Piece of work created by a medical student showing the progression in their learningLongitudinal Integrated Clerkships (LICs) are a novel innovation in medical education which have been used in various institutions in the USA, Canada, Australia and South Africa. LICs involve students learning in an integrated fashion, moving away from the traditional siloed block rotations in medical education. LIC students spend a longer time immersed within a clinical team, where they form meaningful relationships with the team, peers and patients. Importantly, students take an active role with their patients, often advocating for them and guiding them through their healthcare journey. Clinical learning occurs in an authentic manner, synergistically with patient care.

Innovation

MEdIC has led nationally in the implementation and innovation of LICs within the undergraduate medical curriculum. In 2016, we piloted a LIC entitled the “Integrated Clinical Apprenticeship” (ICA), whereby 24 self-selected Year 5 students spent a day a week outside of normal block rotations. The students were placed in a local GP practice and developed their own caseload of patients reflecting a variety of clinical specialties. The students reviewed these patients on a regular basis over the academic year in the GP practice, whilst also following them to other healthcare settings including: secondary care, diagnostics and home visits. Further links to publications on the course and research associated to the course can be found below.

Following the success of the course, this design of curriculum will begin to be rolled out across Year 5 of the curriculum in 2020.

MEdIC is pleased to announce the start of a new and innovative LIC in July 2019 entitled “F-Zero”. F-Zero is a redesign of the current final year at Imperial College and integrates learning across primary and secondary care. Students are places in a general medical firm, general surgical firm and GP practice throughout the academic year within a single geographical area. The students start to take the role and the responsibility of working as a foundation doctor, with close guidance supervision and support.

Research

MEdIC is interested in exploring research associated to LICs from a variety of angles. We have carried out work exploring the experiences of students using a qualitative approach, as well as exploring attributes and assessment outcomes using validated scales and quantitative analysis.

We are also interested in understanding the theoretical underpinning of LICs and have explored areas including authenticity and belonging within LICs.

Accordion

Selected publications

UK longitudinal integrated clerkships: where are we now? 
McKeown A, Mollaney J, Ahuja N, Parekh R, Kumar S 
Educ Prim Care 2019 DOI: https://doi.org/10.1080/14739879.2019.1653228 

Identifying central tenets needed in our education systems: Results from a pilot integrated clinical apprenticeship. 
Simpkin AL, McKeown A, Parekh R, Kumar S, Tudor-Williams G. 
Med Teach. 2019 Jul;41(7):780-786. doi: 10.1080/0142159X.2019.1578874. Epub 2019 May 6. 

A novel Integrated Clinical Apprenticeship: transforming medical students into student doctors. 
Simpkin AL, McKeown AM, Parekh R, Kumar S, Tudor-Williams G. 
Educ Prim Care. 2017 Sep;28(5):288-290. doi: 10.1080/14739879.2017.1319745. Epub 2017 Apr 24. No abstract available.  

Longitudinal integrated clerkships in the community. 
McKeown A, Parekh R. 
Educ Prim Care. 2017 May;28(3):185-187. doi: 10.1080/14739879.2017.1298976. Epub 2017 Mar 23. 

Selected presentations

Parekh R, McKeown A, Ruzangi J, Simpkin A, Tudor-Williams G, Kumar S (2019) Can Longitudinal Integrated Clerkships help protect against a decline in professional attributes in medical students? Evidence from a longitudinal cohort study AMEE 2019

Parekh R, McKeown A (2019) Tackling a perceived misalignment between curriculum and assessment in a pilot LIC. CLIC 2019

Parekh R (2019) “A bit of a doctor factory” What are medical students’ experiences of belonging in Longitudinal Integrated Clerkships? CLIC 2019

Parekh R, McKeown A, Ruzangi J, Simpkin A, Tudor-Williams G, Kumar S (2019) Can Longitudinal Integrated Clerkships help protect against a decline in professional attributes in medical students? Evidence from a longitudinal cohort study CLIC 2019

McKeown A, Parekh R, Kumar S (2018) The Trojan Horse: Medical students as the hidden army for the UK health service? Global Community Engaged Medical Education Muster Conference 2019.

McKeown A, Parekh R, Kumar S (2018) An Integrated Clinical Apprenticeship: Evaluation of a novel Longitudinal Integrated Clerkship at Imperial College ASME 2018

Kumar S, McKeown A, Parekh R, Tanna S (2017) From Chrysalis to Butterfly: Using longitudinal learning to support the transformation from student to apprentice. Royal Society of Medicine, Medical Innovations Summit 2017