Background
Supporting medical students in their transition to newly qualified doctor is an important educational
priority. Clinical Teaching Fellows (CTFs), as both recent graduates and trained educators, are uniquely
positioned to suggest curricular enhancements to support preparedness for practice.
Methods
Our mixed-methods approach involved CTFs across eight UK teaching hospitals. We conducted five
activity-oriented focus groups to explore what CTFs felt needed to change to increase preparedness
for practice. We analysed these focus groups to create a dataset of their suggestions followed by a
survey. The survey invited CTFs to rate and rank these suggestions in relation to their own self-rated
preparedness for practice, with qualitative insights into their choices. We explored commonalities and
differences between high and low confidence participants, with findings qualitatively illuminated.
Results
24 CTFs attended focus groups from which we identified 28 curriculum items and 10 curriculum
agendas. We collected 23 complete survey responses. All confidence groups rated communicating
with colleagues and managing working life as unmet needs, whereas core clinical competencies such
as history and examination were well met. Participants with low confidence identified more complex
clinical competencies including clinical decision making, task prioritisation and end-of-life care as
unmet needs, with decision making and prioritisation being the most important. Confident graduates
rated higher professional competencies such as quality improvement, career planning and education
as unmet needs but of low importance. Graded transition of responsibility was the highest ranked
curriculum agenda. Qualitative insights included suggestions for how learning in clinical environments
could be enhanced.
Conclusions
Our findings suggest that transitioning from student to newly qualified doctor could be supported by
graded entrustment and enhanced shadowing opportunities. Other recommendations include
prioritising more complex clinical competencies, identifying wellbeing as part of preparedness for
practice, equipping students to communicate with colleagues and aligning higher professional
competencies with learners’ needs.