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Teaching Medical Students: A View from the Community

Dr Elizabeth Pearson from the the Fulham Medical Centre gives her perspectives on teaching medical students 

I have been a partner for 10 years in a small practice with 7,000 patients in Fulham. I started undergraduate teaching almost as soon as I qualified as I felt that students get such a short time in general practice and wanted to be part of making it a positive experience.

What inspired you to start teaching?
We all remember a good teacher and when I was training at the Royal Free I had a fantastic placement with a GP in Yorkshire. Even though it was only for 3 weeks it made me change my career choice from surgeon to GP! While working in the hospitals I got fed up with doctors speaking down to GPs and complaining about them referring everything etc. Some of my friends went into General Practice as they couldn't be bothered to stick at hospital work which really irritated me as I never saw it is as a negative fall-back option but a positive career choice which can be really rewarding.

How does teaching fit in with your clinical practice?
Teaching also keeps me on my toes and encourages me to keep up-to-date with NICE guidelines, changes in prescribing advice, advances in diabetic medicine etc. Teaching Imperial College London students who are all incredibly bright means they often ask very intelligent questions about my treatment plans which can help me think through what I have decided and why. When students sit in I always try and use consultation models to show them what to ask in a concise, structured way which gets me into good habits and I feel my consultations run very smoothly most of the time.

How do you obtain patient consent?
My practice always has a notice up warning patients I have a student with me and reception warn them too. When I open my door to greet a new patient I quickly get verbal consent and often tell the patients they get two brains for the price of one which makes them chuckle! I plan my surgeries with a couple of catch up slots in my busy morning surgery and I try and have 15 min appointments in the afternoon when I ask the students to take the histories. This works better than the students trying to take a history under pressure during the emergency morning clinic. We do quick feedback after each consultation they do and then run though each one in detail after the surgery. Sometimes if I am running late and a patient attends with an interesting history I find a quiet room for the student to talk to them for 10-15 mins while I quickly try and catch up.

Tell us an anecdote about an interesting experience with a student
In my surgery we look after some elderly war veterans and their wives and once a student visited a patient at his home and spent a couple of hours being fed beef stew and dumplings and discussing the Dunkirk landings. It turned out his grandfather had died at Dunkirk at the same time so he found it fascinating to speak to someone who had lived through what his grandfather had experienced. It showed me yet again that being a GP allows you to meet so many fascinating people you may never have come across in other jobs and that is such an enormous privilege. My student was clearly very moved and grateful for the opportunity to meet such a remarkable man and to hear how PTSD affects people many, many years after the event.

Any tips for new teachers?
I would advise all GPs to consider teaching undergraduates as you get a chance to make an impact on a futures doctor's view of General Practice and so even if they don't become a GP they will at least appreciate all the hard work and difficult decisions we have to make under pressure all day every day

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