Submission to Bristol Med Chi Website
What are these new academies?
David J Cahill, Consultant Senior Lecturer, Deputy Director of Medical Education (Clinical)
In 2001, the University of Bristol was successful in a bid for an increase in student numbers up to 249 students per year from a previous yearly intake of 169. The bid also included an accelerated graduate programme and a strategy for wider participation from the local community. A key element of the bid for an increase in students was a move towards a greater role for inter-professional education and fundamental to all this was the development of new partnerships with NHS Trusts right throughout the South West region.
The simultaneous development of the Peninsula Medical School (in Plymouth and Exeter) (www.pms.ac.uk) will necessarily alter the configuration of clinical placements for Bristol medical students in the South West Region. The centres which are presently available to us in Bristol for development are Cheltenham and Gloucester, Swindon, Bath, Taunton and Yeovil, Weston Super Mare, in addition to our existing major NHS partners, North Bristol Trust and UBHT.
To respond to this challenge of expansion, we have developed the concept of a ‘clinical academy’. Clinical academies are conceived as “colleges” of clinical teachers based in one location, largely in an acute NHS Trust, but including individuals from primary care and other trusts including the mental health partnerships trusts. Individuals in these local clinical academies will be linked with other academies and will have more formal membership of the Bristol School of Medicine. In each academy base, there will be a physical site with space for the administration of the academy and some facilities for seminar and lecture rooms, access to computers and library facilities. It is expected that these facilities will be developed and shared with other undergraduate health professionals such as nurses and physiotherapists, and also with postgraduate medical trainees.
What makes the biggest difference in this new academy system is that students will come to these academies for longer periods of time, will be more “embedded” in an academy and will have a far greater commitment to health services in a locality than previously. This does involve a major change of structure and attitude across the board by the University and the local NHS Trusts.
When the clinical academy concept was first envisaged, its function was limited to Bristol undergraduate medical education. The current expanded model incorporates at least a undergraduate medical ‘college’, a nursing ‘college’ , National Vocational Qualification training and certification, a postgraduate medical division and perhaps others such as teaching and training of generic skills. It is likely that this model will develop further with time.
The new academies will have a much closer relationship with the medical school than hospitals had previously. We all know that in the past there have been some problems of the transparency of SIFT funding. It is hoped that with this new development that the allocation of funds to support medical education will be much more transparent and the trail of resources will be much more evident to individuals. With this increase in transparency and actual funding that will be delivered to academies comes an element of academic accountability and quality control. Currently, members of the academic staff are accountable to their heads of department and (long before NHS appraisal) have had yearly review by their head of department or division. Teaching quality is reviewed by independent officers of the University who visit each department in turn to comment on its quality of teaching (www.bris.ac.uk/tsu/int_quality/fqats/fqats.html). These processes are likely to be delivered outwards to the academies. The role and responsibility of the academy will then be
i. to deliver more formal teaching than previously
ii. to deliver the same excellent clinical experience
iii. be more involved in assessment than previously
iv. take a greater role in pastoral care.
The people involved in this will be the Academy Medical Dean (AMD) (the Academy lead, funded by University of Bristol) and consultants who will have a greater specialist role in this development, teachers from primary care and administrative and secretarial support. Some consultants within the hospitals will have time brought out from their current sessional time to act as the coordinators of teachers for what are currently called Units. A Unit might for instance include, for my own specialty, the subjects of Obstetrics and Gynaecology, Sexual Health and Neonatology, all incorporated under the title of “Reproductive Health and Care of the Newborn”. In each academy a Unit coordinator would be responsible for the delivery of teaching within that unit. They would have at least two sessions of their time bought out to help them to carry out this function.
To assist people in their personal development towards this exercise, a programme of education for medical practitioners has been developed by the University of Bristol, Teaching and Learning for Health Professionals (TLHP) (www.medici.bris.ac.uk/tlhp/). This allows people to participate either at the Certificate, Diploma or Master’s degree level. Because of the bursaries available at present for NHS teachers, there are very few people who would have to pay for this course. Other challenges in the development of academies include the refurbishment or building of seminar and lecture rooms, the development of library and information technology facilities and links and student accommodation.
The implementation of this new academy concept has a degree of urgency about it. The new intake of medical students up to the increased numbers began in September 2002. These students will “hit” the academies in September 2004 as third year students and will be qualifying at the end of the academic year 2006/7 when they will deliver for the first time part of the government’s objective to increase the number of doctors. At this time, together with the Peninsula Medical School, we in the South West will produce as many PRHOs as we need. It is a huge exercise on the part of the University of Bristol and its NHS partners. We should think of it as our contribution to the rebuilding of the NHS. The supply of well-trained doctors is a critical element in the NHS Plan, and of all our futures. Come and join us!