Undergraduate preparation for prescribing: the views of 2413 UK medical students and recent graduates

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Abstract
WHAT IS ALREADY KNOWN ON THIS SUBJECT • Adverse drug events are common in National Health Service (NHS) hospitals where junior doctors take responsibility for most of the prescribing. • Safe and effective prescribing of drugs is a core competency expected of all medical graduates. • There is a perception from some of those who supervise the prescribing of drugs in the NHS that undergraduate teaching in this area may be deficient, although this view is contested. WHAT THIS STUDY ADDS • Our study suggests that a large proportion of medical students and recent graduates from UK medical schools who responded also believe that their teaching and assessment in this area was inadequate. • This result implies that those responsible for overseeing undergraduate education should urgently review teaching and assessment of competency in relation to prescribing in all UK medical schools. AIMS To gather opinions from UK medical students and recent graduates about their undergraduate training to prescribe and their confidence about meeting the relevant competencies identified by the General Medical Council (GMC). METHODS We designed a web-based survey that was distributed to UK medical students and first year Foundation doctors (graduation years 2006–2008) via medical schools and postgraduate networks. RESULTS Analysis was restricted to 2413 responses from students graduating in 2006–2008 from the 25 UK medical schools (mean 96.5 per school) with a complete undergraduate curriculum. Distinct courses and assessments in ‘clinical pharmacology & therapeutics (or equivalent)’ were identified by 17% and 13%, respectively, with mode of learning described most commonly as ‘opportunistic learning during clinical attachments’ (41%). Only 38% felt ‘confident’ about prescription writing and only a minority (35%) had filled in a hospital prescription chart more than three times during training. The majority (74%) felt that the amount of teaching in this area was ‘too little’ or ‘far too little’, and most tended to disagree or disagreed that their assessment ‘thoroughly tested knowledge and skills’ (56%). When asked if they were confident that they would be able to achieve the prescribing competencies set out by the GMC, 42% disagreed or tended to disagree, whereas only 29% agreed or tended to agree. CONCLUSIONS Many respondents clearly perceived a lack of learning opportunities and assessment related to the safe and effective use of drugs and had little confidence that they would meet the competencies identified by the GMC. There is an urgent need to review undergraduate training in this area.