By Alexander Gordon1, Thomas Roe1, Toby Ball1, Saisunder S. Chaganty1
1Year 5, Medicine, University of Plymouth
Email: Alexander.gordon@students.plymouth.ac.uk
Abbreviations
UKFPO United Kingdom Foundation Programme Office
SJT Situational judgement test
The UK Foundation Programme Office (UKFPO) is the governing body that facilitates recruitment to and running of foundation training, a mandatory two-year programme that UK medical graduates must undertake after medical school.1 The UKFPO recently announced the removal of points for educational achievements in the process of applying to become a foundation doctor.2 This has led to many students being up in arms about the decision taking away the value of intercalated degrees3 4 via social media platforms and various medical bodies (such as the medical school’s council). We are concerned that the use of such rhetoric will deter people from undertaking intercalated degrees in future.
The UKFPO state that their rationale for removing the educational achievement criteria is that the current number of students gaining extra points is domain has become so large (70%) that it is not a useful differentiator.2 They also highlight that people are being rewarded for second degrees integrated within their primary medical degree (i.e., an inevitable part of the course) rather than an intercalated degree which one opts to take a year out of the medical degree to study. Furthermore, they state that the situational judgment test (SJT) is a stronger predictor than educational performance measures (the combined total of your performance in your medical degree and educational achievements).
We cannot agree with the point of view that the SJT is a better predictor than educational achievement. Anyone who has sat the SJT will tell you it seems to be an inane game of potluck, with little evidence provided to substantiate the claim that it determines ability to practice in future. However, the argument pushed by many that the proposed changes lay waste to intercalated degrees is equally invalid. We would argue that such a viewpoint is short-sighted and, if anything, only adds merit to the rationale provided by the UKFPO.
Historically, intercalation has always been intended for students to optionally explore an area of their interest, with some universities actively implementing it as part of their medical school degrees. As highlighted by the UKFPO, the number of students receiving points for educational achievement has substantially increased over recent years, much of which is attributable to intercalated degrees.2 This trend has likely been driven by the financial benefit derived by universities, as well as the fact that points are awarded for having such degrees. In addition, research may be easier to publish from these degrees than a full-time medical qualification, further bolstering one’s score.
However, in concordance with the ongoing trend of academic inflation whereby it is becoming easier to be awarded qualifications, more students have been given the opportunity to intercalate and as such, many have received practically guaranteed degrees for minimal work. We all know of poor-quality intercalated degree options that essentially guarantee all students first class honours for doing next to no exams. The newfound lack of a short-term incentive from 2023 will mean institutions need to provide degrees which provide long term transferable skills and mean that they cannot short-change students on quality. As such, the quality of intercalation options should improve.
The use of points has always demeaned the nature of work done at medical school, with the decile system creating unnecessary angst and competition between students. There is a fixation on it to the point of panic. The decile system perpetuates a culture of box ticking and points scoring at medical school, which detracts from the purpose of our degree – to make good clinicians. This system has been cynically exploited by both students and higher education institutions when it comes to intercalated degrees and it is a good thing that this will now stop.
The most important thing to take from an intercalated degree is transferable skills that will allow you to become more independent in working on extracurricular projects, with the view to facilitating success later in your career.5 The doors opened by intercalation cannot be overstated.6 The rewards of intercalating become very apparent on return to the medical degree. It may be the satisfaction that comes from a consultation with a patient who has a disease you did a dissertation on; the greater ease in conducting research and teaching due to a newly learnt skillset; or simply a greater likelihood of being asked by consultants to undertake extra-curricular opportunities such as audits and quality improvement projects. Intercalated degrees beget opportunities for personal and professional development that will serve you well for the rest of your career. This is ultimately why the UKFPO’s decision should be inconsequential for those who want to intercalate for the right reasons; if you go on to study something you are passionate about, the UKFPO points hardly mattered anyway.
Contribution statement We confirm that all authors made substantial contributions to the conception or design of the work, or the acquisition, analysis, or interpretation of data for the work, drafted the work or revised it critically for important intellectual content and gave final approval of the version to be included in Inspire. Alexander Gordon is the guarantor of this work.
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References
1. UK Foundation Programme Office (2021) About – UK Foundation Programme Available from: https://foundationprogramme.nhs.uk/about/. Accessed 11 May 2021.
2. UK Foundation Programme Office (2021) UKFPO Letter: Educational Achievements Removal for 2023. Available from: https://healtheducationengland.sharepoint.com/:w:/s/UKFPOT/EYd3TEAU749MpYfS4tWDEO8Bx-kdOsDmPs73uTDAH-xzxA?rtime=etNILTQL2Ug. Accessed 10 June 2021.
3. Nabavi N. BMA strongly opposes changes to foundation programme applications. BMJ, 2020;371:m4837.
4. Medical Schools Council (2020) MSC Statement on the UKFPO decision to remove Educational Achievements from the Foundation ranking process. Available from: www.medschools.ac.uk/news/msc-statement-on-the-ukfpo-decision-to-remove-educational-achievements-from-the-foundation-ranking-process. Accessed 29 April 2021.
5. Husnoo N, Goonoo MS. How to boost your specialty training application. BMJ, 2016; 352:i1392.
6. Cleland JA, Milne A, Sinclair H, et al. An intercalated BSc degree is associated with higher marks in subsequent medical school examinations. BMC Medical Education, 2009; 9(1):24.