The Society of Occupational Medicine was one of the organizations invited to submit evidence to the Royal Commission on Medical Education. Printed below is a résumé of the memorandum the Society submitted and of the Royal Commission's recommendations. The Society's reactions to the Royal Commission's views then follow. *
The simulated tutorial is a method for selecting medical students by their performance in a small problem-solving group, currently being tested at McMaster University. Four hundred and thirty-two applicants were randomly allocated to groups consisting of 5 or 6 members, assigned a group leader, and asked to work through two unstructured problem situations in a 50-minute session. Assessors, seated behind a one-way mirror, evaluated applicants according to their abilities to relate to their peers, to function in the group, and to define issues in the problem situations. Feedback from the assessors and applicants suggests that the simulated tutorial is potentially useful as a selection tool. All assessors thought they were able to evaluate the 5 or 6 applicants in the group in the time provided. Nearly 80% of the applicants who anonymously returned questionnaires felt they were able to express themselves during their simulated tutorial. The data also suggest that applicants with experience in small groups and applicants previously rated as having outstanding 'personal qualities' are given higher ratings than other applicants. A validation study of the simulated tutorial, comparing individual's scores with evaluations of performance in tutorial groups in the undergraduate M.D. programme, is currently in progress.
In a new program of teaching and consultation in child psychiatry for paediatric interns and residents, many of them of foreign birth, several approaches were tried: individual case consultation; screening conferences; experiential groups; didactic sessions. None succeeded very well. As a result of this experience, however, we have been able to identify some of the problems of the foreign students (and our own), which made the more usual educational approaches ineffective with them, and to determine better approaches. Some of the students had personal problems of adjustment, most were relatively unfamiliar with the culture, others could not communicat adequately and had scant psychiatric knowledge, and almost all were accustomed to an entirely different student-teacher relation. The most effective way of dealing with these problems was found to be through one-to-one supervision and consultation. Didactic sessions were changed to focus on specific ways to handle specific problems, with only simple, not very theoretical reading material used. With the growth of personal relations, informal consultation and teaching increased, and the formal programme became more successful.
: To examine the social environment of the medical school as it relates to smoking, tape-recorded interviews were conducted with 92 medical students at the University of Manchester. The medical school provides a social setting unfavourable to smoking for many students, but for some non-smokers and many smokers countervailing forces lead to an expansion of the habit during training. Increased opportunity, the influence of peers and social factors, together with environmental stress, tend to encourage smoking. The necessary information about smoking is provided and this influences some, but in general the medical school fails to establish a social climate in which smokers would feel more strongly motivated to give up. Although most students accept in theory that non smoking is part of the doctor's role, this idea is not consistently presented to them during the course. Furthermore, it is not always seen in practice to be adhered to by members of staff, their role models, thus enabling the student who smokes to deny the relevance of his personal behaviour to his future role. Nor is this ameliorated by the students' perception of policy in the medical school as one of, at most, mild disapproval.
In this study second year medical students completed a battery of psychometric tests which measured both cognitive and non-cognitive personality traits. Personality profiles obtained have been compared with reported norms from some other published sources. The scores obtained from factor analyses of these tests were used as predictors of total achievement in cellular biology and physiology over two years. In agreement with reports by other authors we found that the most important trait contributing to achievement was introversion/extra-version with introversion correlating with high achievement particularly in multiple choice tests. Emotional maturity was also a major factor especially as a predictor of success in essay tests. General mental ability, verbal skills, and reading comprehension appeared as significant predictors of achievement, and these were apparently of comparable importance in both kinds of test. Students of foreign origin whose first language was other than English tended to perform better in essay than multiple choice tests but their overall performance was lower than would have been expected from their other personality traits including their verbal skills. On the other hand, students resident in college halls tended to have better overall performance than expected.
