Developing a career in Medical Education
“It develops so many of your interpersonal skills. It’s fantastic to work with the students, I learnt so much from them.” (Pathology trainee, Teaching Fellow)
“It broadens me every time I do it. I always learn something.” (Nurse, medical educator teaching doctors to teach.)
If you work in healthcare, you are already a teacher. Teaching is an intrinsic part of being a healthcare professional (HCP), and whatever your specialty or grade you will have been involved in some teaching from the earliest days of your training. Undergraduate medical education includes presentations to peers and tutors in stand-alone sessions or as part of problem-based learning. Many undergraduate curricula now incorporate basic teaching skills. As a healthcare practitioner, there is also an element of patient education in your role, whether its assessing patients understanding of their condition, consenting for a procedure, or explaining the efficacy and side effects of medications.
Podcast: Dr Marilena Giannoudi talks to Drs Rob Ker and Jonny Guckian about their experience of undertaking teaching fellow jobs.
There is a lot of potential in adding teaching and supervision to your skill set, creating variety in your work and a legacy. There is flexibility in how you do this; it may be full time, part-time, portfolio/ part of another role or as a ‘side hustle’ e.g., in digital education innovation. In Primary, secondary or community care the wide range of possible education roles mean that there is great flexibility in terms of how much of your working week you commit to teaching or supervision. Many find teaching can add variety to their work and is stimulating.
Opportunities for ‘hands on’ teaching range from undergraduate teaching, through postgraduate and allied health practitioner supervision to the delivery of practitioner continuing professional development (CPD) and appraisal. Further experience and training can lead to medical education leadership roles which relate more to the design, planning and management of medical, dental, nursing, or allied health professional education programmes.
Challenges to developing as a medical educator can be competition for opportunities with peers, getting leave and funding to attend courses and identifying contacts to get involved. Networking is important
- Basic medical science teaching e.g., Physiology or biochemistry.
- Fellowships often combine clinical work with, for example, dissection room, anatomy demonstrating.
- Sociology related courses on professionalism, and ethics.
- Problem based learning group facilitation.
- Pre-clinical, early medical contact courses involve supervising pairs of students to talk to selected patients at home or on campus.
- Basic consultation skills, often through simulation with actors.
- Bedside clinical skills “twilight teaching “is popular with trainees particularly valuable in supporting students in the preparation for exams.
- Teaching in clinics and in theatres may involve students observing you or becoming more actively involved.
- Community-based teaching; history taking and examination skills in the GP surgery.
- Focussed GP dermatology, obstetrics and gynaecology, or paediatrics teaching with patient involvement.
- Final year, primary care placement teaching and supervision.
- Supporting with student audits and formal presentations.
If you are seeking a career as a full time medical educator, some experience in curriculum design is important. This can be gained as a teaching fellow or once you have some teaching experience, taking on a role as a course lead or year lead.
The role of simulation training in both clinical procedures and non-clinical skills (“human factors”, teamwork, communication, leadership) is expanding and accelerated during the pandemic to support redeployment. Experience can be gained working as a skills lab tutor or as a communication skills facilitator or PACES examiner. Simulation Fellowship roles can be at any stage from foundation depending on the local requirements.
2. Educational supervision
Clinical practice increasingly involves clinical supervision of junior colleagues and allied professionals. These skills can be formalised by completing training for example to become an F2 or specialty training, educational supervisor. In primary care, such training includes education theory, assessment of learning needs, evaluation and feedback as well as workplace-based assessment.
3. Regulatory roles (Interviewing, examining, and appraisal)
Becoming part of a medical school interview panel is a satisfying way of contributing to widening participation and diversification of the workforce. Acting as an undergraduate examiner is a good opportunity to meet other teachers at benchmarking sessions and can help develop your teaching. This can lead to postgraduate examining for the Royal colleges. Becoming an appraiser in primary care is a good way to become involved in the support of the professional development of GP colleagues. Training in writing appraisal summaries and locality learning sets support appraisers.
4. Education leadership
If you are aspiring to leadership roles, undergraduate opportunities include:
- Medical school tutor or lecturer , subject lead, or year lead -
- Director of medical education (DME)
Post Graduate medical education, leadership roles include
- Training programme director
- Associate dean
- Head of school
5. Innovative roles in education
Advances in Technology Enhanced Learning (TEL) offer the exciting opportunity to develop entrepreneurial innovations e.g., apps and those incorporating virtual reality (VR). The NHS Clinical Entrepreneurship scheme supports such innovations and NHS related startups. https://nhscep.com/
The Introduction to Clinical Teaching (ITCT) is an excellent one day interactive, teaching course appropriate for anyone seeking to develop their practical teaching skills. ( https://www.ucl.ac.uk/medical-school/study/postgraduate/introduction-clinical-teaching other universities offer similar). Undergraduate course leads offer specific training for different courses. Standalone modules, a PGCERT in medical education, a Diploma or Masters in Medical Education are offered by many universities. Often these are modular and can be done at your own pace.
Supervision training to become a clinical supervisor or named educational supervisor for F2 /trainees is offered through regional HEE/ Workforce, Development and Training (WD&T) teams at NHSE The link to supervisor courses for London and KSS is https://london.hee.nhs.uk/multiprofessional-faculty-development/courses-and-conferences
Educator training resources on a range of topics are available through the e-learning for health. NHS staff accessing these through their electronic staff record will have their learning logged. https://www.e-lfh.org.uk/programmes/educator-training-resources/
Individual trusts advertise clinical teaching fellowships which offer experience in undergraduate teaching on clinical placements , assessment and examination and remediation. The posts generally include time for the Postgraduate certificate in education PGCE e.g., 1 session /week and individual teaching development. Such posts are linked to a hospital clinical post in the same trust or expect a training post in Primary care.
Some clinical fellow posts are advertised as OOPE (Out of programme experiences) with different ratios of clinical: undergraduate teaching work for example 60:40 and are aimed at those at specialty registrar grades who understand education theories, have completed specialty exams, and have relevant experience e.g., in procedures (such as endoscopy), surgery/anatomy or simulation. These opportunities may arise throughout the year, it’s best to plan ahead.
For doctors and dentists in training seeking a career in academia, (research and or education) the National Institute for Health and Care Research (NIHCR) funds 2 types of awards.
Approximately 250 Academic Clinical Fellowships (ACFs) and 100 Clinical Lectureships (CLs) in medicine are funded each year and up to 23 ACFs and 11 CLs in dentistry each year. These posts are hosted by medical/dental schools and their NHS organisations in partnership with local postgraduate Health Education England (HEE) teams. ACF posts consist of 75% time in specialty clinical training and 25% time in research or educationalist training. They are appropriate for those in the early stages of specialty training. https://www.nihr.ac.uk/
Clinical lectureships are for those in higher clinical training who have already gained a PhD and they offer a 50%, 50% split between clinical work and research or educationalist training.
A third type of NIHCR award is for those beyond training. The In-Practice Fellowship (IPF) funds Masters-level training for GPs and dentists in clinical practice. More information on these posts see https://www.nihr.ac.uk/explore-nihr/academy-programmes/integrated-academic-training.htm
More information for nurses , midwives and allied health professionals, seeking NIHR funded posts, is at https://www.nihr.ac.uk/explore-nihr/academy-programmes/hee-nihr-integrated-clinical-and-practitioner-academic-programme.htm
SPIN fellowships are for newly qualified or early career GPs, practice nurses, and those new to nursing.
They offer the opportunity for a project in conjunction with a salaried post. The local SPIN team and ICB (Integrated Care Board) training hub can offer information on available posts and projects. The project could be an education related one.
- Reflect on your prior experience. You may have other teaching experience e.g., GCSE tutoring, teaching piano or languages.
- Seize opportunities for ‘on the hoof’ opportunistic teaching. Have a few things prepared.
- Contact your local medical school or trust undergraduate coordinator/manager and ask about teaching opportunities.
- Collect anonymised feedback from your learners to reflect on and improve. This can be a simple poll with a QR code.
- Consider some career coaching to decide how much of your working life you want to be devoted to teaching and or supervision.
- Keep an eye out for opportunities to attend and present posters at education conferences.
Ask inspiring educators their top tips for a career in medical education and emulate them
A foundation doctor who came to the professional support unit service because of dissatisfaction with their career and uncertainty about continuing, used free, confidential coaching to explore their strengths, values, and interests. Recognising that they had always enjoyed teaching, they used the coaching to plan how they would incorporate medical education into their career. As a medical student they had taught younger peers through the MedSoc. Building on this experience, they signed up for an Introduction to Clinical Teaching, and looked for medical education Fellow posts as an F3. Having a clearer plan for the future, incorporating education, while still uncertain about specialty choice, gave them a sense of control and a bit more time to explore their career options with some tasters.
Access coaching and careers support at any stage in your training through your local Professional Support Unit. https://www.hee.nhs.uk/our-work/professional-support-postgraduate-medical-dental-trainees
I started teaching as a newly qualified salaried GP with medical students sitting in on my clinics. Coaching helped me realise that, as a single parent, being a portfolio GP suited me best. Over the years I have taught on a range of courses at my local medical school, e.g., PBL, first clinical attachment, medical ethics, clinical decision making, and Significant event debrief sessions. I really enjoy teaching communication skills with skilled actors from whom we can learn a lot. In mid-career I became an appraiser and later developed my medical education leadership as a Deanery GP tutor involved in designing the curriculum for appraisers and facilitating appraiser groups. With the local GP liaison team, I designed an innovative matching scheme for GPs to sit in with secondary care colleagues as an alternative option to meet their Professional Development Plan objectives. Having completed a part time PGCert, I supervised F2s and specialty trainees as a clinical supervisor. My portfolio flexibility has enabled me to follow my interests and I now enjoy faculty development e.g., training educational supervisors, teaching others to teach and teaching coaching skills. Coaching International Medical Graduates and those who are neurodiverse is my ‘bystander intervention’ to reduce the attainment gap (previously called ‘differential attainment’) and increase equity in the medical workforce. I am also supporting the next generation of doctors to pursue social justice and sustainability by teaching Health Equity. Having always had a passion for the arts, I have completed a masters and am now doing a PhD in medical humanities and enjoy delivering workshops for reflective practice and well-being incorporating the arts and coaching. This is ‘social prescribing’ for healthcare practitioners, and I collaborate with artists, musicians, authors, and performers. By experiencing the benefits first hand practitioners recognise the potential of the arts for their patient’s wellbeing as well as their own. Medical education has definitely enriched my career and helped maintain my enthusiasm for my clinical work, innovation and person centred care.
Soundbites from experienced medical educators about what they love about teaching;
GP Undergraduate teacher.
"We all like to feel that we've made a difference to the patient in front of us but think how more we can make a difference if by imparting knowledge to, honing a skill of or changing an attitude of a class of students. You can potentially make a difference to all the patients those students will see in their career! However, teaching also has more immediate benefits to the teacher - it really makes you think about what we do, how we do it and why. This helps us identify "unknown unknowns" in our own knowledge and skills. It also enables you to stand back and think about what you have learnt over the years, and how skilled you may have become - which we are not always good at doing, and is a good antidote for burn-out! Today's students are mostly dynamic, intelligent, well-rounded, self-motivated and resourceful young people (no wonder I always hear teachers saying "I couldn't get into medical school today") who are delight to interact with. What's not to like?"
...and another clinically retired, GP teacher
"As you have probably guessed I still love teaching and retirement from full-time practice has offered me the opportunity to choose to engage in educational activities that are both paid and voluntary and with students of differing ages. As i am a carer for a family member, I find that a flexible mix of face to face encounters and internet tutoring suits me best . Apart from core case and communications skills training for medical undergraduates, I also supervise one or two medical students doing a special study module in medical history. I am also a volunteer for the Refugee Council's Building Bridges project which helps refugee doctors study for the Occupational English Test and the PLAB exams. I expect you know these are required qualifications for GMC registration. This project involves about 25 retired doctor volunteers. Most are ex GPs.
I am very proud to be part of this important educational programme. In the last 13 years 147 doctors have been helped to obtain registration and find work within the NHS."
The Association of Medical Educators (ASME), with its trainee section TASME, the Academy of Medical educators (AOME), and in the USA the Society of Teachers in Family Medicine (STFM).
The International Association for Health Professions Education https://amee.org/AMEE/
Inspiring Podcast with Drs Rob Ker and Jonny Guckian about their teaching fellow experience
Video. The Benefits of Being a Primary Care Supervisor. NHS England Workforce, Training and Education https://www.youtube.com/watch?v=axAR_dXn76Q
Video Professor Dame Helen Stokes Lampard on her portfolio career including Medical Education https://www.youtube.com/watch?v=MyU_xnoKaG0
Video Dr Ben Burville GP, GP Trainer, Appraiser and more…https://www.youtube.com/watch?v=IUaMO_s0D4s
Judith Neaves GP, GP tutor and RCGP examiner and more…https://www.youtube.com/watch?v=LbeCpY_VKlo
Tim Swanwick, Kirsty Forrest, and Bridget O’Brien Understanding Medical Education: Evidence, Theory and Practice (Wiley, 2018).
Kaufmann ABC of learning and teaching in medicine: Applying educational theory in practice. BMJ 326: 25 January 2003, 213-216
Ramani & Leinster, AMEE Guide no. 34: Teaching in the clinical environment. Medical Teacher (2008) 30: 347-364
Millard L Teaching the teachers: ways of improving teaching and identifying areas for development Annals of the Rheumatic Diseases 2000; 59:760-764.
Dr. Linda Miller NHSE London KSS [Careers Consultant & Coach]