Medical students will miss out on important opportunities to conduct patient consultations unless more patients are willing to help with training, according to experts from the University of Birmingham's Medical School.

Writing in this month's Journal of Medical Ethics (Vol 34, Issue 2)  the team from the University's department of Primary Care and General Practice argue that because more patients are now refusing to take part in medical education, students may be qualifying with gaps in their practical experience.

This has potentially damaging implications for the quality of newly-qualified doctors in the UK.

Currently, patients need to give explicit permission before medical students are allowed to become involved in their treatment or care. The authors believe that this should be replaced by a system that starts with the idea that there is no reason why students who are competent to do so should not be helping to treat patients.

Associate Professor Nick Ross from the Birmingham team comments: "Whilst the personal choice of each patient is of paramount importance, it is not in patients' interests to see doctors who are not fully competent in a clinical environment.

"We believe that the current system does very little to encourage patients to take part in medical education or to explain the benefits of having a student present during a procedure.

"The changes we propose would still maintain the principles of patient choice, but would help expand medical students' clinical opportunities.

"As patients we have to think about the consequences of refusing to take part in medical education and the need to have young doctors who are confident in clinical situations when the qualify."

The paper proposes that more should be done to help to reassure patients that students have the necessary skills to perform a procedure. This could involve asking students to explain their relevant skills and experience to patients in advance.

Encouraging greater participation in medical education does also place an obligation on Medical Schools to make sure that students have received sufficient training before taking part in any procedure under supervision.

Professor Jim Parle adds: "Patients rightly want to know that their treatment is being conducted by someone with the relevant skills.

As long as students have received adequate training they should be given the opportunity to engage in procedures. Patients would almost certainly be less inclined to opt out of medical education if they were confident that students have the appropriate skills.

In the end it is not in the interests of patients to exclude medical students from consultations - as this is likely to lead to poorer doctors in the future. "


For further information or to request a copy of the paper contact: Anna Mitchell Press Officer, University of Birmingham, Tel 0121 414 6029, Mob 07920 593946, email


The full title of the paper is: Medical education and patients' responsibilities: back to the future? It is published in the current edition of the Journal of Medical Ethics, Volume 34, Issue 2.

The paper is available from the he Journal of Medical Ethics website:

The Department of Primary Care and General Practice

One of the largest academic centres for primary care in Europe, 5* RAE rated, and a founding member of the National Institute for Health Research (NIHR) School for Primary Care Research (NSPCR).

The department has an expanding teaching programme. It is responsible for over 20% of the MBChB course: with responsibilities to design and deliver all community based teaching, as well as all behavioural sciences, ethics, and communication skills.

In terms of research, the department has significant research programmes in: cardiovascular disease; cancer and chronic disease; medical decision making; medical ethics and mental health. Attracting external research funding in excess of £3 million per year, the department has particular expertise in large primary care based clinical trials and health technology assessments as well as major epidemiological studies in primary care.