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Medicine Course Structure
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Course StructurePostgraduate EducationIntercalated DegreesCourse Style Comparison

Course Structure

Medical courses usually have the same sort of syllabus as that is controlled by the GMC (General Medical Council). The main differences in medical schools are the methods of teaching.

There are two main methods of categorising teaching. The main differentiation is usually made between PBL courses and lecture-based courses. However, on top of this, a course may be taught with a subject-based emphasis (e.g. biochemistry, anatomy, physiology etc) or with a systems-based emphasis (e.g. cardiovascular system, respiratory system, musculoskeletal system). It may also be integrated, with some aspect of clinical study running alongside the teaching of basic medical sciences.

Problem-based learning (PBL)

This is a new dynamic style of course which has been praised by the General Medical Council. It was originally pioneered for the teaching of medicine by McMaster University, Canada in the 1960s, with great success. It was since adopted for UK medical education, initially by Manchester University in 1994. Subsequently it has been taken up by a number of medical schools in the UK, and is now also offered by Liverpool, Glasgow, Barts and The London, Peninsula, Keele, Hull-York, and East Anglia.

In most versions of PBL, students work together in small groups on a set scenario. There is a facilitator present, whose role is to ensure that students do not go too far off-track and to keep discussion relevant. Students share their existing knowledge and understanding relevant to the scenario, and agree what they need to learn ('learning objectives'). They regroup at a designated time in the future to discuss and evaluate their findings and, where possible, develop a consensus answer with which most people are happy. PBL should not stop there, and students dissatisfied with responses agreed should seek further clarification.
A more in-depth description of PBL

It is argued that this type of course requires a great deal of self motivation as its emphasis is on self-directed learning and people not used to this teaching method may take some time to adjust.

Research on the PBL method has shown that, although at time of graduation students from more didactic courses have a far greater knowledge span, an assessment of the same students 18 months down the line showed that PBL students retained more knowledge from their degree. PBL has also been shown to enhance interprofessional team interaction and communication skills. Problem-based learning graduates also rated the quality of their training and preparation for practice significantly higher than did graduates from the other schools.

Lecture-based

Lecture-based courses present their course content primarily using didactic methods with large-scale lectures to the entire year group. The vast majority of, if not all, schools will have some lecture-based teaching.

Systems-based

Teaching is based on body systems such as the digestive system, learning all of the the anatomy, physiology, pharmacology, pathology, biochemistry, genetics and clinical skills relevant to that system.

A major plus of this method of delivery is that the anatomy etc. becomes functional, with an obvious relevance, something that can be lost with the often dry teaching involved in delivering all of the human anatomy at once. Many students find that this helps motivate them as they can easily see why a subject is important. A down side of this method of teaching is that links between the systems are usually left to the student to make, and as such the relevance of one system to another can be missed.

Subject-based

Teaching is based on subjects such as anatomy, pharmacology, pathology and biochemistry. These courses are becoming quite rare now and are associated with those schools that use a lecture based course although there is a small number of courses that have a PBL element.

Integrated

Integrated courses are those where basic medical sciences are taught concurrently with clinical studies. To the fresher to be, all integrated means is that you will have some clinical contact in your preclinical years. To the clinical student is means that lectures, PBLs etc. will be integrated into your clinical practice.

To the cynical amongst us, all courses have some degree of early patient contact, as medical schools have realised that this is something that more and more would be students look for in a course. The less cynical train of thought says that integrated teaching and learning encourages the application of evidence based learning, which is equally important in both preclinical and clinical phases. Understanding the clinical and surgical importance of an organ or a biochemical pathway is also a great aid to learning – whether it be on a systems based or on a subject based course.

The misconceptions demystified

The method of delivery (i.e. lectures, seminars, PBL) is an entirely separate issue from the way the material is covered (i.e. traditional and systems-based). The comparisons should be: lecture-based versus PBL-based; and traditional versus systems-based.

To explain, a traditional course is essentially the same thing as a subject-based course. The material is covered by subject discipline (anatomy, physiology, pharmacology, pathology, etc.), whereas a systems-based course, as highlighted above, covers the material by body systems (cardiovascular, respiratory, renal, endocrine, etc.).

In many cases there are elements of all four of these principles gelled into the course. So, for instance, a predominantly-PBL course will usually have some lectures and is likely to be integrated but with minor traditional-esque elements.

Postgraduate Education

Work in progress

Intercalated Degrees

You can read the full guide to intercalated degrees here.

An intercalated degree gives you the opportunity to incorporate a further degree (BSc or BA) into your medical course. It takes different formats at different universities, It usually takes one year which could be after your second or third year. At some medical schools it is compulsory year making the course 6 years in total, some offer it as an option to all students and at some places it is only offered to the most academically able students.

There is usually a range of degree's available to choose from, traditional science subjects such as: Biochemistry, Anatomy, Physiology, Pharmacology, or topics such as Medical Law, Ethics or History of Medicine.

Why intercalate?
  • Intercalating gives you the chance to study a particular subject in depth, enabling you to expand your knowledge on a specific topic.
  • Intercalating often gives you the chance to be involved in research or Lab work, something which you may not get to experience during the rest of your medicine degree.
  • Intercalating may give you an advantage over other candidates when applying for competitive specialties, for example intercalating in Anatomy would be useful if you wish to pursue a career in surgery.
Why not intercalate?
  • The main downside to intercalating is the extra year it takes which will obviously be an expense which you had previously not considered.
  • A year studying a specific topic may make you forget some of the things you've learnt in the other years of your medical degree.

Intercalating is something which you should think about as early as possible, you may even wish to consider it before applying to medical school. You may not be interested in intercalating, in which case a 6 year course may not be for you. Alternatively you may really want to intercalate so it may be a risk to apply to universities which only let certain people intercalate.

Whilst there are good points and bad points to intercalating, its something you should consider carefully to make sure it is right for you.

Course Style Comparison


COURSE STRUCTURE
CLINICAL TRAINING
Type
Student-Activating Teaching (%)
Integration (%)
Community Based (%)
Pre-Clin Divide
Clinical Training (%)
Real Patients (%)

Bart’s and The London

Birmingham

Bristol

BSMS

Other

Cambridge

Durham

UEA

PBL

NO

HYMS

PBL
NO

Imperial

Keele

PBL

YES

KCL

Lancaster

Leeds

Leicester

Case

NO

Liverpool

Manchester

Newcastle

Lecture/Case

YES

Nottingham

Other

YES

Oxford

Lecture

YES

Peninsula

PBL

NO

UCL

Sheffield

Southampton

Other

NO

St. Georges

Warwick

Case

YES

Aberdeen

St. Andrews

Dundee

Edinburgh

Glasglow

Cardiff

Swansea

Queen's Belfast

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