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All Medical Students should go to jail!

by Dr Ros Herbert, Health Inequalities and Medical Education SCM Course Lead (r.herbert@imperial.ac.uk)

This was the pitch made to a panel of 'Dragons' at the Society of Academic Primary Care conference in Cambridge recently. Modeled on the popular TV show, Dragons’ Den, a team made up of Giskin Day( Medical humanities Lecturer), medical student Hannah Tullett and myself, tried to persuade the panel to invest in
an innovative new module in health inequalities that has been piloted very successfully at Imperial College.

We argued that not only should medical students go to jail, but also to refugee clinics and homeless shelters – all settings in which practising medicine is particularly challenging. research shows that medical students often become less sympathetic to patients with social deprivation as they go through medical school. This is probably because these patients are most often seen in accident & emergency when problems are acute. Students have little exposure to the contexts which have led up to emergency admissions. The final year health inequalities module we have created allows students to work alongside experienced medical practitioners dealing with issues faced by people in dire circumstances.

Giskin's role in the module is to facilitate the formative assessment of this module which is to present a creative response inspired by their experiences. This part of the module is called ‘temoignage’, or ‘ethical witnessing’. The students and Giskin visit a gallery or an exhibition to see how artists tackle the tricky issue of representing suffering of others without merely appropriating their stories. Students then create their own work in any medium to capture an element of their responses to what they have encountered on the three week module. So far, students have chosen poetry, painting, music, performance, posters and leaflets to convey their responses and they have shared these with fellow students and faculty.

What happened at the Dragons’ Den? Well, our pitch caused quite a stir, and we faced down a grilling about our insistence on the value of experiential learning in this context over more traditional didactic teaching. We narrowly lost out on the investment to an app for e-management of chlamydia on the grounds that the app needed the investment (which was monopoly money, by the way) more than we did. Nevertheless, our pitch set the conference talking and our presentation, which set out the module in more depth and included Hannah reading a poem she had written about homelessness, was very well received. Thank you so much to all of you who have contributed to this module. It has and will continue to have a transformative effect on how students view community healthcare, and it is wonderful to see how students have embraced the creative element. All of the students have reported that the module has been inspirational and unforgettable.

As it has been so popular, we are now taking elective students and are planning to expand the health inequalities teaching to the third years next academic year. If you are not already involved and work with disadvantaged groups in any capacity, I would love to hear from you.

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