Historical background and nowadays situation:
The principle teachers of the undergraduate
medical curriculum are usually junior doctors and consultants, who in the
modern busy clinical environments have limited time for teaching of
undergraduate students. Changes within the NHS in the last
two decades together with the emergence of medical education as a recognized
specialty in the 1990s lead to changes in the medical system, including the
introduction of the posts of Clinical teaching fellows (CTFs).
In the late 1990s CTFs posts were created, to
recruit doctors who were employed to teach undergraduate medical students, most
of them often undergo a teaching qualification. This allows them to bridge this
gap between practice and theoretical education.
Wilson et al., in their 2008 survey reported
that there were about 77 CTFs posts in 15 medical schools in UK that were funded from a variety of sources including
universities, the NHS, Service Increment For Teaching (SIFT) and endowments .1 Furmedge et al., in 2013 reported that the number of
these posts has continued to increase considerably since 2008 , mentioning that the BMJ Careers
journal alone has carried advertisements for 244 CTFs jobs from
2008 till 2013 and 27 of these were during the year 2012.2
BMJ careers national data from 2013-2017 not
CTFs post settings and structure
posts are usually joined by junior doctors at the period between the end of the
foundation programme and getting the certificate of completion of training,
although several post-certificate general practitioners have taken up posts. These
fellowships can also be joined as out of programme experience for one year. For
many doctors, these posts provide a less stressful period away from busy
clinical training programs.
CTFs posts are distributed among medical schools, professional
bodies, and hospital trusts. CTFs role, spectrum of activities in these posts
varies according to the post setting. In medical schools, CTFs teach clinical skills to undergraduate medical students,
they also may develop an area of their curriculum, or become involved in
assessment of these students. In the hospitals they
usually focus on organization and delivery of teaching to undergraduate
students while those joining organizational posts are involved in a mixture of activities
of CTFs working in universities and those working in hospitals.
Some of CTFs
posts are restricted to teaching, while many are more flexible, allowing these
physicians to gain more experience in a clinical specialty in addition to their
core teaching work. 2 Doctors join CTF,s posts for different reasons; some want to
work in medical education field , while others wish to improve their curriculum
vitae for specialty training applications.3
CTFs multiple roles:
Irrespective of the setting, CTFs post is usually busy but in a different way from clinical
work, they take part in many important roles. Teaching is an integral part of
being a doctor 4 and working as a CTF provides the opportunity
to develop that vital skill. Teaching activities of CTFs includes seminars and
lectures in addition to ward based bedside teaching.
CTFs as mentioned above work part of their times in a certain specialty which
makes it easier for them to perform ward based teaching and gaining experience
in that speciality, the clinical part of their career can play a beneficial
role in the bedside teaching of undergraduate students . A study published in
2014 showed the positive impact fellows had on students learning by leading
teaching on surgical post-take ward rounds.5
CTFs also act as mentors who provide a part in
the personal and professional development of students. Woodfield and O’Sullivan
in their small questionnaire based study of a group of final year medical
students in the academic year 2011-2012 reported that undergraduates value the managerial
and mentor role that teaching fellows offer.6
CTFs also can play an important role in undergraduate
medical students examinations, both during the course and at the end of
placement after they undergo training to ensure consistency.7
Beyond simply “teaching,” undertaking
a teaching fellowship can be a richly rewarding experience and a ripe
opportunity for personal and professional development, enabling the holder to
return to clinical practice with a new perspective. CTFs posts offers a culture
in which creativity and risk taking may be more valued than in the clinical fields.
Teaching fellows may find themselves creating something entirely novel and
leading a team to make it happen. This autonomy is, for some, the role’s most
valuable aspect. 3
These posts also offer the opportunity for
participants to complete a postgraduate qualification in medical education,
usually to certificate level but with chances of progressing to diploma or
These postgraduate certificates in medical education offer the opportunity to
develop an understanding of the theories and practical elements that govern
medical education, and accreditation with a professional qualification. 2
All are winners
These posts are not only important for doctors
wanting to gain additional educational experience and those pursuing medical
education certificates, but it is also important for medical schools and organizations
seeking to improve the quality of teaching of the undergraduate students, as
well as the performance of the recently graduated doctors and innovation of the
S, Denison AR, McKenzie H. A survey of clinical teaching fellowships in UK
medical schools. Med Educ 2008;42:170-5.
2. Furmedge M, Verma A, Iwata K, Belcher
R, Ntatsaki E., etal.The
rise of clinical teaching fellowships.BMJ careers 2013.
3.Thomson R, Loveland A,
Stewart J, Fisher J. How to stop the runaway train of clinical training.BMJ
4. General Medical Council. Outcomes for
graduates: tomorrow’s doctors. 2015.
5.Force J, Thomas I, Buckley F. Reviving
post-take surgical ward round teaching. Clin Teach 2014;11:109-15
6.Woodfield G, O’Sullivan M.
Clinical teaching fellows: everyone’s a winner. Clin Teach 2014;11:136-40.
7. Pippard P, Anyiam O. The many roles of a clinical
teaching fellow. BMJ careers 2016.