Category: Awards

This week’s blog is from Dr David Hettle, hot off the recent announcement of winning the ASME/GMC Excellent Medical Education Award (postgraduate category). David tells us a bit more about the planned research project with colleagues across the country, exploring the experiences of doctors undertaking an entry-level medical education roles (ELMERs).

Lisa-Jayne Edwards (University of Warwick), Claire Stocker (Aston University), Julie Browne (Cardiff University), Cara Bezzina (University of Glasgow), David Hettle (University of Bristol)

Introduction

More and more doctors take time out of clinical training, with many choosing to undertake teaching posts during years out, especially ‘F3 years’: time out of training after your initial standardised two years post-graduation¹, the ‘Foundation Programme’. These teaching posts have a variety of names including Clinical Teaching Fellows (as they are locally in Bristol), Teaching Fellows, and Education Fellows.

With the increasing need for educators, these posts host a crucial place for doctors developing interest, skills and expertise in medical education as they progress in clinical and educational training. Therefore, there is need to understand the landscape of educational practice which these positions deliver and support the development of these current educators and future educational leaders.

Previous work reviewed the current landscape of entry-level education posts across the UK, finding over 400 positions per year in the UK in 2023², up from 77 in 2008³. Though the numbers of these posts have increased, due to the variety of different titles used and the often transience of the doctors in these positions, research into posts is challenging. Importantly this means research into the quality of these posts remains under-studied.

Why does this matter?

This research holds great opportunity to really find out how early-career educators can be supported. Currently, there seems to be wide variation in the quality of posts, with some offering financial support for educational accreditation, others designated time to teach and develop skills in specific aspects of education.

On the flip side, they are others without any additional time, support or links to educational teams offered, yet still carrying responsibility for others’ learning. This work hopes to facilitate more information and some degree of quality control for early-career educational roles as occurs with other medical specialties, for example through their colleges and specialty societies.

The ELMER study

Building on our work undertaken alongside the Academy of Medical Educators (AoME), this new project through the Association for the Study of Medical Education (ASME) seeks to explore the perspectives of current early-career education post-holders. We will investigate how different role qualities and opportunities impact their experience within medical education and, as a result, doctors’ inclination to pursue future teaching and training responsibilities once they move on from these posts (often back into clinical training).

To encompass all similar roles, our research team has chosen to use the term ‘Entry-Level Medical Education Role’ or ELMER as an individual’s first formal role in medical education.

We will use these doctors’ experience in their ELMERs to identify factors which promote formal teaching and increased educational activity and development. We have positioned the study in a pragmatic paradigm, focusing on the interaction between individuals (i.e. ELMER post-holders) and their environment, emphasising experiential research, and actionable knowledge. The study will use a mixed methods approach using a survey, followed by interviews, inviting any current ELMER post-holders to take part. Qualitative data will be analysed using reflexive thematic analysis, developing and telling the story of current ELMER post-holders.

Alongside the prior review of ELMER posts across the UK, the primary objective of this integral work is to offer insights that can inform policy decisions on how ELMER roles can support doctors in training to become future trainers, assessors, and leaders in medical education.

Why is this work so important to me?

As someone who has been a CTF in the past, but having finished that formal role wondered ‘where next?’, this work adds to the evidence for the development of a more formalised medical education career pathway, supporting educators of the future, alongside their clinical training. The current lack of such a pathway risks losing excellent educators after their ELMER posts, a risk which the field of medical education should not leave to chance.

Watch out for details of how to be involved soon if you are an early-career educator, ‘ELMER’ – we’d love to hear your experience! Drop me an email at david.hettle@bristol.ac.uk if you want to hear any more before then.

References

1. Church HR, Agius SJ. ‘The F3 phenomenon: Early-career training breaks in medical training. A scoping review’, Med Educ 2021; 55(9): 1033-46.
2. Hettle D, Edwards LJ, McCormack R, et al. (2023, Dec 4-5). A UK-wide review of Entry-Level Medical Education Roles (ELMERs) [Poster presentation]. Developing Excellence in Medical Education, Manchester, UK.  https://www.demec.org.uk/category/demec-2023/
3. Wilson S, Denison AR, McKenzie H. A survey of clinical teaching fellowships in UK medical schools. Med Educ 2008; 42(2): 170-5.

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