Summary: Dr Neel Sharma discusses the issue of one size does not fit all when it comes to medical education. Description: Last month, 10 medical students at the AMA’s Accelerating Change in Medical Education initiative highlighted their opinions on what is relevant to their learning (1). Topics related to leadership training, health policy, health economics and experiential learning were mentioned. Although hardly a grand scale analysis by any means, this first step clearly demonstrated that one size does not fit all.

Often in medical education we tend to replicate interventions and teaching strategies without fully understanding the needs of our target audience. Whilst living in Asia, I note my students typically prefer a more didactic approach whereas in the West a more interactive approach was better placed. This is nothing to be frowned upon. And differences in culture should of course be respected.

Focusing on certain aspects of the AMA discussion, I would say health economics for example wouldn’t be such a heavy focus for students in the UK. The health care system is of course publicly funded and whilst I do recall the odd episode of a senior being resistant to daily CRP orders due to cost, we generally don’t tend to consider cost in our daily practice. That isn’t to say we shouldn’t be considering the significant debt the NHS currently faces and the need to somehow magically fund a 7 day service as per current debate. Yet it is more likely that rising costs are related to other factors such as unnecessary referrals to A and E and social admissions. Earlier this month, the need for training and support in ‘whistleblowing’ was highlighted as mandatory for UK medicals students following the failures at Mid Staffordshire NHS Foundation Trust (2).

Therefore as educators we should all keep in mind our target learners and setting and do our best to resist following the practices set by other institutes but rather lead at our own.

1.    AMA’s Accelerating Change in Medical Education initiative

2.    BMJ News Article