Undergraduate preparation for prescribing: the views of 2413 UK medical students and recent graduates
This 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.
Teaching safe and effective prescribing in UK medical schools: A core curiculum for tomorrow's doctors.
This article by Simon Maxwell (Clinical Pharmacology, University of Edinburgh) and Tom Wallay (Pharmacology and Therapuetics, Universtiy of Liverpool) explores the General Medical Council's publication Tomorrow's Doctors (2002) and how its key learning outcomes of managing disease processes through drugs can be achieved through a core curriculum in all UK medical schools.
This follows a concern that in 1993, an earlier edition of this publication resulted in the loss of core clinical pharmacology training for medical students.
From The Sunday Times
May 4, 2008
Doctors 'fail in prescribing'
74% of junior doctors fear training to prescribe drugs inadequate
An Edinburgh clinician is calling for a GMC review after finding junior doctors blame lax training for their poor prescription writing
THREE-QUARTERS of junior doctors say they are putting the safety of patients at risk because they have not been trained to prescribe drugs properly, says a new report.
In a survey of 2,400 junior doctors by scientists at Edinburgh University, 74% said the teaching of drug prescription was inadequate and more than half said their training failed to test their knowledge and skills.
More than 40% said they were not confident they would achieve minimum prescribing competencies set out by the General Medical Council (GMC).
Almost two-thirds said they were not confident about prescription writing and barely a third had filled in a hospital prescription chart more than three times during training.
“Our study suggests that a large proportion of medical students and recent graduates from UK medical schools who responded believe that their teaching and assessment in this area was inadequate,” said Dr Simon Maxwell, a clinical pharmacologist at Edinburgh University and co-author of the study.
The report, to be published in the British Journal of Clinical Pharmacology, has prompted calls for the GMC to conduct an urgent review of undergraduate training.
It is believed that mistakes in prescribing, most of which are avoidable, kill dozens of patients every year.
A study published in The Lancet in 2002 found that, of 88 serious medication errors in a UK hospital, deficits in “skills and knowledge” were a factor in 60% of cases.
An Audit Commission report suggested that adverse medication events were responsible for the deaths of 1,100 hospital patients in 2001 in the UK, a fivefold rise on the previous 10 years.
Across the UK, adverse reactions to medicines are estimated to account for one in 15 hospital admissions at a cost of about £470m a year.
The National Patient Safety Agency database receives 40,000 reports annually of medication incidents from acute and general hospitals.
“The medical curriculum as far as pharmacology is concerned is substandard,” said Robert Cumming, chairman of the Scottish Health Campaign Network.
“This problem has been around for a while and it still hasn't been solved. This requires students to be taught pharmacology in a rigorous fashion. There are significant problems and complaints being raised by patients.”
Last week, the GMC insisted that there were no proven links between patient deaths and the standard of medical training.
However, it is carrying out a £100,000 study to investigate the prevalence and causes of errors in doctors' prescribing.
Hundreds dying because doctors lack training in prescribing drugs
by FIONA MACRAE and JENNY HOPE, Daily Mail 19th July 2006
Hundreds of patients are dying needlessly because young doctors are not being properly trained to prescribe medicines, it is claimed.
Some of Britain's leading doctors issued a stark warning that thousands of lives are being put at risk because doctors are 'sailing through' their careers without learning how to use even basic drugs such as morphine.
Closure of university pharmacology departments and downgrading of the subject in medical training means nurses are now taught more about drugs than doctors, they said.
Offiical estimates suggest serious reactions to medicines account for one in every 15 admissions to hospital - and errors in prescribing are likely to cause hundreds of deaths a year.
Professor Mike Rawlins, chairman of the National Institute for Health and Clinical Excellence, the body responsible for treatment and 'rationing' guidelines in England, said: "Five to ten per cent of admissions to hospital are due to adverse drug reactions and the majority of these are avoidable. There is a serious problem about the competence of young doctors in prescribing. "
Professor David Webb, of Edinburgh University, said: "We now have extremely powerful drugs and a lot of them are quite complex to use. But doctors are getting less and less training in the safe and effective use of medicines."
He said it was now possible to "sail through a medical career without any assessment of how you use drugs".