Transforming undergraduate education in geriatric medicine: Curriculum design, innovation and evaluation at Bristol Medical School

Global population ageing is a defining challenge of our time. The World Health Organization (WHO) advocates investment in high-quality undergraduate education in geriatric medicine (GM) as a means of anticipating the future needs of healthcare systems, by equipping ‘tomorrow’s doctors’ with the skills and knowledge to care for older adults with complex health and social care needs.[1]
In their international study of undergraduate education in GM, the WHO identified significant failings in UK medical training: 15.8% of students received no teaching in GM.2 They also found that education in GM at medical school positively influenced students’ attitudes towards older people, which in turn made them more likely to consider a career as a specialist geriatrician.[2]
We are uniquely positioned at Bristol Medical School (BMS) to innovate and evaluate undergraduate education in GM, being at a transition point between two curricula, marking BMS’ departure from a ‘traditional’ curriculum into case-based learning. The outgoing ‘MB16’ curriculum included a 4-week unit in GM, whilst the new ‘MB21’ programme includes an 18-week clerkship titled ‘Complex Medicine in Older People’ (CMOP).
CMOP is a clinical clerkship with 18 cases at its core, developed in line with the British Geriatrics Society’s recommended undergraduate curriculum, covering the fundamental aspects of GM with increasing complexity.3 The core cases and clinical learning are enhanced with four expert lectures, five tutorials and three journal clubs. Reflective practice is modelled and promoted with Balint groups and book club. Consolidative workplace-based assessments and clinical portfolio mirror those used in postgraduate training, preparing students for professional practice. CMOP is iteratively improved in real-time using staff and student feedback.
This marked shift in mode and duration of teaching affords the opportunity to evaluate the impact of differing education in GM. Embedded within CMOP is a programme of mixed-methods evaluative research funded by The Dunhill Medical Trust, comparing outcomes between MB16 and MB21, and longitudinally across the 18 weeks of CMOP. Short-term outcomes being assessed are students’ attitudes towards older people, empathy, and career intentions. In the long-term, we have consent to link this data to students’ undergraduate examination results and future progression data from the General Medical Council (F1 preparedness and specialty recruitment).

References:
1. Keller I, Makipaa A, Kalenscher T, Kalache A. Global Survey on Geriatrics in the Medical Curriculum.; 2002.
2. World Health Organization Department of Ageing and Life Course, International Federation of Medical Student Associations. Teaching Geriatrics in Medical Education II.; 2007. Accessed June 21, 2021. https://www.who.int/ageing/projects/TeGeMe_II.pdf?ua=1
3. Gordon A. The British Geriatrics Society Recommended Curriculum in Geriatric Medicine for Medical Undergraduates. Published August 3, 2013. Accessed June 21, 2021. https://www.bgs.org.uk/resources/the-bgs-recommended-curriculum-in-geriatric-medicine-for-medical-undergraduates