Guidance on undergraduate clinical placements

Introduction

The role of clinical placements and those involved

Clinical placements are important within an undergraduate medical programme. Placements give medical students (students) practical experience in different healthcare settings. This experience plays a vital role in preparing students for medical practice. It's important to plan placements with the most learning potential. Students should be integrated and valued within clinical teams. Organisations responsible for the education and training of medical students should deliver high-quality educational and clinical supervision. Supervisors should be well trained and compassionate.

Students

Students are responsible for their own learning and should meet our Outcomes for graduates and be able to carry out the necessary Practical skills and procedures by the time they qualify. They should feel prepared and supported, which helps to create good learning opportunities. Throughout this guidance we refer to students as one group, but they all bring different skills and experience. Diversity across medical school cohorts diversifies the medical field, which benefits patient care and should be supported.

Medical schools

Medical schools should work with placement providers to arrange placements that have genuine educational value. They should give students the opportunity to experience what it's like working in a range of healthcare settings including primary, secondary, community or other health and social care settings.

Placement providers

Placement providers should work with medical schools to effectively manage clinical placements. Placement providers should make sure students can build on their knowledge and practical experience as required in Outcomes for graduates. Placement providers should be knowledgeable about raising concerns procedures. They should also understand equality, diversity and inclusion policies that concern students' welfare.

How the clinical placements guidance relates to our other standards and guidance

Through Outcomes for graduates, we set the learning outcomes for UK medical students to make sure they have the skills, experience and behaviours needed to join our register. Combined with Practical skills and procedures we make sure those qualifying in the UK are safe to begin work as a foundation doctor.

Promoting excellence: standards for medical education and training sets out the requirements for the management and delivery of undergraduate and postgraduate medical education and training. As part of this, we expect education providers to prepare students to make the transition from medical school to professional practice.

This guidance brings together the key standards and requirements in Outcomes for graduates, Promoting excellence and Promoting excellence: equality and diversity considerations, that relate to clinical placements and student assistantships. It includes professional values and behaviours in Good medical practice, and links them to the planning and management of clinical placements. It was also produced in line with Caring for doctors, Caring for patients. Please read these documents if you're planning a clinical placement or assistantship.

This guidance includes key themes from these documents. They're shown in the four theme headings:

  • Patient safety
  • Quality of placements
  • Medical students should feel prepared, supported, and safe
  • Medical students should feel part of a team.

What we mean by...

Clinical placement

A clinical placement can be defined as any arrangement where a student is present, for educational purposes, in an environment that provides healthcare or related services to patients or the public. Placements can take place in primary, secondary, community or other health and social care settings (with some aspects being undertaken remotely such as consultations) and are not confined to the working environment of doctors but should include the wider multidisciplinary team. Students can be actively involved and contribute to patient care as part of the team.

Student assistantship

A student assistantship is a type of clinical placement, undertaken towards the end of the student's undergraduate course. It should be designed to prepare the student to start practice as an F1. Although some direct care of patients is implicit and necessary, it is primarily an educational experience. It should provide a number of hands-on learning experiences that allow the student to work within clinical settings and to practise clinical skills. The students should be fully integrated within a clinical team and should be responsible for carrying out specified duties under appropriate supervision.

Shadowing

Shadowing is a period of time that should be provided to all graduates to help them get to know the site of their Foundation Year 1 training and assist the F1 who they will replace when they start employment. This time period should ideally take place as near to the date as possible that they will start their F1 position.

Named educational supervisor

A named educational supervisor is a trainer who is selected and appropriately trained to be responsible for the overall supervision and management of a specific student's educational progress during a placement. They can be based within the medical school or placement provider. The named educational supervisor should regularly meet with the student to help plan their training and review progress against agreed learning outcomes. They should bring together all relevant evidence to form a summative judgement about the student's progression at the end of a placement. They should also facilitate the student's reflective learning by discussing with them the patients and procedures they have experienced during their placement.

Named clinical supervisor

A named clinical supervisor is a trainer who is responsible for overseeing a specific student's clinical work throughout a placement in a clinical or medical environment and is appropriately trained to do so. The named clinical supervisor leads on providing a review of the student's clinical or medical practice throughout a placement and contributes to the educational supervisor's summative judgement at the end of a placement.

Clinical governance

Clinical governance is the system through which National Health Service (NHS) and Health and Social Care (HSC) organisations are accountable for continuously monitoring, improving and safeguarding the quality of their care and services.

Supervisors

Different grades of doctors and senior healthcare professionals can provide different levels of supervision for students. These are explained in full in section 8 – Supervision.