How do medical school applicants respond to the requirement for work experience? An exploration of going abroad. Stephen Collins and Anja Timm

Transcription

1 How do medical school applicants respond to the requirement for work experience? An exploration of going abroad Stephen Collins and Anja Timm ASME ASM, Edinburgh, 16 July 2015

2 Background - Intense competition for places at UK medical schools 1 - MSC recognises that finding UKbased work experience can be difficult 2 - Anecdotally, we heard that some applicants were paying to undertake international work experience (i- WEX) - As there was no published research available on i-wex, we designed and conducted this exploratory study. 2

3 Literature Review Medical Electives are often associated with: 4-6 compromised patient safety, and a one-way process tilted heavily in favour of visiting students Gap Years literature has identified: ve effects -ve effects Helping a charitable cause 7 Completion of unsatisfactory work 10 Exploring a new culture 8 Gaining an edge over contemporaries 9 Neglecting desires of local community 11 Reinforcement of unhelpful stereotypes 8 3

4 Methods Part of an ongoing project investigating the Hopes and Fears of new medical students (ethics approval: SOMSEC020.08) Semi-structured interviews Participants recruited from years 1, 2 and 3 of BM5 course Duration of interviews: minutes Transcription (536 pages, 121,000+ words) Thematic analysis Data saturation was not reached 4

5 Findings: initial observations All participants (n=13) had conducted work experience in the UK (WEX) and six had also done i-wex. Within this small sample, the following was observed: Independently schooled (n=4) Less UK-based WEX Less voluntary work Very rarely conducted i-wex State-schooled (n= 9) More UK-based WEX More voluntary work Also conducted i-wex Of the six participants with i-wex experience, three had attended grammar school. 5

6 Findings: the cost of i-wex Prices paid vary from 1500 (8 days) to 4000 (4 weeks). Includes accommodation, food and hospital placement Excludes flights, visas and vaccinations. Commercial i-wex destinations include: Honduras, Kenya, Tanzania, Malawi & Nepal. 6

7 1. Cost of i-wex (quotes) Some participants spent all their savings to undertake i-wex. 7

8 2. i-wex advantages Within the medical school interview context Many participants felt i-wex gave them more (interesting) things to talk about. 8

9 2. i-wex advantages Stories and souvenirs Participants also commented on the colourful stories and exotic keepsakes they were able to collect and bring home with them. 9

10 2. i-wex advantages Stories and souvenirs Participants also commented on the colourful stories and exotic keepsakes they were able to collect and bring home with them. 10

11 3. i-wex disadvantages 5 out of the 6 participants with i-wex could not think of downsides. However, the other study participants were able to identify disadvantages. 11

12 3. i-wex disadvantages 5 out of the 6 participants with i-wex could not think of downsides. However, the other study participants were able to identify disadvantages. 12

13 4. The freedom and the drama of i-wex i-wex participants experienced fewer restrictions than in the UK context. 13

14 4. The freedom and the drama of i-wex Some participants reported a palpable sense of excitement regarding their involvement in clinical tasks overseas. 14

15 Other issues i-wex raises Firstly, i-wex companies focus is primarily on making money and this is likely to shape participants experiences: Secondly, irrespective of what they actually observed, applicants with i-wex experience are free to embellish their experiences at interview. 15

16 Literature Review recap Medical Electives are often associated with: 4-6 compromised patient safety, and a one-way process tilted heavily in favour of visiting students Gap Years literature has identified: ve effects -ve effects Helping a charitable cause 7 Completion of unsatisfactory work 10 Exploring a new culture 8 Gaining an edge over contemporaries 9 Neglecting desires of local community 11 Reinforcement of unhelpful stereotypes 8 16

17 Summary and Conclusions The commercial nature of i-wex requires further investigation. Ethical and inequality concerns are similar to those raised about electives and gap years. i-wex participation is unlikely to supply applicants with the realistic understanding of the UK health service that the MSC stipulates. In fact, only one of 13 participants was aware of the MSC guidelines on work experience (!). This study highlights that applicants experience very different levels of support, which significantly restricts (or enables) their access to work experience. 17

18 MSC guidelines vs advertising Medical schools do not generally support or encourage overseas clinical work experience. Medical schools are looking for applicants who have an understanding of the UK health service either by undertaking clinical work experience or by talking to UK doctors. 18

19 Figures accurate as of 12th July

20 Recommendations For selectors/medical schools: Refer back to the latest MSC guidance for work experience to avoid confusing candidates about what is required and why. Ensure all selectors are aware of the considerable differences in opportunities and advice available for applicants from different schools. Explicitly address i-wex in selector training. 20

21 References 1 - UCAS Table of End of Cycle 2014: Data Resources, UCAS, pg.2. dr3_015_03_0.pdf 2 - Medical Schools Council. Selecting for Excellence - Work experience guidelines for applicants to medicine. December (accessed 12th December 2014). 3 - Medical Schools Council. Selecting for Excellence - Final Report. December 2014, pg (accessed 5th May 2015) 4 - Radstone SJJ. Practising on the poor? Health care workers beliefs about the role of medical students during their elective. Journal of Medical Ethics, 2005; 31(2): Petrosoniak A, McCarthy A, Varpio L. International health electives: thematic results of student and professional interviews. Medical Education, 2010; 44(7): Dowell J, Merrylees N. Electives: isn t it time for a change? Medical Education, 2009; 43(2): Tomazos K, Cooper W. Volunteer tourism: at the crossroads of commercialisation and service? Current Issues in Tourism, 2012; 15(5): Raymond EM, Hall CM. The development of crosscultural (mis)understanding through volunteer tourism. Journal of Sustainable Tourism, 2008; 16(5): Heath S. Widening the Gap: Pre-university gap years and the economy of experience. British Journal of Sociology of Education, 2007; 28(1): Brown S, Morrison AM. Expanding volunteer vacation participation: an exploratory study on the mini-mission concept. Tourism Recreation Research, 2003; 28(3): Broad S, Jenkins J. Gibbons in their midst? Conservation volunteers motivations at the Gibbon Rehabilitation Project, Phuket, Thailand. In: Lyons KD, Wearing S (eds.) Journeys of Discovery in Volunteer Tourism. CABI Publishing: Cambridge, MA; p72. Anja Timm (A.Timm@soton.ac.uk) and Stephen Collins (SC5G10@soton.ac.uk) 21