second year that I even met another person going to Preston. Needless to say, none of the friends I'd originally made were. Fantastic. From that point onwards I decided that I was no longer there to enjoy university, I was there to endure it to gain my qualification. I met one of the senior staff (albeit not that senior, they're completely off limits) I cried, I shouted, I pleaded, I exclaimed how unfair the supposed random allocation had been why could they not see it? In the end, I was told just to deal with it. Gee thanks for all the support.

As second year went by, my disdain evolved to hate but I kept plugging away and had no troubles academically. By this stage, the glimmer of student support we'd been given in first year had disintegrated and we were left to fend for ourselves. Most of my emails and letters were now being ignored. Why I don't know, I was persistent, but had never been anything but polite in my requests.

One thing is for sure, I certainly wasn't moving to Preston. It might be 40 miles away, an hour's drive at the best of times but having fallen for the city of Manchester and expecting to be there for 5 years I wasn't about to upsticks to a city I already hated.

For reference, it was at this point, at the end of second year that I met missbliss. I decided to continue living in Manchester and commute to Preston, a few others followed suit but it was almost impossible to share lifts as everyone was doing things at different places at different times. Commuting, combined with visits to missbliss in Cambridge soon meant that I was often driving almost 1000 miles a week at a cost of about £100 per week. In January of third year I was forced to move to Preston for the rest of the year, it was every bit as bad as I thought.

You might think that by now I had accepted being in Preston and moved on and I just about had when I heard that a mistake had been made in the allocations for the next batch of students and the medical school were offering students £2000 if they would swap an allocation in Manchester for one in under subscribed Preston. In other words, they were offering £2000 to students who could be persuaded to go to Preston. WHAT THE HELL?!? Where was the £2000 for student who had to go against their will? What on Earth were the medical school thinking when they decided they could offer some students money and not others, had this happened in my year I would have taken legal action. Because it wasn't my year it just made me even more angry! It was at this point I submitted a freedom of information request so that I might see the algorithm or process used in the allocation of hospitals. They didn't even refuse because nobody ever actually got back to me, I should have reported them to the information commissioner at that stage for breaking the FOI act.

I let the subject drop again but worse was yet to come. The following year during the allocation for the new cohort of students the process had to be declared null and void. Can you guess why? It had finally been exposed as unfair, can you guess how? The process was biased against students without clinical partners, exactly as I had told them in my appeal letter 2 years previously! Now I was livid, I had always known the allocation process had been unfair, if I'd been allocated Preston by a completely fair system, I mightn't have liked it but I would have put up with it. I demanded a meeting with the dean of the medical school of course I was ignored, but this time, I'd been proved right and wasn't about to let it drop so easily. I had to make do with a meeting with someone else. I went to the meeting to ask if the allocation process that had been abandoned that year was the same one used in previous years. Unfortunately I was met with a very defensive woman who wouldn't tell me anything and if anything, wanted to intimidate me rather than explain things to me. The meeting didn't go well, I was polite but was clearly not being listened to. It was clear that the medical school wasn't about to admit that they were wrong, after all, hundreds of students had appealed against this procedure, to admit a mistake at this stage would have been a disaster. I asked if I could at least have an apology since my appeal was based on a claim the process was unfair just as it had now been exposed to be. I was told, in no uncertain terms that I could definitely NOT have an apology and, already having been deceived, ignored and lied to, was threatened that taking this topic any further could be detrimental to my place within the medical school. I was taken aback, this was a threat in all but words that if I carried on with this issue I could face being kicked out of medical school - on what grounds I'm not quite sure. At that point I realised I was fighting a losing battle and started blogging instead.

Before I draw a big black line under this topic, I need to cover a few of the potential counters to what I've said. Some of you might think I have a point, others might think I'm just a bitter individual, some might say 'it's only Preston' and most of you probably don't even care. You're all entitled to your opinion just as I am but let me explain a little about why this is such a big thing. I applied to Manchester University because I loved the city, having been sent 40 miles away to Preston there is very little chance to do anything in Manchester and you have very little access to the university facilities or support. It is my belief that you also miss out on educational opportunities by being in Preston although it is a good hospital which may make up for this in some respects. I decided to stay in Manchester, that decision cost me the best part of £5000 in fuel and £3000 in lost free accommodation in final year - despite the travelling it was worth it. You could say 'life is just unfair' - maybe you're right but at least now I'm much more prepared for it. You could say 'you're going to be a doctor, you need to be prepared to move wherever', again, I'm much more aware of this and willing to accept it but at the same time I would hope that where such a system is used to allocate jobs, it would be fair and at least in part based on input on my part, whether that be an application form or interview. Finally, I hear that in future, applicants are going to be told if they've been allocated to Preston when they apply to Manchester through UCAS. I suggested to them 3 years ago this was the only fair way of doing things. Preying on the desperate there Manchester - I'm sure there are plenty of people without offers who'd love a place at Preston.

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Now we've got that beast out of the way we can go back over a few other things that have happened in the last 5 years. Honestly, I know I'm bitter about the whole Preston issue but that isn't the only reason that I despise Manchester.

Almost more important than the Preston issue is something which came to light recently. Apparently the medical school had, in the past, restricted learning opportunities at particular hospitals because they couldn't ensure that similar opportunities could be provided at other hospitals. In one example where changes to the third year curriculum were implemented (whilst we were in fifth year) so that all third years would be taught suturing, the opportunity was denied to the fifth years on the grounds that it was for third years only. We had never been taught it despite it being a potential finals station, after pressing for it we did eventually get the same opportunity. Firstly, you should be doing everything you can to maximise learning opportunities and secondly where do you get off telling people who and what they can teach? Ridiculous. I know you don't care about your students but that is a whole new level.

That leads me nicely onto another issue. It was often said that Preston missed out on some of the opportunities in Manchester but in one case students at one hospital were given access to 14 questions on one of our exam. I'm pleased to say that after much complaining this issue was rectified in that these questions were excluded from the marking but it should never have happened in the first place. It was discovered this once but who is to say how many times it has gone unnoticed in the past?

This is just one of myriad issues that people have had with the examination system. I'm sure you all remember my OSCE fiasco. I'm not going to complain about that here because that is an academic issue and I'm bound to be biased against it. What I can say, having seen OSCEs (practical exams) from both both sides (being an examinee and a volunteer) is that in their current state at Manchester (and to be fair, at most places) they are a lottery. The exam cannot be run objectively at 4 different sites at the same time and the marking is so subjective it makes the whole thing almost pointless.

Next we have student support - or lack thereof. Manchester should be ashamed of itself in terms of this. There was some limited support in the first year but after that you may as well not even exist, nobody at the university cares about you. At Preston the support was good as the hospital staff were willing to listen, but centrally support is non-existent. I'm pleased to see this is something they're trying to address, whether it will be or not remains to be seen.

I'm sure you all know what I think of PBHell. I hate it. They may as well give you a list of things to learn on day 1, send you away and bring you back 5 years later to examine you on it. Conceptually PBL isn't bad, but it doesn't work when it is relied upon to be a substantial method of learning. You can't learn all you need to know without some sort of input. There isn't a lot of evidence out there comparing graduates of PBL courses against traditional courses but this is slightly concerning given that Manchester and Liverpool were 2 of the pioneers of PBL in the UK. PBL does give you the flexibility to learn what you want when you want but I'm gravely concerned about some of the graduates this course has produced. A much better approach would be a combined course featuring comprehensive lectures and PBL.

PBL can be effective if every required element is there, unfortunately where medical students are concerned this is almost impossible. Yes I might be bitter and angry but at least I'm not a bully. I've met some really great people in the last 5 years but I've also met some particuarly mean and nasty pieces of work.

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Finally I want to talk about graduation. A day where you are supposed to celebrate your achievement. As I've said before, for me it was less about the achievement and more about being free from this incompetent institution. The ceremony itself was so cringeworthy it was awful. The worst part for me was the main speech, it was given by a senior staff member who didn't introduce himself, we should probably have already known who he was but such is communication within the medical school, few people had a clue who he was. I'm still not entirely sure and I don't understand his nu-speak title anyway. I'm sure he is very good at what he usually does but he was definitely off that day. He launched straight into a completely irrelevant speech delivered with all the charisma of a dead aphid. If we're supposed to be proud of our achievement I would hope that the staff would be proud too, but the speech was delivered with such monotony that it was clear that the speaker didn't care and probably didn't want to even be there. Worse than the style of delivery was the content. The opening motif was introduced as we were told, "Although the University is rather old, it continues to benefit greatly from being new". The rest of the speech contained contrived examples of many old and new things, but we were graciously informed that we hadn't managed to deplete the knowledge stores of the university ("Is not knowledge the property of humankind?"). I could not engage with anything that he said. In another speech, the pinnacle had to be the mention of Harold Shipman (well I suppose at least he is a former graduate of Manchester) - what a fantastic way to celebrate a new generation of doctors! Perhaps I misread the atmosphere but everyone I've since spoken to felt the same about the whole thing - I didn't even notice the Shipman reference until later. At least when the names were read out by the Medical School Dean (again, I think it was him but I'm not too sure, having never seen him in the last 5 years) he delivered them with a bit of passion, as though he was proud of us all. The Dean also read well when it came to the affirmation, a modern day version of the Hippocratic Oath which we all affirmed in turn. When we finally got out, fittingly it was pissing it down and there were shouts telling us to "leave the building as quickly as possible".

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As a disclaimer - to prospective students, I should say that other opinions are available. At least a couple of (maybe even 3) people are very happy at Manchester, although I'm really interested to see how they do in the national student survey - 3 guesses for what I gave them. I'm afraid I won't be recommending Manchester medical school to anyone, in fact, where possible, I will actively discourage students who might be considering it. For anyone who is already at Manchester or who, despite my advice still insists on applying, the course has changed significantly in the past 5 years, and seems to have improved a lot. I hear they even 'teach' you anatomy these days. The faculty even have a new blog and I must say that this chap looks to going in the right direction so it might not all that bad if you do end up stuck there.

And that, ladies and gentlemen, is that. The end of a long journey, one that I'm very glad is over. I'm looking forward to a completley new chapter in my life, one with less bitterness and fewer grudges. To those of you that I like, you know who you are, the very best of luck. To those of you that don't like me, it has been a pleasure, I'm honoured to have had such an impact. Finally to Manchester Medical School, a good riddance for all.

If you read all that you deserve a pat on the back, for those of you from Manchester, I'm sorry but I've not said anything that isn't true.

edit: seems Shipman was indeed a Leeds graduate not a Manchester graduate, oh well.

50 comments:

Kelly said...

I read through it all. A pat on the back for me then! It sounds even more appalling at Manchester med school than what I had gleaned from reading your blog over the past year or so. My experiences haven't been so great at my med school but are still much better than yours. Kudos for managing to stick with it and keep motivated to rise above the crap they threw at you for 4 years. Onwards and upwards now...

Nick said...

Hate to make it even worse, but i'm pretty much 10000% certain that Shipman was a Leeds graduate

Nick

Anonymous said...

Wow.....I read through everything and it certainly leaves some food for thought!

It's a shame you didn't enjoy your time at Manchester! I must admit I feel like I made a lucky escape as I applied as a graduate this year and received an offer for Manchester along with King's and Barts & The London. I was tempted to go to Manchester so I could experience something new (having studied at King's previously) however I picked King's in part due to your comments about Manchester...(yes I have been following your blog!)

To be fair in terms of hospital allocations I think most big medical schools have to send some students to smaller hospitals away from the main teaching hospitals quite simply due to the limited capacity of the bigger hospitals, but if they have to do this it should be made clearer upon your application (such as in Hull York medical school where you are allocated to either Hull or York during your UCAS application).

In reference to your point about Manchester, this year in my offer pack it did state quite clearly that I would be allocated to one of three teaching hospitals on a random basis but I wasn't informed of which hospital this would be - so it does appear that the medical school administration are making tentative steps to improve the allocation process.

I guess what is more suprising for me is what you described as a lack of student support. I can't really comment on that having not attended Manchester, however it does appear that you had to fight your battles on your own which I think is a shame. I know at King's there are support groups such as SMEC, MedSoc and the main student union which can support students and make complaints on your behalf? Does no such system operate at Manchester or do they exist but you chose not to use them?

In terms of Manchester not caring about their students, again having not attended this university before there is no way I could provide a balanced opinion on this. However I do think that there are hints of this attitude towards students even in the application process.

For instance this year, at my interview at Manchester, I had no opportunities to meet any current medical students and I was not offered a tour of any of the buildings or accommodation (which was important for me since I originate from London). I can see why they may not provide this during interviews as they are busy occasions, however I was not even invited to a post offer open day. When I enquired after one I was told that Manchester they used to provide them but they have been stopped and that the only way to tour the medical school is to go to a pre-application open day which had already occurred last year in July!

This was a completely different experience when compared to Barts, where I got to meet students before my interview, tour the building afterwards and was invited to three post open days!

Even King's (who's staff can be notoriously unfriendly!) managed to arrange several post offer open days where you get to meet current students, the sub-dean and have a detailed explanation of what the course entails.

As a graduate I wasn't too fussed as if I really wanted to I could tour myself around, however it is nice to know that a university that gives you an offer will at least pretend that they are friendly!

In any case I have rambled on enough but I thought I'd just add my thoughts to this post.

Good luck for the future, I'm sure you'll make a fine doctor!

ThePaddlingDoc said...

LittleMedic, fair play to you for saying your bit, and for standing up for your rights throughout what seemed a completely torrid time.

I could write a book about my Nursing Degree and the woeful incompetence of the institution from which I gained it, heres hoping that my Medical School experience will make up for it!

Anyway, your out the other side, and you should be proud.

All the best with the FY1!

Ms Medic said...

Wow, you are one pissed-off critter. Funnily enough, my medical school did some disgraceful things, but I am not as cross as you, having been hit less hard by them. Happy thoughts then that you are well out of there, and that whatever you missed out on, you did acquire an MBBS and MissBliss!

Anonymous said...

I, too, applied to where I thought I would get in, rather than where
I wanted to go. Also where I thought would be cheap to live in (which meant no london schools). Absolutely one of the dumbest decisions I ever made. I spent 5 years in a university I hated, in city I didn't hate, but didn't like either. Which all added up to a very miserable 5 years. On graduating this year, it wasn't happiness I felt, but relief that I would be free from the uni I went to.

Having said all that however, I have to say Manchester sounds even worse than my uni!!!

Elaine said...

Well, there you are, I made it through, so I deserve a pat on the back!

Now at least you and missbliss can move away from Manchester and look forward to the future, having got the past out of your system so comprehensibly here.

anna gregory said...

What a great post - I feel the same way. People keep asking me if I am enjoying medicine but I don't see how anyone can really! It just feels like four or five years of torture that one has to get through in order to become a doctor.

I can't wait for your first posts when you hit the wards!

Anna
xx

clare said...

Having lived in Preston for a silly amount of years (having moved there for uni and only escaping last year!!), I fully support the while de-preston idea. (although i had to laugh at that bit as I thought that I was the only one that called it that!!)
We used to escape Preston to go to Manchester..... purely to get out of there.
I honestly don't know why everyone who goes to Preston hates it so much..... i know its not everyone but it does seem to be the majority of the people that I talk to.
I think the whole problem is that UClan doesn't have a medical school (they were only building the dental school when i left last year). I assume thats why they're dragging people kicking and screaming from Manchester and Liverpool.
Of course I could be wrong.
Please try and put it behind you- you're moving on from this :)

madsadgirl said...

An interesting read. I hope that you have better luck in your new hospital (I'm sure you will) and that you enjoy a happy life with missbliss. I'm looking forward to posts about your new life as a Doctor.

Anonymous said...

I agree with every single point that you make (as a Manchester medical student myself)-a Wythenshawe student. The university is terrible- they could not organise an egg and spoon race if they tried!! I got sent to Blackpool and Leighton for most of this year so had to live outside Manchester too. I'm just intrigued to know...what exactly did they say about Harold Shipman?

American MD said...

What a useless whiner you are!

I'm sure you will fit right in at the NHS. Please, oh please, never think of emigrating to the USA!

Future Doc said...

Congrats on sticking it out! I'm glad your finally free.

Manchester sounds so shit and it's quite off putting. Mission well done.

But honestly, I'm glad you blogged about it. Sounds like it kept you from going insane sometimes!

p53 said...

The Little Medic,

I feel the pain (esp being in the group year when the medic school offered GBP2000). I did apply to Manchester-based hospitals with a clinical partner... but look where I ended at. And of course like many others, I appealed. Fast forward many letters and meetings with those higher up, I finally realized that fighting for fairness and equality is truly disregarded by them.

Being an international student adds more problem to all that you mentioned. My sponsor may as well waste the money on something completely useless rather than sending anymore student here. Look at the percentage of international students here in Preston- more than 25% each year (international intake was around 5% for our batch). I'm sure there must be some sort of conspiracy against us (ha, possibly you can write an entry about this!)

I think many others have been doing the same thing: advocating against doing Medicine at Manchester. Hatred for Preston is now a deep rooted issue in me despite having live here for two years now. De-preston.. ha-ha-ha. I pretty much feel that the joke's on me.

I don't even know whether anyone is ready for the JAN final exam.

p53 x

Calavera said...

Goodness, it sounds like an appalling medical school - the small issues that I had with my own sound utterly trivial by comparison!

What an awful experience - what especially angers me is the way that the woman treated you when you went to meet with her, and them almost threatening expulsion - that is absolutely horriffic. I can't believe that a medical school would behave in such a manner - I think that actually is bullying!

Awful.

Well done for surviving it all, and coming out on the other side!

steph said...

Well-voiced!

I admire anyone who's prepared to stick to their principles and stand up for what they believe in. You'll reap the rewards in years to come.

That chapter of your life has now closed and another is about to begin.

Lights, camera...action!

GOOD LUCK!

Anonymous said...

Suck it up, at least you were in the same medical school. One thing they don't tell people applying to medicine at cambridge is that after 3 years you have to re-apply in order to get into the medical school. No where else does this happen - in every other place - oxford included you are near certain of getting a place at your original medical school. When you apply./start at cambridge the impression si that you havea CHOICE for your medical school. infact its out and out competition, and interviews and some people randomly dont get in and have to go to other medical schools (in my case london) leaving lots of friends and a home behind.

The Little Medic said...

Thanks a lot for all the comments, mostly positive it seems. I'm particularly interested by those who have some experience of Manchester as it seems I'm not the only one in the blogging world with a grudge.

American MD - Don't worry, I won't ever emigrate to America, especially not if it involves working with people like you! I could just move back to Preston for that :)

p53 - Hi, firstly, well hidden blog you've been keeping there. Secondly I don't know how they got away with that whole £2000 thing, I really don't.

As for your point about international students. It wouldn't surprise me if there wasn't some sort of bias there too. I can definitely see what you mean.

anon 00:31 - This clearly isn't right either and should be addressed. You correctly say that I was still in the same medical school but in effect, I had little to nothing to do with it after being sent to Preston. 40 miles may not be a long way but many becomme almost totally isolated - especially those without transport. I believe London and Cambridge are a similar distance apart. At least London is an interesting place, unlike preston!

Lionel said...

Medical school admin staff are chippy, high handed and defensive the world over so I feel your pain there.

However, by including the cost of your trips to see you girl friend into the cost you bore by being allocated to Preston you are grossly over estimating how much being placed there cost you. At the risk of being pedantic.

Anonymous said...

At least you travelled at a time when fuel was cheaper! Could you manage to travel to Preston from Manchester now?!
All sounds awful but I've come to the rather sad conclusion that all universities are about bureacracy, money and research with little or no attention being paid to the welfare of students.

Sage said...

Glad you made it through med school in one piece, they did make it hard on you at times and that makes your achievement even more worthwhile.

Congratulations - keep up the blogging if you can.

Mayhem said...

Wow...just wow. I have little love for my medical school but it's not the horror that Manchester seems to be. At least our Dean is on our side (and is roundly denounced by most of the faculty for it) so we have gotten some of issues dealt with.

The Little Medic said...

Lionel - actually the £5000 total fuel figure is the cost purely of me travelling to and from Preston over the last few years. It does not include any personal travel and does not include the extra servicing costs incurred.

PhD scientist said...

Goodness. Where to start, LM??!

As I'm sure you worked out long ago, I work for Manchester Univ, though not for the Medical Faculty.
There. Outed myself.

First, I've already written loads about the OSCE stuff when it was happening, so I'll skip that.

I think I would start by saying that I really do believe every medical school will have happy students (and ex-students) and unhappy ones. Fact of life. Some people just aren’t a fit with some courses, or institutions. That is true with jobs, too – people who hate working at University A thrive at University B. Others love A and hate B. I predict same for hospitals! Who can say why?

I must say I’m surprised that (if?) Preston has proved so unpopular. I had heard from several sources that Preston was always popular with the junior docs. My other half was an SHO at Preston for 2 yrs in the late 90s, having been a House Officer at the MRI (Manchester Royal Infirmary), and she always says Preston was paradise compared to the MRI - smaller, better sense of hospital "community", nicer people, senior doctors more ready to take the time to help you and less "academically grand" etc etc.

Re “getting Gulag-ed” to Preston, many of these problems are sadly inevitable and stem from the expansion of medical school places in the mid-late 90s. Back when the M'cr pre-clinical intake was 200 students they could all go to the MRI, Hope (Salford) or the then Withington Hosp, so no-one had to get displaced miles out of Manchester. But once the year group expanded to 350-odd, and adding the St Andrews lot as well in yr 3, there just wasn't the capacity. Of course, without the expansion, there would be a lot less students able to do medicine. Recall also that the Govt upped the nos. without upping the money – in fact going from the early 90s to the late 90s we (the Univs, inc med schools) had to take twice the students for the same cash. The resourcing implications of this – combined with the pressure Univs put on staff to make up the shortfall in Univ finances by generating research money - are everywhere. They are most obvious in the fact that everyone feels overstretched and time-poor, which knocks on into students sometime feeling that hurried and tetchy staff find them an irritant. The NHS parallels should be obvious.

Anyway, post expansion the "overspill" had to go somewhere, and that was first Keele and latterly Preston. I suspect (though I don’t know) that the bosses may have just crossed their fingers and said "We'll get enough volunteers for Preston...won’t we? Yes, of course we will. Or close to”... and then were caught out by the vehemence with which students wanted to go to one place and not others. It really is a surprise to the staff that students aged 20-21 are so set about “I want to go here and DEFINITELY NOT here”. All the staff believe it won’t make a fig of difference to the teaching you get, or your career prospects, which base hospital you get. And it frequently gets pointed out that once you are on a junior doctor rotation you pretty much have to go to the hospital where you’re sent.

I do agree with you that the medical school should be clear right from the start that you are going to be allocated to one of three base hospitals in yrs 3-5, and inevitably it may NOT be the one you would prefer. At present there is a lengthy presentation about the allocation process in the second half of year one, so that is pretty early given that you don't start in the hospitals until yr 3. But of course that’s not “before you sign up”.

I'm saying "they", rather than "we" here, because I don't have anything to do with the course beyond year one!! I actually work for the Faculty of Life Sciences that is "subcontracted" by Medicine to teach years 1 and 2 of the course. So I am nothing to do with the course “admin and office bureaucracy”, which is all run by the Medical Faculty.

I think the thing that would worry me most if I WERE the Medical Faculty lot reading your piece is that you felt you had no "mentor" or contact point in yrs 3-5. Now, the subject of "personal tutors" for Manchester MBChB students has been discussed endlessly (honest), but it is a tough one since: (i) you will always get a different PBL tutor every semester; (ii) yrs 1 & 2 are taught by one Faculty and yrs 3-5 by another, with different staff; and (iii) inevitably it means resource – who would the tutors be, first off, and also ”time means money”. The hope is – and the decision was taken when the PBL course began, though it has been re-visited endlessly since - that your PBL tutor in any given semester should be your first port of call, with the "Senior Tutor" as the next step. Surely each base hospital has one or more "Senior Tutor to clinical students"?

As a PBL tutor in year one for a decade plus, I have certainly dealt with all kinds of student issues and problems for people in my groups, from exam worries to assorted health probs to family issues etc etc. Most PBL tutors I know (again I'm talking yrs 1&2, can't speak for yrs 3-5) understand that that is part of the job, though they are also told to recognize when they are out of their depth and pass you on to someone appropriate.

Finally, re the pluses and minuses of PBL: I’ve read the Chris McManus et al. BMC Medicine study on pass rates for MRCP. It is slightly concerning that pass rates differ so much for different medical schools. But re. specifically “PBL or not PBL”, actually there is not enough data to reach any conclusions, and there won’t be for a few years. This is because only the last two years in the McManus data on M’cr (Supplementary data Fig 11d if you’re interested) will be people who almost certainly did the M’cr PBL course – the earlier years (pre 2004) will be people who did the old trad lecture-based course (details: PBL course first intake was 1995-6; first graduates summer 2000; unlikely to do MRCP part 1 until 3rd hospital yr at earliest, so figure 2003 earliest, more likely 2004 or 5). For Liverpool it will be even less years as they started PBL one or two yrs later than M’cr.

Now, you could infer from the graphs in McManus that M’cr has always had a low-ish pass rate for MRCP. But you can’t blame that on PBL. You could even argue from Fig. 11d that PBL had improved the rate! But speaking as a scientist, the real answer is “too early to tell”.

Finally... as I’ve said before, it’s a shame you didn’t really get what you wanted out of the course… though I would say that you often can’t really tell until years down the track how good, or bad, your Univ education really was. But your feelings are what they are, and you obviously feel you got screwed over, which is a shame. However, as MsMedic pointed out, you did end up with an MBChB AND Miss Bliss, plus you’re only 23 or whatever. World… oyster… you get the idea.

Anyway, vaya con dios… etc., and enjoy the difficult bits to come.

(Manchester Univ) Phd Scientist

The Little Medic said...

PHD Scientist - Thanks as always for a well written and thoughtful comment.

As you say I suspect, as in any university/organisation/hospital there are always going to be some who like it and others who don't. This is one reason why I'm interested to see the student satisfaction score in the upcoming publication of the National student survey results. It will if nothing else prove roughly where Manchester is in comparison with other universities.

Preston is unpopular mainly because it is not Manchester. The actual hospital is pretty good (if you could move it to an equal distance away as wythenshawe, it might even be the most popular) therefore most of the doctors you hear talk about it are quite positive. In fact, I'd stood up and said as much in front of 50 or so prospective preston students. I'm not the Manchester staff were too impressed when I stood up and said they were all lucky in a way to be going to Preston as at least the staff care about you in Preston, they sure as hell don't in the Medical School.

You make a very important point about student support. And as I recently commented on the MHS faculty blog, the support is shocking. I should say that in year 1, the support given by the PBL tutors was fantastic compared with other years, perhaps this is because you're all part of a different faculty and therefore aren't all nasty. At one point I did need some support, my scientist PBL tutor was really good but when it was supposed to be referred to a more senior position within the medical school I never heard anything else about it. Great eh? The support in Preston is quite good, but there wasn't really provision of a senior tutor other than the Dean in Preston. He was very good but unfortunately, he knew very little about the Manchester course and Manchester's way of doing things (I don't think this was his fault, more poor communication within the medical school), in years 3-5 support from Manchester is non-existent, more than that, the staff that I've encountered are rude!

I agree that the evidence on the effectiveness of PBL is shaky at best, like you say, in the longer term, this is still very new. Having studied PBL for 4 weeks as a special study module, I'd like to think I was widely read on the topic. It is almost impossible to compare directly PBL against traditional and with things changing so rapidly, it is hard to get any kind of overview of the 'PBL years' so to speak.

Thanks again, and for the record, I'm still only 22! :p

PhD scientist said...

Twenty-two...blimey. Even more world/oyster factor, then.

Enjoy it while you're young. What I wouldn't give to be 22 again. Or even 30..!

missbliss said...

He must be one of the youngest newly qualifying doctors going seeing as he's the youngest in his school year, didn't take a gap year and didn't intercalate! A doctor for a whole month before turning the big 2-3.

PhD scientist said...

Probably. I was right at the young end of the school yr too, so chose to take a year out to work / travel before going to Univ aged 19 yrs plus a month or two. So when I was LM's age I was one year into a PhD with two more years still to go.

When I was a kid some of the bigger private schools used to run a scheme to hot-house "high-flyers" through ALL their O-levels (as then was) in two years from age 13 instead of the usual three... don't know if this still happens for GCSEs. The upshot was that some people started Univ when barely 17 years old, not a desperately good idea in my opinion. I honestly think (and again most Univ teachers think the same) that the University years are as much about growing up as about getting educated.

Anonymous said...

Its interesting hearing how they manage things in Manchester. I'm really surprised that they would assign you to one hospital for 3 years with no flexibility & I can see how this would be incredibly annoying. But also a bit surprised by the negative view of Preston - I've never been there but in general in my time at medical school found the more periperal placements to be better teaching.

They tend to be populated by (grossly generalising) more chilled out, relaxed, less career orientated doctors as opposed to those in incredibly competitive teaching hospital environments who often seem too busy to teach. At Edinburgh everybody rotates round various placements in SE scotland such as Kirkcaldy, Livingston, Borders, the furthest of which is Dumfries around 110 miles away. (This pales in comparison with the Aberdeen students who get to pay visits to Orkney, Shetland and Stornoway!)

Generally speaking these have provided just as good an experience as the more central hospitals and because you only spend 4-8 weeks in one place before moving on, nobody feels picked on. You can request a favourite but its generally understood that most of the time, you'll just get randomly allocated. I'm fairly amazed they just lumped you off to Preston for 3 whole years! It sounds like you've been waiting to get this off your chest for a long time so well done putting up with it for so long.

Mr Mobius said...

I have to agree with anon from Edinburgh about being surprised that you were kept at the peripheral hospital for the whole three years. At Queens in Northern Ireland you get placed at peripheral hospitals but each rotation lasts for a couple of months at most, you get free accomodation at hospitals away from Belfast, and you get to pick where you want to go. So you'll only be at a peripheral hospital for a maximum for a few months.

Even after allocations, you can swap with other students for their places at the same rotation in a different hospital if you'd prefer to be nearer to Belfast.

I know that a lot of people from the Enniskillen area (nearest major hospital for me) swap with people from closer to Belfast since a lot of people don't want to have to travel down to Enniskillen, but for people from around that area it is far easier and cheaper to travel to.

It's unfortunate for you getting somewhere you didn't want but it was only 40 miles away, a lot of places here are up to 80 miles from the university due to the main city being a coastal city and only one medical school in N.I.

You've graduated and can now be happy or complain about F1, but try to enjoy it anyway for you at least are now being compensated with a salary.

I've only finished 1st yr of med school so I still have it all ahead of me. At least you have a degree to fall back on.

Ms-Ellisa said...

WOW congrats on keeping your sanity through all that...

The one with the money got me the most. I printed your post and read it on the bus while people were looking at the strange person reading "some leaflet".

It's horrible what you had to go through. But, hey, you made it through it, right? You got what you wanted (you're a doc now) and you don't need them anymore.

Stuff like that happens to all the schools all over the world- so if you're lucky enough you might "not find out that it happens" and just sort of "sleep" through your years as a student.

It's also good that you at least faught for your rights. I would have just cried at home and left it at that.

I tried to confront a few people once but all they did was lie to my face and leave me totally wacked on the spot, speechless.

Look on the bright side- you suffered all that and you turned out okay.

This prooves that even through "the darkest of times" you can survive and make it good.

Take care of your future now and "never mind the..." :)

The Manchester Medic said...

A very interesting post...

I was involved in the allocation process that had to be re-done because it was unfair. My friend ended up in Preston whereas I was sent to one of the city centre hospitals. This was terrible news as we were planning to share a flat. So when the allocations were declared null and void, we applied as clinical partners so that we would be at the same hospital. You are 100% right that students should be informed of the "danger" of ending up in Preston/Keele (do they still send people to Keele?). One thing that I do have to say however is that the undergrad building at Preston is a lot nicer than what we have, and the staff there seem great (admittedly I only saw the place for one morning).

I can't really comment on the student support issue as I haven't really required any. I am aware that our hospital dean is available for us to talk to if necessary. But I wouldn't have a clue where to go looking for help in the main university if the need arose.

All in all, I agree with a lot of what you are saying. The university seems very unfriendly, and students appear to be little more than a number to the staff. I'm pretty certain that if I knew now what I had known before, I would have been one of the St Andrews students applying to Edinburgh rather than taking up my place in Manchester. Having said this, I am not saying that I am unhappy here - just that I think things could be a lot better elsewhere.

PhD scientist said...

M'cr Medic, I honestly doubt it would have been different in Edinburgh. The pressures on Univs, on clinical academics, on the NHS and on NHS staff are pretty much the same everywhere. They largely come down to time and money, see above.

Manchester students don't get moved to Keele for the clinical yrs any more as Keele now has it's own stand-alone medical course where pre-clinical ys 1 and 2 (taught in Keele Uni) feed into yrs 3-5 (centred on the N Staffs Hosp).

Re. Mr Mobius' comment, as I don't work on the M'cr clinical yrs I can't be absolutely definite about whether people get cycled round any of the other NW (district general) hospitals, but I am pretty sure they go to at least one or two - there will be a list of 4-6 DGHs associated with each "base hospital" (see below) and students will spend some time at one or more of the smaller hospitals. I don't think it works as a "cycle", though, as it was felt better for people to have a "home base", see below. There certainly are loads of other DGHs round the NW of E - I know this as Mrs PhD has been a doctor at a bunch of them.

For the readers that don't know, the way the M'cr system works is that the whole yr gp is together on one site (the Medical School in the Uni) for "preclinical" (mostly) yrs 1-2. But in yr 3, and once the St Andrews students arrive, the yr group swells to 400+ students, which is unmanageable size-wise on a single site - apart from anything else there is no lecture theatre in the med school that holds more than 300.

The system for yrs 3-5 is that students get allocated to one or other of four "base" hospitals, namely the MRI (Manchester Royal Infirmary, central M'cr next to the Uni), Salford Royal/Hope Hosp (five miles across town), Wythenshawe/South M'cr Univ Hospital (7-8 miles out on the way to the airport) and Preston Royal (40 miles away).

The idea was basically to make the system LESS impersonal by (i) having smaller student "cohorts" in the four base teaching hospitals; (ii) "basing" them there for 3 yrs so they would have time to "belong", i.e. integrate into the life of their base hospital; and (iii) having staff on each site who are tasked with looking after them, e.g. Senior tutors, "clinical ed coordinators" and so on.

If the looking after really doesn't happen in practise, this should be brought up strongly at the relevant staff-student commitee. As I have said before, Univs do listen to what is said in these commitees. It goes without saying, though, that a letter signed by half the students in the yr saying "XYZ isn't working well" is more noticeable than one or two very vocal individuals complaining that they have been done down. Univ student year reps on the various sites SHOULD be keeping their ear to the ground for this sort of feedback. If they aren't, then the students have voted in the wrong people. And if no-one says anything to the yr reps, but instead people just chunter away on the blogs, the info doesn't get back to the relevant places at all.

Finally, as LM says, one unavoidable problem with the hospital allocation is that three of the four hosps are "Manchester" , with Preston being the odd one out. So some students are adamant they don't want to go to Preston, and kick up a tremendous fuss if they get sent there, see my previous post. I think Preston only takes 70-80 out of the total year group of 400+, though. Of course, if Preston is being chronically "under-subscribed" (which in turn means more people being forced to go there against their will), this might imply the medical school is not doing a very good job of "selling" Preston to the 2nd yr students.

I personally suspect the problems is two fold. One is the "socially I want to be in M'cr not Preston" factor we have already discussed. My other theory is that medical students, who are achievement-oriented to say the least, believe in the persistent student urban legend that says that working in the MRI (in particular) will mark you as a high-flyer and help you get the best electives, FY1 posts etc. etc. As far as I have ever heard this is complete bollocks, but students' folk beliefs die hard.

Sorry to sound a bit tetchy, but there is often too much back-stage whispering and not enough fronting-up in this kind of business. LM has had the right idea in that he has gone to the Dean or whoever, talked to them, and made his concerns known. While they may have thought he was an awkward bastard, most people with a bit of experience of bureaucratic systems understand that you need awkward bastards to keep the system honest and show you where things are not working quite right. In the best system, I would say you should make a "barrack room lawyer" type like LM the student yr rep. Unfortunately, too often student reps are either pathological swots scoring another career gold star, or people who promise to help secure free beer at parties.

The Little Medic said...

PHD Scientist - Ultimately I think Preston are working towards being their own medical school too although competition is coming strongly via Lancaster, currently used by Liverpool. I think this is a good idea.

You correctly say that Manchester students cycle around affiliated DGHs, this has always been the case. It is now the case at Preston where students goto places like Blackpool (the yeargroup at Preston has grown beyond its means).

For me, the size of the year group is one of the biggest problems. It was too big in the preclinical years at 360 (start yr1 I think) but by the time you have St Andrews students, direct entry students and foreign students in clinical years the group is getting on for 500. It stinks of "lets push as many students through as we can to get as much funding as we can, don't worry about the students themsevles". You might not think this is the case but it certainly seems like that as a student. 500 is crazy, 400 is too many there should be a limit of 300 in each year! At least there would be a chance of better organisation.

When we went to Preston our year group was 46. A good size, but still small enough so that the support there and teaching were good. But with swelling numbers this has changed and the groups are approaching 100. Preston has started to lose its small, friendly, personal atmosphere.

Selling Preston to the students is like selling a Hoover to a Dyson owner, they just don't want to know! You might convert 1 or 2 but when you need 80, you may as well not bother. I think you're pretty well on with your reasons. Mostly people don't want to go there for social reasons and or a fear that it won't look quite as good on their CV (which is bollocks if you ask me too). Most students recognise that teaching in Preston is as good if not better than at Manchester hospitals but even this isn't enough to sway them.

Finally, with regards to students reps etc, what you say is right. Unfortunately, students on the whole are lazy towards anything that doesn't include copius amounts of beer/vodka. When I started at Preston there was no liason whatsoever. I really tried to implement something and it started to work locally. The one central meeting I was invited to, I was unable to make but for the most part, again Preston was ignored. I know of a sort of liason system that works centrally but I have no idea how it works or what it does, it seems very vague and mostly goes unoticed. I really hope this is starting to change and that Preston is being included more.

How many students does it take to start to effect change? Lets say in my year there were 46 people allocated Preston, out of that I imagine 30+ complained. 30 out of 470-500? Big enough? Doesn't seem like it. The year after group size now 60, 40+ complaints, 40 out of 470-500? Again not big enough. The year after 80+ students allocated Preston, 60+ complaints - big enough? Perhaps - this is the year that the system had to be re-done as it was finally exposed as unfair. Of course the other 350 students at other hospitals don't give a toss about complaining because they're happy.

Anonymous said...

I think the issue of too many medical students has affected quite a number of medical schools in the UK. It's the same in my school (Nottingham). We've now joined up the Derby medical school (graduate entry) for the clinical years, so the student population has suddenly expanded considerably, without a parallel expansion of the teaching resources. The school added 2 DGHs (Lincoln and Boston), but IMHO, this hardly makes up for the large increase in students. Teaching quality has most definitely suffered, and it just feels too crowded now.

I believe this expansion of medical students was done several years ago to address the shortage of doctors back then. But isn't the UK facing the exact opposite problem now, from what I hear about the MMC fiasco? Also, a rapid expansion without paying attention to deterioration in teaching quality is just ridiculous!! Time to reduce the medical student population again.

PhD scientist said...

Hi LM

Univs don't set the year group sizes, in the sense that the TOTAL no of UK medical school places nationwide is determined by the Govt. So the Govt /Dept of Education sets the no of places nationally and Univs "bid" for more places. But you are right that there is a "driver" for Univs to expand the courses - more places mean more money coming in, with the idea that economies of scale apply for the Univ. So capping yr group sizes is a non-starter, I think.

As I said before, the big medical school expansion came in the 90s. When the PBL system was designed the M'cr entry in yr 1 was 200, compared to nearer 300 by around the millenium, and 360 now. But if the Govt says "more doctors will be trained", then the Univs will take more students. Bet on it. Apart from anything else, you can only really soak up the expanded nos (nationwide) if all schools expand to some extent. It is a far far bigger, and riskier, job to start a new medical school from scratch than to expand an existing one. Going along with this, ALL the established UK medical schools have expanded to a similar degree since the early 90s, so it would pretty much have been impossible for M'cr to put a cap on nos.

I must say I hadn't realised there were quite so many St A's students coming into the M'cr yr 3. I had guessed only about 80 of them, as I thought a lot now stayed in Scotland, but it sounds like that is wrong. Do they really boost the overall yr 3 group to 500+? That is a hell of a lot. But all the more reason for running four different sites to cut the number on each site to (hopefully) manageable dimensions.

It will be interesting to see if Preston tries to set up on its own. I suppose it would be feasible if they got the Univ of Central Lancs biosci people to help run yrs 1 and 2, but that would involve the Royal Preston "exchanging" their M'cr (Russell Gp Uni) connections for Preston (ex-Poly) ones, which in terms of the University "pecking order" would be a big, big leap. The way I could see it happening is slightly different, and would be for Lancaster and Preston to set up a joint "Lancashire Medical School", with half the yr group on each site. This is how Peninsula works, with the students divided (all the way from yr 1 to yr 5) between Exter and Plymouth.

Currently Lancaster is running as a Liverpool "satellite", using the Liverpool PBL curriculum - rather like the way Keele did by being "spun out" from M'cr and using the whole M'cr curriculum. As I heard it, the Lancaster students currently have to sit in a lecture theatre at the appropriate hr and get their lectures as "video lecture feeds" from Liverpool.

Anyway, I agree with you that, if the Univs take the extra student nos and the money, they are obliged to put the structure and manpower in place to support the students properly. But as to the drive for the frantic rush to expand, that lies squarely with the Govt.

The Little Medic said...

PHD Scientist - The current year 3 has at least 485 people in. I'm not 100% sure how many graduates there were this year. A similar number I think

Anonymous said...

This is going to have long term implications. Since when did sacrificing quality become an option when it comes to medical education? International students come to study in UK universities due to their reputation for a high standard of teaching. And we spend about 100,000 pounds in tuition fees alone. This reputation needs to be mantained, you can only ride on past achievements for so long.

Having just gone through medical education here, I absolutely do not feel my money was well spent. The experience was just not up to standard. Granted, I've never been a medical student anywhere else, so I may have ended up dissatisfied even if I had gone to another country to study. But comparing my experience with that of my friends who went to Australian, Irish and American universities, I believe otherwise. For now, I would be telling my friends to stay away from the UK for medicine. It's not worth it.

The Manchester Medic said...

PhD Scientist - There were 130+ students graduating from St Andrews in my year, of which I would guess 100-110 took up their Manchester allocation. This was by all accounts a big year however (rumour has it that they made too many offers) and the subsequent year groups are significantly smaller.

You are also right in thinking that students will now have the chance to stay in Scotland rather than come to Manchester. This has only been an option from 2008 however and therefore Manchester hasn't seen the effects of it yet. It will be interesting to see how many St Andrews students are added to the Manchester year group this year.

Anonymous said...

You make some valid comments, however as usual
one must look carefully at each side of the issue,
unfortunately you have overlooked this.

Good on you for having a strong opinion on the
oft ill-implemented design of our course, but I lean
toward the feeling that all this is just back-biting.
Sadly this is how it comes across - would've been
usefully delivered whilst actually part of the UG
course, able to talk to people and join committees;
knowing all this you should've really been more
eager to direct this toward the course's actual
design. You should've directed you ire toward the
organising bodies, via the appropriate channels,
for plenty of such opportunity existed over the last
five years.

By choosing this medium to vent your frustrations
you merely come across as a malcontent. A shame.
Knowledge is power, and I'm certain your main
arguments would have been of interest to the
teams and groups who are responsible for the
integration of clinical and non-clinical study and
educational issues in a broader sense.
My point, I guess, is that we all graduated, we all
avoided the various pifalls and traps along the way,
somehow, despite the course's admittedly shoddy
overall execution and implementation. Sadly, it is
now too late to change anything.

Preston, for what it's worth, seems a great place to be taught. I understand they've even got rid of the 'rec room' in the portacabins.

The Little Medic said...

anon 17:07 - You may be right to a certain extent when you call my rant back-biting, but not in the way you might think. I specifically decided to wait until after graduation for my own reasons.

As for directing my complaints to the right people during the past 5 years I have done so, extensively. As I said in the post, for the most part, I was ignored. I have always offered my opinion and advice where I thought there was a slim chance that it would be listened to. I probably could have done more, but after having been threatened by a senior staff member I couldn't really get enthusiastic about trying to change things.

As you say, Preston is indeed a good place to be taught. Although it isn't as superior as it is sometimes made out to be on the teaching front. Were Preston 7-10 miles outside Manchester rather than 40, I would have been much happier and content on that front. Unfortunately it isn't.

Anna said...

I am utterly amazed Manchester students have one base hospital. I graduated from Birmingham med school this year, and we have been rotated to different placements throughout all our clinical years. Not only does this make travelling distances fairer (or living away from Brum, as students assigned to Hereford do - 46 miles away, having looked that up I now truly comprehend the commute from Preston) it also allows students to experience the differences between rural DGHs and big tertiary care centres, to learn different ways of working and be exposed to different teaching methods and opportunities. It creates doctors better equipped to work anywhere, with anyone.

I was part of a consultation group of final years earlier this summer, who were asked about changes to Birmingham's curriculum. Basically, the proposed changes boil down to two things: more PBL and one base hospital. The subdean admitted why: Birmingham cannot sustain its current curriculum with increased intake - currently approx 450 students in each clinical year.

I fear that my beloved, though at times incompetent (aren't they all?!), medical school will be following Manchester's route, to the detriment of students's well being and success in the course.

I agree that getting your voice heard by senior staff in medical schools is difficult, and very quickly leads to fitness to practice issues being leveled against you.

I'm glad you managed to get through the minefield relatively unscathed TLM!

Anonymous said...

Here in Australia we can get sent to rural clinical schools which are 3-5 hours away. Some people can even be sent to a different state eg northern territory, which could be up to 2-3 days drive from their medical school! Not only that, but many of our rural clinical school student are forced to rotate to different home/base hospitals every 6 months.
Furthermore, our rural clinical schools are government legislated so our uni has to find a certain number of students to go there (with reserves who may be allocated there at the last minute if the quota is not filled).
But, on the up side, they have free , newly built accommodation cos the government and the uni have money to throw at it. Their orientation time involves free winery trips!

doctorwho said...

just started reading your blog now, as a 4th year at bristol, i totally understand your annoyance at getting sent to preston like that, although it does sound manchester is a lot worse than here. Basically in britol we get sent away 3rd yr onwards for half of the year each year, this year being for me swindon (50 miles) and last year gloucester (40 miles). We have absolutly no choice where we are sent, no application process, but atleast we know we will be in bristol for 6 months of the year, and the next year we will be in a different hospital, so we get to be based everywhere. Apparently they do it that way to keep it fair. I agree with you in that they should make it clearer before you apply that you may not be in that city long, and to kiss goodbye to the non-medic friends you have made!

Anonymous said...

hahaha that was Awesome!!! loved it...

Yes i read it all and i feel proud of myself...

I thought the whole graduation thing was especially funny :D

there was a slight bitterness in the post but I can understand why you'd be angry at them... perhaps a post on the effect of regret and rightful anger.

oh well, you sound like a really cool person anyway. wish you all the best in your future.

xx

ethelfleda said...

Manchester fortunately managed to alert me to their incompetence in the application process, but losing the supplementary reference they requested from me. Twice. So when they rejected me it wasn't much of a wrench!

"A much better approach would be a combined course featuring comprehensive lectures and PBL."
Which is exactly what the uni I'm at now does. Go me!

Anonymous said...

You are one pissed off little so-and-so. I am a medical student, happy to go where I can, what do you think you are qualified? Oooh, you got sent to Preston, well blow me down. And all the extra costs you incurred and free accomodation you gave up is your own problem not the university's. I hope I never come across you in my working life.

Anonymous said...

Interesting reading, if a bit toys out of the pram.

A couple of points.

Firstly, I've heard it said that Preston spend more of their earnings from teaching on new teaching facilities than the cash-strapped MRI does, but you seem to have already gone from complaining about the quality of teaching at Preston to informing us it's a "good place to be taught" anyway? And I appreciate the teaching quality isn't really the issue.

I personally think Preston Hospital would be more accessible if it was actually in Preston rather than a way out of town - that would make a public transport commute more viable (if rather costly). I guess that's not a very helpful observation really.

Thirdly, most uni students I've known of (including myself) actually spoke to existing students at the Uni before applying - was the Preston scenario somehow kept a secret from you? If not, you must always have known there was a good chance you would end up there for three years (even with a fairer allocation - and I agree the process should be fair and transparent). Applying to Manchester to study medicine without any risk of a Preston allocation was never an option for you (as it isn't for current applicants) and you should really have been aware of that and got over your bad luck a while ago.

Anonymous said...

I have just read the whole of your blog and i have to say as a cardiff medical student in my final year you need to man up and stop whining! In 3rd year we are allocated to various hospitals around south wales up to 40minute drive one way everyday with no reimbursement on petrol. 4th and 5th years we can be allocated anywhere in wales and i mean anywhere. In order to get to bangor for example it takes between 4 and 6 hours in a car. For this you will be reimbursed for the trip up there, and the trip back at the end of your 6 week placement. Consider yourself lucky you only had an hour to drive to go see your mrs. Last year i had at least a 2.5 hour drive every time i wanted to see my bf for the entire year. you don't see me blogging my guts out and making appointments with the dean to have a good cry

Anonymous said...

I'm a 3rd year at Manchester and based at a Manchester hospital.

I really don't think the medical school is anywhere near as bad as you like to make out it is.

They do seem to have acted poorly in their treatment of you and their addministration isn't the best, but instead of being so angry couldnt you have just gotten on with it? Quite a few of my friends were sent to Preston, with and without partners, and they all just took it on the chin. It would be interesting to see what your opinions of Manchester would have been had you been sent to your first choice hospital - I'm guessing not half as negative as they are now!