medical school in the united kingdom medical school in the united kingdom in the united kingdom, medical school generally refers to a department within a university which is involved in the education of future medical practitioners. all leading british medical schools are state-funded and their core purpose is to train doctors on behalf of the national health service. courses generally last four to six years: two years of pre-clinical training in an academic environment and two to three years clinical training at a teaching hospital and in community settings. medical schools and teaching hospitals are closely integrated. the course of study is extended to six years if an intercalated degree is taken in a related subject. for introductory information about medical schools and information about medical schools in other countries, see medical school. guy's campus of king's college london medical school depicted in 1820 by james elmes and william woolnoth admissions in the united kingdom students generally begin medical school after secondary education. this contrasts with the us and canadian (outside quebec) systems, where a bachelor's degree is required for entry to medical school. entry to british medical schools is very competitive. application pre-clinical medicine (a1) ucas application and acceptances statistics, 2007 - 2014.applications for entry into medical school (in common with other university courses) are made through the universities and colleges admissions service (ucas). ucas allows four applications per applicant for medicine, as opposed to the usual five. the remaining one can either be left blank, or be used to apply for a non-medical course. most uk medical schools now also require applicants to sit additional entrance tests such as the universities clinical aptitude test (ucat) (required by 26 universities) and the biomedical admissions test (bmat) (required by 8 universities). the number of available medical school places had risen by 3,500 since 1998. there are national quotas imposed on the number of places for students on medicine and dentistry courses in the uk as much of the training needs to occur in a healthcare setting. in 2016, places at medical school were offered through the clearing process for the first time, with st george's, university of london opening up places on its five-year medical degree undergraduate course. the ucas personal statement gives applicants the opportunity to write about why they are suitable for medicine. common subjects discussed during these statements include work experience, subject research and extra-curricular activities. personal statements are reviewed by university admission boards and applicants scoring highly in tests and with a good personal statement will be called to interview. the interview interviews for medicine differ between individual universities. the majority of medical school interview applicants using either a traditional interview or the multiple mini interview (mmi) formats. oxford and cambridge medical schools have their own distinct way of interviewing with focus on science questions and other medical schools also use group tasks to assess applicants. traditional the traditional medical interview consists of 2–4 interviewers sat across a table from the candidate. interviewers take turns to ask the candidate set questions and rate their responses on a likert scale. interviews last between 15–30 minutes. questions cover a range of desirable criteria that future doctors should possess. multiple mini-interview (mmi) developed at mcmaster university medical school in canada in 2004, the mmi format assesses candidates as they cycle through a selection of 'mini' interview stations similar to the medical school osce. 1-2 interviewers assess candidates at each station (which typically last 5-8 minutes each) and each station is focussed on a particular skill desirable of a doctor. criteria assessed at individual stations may include: reasons for application to study medicine influence of work experience contribution to school and society academic ability and intellect knowledge of the course and medical careers descriptive skills dexterity empathy communication skills initiative and coping under pressure reasoning and problem solving skills teamwork skills degree awarded after successful completion of clinical training a student graduates as a bachelor of medicine, bachelor of surgery, abbreviated as 'mb chb' for aberdeen, anglia ruskin, aston, birmingham, bristol, buckingham, dundee, edinburgh, glasgow, keele, lancaster, leeds, leicester, liverpool, manchester, sheffield 'mb chb' for warwick requires a first degree; 'mb bs' for schools currently or previously part of the university of london (king's college london gkt school of medical education, barts and the london school of medicine, st george's, ucl medical school) and also norwich medical school, hull york medical school, imperial college school of medicine, university of central lancashire, and newcastle university. 'mb bch' for cardiff; 'mb bch' for swansea requires a first degree; 'bm bch' for oxford, 'bm bs' for university of nottingham, peninsula medical school - now split into the university of exeter medical school and the university of plymouth medical school and brighton-sussex, 'bmbs' for southampton, 'mb bchir' for cambridge. queen's university belfast gives the degree of 'mb bch bao' (bao is bachelor of the art of obstetrics). the university of st andrews offers a pre-clinical bsc or bsc(hons) with subsequent entry to either manchester, barts, glasgow, dundee, edinburgh or aberdeen for clinical teaching and a subsequent mb chb/equivalent course types broadly speaking, undergraduate medical education in the united kingdom may be thought of along two continuums: the teaching method is one continuum - on which problem based learning is one extreme, and lecture based learning is the other extreme. the course structure - on which a clear pre-clinical/clinical divide is one extreme, and a totally integrated curriculum would be the other extreme. these two can be combined in different ways to form different course types, and in reality few medical schools are at the extremes of either axis but occupy a middle ground. problem-based learning problem-based learning (pbl) is a principle based on the educational philosophy of the french educationalist célestin freinet in the 1920s, and is used in many subject areas including medicine. it was first developed in relation to medical education at mcmaster university medical school in the late 1960s,. it was introduced to the uk by manchester university. it refers to a whole process, and not merely to a specific event (the pbl tutorial). in the uk, the focus is on a pbl-tutorial which is conducted in small groups of around 8–10 students (although this varies with seniority and between medical school) with a tutor (or facilitator) who usually comes from either a clinical or academic background, depending on the level of the course. there is an academic, clinical or ethical scenario, where the students select which areas of study to pursue in their own time. academics at maastricht university developed seven steps of what should happen in the pbl process: the group read the scenario and clarify terms they do not understand they define what the problem is they brainstorm possible hypotheses or explanations come up with a possible solution define a series of learning objectives they should achieve by the next tutorial, arising out of the problem gather information to fulfil the learning objectives - this can be in the form of private study or reading; attending a lecture; having a discussion or teaching session with a relevant "expert"; attend a ward round or clinic; interview a relevant patient at the next tutorial, students share the information they have gathered since the last tutorial, and discuss areas where information they have gained conflicts - this may lead to further learning objectives if they find they are still not clear. in keeping with the ethos of self-directed learning, during sessions it encourages a shift in power from an academic tutor to the students in a pbl group. however, it will be seen that lectures, tutorials and clinical teaching sessions can play a part in problem-based learning - but the emphasis is on the student to decide how these will enable them to fulfil their learning objectives, rather than passively absorb all information. the introduction of pbl in the uk coincided with a general medical council report in 2003, tomorrow's doctors, which recommended an increased proportion of learning should be student-centred and self-directed. this encouraged medical schools to adopt pbl, however some medical schools have adopted other methods to increase self-directed learning, whilst others (notably oxford and cambridge) have always had a high proportion of student-centred and self-directed learning, and have therefore not introduced pbl. manchester medical school adopted a new pbl curriculum in 1994, and were followed by liverpool medical school and glasgow medical school. the norwich medical school, at the university of east anglia also uses a pbl based curriculum. some of the uk medical schools created since that time have adopted problem based learning. brighton and sussex medical school has a lecture-based approach supported by small-group and self-directed work. similarly, imperial college london employs mostly lecture-based teaching but uses supplementary teaching methods such as pbl to deliver a more rounded education. tomorrow's doctors also criticised the amount of unnecessary scientific knowledge irrelevant to clinical practice that medical students were required to learn, meaning that the curricula were altered in other ways around the same time that pbl was introduced in the uk. one study criticising problem-based learning found that some medical specialist registrars and consultants believe that pbl can promote incomplete learning and educational blind spots; particularly in anatomy and basic medical sciences, due to ultimate decision making within the pbl group resting with the students. this has also brought into question whether the lack of anatomical knowledge adequately prepares graduates for surgery, or negatively affects enthusiasm to enter certain specialties; including academic medicine, surgery, pathology and microbiology., although the purposeful reduction in anatomy teaching within all medical curricula which occurred following tomorrow's doctors may be in part to blame for reduced anatomical knowledge, rather than it being due to pbl. studies have shown that students believe that pbl increases the educational effect of self study and their clinical inference ability, and although studies are conflicting, one showed that uk prho graduates believed that they were better at dealing with uncertainty and knowing their personal limits. students feel less detached from clinical medicine through pbl and thus this may increase their enthusiasm for learning. notably, universities that pioneered successful problem-based-learning such as university of montreal or mcmaster are themselves prestigious institutions that hold worldwide reputations for clinical and academic excellence, taking the top few percent of worldwide graduate applicants. pbl can be considered to be more suitable to teaching of graduate medicine, whose students may benefit from the maturity of an existing degree and previous experience of self-directed learning, and perhaps unsuitable for less able students and undergraduates. lecture-based learning lecture-based learning (lbl) consists of information delivered mainly through large lectures or seminars. this had been the predominant method of delivering pre-clinical medical education at many uk medical schools prior to the introduction of tomorrow's doctors. teaching is delivered via large teaching events at which several hundred students may be present, which guides learning. students are encouraged to do their own reading between lectures as the lectures will only cover the main points. key points in support of lbl include that students gain the opportunity to listen to leading clinicians or academics, whereas pbl tutors may be underused. lecture-based learning is also considerably cheaper to organise, requiring fewer staff members who can deliver lectures to large numbers of students at once, rather than the large number of separate tutors needed to deliver problem-based learning to small groups of eight students. criticisms of lecture based learning include that students get much less interaction with both tutor and colleagues - they passively absorb information in lectures rather than questioning and searching out answers. the lack of interaction also means it is harder for tutors to know if individual students are struggling as they will only find out if students have not understood the lectures in exams, when arguably it is too late, whereas in problem-based learning, the tutor can assess how much each student is learning based on the student's participation in discussion within the weekly tutorials, and may be able to help students who are struggling earlier. lbl has been criticised for 'spoon feeding' students and thus not preparing them for future continued medical education, which is by necessity, self-directed. however, most lecture-based curricula involve a significant proportion of students doing self-directed reading between lectures. some have also criticised lecture based learning for overloading students with information