Julian Wright: Teaching the educators

RECRUITING senior medical educators to Australia from overseas may provide them with a new and stimulating environment, but it can be a time-consuming and expensive process.

This whole process could be circumvented by producing a sufficient faculty of Australian senior medical educators.

The lack of a defined pathway for doctors to specialise in medical education combined with the traditional model in which clinicians with no educational training do the teaching leads to the risk that medical students and junior doctors may be exposed to poor-quality teaching experiences.

In the UK, the Academy of Medical Educators was formed in 2006 to set professional standards for medical educators. The academy also provides educational activities and resources for educators.

Such an academy could be replicated in Australia with the aim of increasing professional recognition for those who are interested in pursuing a career in medical education.

While most clinicians in the UK are involved in medical education to an extent, those with particular enthusiasm, aptitude and interest in teaching can gain recognition for their skills in the form of membership or fellowship of the academy.

Clinicians can individually negotiate teaching time with departmental directors as part of annual job plan and performance reviews. Within National Health Service (NHS) hospitals, clinicians receive equal payment for sessions spent on teaching activities as for clinical sessions such as ward rounds, outpatient clinics and theatre sessions.

This is an important difference between the UK and Australia, where some clinicians have contracts with universities for medical student teaching distinct from contracts for their clinical work, with teaching renumerated at a significantly lower rate. This is a major disincentive to clinicians to teach, with the separation of clinical and educational activities sending a negative message regarding the value of medical education.

Teaching activities are thought to be valued less by universities than research and less by hospitals than clinical work. Clearly funding is a major factor in this issue, with teaching unable to compete for funding on a level playing field with the other roles of academics and clinicians.

Yet many academics take on the combined roles of research and teaching, and the value of scholarship in teaching is often under-recognised.

In the UK there is increasing emphasis on equipping clinicians to be high-performing educators. Many educators undertake graduate certificates, diplomas or masters degrees in medical education — another avenue which should be encouraged for clinicians who wish to have significant involvement in medical education in Australia.

Moves in the UK to consider registering clinicians as educators/trainers with local deaneries based on a portfolio of evidence are underway. GPs are already registered with the UK General Medical Council as trainers or non-trainers.

There is a view that all doctors can and should teach. This assumes all doctors will be good at teaching. For this to be true all doctors should be accredited as educational supervisors based on their attendance at local training sessions, which could teach the basics of experiential learning, adult learning styles, feedback and assessment as the bare minimum skill set needed by a medical educator. For senior medical education leaders, more advanced training would be required.

Medical education faculty development programs have had a high level of participant satisfaction and positive outcomes in terms of leadership positions sought and new courses developed.

Medical education leaders need to form a long-term strategy for the recruitment and retention of future Australian senior medical educators. My suggestions aim to raise the status and continue the increasing professionalism and accountability of medical education in the interim.

Professor Julian Wright is director of medical student education, Rural Clinical School, University of Melbourne Medical School. He was previously director of postgraduate medical education at Central Manchester University Hospitals NHS Foundation Trust, UK. He is a fellow of the UK Academy of Medical Educators.