Education: Trust me, I'm an OU doctor

Distance learning is the latest innovation in attempts to draw a broader range of students into the medical profession. But is home study really the answer?
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The suspicion that your doctor might have trained through a correspondence course is not one to inspire confidence as you lie back and count to 10 on the trolley going into surgery. But all this may be about to change. Distance learning, of the tried-and-tested Open University variety, is at the heart of a pioneering new medical education project based in the south-west of England, which is to be called the Peninsula Medical School. At the other end of the country, a similar venture, bringing together the Open University and the University of Leeds School of Medicine, will help to train doctors in West Yorkshire, with a particular emphasis on encouraging recruits from the ethnic minority communities. It will enable students to begin their education part-time with the OU before taking up a place with third-year students at Leeds. The joint bid paves the way for more medical students to experience first-hand the challenges of delivering health care to different population groups in the same district. It will also create opportunities for recruiting minority ethnic students from the local communities, particularly women, by enabling them to study at home.

Back in the West Country, the Universities of Exeter and Plymouth, neither of which is currently involved in the undergraduate education of doctors, have joined the OU to bid for a new and unique medical school to take on some of the extra 950 recruits that the Government plans to train for the profession. If the bid succeeds, this will be the first time medical students will have been taught by distance learning and gained all their clinical training in the south-west.

Currently, there is no English medical school to the west of Bristol, although both Exeter and Plymouth run post graduate facilities for a range of medical professionals who have already qualified. They and the local health authorities are also involved in some of the clinical training of Bristol medical students.

The proposed new medical school will build on this existing expertise in Plymouth and Exeter. But it will also use radical new training methods, based on the OU's existing experience in teaching both science and professional skills through distance learning. "What we will offer is science teaching, support for teachers and students, staff development, information technology and support materials," says Professor Janet Grant, director of the OU's joint centre for education in medicine. "For the south-west peninsula, this is a rare opportunity to develop an innovative way of training doctors in a way which is relevant to our health-care system and to the health needs of the community."

In line with Government policy, and the Campbell Report, which called for improved access and equity in the allocation of medical-school places, the new centre would also aim to attract students from different educational backgrounds on to high-level courses - in this case, graduates, but not necessarily scientists. This is another area where the OU has both experience and expertise.

A project team involving staff from all three universities, and the health trusts and authorities in Devon and Cornwall, worked on details of the medical school bid. Each student accepted will undertake a foundation course in medicine run by the OU, with residential schools and early clinical contact offered in Exeter and Plymouth. During the foundation course of two years they will be able to study from home and keep any existing jobs they may have, in traditional OU style.

Entry to the advanced, predominately clinical, and full-time part of the course will be dependent upon satisfactory completion of the foundation course. The OU will also be involved in this part of the course, and is planning to develop adaptations of its existing communication and professional skills teaching for medics.

"This is a tremendously exciting opportunity to work in partnership to provide a radical new training for medical students which will enable them to meet the challenges of the 21st century," says Professor John Tooke, director of Exeter's school of post-graduate medicine and health sciences. "A graduate-entry programme will enable us to broaden the range of people coming into medicine, to the benefit of patients."

The Open University believes that its pioneering record in distance learning makes it an ideal partner to push forward the Government's ambition to train not only more, but slightly different, entrants to the medical profession. They will not only draw on their existing science courses to provide the foundation course in the south-west, but also provide quality assurance and skills teaching and other support for the new medical schools students as they enter their clinical training.

"With our standards of teaching quality and experience of supporting geographically dispersed students and teaching staff, we believe we have a unique contribution to make," says Professor Ann Floyd, the OU's Vice- chancellor for curriculum and awards.

The idea has already proved sufficiently radical to attract interest from other university medical schools, such as Leeds, but also St George's in London, which is equally interested in the Campbell Report proposals. They are discussing with the OU the possibility of reserving some third- year places on their courses for prospective students who have undertaken the new medical foundation course from anywhere in the country.

The OU also has a third strand to its medical bow in the development of an access course for prospective doctors who do not have the appropriate A-levels to enable them to apply for a place on a conventional medical degree course. The precise content of such a course, which will be developed from existing OU science modules, is now being discussed with individual medical schools which might take access students.

According to Professor Janet Grant, all of these developments are very much in tune with the way the medical profession is going. "There is a major debate going on now in medicine both about graduate entry to the profession - which is the norm in some other countries such as the USA and Australia - and about the ability of traditional students to understand the lives of some of their patients.

"I think there is general agreement that a wider range of students is desirable. The approaches we are pioneering, both through the foundation course and the proposed access course, will make it easier for non-traditional students to become doctors," Professor Grant concludes.