Why MBChB at the University of Aberdeen

An interview with Dr Colin Lumsden, Lead for MBChB at the University of Aberdeen

What is Faculty Development & Medical Education?

Hear what professionals have to say about what shapes medical education.

01. Why MBChB at the University of Aberdeen.mp3

Speaker 1 Good afternoon everyone. My name is Florian. I'm joined today by Professor Colin Lumsden. Professor Lumsden graduated from the University of Saint Andrews in Manchester with a joint medical programme in 1995. He's an honorary consultant in paediatric allergy. He is a professor of medical education, a director of the Association for the Study of Medical Education and a National Teaching Fellow. He has joined University of Aberdeen in 2020 as lead for the next programme. So Colin, just to start off, why be at University of Aberdeen?

Speaker 2 Okay. So that's a that's a very difficult question. So I began my medical education career when I was a new consultant in 2005 when I, started my consultant job in Preston in the northwest of England. And I took up educational rules there fairly early on because I had an interest in supporting trainees and students through their educational pathway, never knowing that I would end up in this particular situation. So, I joined the University of Manchester in 2009 and was there until I came, to Aberdeen. So I was there for 11 years and various different roles, developing my educational profile, developing my developing my educational kind of credentials. I did a master's in medical education at Cardiff. I actually started just before I had actually gone to, to Manchester, which I think gave me a really firm grounding in medical education. And, a lot of the theory that underpins what we do. I was ready for a change, of of circumstance, I felt that I was ready for leadership. I think there's only so long you can do some roles, and you feel that you've got something to give somewhere else. So I actually met Professor Peter, who's the director of the institute, at an international conference, and we just happened to get onto the, the, the topic of Aberdeen and whether it would be something of interest to me. So it definitely was of interest to me. I guess it helps that I'm from Aberdeen originally. I grew up in Aberdeen, so yeah, probably not from Aberdeen, but I moved to Aberdeen when I was seven, in 1978. And I did my schooling here. So, in a way it was a journey home for me, a relocation up north and an amazing opportunity to lead a medical problem. There's not many of those jobs around. And for us in medical education, they're kind of the pinnacle of, of of your career, if you like to lead a medical school. So it was an amazing opportunity that I couldn't turn down.

Speaker 1 Right. That's absolutely fantastic to hear that. You came back to your roots in a way like you said. And what do you think attracts some clinicians to a career or at least attracts to academia and education? What's appealing about it?

Speaker 2 So I think it's really interesting. I, I do see people who very early on their careers, want to pursue a career in medical education. But the vast majority of us, I think, actually come into it later on in our careers. Certainly I didn't have a huge interest in medical education as a trainee. I think I enjoyed teaching, I enjoyed supervising people more junior than me. And it's only when I became a consultant that they, I had the opportunity to lead on certain aspects of that. I think it's really satisfying to supervise, to teach, to help the next generation of doctors coming through. I think. I think most doctors have a very vivid memory of their experience, in training, and education in medicine. I mean, it's a long path, you know, from from going to university in 1989 to become a consultant was 16 years and that was working full time. So I did it. I did it pretty quickly, to be honest. And that was the six year undergraduate program. So we all remember those times. We all remember the difficulties. I think we are really collegiate. We like looking after each other, so it's really nice when you get really bright, motivated people. And to help them, with their careers. I find that so satisfying. So I always see the most satisfying part of my job is identifying new talent, people who enjoy what they're doing, who are good at it. And, you know, maybe I'll work for them one day. You know, I have no problem with people succeeding in their career and overtaking me. Absolutely no problem.

Speaker 1 So what does your role as the leader of the MCB curriculum mean to staff and students?

Speaker 2 Okay. What does it mean to staff and students? I guess I have a position of problem. I would have to admit, I don't really see myself as some exalted person in the program. I'm kind of the same person I was before. I think I'm quite humble about it. I don't, I don't, I don't stand on ceremony at all. But when I meet people, they do treat me differently because of my position, as the lead of the NBC VP. So their perception of me. I don't really have any control over. But, you know, again, I have ultimate responsibility for the medicine program to ensure it runs, as it should, that I am accountable to, regulate what should be the General Medical Council, that I am accountable to the university that we are delivering, an educationally relevant, course that delivers outcomes for graduates and, you know, competent graduates. So, it's a it's a really responsible job. But at the end of the day, I work with amazing leads. Who? I know you've spoken to some of them already who do all that work. And my role is really to ensure that there's coordination of that and that there's a coherent program that works for the students.

Speaker 1 You must have a good overview of everything that's going on at, I think for everybody in terms of medical education, what should a new clinical staff that wants to be involved in the MCB, know about it?

Speaker 2 Okay. So this is a really interesting one, and there is a whole story behind it because I came in 2020, in January of 2020. And you know that something happened shortly after I arrived. So I arrived to a very well-run, very well thought of very well-respected medical program. And within three months, I had shut down that medical program because of Covid. You know, we had to do that. That process in itself made me have to look very closely at the program, how it was put together, how it runs, what are the critical elements in that program? So looking back in hindsight, it was quite a positive thing because it's difficult to come in with new leadership when something is doing so well. You know, it's it's much easier if if there are problems that need fixing. So so from that perspective, it was a real journey and I had to learn how the program went together. I had to learn about the ethos of it. The medical programs in Scotland are really quite different to those in England, which I hadn't realised at all. So most of the English medical undergraduate programs have three years of clinical practice and two years of pre-clinical. We don't call it pretty critical, but but essentially they are and it's the other way round in Scotland. So I had to try and get my head around why it was different. So I think there's a, there's more, getting people on the same level in the first year of medicine. And certainly I knew that in the first semester. This is the foundation medicine course, which gets everyone to to a similar level. So, having having experienced it for a few years, I did find it slightly odd, and I had to get my head around it a little bit. But I do see that it provides a really firm foundation of knowledge in the clinical years. So, I think for anybody coming to Aberdeen and wondering what the medical program is, the first three years of the program are very much about building that basis of knowledge, to teach through into clinical years. And the clinical use are very much around experiential learning, learning on the workplace, learning from clinicians about professional behaviours as well as clinical knowledge, diagnostics, clinical reasoning, all these elements. And the final year is is almost like an apprenticeship type year because the students have done their final exams at the end of their fourth year. So the final year is really a place for students to be able to put that together in practice and actually be useful parts of clinical teams. Now, I think that was really, really helpful in lockdown because, and, post-lockdown, because our students were really valuable members of the healthcare teams, they were actually integral parts of it that made it work. So I'm really proud of that. Something that we did to help, clinical practice.

Speaker 1 You mentioned Covid, and that was quite a disruptive event for everybody. Do you think that revealed the fact that different university bodies and, clinical practices or the NHS are working well together or that there is room for improvement.

Speaker 2 Was always room for improvement, isn't there? So, in some ways, I'm on a new journey to find out what, a normal Aberdeen medical program is and how it works. One of the benefits, as I said, was being able was having to get a real firm grasp of what we did, how we did it, because we had to make decisions about what we couldn't do and whether they would be compatible with a graduating student. But it also meant that I didn't get the opportunity to get to know NHS Grampian. So I am a practising clinician in NHS Grampian, but I'm in the Children's Hospital. I, I've only recently met an awful lot of people. That I known from teams. And so there is a bit of a learning journey for me around the working practices in NHS Grampian. Okay. And not just NHS Grampian, NHS Highland, Orkney, Shetland, Western Isles. We have students all over the place. So, I found that, there was an amazing collegiality here and I think that's what transmits through to our students that people want the best for our students and will work together to achieve that aim, which I didn't always see in my previous employment. But if you think about somewhere like Manchester, there are 500 students in a year. There are well over 25 hospitals that the students go to. It's a very different environment. So it's smaller here, but very, collegial. And people do work for the benefit of the students, which which makes my life an awful lot easier.

Speaker 1 You mentioned that we have contact with, for example, NHS Grampian and other boards. Do you think we play to our strengths? As a university, we are quite well placed to collaborate with remote rural, for example.

Speaker 2 Okay, so I think what's really great here is that we have a real tight, bond between the NHS and the university. I mean, it's particularly noticeable in Grampian, but but we have it across other boards as well. The fact that we are on site, with a purpose built medical school, and there is real tight governance between two of the organisations is a massive plus and it's something you don't see in every medical school. So I think we do work synergistically extremely well. We have great, connections with, remote and rural, hospitals, placements. I know we're the probably the oldest remote and rural programme in Scotland. I think we're, well, well-established. We've been doing it for an awful long time, and we have a lot of students that graduate from it. We probably don't speak about it enough. Because I think people think there aren't any rural programs when we've been doing them for decades. So, I think we do do, do some promotion about the work that we're doing there. It's really challenging, isn't it, that that ability to deliver a high quality medical education across the whole of the north of Scotland, and it is a big geographical area, although I feel a bit daft when I go to Australia and things and talk about big geographical areas. But I think technology, which we've had to embrace during lockdown, does actually offer opportunities to improve our our communications with our health boards and NHS Highland is vastly improved since we all started using teams. Now teams comes with its downsides, but that ability to communicate and work across patches, has been vastly improved since I've been here.

Speaker 1 Speaking precisely about this as a new, clinical educator. What support? It's available from you, from the university to fully engage with teaching.

Speaker 2 Okay, so so a new clinician coming, teaching here in the University of Aberdeen. So, so we have an excellent educator network, and there are, recognition of trainer workshops. I know I run, pretty regularly. I know the postgraduate teams offer lots of support and courses, to get that recognition of, of trainer status. I knew that I had to get it myself this year because it didn't transfer from England with me. As I said before, all the normal processes of developing your skills and CPD were all put on hold during lockdown. So I'm just beginning to see what opportunities there are available at the moment. I know that you yourself and Kim Walker, here in the university are doing an enormous amount of work on staff development, on access to resources for for developing expertise. So I'm a real, supporter of the work that you've been doing. I'm really pleased that it's gone on to a site the NHS clinicians use all the time. Anyway, on Tuesdays, and I'm really, amazed to see the amount of progress you've made already with that. So there are definitely formal opportunities. We have a postgraduate certificate in, clinical education, which, people can enrol in and really just discounts for that. But there's lots of informal help. There's lots of existing educators. And I think that's one of the benefits of having the study centre arm, medical school on site is that people can get involved, in medical education and bespoke to do so.

Speaker 1 And for staff that are already teaching on the curriculum, what support is. Available for them.

Speaker 2 So I think staff that are already teaching on the curriculum, are incredibly, well, appreciate I guess it depends what they want to do. Lots of. I believe that every NHS clinician has a responsibility to teach and supervise. I think it's just in our DNA. That's what we all expect. Lots of people do that. And the, they're very happy doing that and they don't want any further qualifications or credentialing for that. Now, I think there's a basic level that you need to have, and that is tied up in your recognition of of trainer status and the requirements for that that you have to have in your developmental portfolio. But there's always opportunities if people want to develop their expertise and take their teaching to another level. There are leadership roles coming up. All of the time. We have a massive expansion on student numbers that provides its challenges, but it also provides opportunities and that we have opportunities for people to develop their educational excellence and lead on various aspects of the MXGp program.

Speaker 1 I know you mentioned that you're trying to figure out how things were done pre-COVID. Were there any challenges from that period that have translated into into present?

Speaker 2 Okay. I mean, so, I think when I arrived, we had about 180 students in each academic year. This year, we'll have 300 students in each academic year. So, as I said it, it's really difficult because I wasn't here. Prior, I didn't see any sort of normality in Aberdeen. I think the whole clinical landscape has completely changed how we practice. We've seen how all those challenges in acute care, social care, bed availability, there are staff that are under enormous pressure and have been, for well over three years now. People are tired, fed up, and I feel that I'm pushing more students into those, scenarios to try and, maintain that pipeline of graduates coming through that are going to help eventually sort to, you know, help out with some of the issues that we're seeing. So, part of it is, is a journey of discovering what is already in place, what is good. And I know there's lots of amazing activity that already goes on. But also it's, it's to find out where we have opportunity to expand into. And so there's a significant piece of work going on at the moment around exploring our clinical capacity, what we can, where we can improve that capacity, how we can, assist clinicians, what resources they need to be able to deliver high quality medical education.

Speaker 1 So looking past the limitations that higher number of students would impose, what are your visions for the curriculum?

Speaker 2 Okay, this is a really difficult one, isn't it? Okay. So look, I think we would always say that we want a high quality program. I think that's the, the the number one thing. It should be excellent and offer an amazing student experience. I was asked this in my interview. Actually, it's a very difficult question to answer when you are top of the rankings and metrics amongst UK medical school, where do you go from here? I said at the time that I would aim for us to be the best medical school in the United Kingdom. We've rank. We've ranked second in the Guardian rankings for medicine for at least the past few years. I can I can see, and we were first overall for, student satisfaction, overall students student satisfaction in the United Kingdom this year. That is an amazing feat. I think people have got a little bit complacent about that because I already know who's done so well in it. But I came from a school where we were not at the top of the rankings. And it's much more challenging environment if you're in that situation. There's a lot of pressure. So I want to be the best medical schools in the kingdom. How do you define that? That it is no way of defining that. I think we're already known as being a really supportive medical school. I've heard that from students. I've heard that from parents in opening day, on open days, the they tell me that Aberdeen has this reputation of supporting students through the program. And I think that's absolutely incredible. There are real challenges for many of our students who suffer with wellbeing, mental health, and I think we do a great job in supporting students to succeed in their chosen career. I want us to be open to all we have a, widening participation strategy that has been incredibly successful to date. We have our G2, program where we have 30 students a year through that, we have increasing widening participation targets from Scottish Government. So we are really opening up our access. I'd like to see us, reinvigorate our drive to. Recruit students from remote and rural locations. I knew we were. We were always really successful in the past, but we seem to have had a little dip in our applications from remote and rural locations, so we are definitely putting a strategy together to go out to schools to engage with pupils much earlier on. Actually, if we go in too late, they've already made their subject decisions and in some ways that has not helped them in application to medicine. I think our, admissions policy is incredibly inclusive and diverse. I think we allow the vast majority of students who are capable of, pursue a career in medicine in, into medicine, that offers us huge challenges in terms of providing the support. So we know we have several wheelchair users now within our medicine program, and we're now beginning to discover that we're perhaps not as wheelchair accessible as we as we thought we were. So, that has significant resource implications to the school. We have definitely, invested in more student support staff. And that's one of the big things that we did in the last year. So I want to be supportive. I want to be fair to all, I want I want us to be to have an anti-racist stance, not a, not, to, to actively discourage racism. And that as a huge piece of work that started after, the unfortunate events with George Floyd in, in 2020, it was actually our medical students that wrote an open letter, the, received widespread, publicity, within the media. And we had to respond to that. So I'm really proud of the work that we've done with NHS Grampian and all our partner boards to try and stamp out racism and discrimination in all its forms. And I know we've done a huge amount of work in that, but there's plenty to go. We, are starting work on decolonising our curricula, that I know I was at the Senate yesterday was approved, via Senate. So it's something that we are all going to have to do. I think there's a little bit of learning there. The, about what decolonising the curricula actually means. I myself will be on that journey, but there will be resources to help with that. So I want us to be inclusive and support everyone to go through. I don't see any unfairness in our program. I think it it goes without saying that we want an excellent student experience. We want students to learn, all the capabilities that are required of a newly qualified doctor. I think we do that already quite well.

Speaker 1 And finally, do you believe that we respond, in a timely manner to student input? Do you believe that students also have the means and are encouraged to provide that input?

Speaker 2 That's a nice question to ask me at the end, isn't it? Okay, so I when I become aware of any student input, I am always quite taken aback by how quick the response is. This is this is in contrast to other places I have worked. I know that if any emails go to our head of school, go to any of our report. Mechanisms are anonymous reporting. If they go to the director of the institute, they come to me. We deal with them almost immediately and we try to find a resolution for that. So I think we are incredibly responsive. I think that does translate through to the students that they have. Trust that we will deal with things in an appropriate manner as quickly as we can do. I believe that we have the best mechanisms for students to report back to. So we have our, staff student liaison committees. I think it's always been a bit of a criticism that, even though they have elected representatives in there, do they always reflect the, the, the feelings of the whole year? I think this is brought into sharp contrast during Covid, as we had really difficult times, with particular year groups, which had a really horrible experience in lockdown. And I think there's work to do in improving those mechanisms. But yes, I would say that if you have, a legitimate concern that you want to report to us, I will always respond extremely quickly to that. I may not be able to give you the response that you want, but I will respond to it and we will look into what we can do to improve anything.

Speaker 1 I'll call in. Thank you very much for agreeing to take part in today's podcast. I know I look forward with excitement to see how the medical education environment will be shaped in the following years.

Speaker 2 Thank you Florence.