LETTER TO THE EDITOR
Year : 2014 | Volume
: 27 | Issue : 3 | Page : 300--301
Recent 2015 changes to the UK foundation training application: A deterrent to medical student research?
Michael M Modell, Thomas Snell, Smruti Varothayasingham, Stephen D Robinson
Brighton and Sussex Medical School, Audrey Emerton Building, Eastern Road, Brighton, East Sussex, BN2 5BE, United Kingdom
Michael M Modell
Brighton and Sussex Medical School, Audrey Emerton Building, Eastern Road, Brighton, East Sussex, BN2 5BE
|How to cite this article:|
Modell MM, Snell T, Varothayasingham S, Robinson SD. Recent 2015 changes to the UK foundation training application: A deterrent to medical student research?.Educ Health 2014;27:300-301
|How to cite this URL:|
Modell MM, Snell T, Varothayasingham S, Robinson SD. Recent 2015 changes to the UK foundation training application: A deterrent to medical student research?. Educ Health [serial online] 2014 [cited 2020 Jul 6 ];27:300-301
Available from: http://www.educationforhealth.net/text.asp?2014/27/3/300/152199
The United Kingdom Foundation Programme is the training programme for the first years of postgraduate medicine.  The UK Foundation Programme Office, responsible for organising and overseeing applications across the UK, operates the Foundation Programme Application System (FPAS), facilitating the allocation of final year medical students to foundation posts in the UK Foundation Programme. This merit-based application assigns a maximum score of 100 points to each student, composed of up to 43 points for undergraduate academic achievement, 50 points for the Situational Judgement Test and the remaining seven points available for extra-curricular academic achievements.
In recent years, in the interest of fairness, the UK Foundation Programme Office has refined its criteria for rewarding extra-curricular educational achievement. This has rendered academic prizes students win and conference presentations they give ineligible to receive points for the 2014  and 2015  applications, respectively. Only students who have had the opportunity to pursue additional degrees or successfully publish within academic journals are able to earn points awarded for educational achievement. While there is an undeniable fairness issue to support these changes, we perceive they may deter medical students from pursuing academic prizes and presentations, which in turn may negatively impact student interest, exposure and experience within academic medicine.
Worldwide, medical student publishing rates have increased greatly over the past 30 years,  with career progression often reported as the primary motivation for publication and presentation within the UK.  Regardless of such trends, only a small proportion of medical students (approximately 14%) have published work at the time of graduation. 
The General Medical Council's 'Tomorrow's Doctors'  states that a doctor should be able to "formulate simple, relevant research questions in biomedical science, psychosocial science or population science and design appropriate studies or experiments to address the questions", hence these skills are important to develop during undergraduate training. Presentations also promote communication, partnership and teamwork skills that are essential and in line with Good Medical Practice. 
With career progression in mind as a key source of motivation, it seems that removing the incentive in the FPAS could be perceived negatively. However, students should bear in mind that these educational achievements will benefit their careers in the long-term. Student exposure to academic research at an undergraduate level is often limited to research projects, the medical curriculum or as part of an intercalated or previous degree. Given limitations regarding allocated timeframes and the depth of projects, it is often difficult to have the rigorous methodology required for publication in a peer-reviewed journal.
Presentations provide students a more accessible opportunity to gain recognition for their work, network with clinicians from around the world, and obtain public-speaking experience at national and international conferences. This is a more achievable goal for most medical students than publication, and a goal that can be pursued independently, promote initiative and allows students to pursue their own research interests in a more self-directed fashion. Publications, in contrast, require more involved support structures, financing and guidance from tutors within the medical school.
Many medical schools do not provide students the opportunity to engage in research as a compulsory component of the medical degree. Conversely, many schools encourage research skills. Brighton and Sussex Medical School, for example, requires students to present research from year two of the curriculum, and undergo an individual research project in year four, with presentations and publications encouraged. Students from medical schools that do not include research as a compulsory element may be disadvantaged in their scores from the UK Foundation Programme used in winning residency postings. Additionally, six year medical degrees, with compulsory intercalation present an unfair advantage over other schools that must impose a cap on the number of students entitled to intercalate.
Students with additional degrees are more likely to have these achievements, having had increased exposure and time to pursue these endeavours. Those without these qualifications are therefore at a disadvantage, and with the recent increase in tuition fees to ͳ9000 per annum, financial implications may deter students from spending an additional year to avoid further debt, regardless of the opportunities available.
These recent changes to the FPAS criteria for academic achievement were implemented in the interest of ensuring the application process remains fair and consistent for all students. However, the quality and extent of a person's contribution to a publication can also vary substantially. While the number of conferences is considerable, this is significantly dwarfed by the number of journals to which students may submit their research. However, presentations still allows the pursuit of academic achievement and motivates students to undertake research.
We propose that instead of the recent changes to remove posters and presentations from the FPAS, a more robust screening mechanism for verifying presentations and posters should be developed. One possible solution could be to include a dropdown list of pre-approved conferences that students can select, and require concurrent medical school approval to prevent abuse to this system.
Furthermore, medical educators in the UK should encourage students to undertake research at an early stage and present at high quality conferences, which have been pre-approved and publicised within a widely accessible database. Key stakeholders of the FPAS, including the General Medical Council, British Medical Association, National Health System employers, foundation and medical school representatives, could approve such a list of organisations.
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