July 2017


Challenges facing undergraduate degree programmes in Medicine

Editorial Department - AQU Catalunya

In conclusion to the contributions put forward at the workshop Ways to improving the training of medical students held at the University of Barcelona on 15 March 2017, this article presents a summary of the main challenges that were identified and, where applicable, who is responsible for their implementation (in brackets).

The high quality of degree programmes in Medicine was made evident throughout the day in terms of student access and admission, training programmes and the quality of the health care system. Review and assessment processes, available surveys that have been carried out (graduate satisfaction, employment outcomes, the satisfaction of chief medical officers), and the experience of the speakers and participants at the event were all important in contributing to the identification of opportunities for improvement, which are grouped below according to different themes:

Public information and student access and admission

  • Inclusion of information from medical and healthcare facilities associated with the faculty that are involved in placement and practicum, together with a short CV of the teaching staff (universities)
  • Setting up of a mechanism to ensure the required vocation of service for undertaking undergraduate studies in Medicine (government)


  • Strengthening of skills-based training, in particular:

o Decision-making

o Scheduling, time management and the efficient use of resources

o Communication skills

o Negotiation and conflict resolution.

A clinical environment and clinical practice are ideal for the development and assessment of these skills (universities)

  • Strengthening of clinical training (clinical practice) through closer collaboration with schools and faculties of medicine including clinical practice from year one onwards (where none exist) (universities–government)
  • Enhanced assessment of professional skills in: communication, professional values, team work, etc. (universities)
  • Continued implementation of clinical problem-based learning (PBL), increased use of an interdisciplinary approach through joint assessment (universities)

Student support: academic guidance, mentoring

  • Inclusion of portfolios as a methodology in training at higher education level (universities)
  • Improved feedback mechanisms during placement and practicum through the use of tools like Mini-CEX, portfolios, incidents of critical cases, etc. (universities)
  • Improvements to mentoring programmes (universities)

The internal quality assurance system (IQAS) of study programmes

  • Implementation of IQAS: inclusion of satisfaction surveys of both teaching staff and students, and the consolidation of improvement plans as a management tool (universities).

Objective structured clinical assessments (OSCA)

  • Increase in the pool of cases of OSCA (Department of Health)
  • Increase in the participation of students in OSCA (universities)
  • Inclusion of OSCA prior to the completion of study programmes (universities)
  • Definition of a system for an inter-university OSCA for students who have been unable to undertake one

Medical interns

  • Redesign of the examination for medical interns to include clinical skills (communication, collaboration, time management, etc.) (government)
  • Contact maintained with patients during a medical intern's preparation year (government)
  • More importance placed on the academic record (transcript) in the final grade of medical interns in order for students to more highly value subjects that include required skills (government)
  • More rigorous skills and knowledge-based assessment of medical interns: for example, with the inclusion of external review panels (government)
  • Involvement of medical interns in undergraduate training (government)

Links between professional practice and the academic world

  • Consolidation of a number of posts for assigned permanent teaching staff (universities–government)
  • Increase in the ratio of assigned teaching staff. The proposed ratio is 1 to 1 (universities–government)
  • Facilitate compatibility between work on a doctoral thesis and specialist training for interns (universities–government)
  • Inclusion of assigned posts outside of hospitals (prevention and public health) (universities–government)



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