Page 8 - Volume 69 Number 3
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Share Your Story
By Andrew R. Barnosky, DO, MPH
Letter from the U.K.
Editor’s Note: WCMS president Barnosky spent the month of June teaching medical students at the University of Oxford in the United Kingdom. Since this is not something most of us will ever have a chance to do, I asked him to describe what he observed and what he learned about medical students and medical education in the U. K. and to make any other observations of interest. Here is his letter from the U.K.
Oxford is a beautiful city with a population of 160,000 that is home at its core to 38 colleges, the earliest of which dates back to the eleventh century. It is considered the oldest English-speaking University in the world. With 23,000 students, it is about half the size of the University of Michigan. The colleges, although roughly similar in size, structure and archi- tecture are each unique in character. The buildings remind one of those at the University of Michigan Law School. The colleges are situated, often right next to each other, in the central part of a city that also contains historic libraries, museums, churches, parks, and shops. The college choirs are stunning. The city is truly a lovely and inspirational place, alive with abundant architec- tural and natural beauty.
The Division of Medical Sciences, Biomedical Research Center, and Oxford teaching hospitals are an integral part of the University. Students at Oxford (and MOST other British medical schools) enter medical school after the equivalent of high school, in which they embark on a six-year program: three years of preclinical studies followed by the three clinical years.
In the preclinical years, students live and study in one of the 38 Oxford University Colleges where they pursue the non-medical aspects of their studies. These three years of study are based on the tutorial system in which one to four students spend an hour with an academic tutor each week discussing their week’s work, usually the writing of an essay on topics in the humanities, social sciences, mathematical, physical, and/or life sciences, or completing a problem sheet
in mathematical, physical, and life sciences, and sometimes social sciences. The medical education in these three pre-clinical years is completed by having all of the students come together as a large class on Oxford’s medical research and educational campus.
The final three years of training are hospital-based predominantly at the 832 bed John Radcliffe Hospital in Oxford, which opened in 1973.
The course I was invited to teach is called Principles of Clinical Anatomy (PCA). Oxford students take a traditional dissection-based anatomy course in their first year of studies. The PCA is a three-week course required during the intersession between the end of their first three preclinical years and the beginning of the three clinical years of study. The PCA gives an intensive and comprehensive, clinically focused overview of human anatomy designed to teach students the most relevant aspects of anatomy that will be of immediate use as they begin their clinical years of training. The core faculty members for this course spend eight hours a day in teaching and student contact. The course is a mixture of lectures, small group teaching, and tutorial-style learning in the dissection suite. Students must pass a compre- hensive examination at the end of the course in order
to advance to the clinical years.
I found Oxford students to be very similar to the
students with whom I teach at the University of Michigan Medical School. They are bright, inquisitive, hard- working, insightful, and also exceedingly polite and professional. While good-humored, gregarious and enjoyable to interact with, they are at the same time very serious-minded regarding all aspects of their studies. The one big difference between Oxford students and University of Michigan students is that they are, across-the-board, simply much younger. Having entered medical school following the completion of the British equivalent of high school, the students begin their fourth year at the age of most traditional American undergraduates in their junior year. And while medical school in the United States is a post-graduate experience in which there may be a deliberately wide variation in the student ages, prior educational accomplishments and work experiences. The same is not true in the U.K., where the students are uniformly of the same age and experience.
I was impressed by the importance placed at Oxford on students’ anatomical knowledge prior to the beginning of their clinical years. I would not say that it is better than what we do here at Michigan, as I feel that the outstanding dissection-based anatomy education
8 Washtenaw County Medical Society BULLETIN JULY / AUGUST / SEPTEMBER 2017

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