A survey of UK medical schools' arrangements for early patient contact.

BACKGROUND Many U.K. medical schools have patient contact in the first two years of the undergraduate course. AIM To compare the purposes and organization of early patient contact in UK medical schools and to relate these arrangements to the schools' curricular objectives. METHODS A telephone survey of lead educators in UK medical schools. Categories of contact were plotted against phases of the course to discern patterns of organisation. RESULTS The quantity of contact varies considerably (four to 65 days). There is a pattern, with learning objectives around the social context of health and illness preceding skills based work and integrated clinical knowledge for practice coming later. Schools fall into three categories: close adherence to the preclinical/clinical split, with limited early contact acting as an introduction to social aspects of health; provision of substantial patient contact to maximize the integration of knowledge and skills; and transitional, with limited clinical goals. General practice provides between one third and one half of early patient contact. CONCLUSIONS Arrangements meet the objectives set by each school and reflect differing educational philosophies. Change is toward more early contact. There appears to be no national guidance which supports a minimum quantity of patient contact or specific educational purpose in the early years of U.K. basic medical training.