2009 Factors That Influence First Year Medical Students’ Choice of Student Selected Component

2009; 31: e418–e424

WEB PAPER

Factors that influence first yearmedical students’ choice of studentselected component

JANE RICHARDSON

University College London Medical School, UK

Abstract

Background: Undergraduate medical training should ensure students have choice and autonomy in the learning process,

including the student selected components (SSCs) which should comprise up to about a third of the curriculum. Students’ choices

of SSC will influence the knowledge, skills and attitudes they acquire.

Aim: To investigate how motivations and personality in first year medical students influence their choice of SSCs.

Method: A questionnaire regarding motivations for SSC choice and the NEO-FFI personality measure was administered to all first

year students at a London medical school. Relationships with type of SSC were examined.

Results: A total of 82% (268/329) students responded. Six motivational factors arose from a principle components analysis of the

questionnaire: future achievements, prior information, internal motivation, personal recommendation, convenience and certainty.

Students with different motivational factors chose different SSCs, and had different personality traits. Weak but significant

correlations were found between personality traits and motivational factors, but not between personality and SSC choice, or sex

and SSC choice.

Conclusions: This offers insight into medical student choices of SSC and is the first step towards ensuring appropriate provision

of modules that students wish to study to enable them to meet the demands of the medical profession.

Background

Medical education has recently undergone considerable

change worldwide: it is now generally recognised that basic

undergraduate medical training should ensure medical stu-

dents have a degree of choice and autonomy in the learning

process (The World Federation for Medical Education). In the

UK, the General Medical Council (GMC) recommended in

their publication ‘Tomorrow’s Doctors ’ (General Medical

Council 1993, 2003) that the undergraduate medical curricu-

lum should include student choice via student selected

modules (now called student selected components or SSCs).

The GMC suggests that SSCs should take up between 25%

and 33% of the medical school curriculum, and together with

the core curriculum, must cover the knowledge, skills

and attitudes necessary for graduates to practise as newly

qualified doctors (General Medical Council 2003). The GMC

carries out a programme of regular visits to UK medical

schools to monitor educational quality and standards and

compliance with their recommendations (http://www.gmc-uk.

org/education/undergraduate/undergraduate_qa.asp).

The SSCs aim to increase the student-focused nature

of undergraduate medical teaching and should allow

students to:

(a) ‘learn about and begin to develop and use research skills;

(b) have greater control over their own learning and develop

their self-directed learning skills;

(c) study, in depth, topics of particular interest outside the

core curriculum;

Practice points

. Since 1993, the General Medical Council has required

that Student Selected Components (SSCs) make up

between one quarter and one third of medical school

curricular content. Many SSCs have been evaluated

individually, but little prior research exists about the

influences on students’ choice of SSC.

. This is the first study to offer an insight into the factors

influencing students’ choice of SSC, demonstrating

relationships between the types of motivations students

had for choosing SSCs and the type of SSC they

subsequently took.

. Six main factors were identified as the reason why

students chose their SSC: future achievements, prior

information, internal motivation, personal recommenda-

tion, convenience or strategy and certainty

. This study would usefully be replicated in other medical

schools and offers guidance for future qualitative and

longitudinal research that would shed further light on

the issues raised, and for staff seeking to guide students

through the process.

Correspondence: Jane Richardson, University College London Medical School, Academic Centre for Medical Education, 4th Floor, Holborn Union

Building, Archway Campus, Highgate Hill, London, N19 5LW, UK. Email: [email protected]

e418 ISSN 0142–159X print/ISSN 1466–187X online/09/090418–7 � 2009 Informa Healthcare Ltd.

DOI: 10.1080/01421590902744878

(d) develop greater confidence in their own skills and

abilities;

(e) present the results of their work verbally, visually or in

writing;

(f) consider potential career paths.’ (General Medical

Council, 2003).

In addition, SSCs should be offered in a variety of subjects, e.g.

languages and computing, although the majority must be in

subjects related to medicine.

SSCs at this medical school are offered in a wide variety of

topics (Table 1) and form a compulsory part of the MBBS

programme. In the first year of the undergraduate curriculum,

SSCs occupy 16 afternoons of the academic year, approxi-

mately 11% of scheduled teaching time.

Studies exploring the introduction of SSCs into medical

school curricula have mostly taken place at the level of the

outcomes of a particular SSC (Fletcher & Aguis 1995; Downie

et al. 1997; Lazarus & Rosslyn 2003; Cave et al. 2007) or have

analysed the development of, for example, transferable skills

during SSCs ( Jha et al. 2002; Gill et al. 2008). The ad hoc

development of the SSC programme by medical schools since

its inception means that the drivers for students in choosing

what to study have yet to be examined.

Given that SSCs should take up to a third of the curriculum,

the SSCs students choose will determine the knowledge, skills

and attitudes with which they qualify. This may have further

implications for career choice and competency. Thus it is

important to consider the effect of the full programme of SSCs

taken by individual students during their undergraduate

training and, specifically, to consider their motivations for

choosing particular types of SSC. Insight into student choice

will enable medical schools to offer a range of SSCs that satisfy

the requirement for student-centred learning. If, for example,

particular factors influence students to systematically choose

only certain types of SSC and to ignore others, this has

important implications for medical schools to ensure that

students are exposed to the breadth and depth of education

that enables them to meet the requirements of the modern

medical profession. Students too may benefit from under-

standing their own choices. In taking greater responsibility

for their learning, students need to develop their own ideas of

what options they should choose, for example not only

building on their strengths but recognising and addressing

their weaknesses. If we are to build a student-centred

partnership in curriculum choice, both teachers and learners

will benefit from understanding underlying motivations.

This study is the first preliminary investigation into the

factors which influenced students at one London medical

school to choose particular types of SSC in their first year of

study. At the school studied, students typically choose two

SSCs in their first year, one in each of the first two terms. They

are encouraged to study different types of SSC, although no

hard rules are laid down about this and the range of SSCs

available reflects largely ad hoc developments. We are

focusing on students’ first ever choice of SSC in the hope

that this will be the choice least influenced by other previous

SSC choices and experiences or the influence of others in the

medical school. The research questions we investigated were:

. Do students have different motivations for choosing their

first SSC?

. Are those motivations related to the type of SSC that they

choose?

. Are individual students differences (sex and personality)

related to their motivations and/or subsequent choice

of SSC?

Methods

Participants

All first year students at one London medical school (n¼ 331;

51% male, 49% female; mean age 19, age range¼ 17–47). Five

students were exempted by the medical school from taking

SSCs and were therefore excluded from the analyses.

Questionnaire measures

Choice of SSC. Students were asked to indicate their first

choice of SSC. This was the main outcome measure for the

study. They were also asked for the SSC they eventually took,

if different.

Table 1. Categories of SSC and students’ first choices of SSC.

SSC category Individual SSC titles Number

Biosciences Biomaterials 6

Clinical problems in biochemistry 16

Speech production 14

Structure and function of medically

important proteins

6

Medical humanities Medical humanities: Sickness on

the silver screen

7

Medicine in the movies 1

Poetry and prose in medicine 6

Should euthanasia be legalised? 10

Medicine and society Changing British Society 7

Child psychological traumas 56

History of Medicine 9

Medicine in the

community

The Bromley-By-Bow Healthy Living

Centre

3

eHealth 0

Sexpression – teach sexual educa-

tion in schools

25

SPECTRUM (charity) 1

Languages Arabic Level 1 7

French 12

French – business and current

affairs

7

German 10

Italian – beginners 6

Japanese – beginners 6

Spanish 24

Generic skills European vomputer driving licence 10

Research project 10

Teaching and learning in medicine 8

Missing 1

Total 268

First year medical students’ choice of SSC

e419

Motivations for choosing SSCs. Students rated 16 items on a

5-point Likert scale from strongly agree to strongly disagree,

measuring different motivations for choosing their SSC.

These items were designed by one of us ( JR) and then

checked for face validity by three of us: a psychologist (KW), a

statistician (HP) and a clinician (DG) all involved in SSC

delivery.

Personality traits. A questionnaire containing a validated ‘Big

Five’ personality traits measure (NEO-FFI) (Costa & McCrae

1992) was administered. This is widely used in conceptualising

personality (e.g. Costa & McCrae 1992; Furnham 1996; Judge

et al. 1999) and has been found to account for individuals’

motivational styles (McCrae et al. 2002). The ‘Big Five’ are

neuroticism (N), extraversion (E), openness to experience (O),

agreeableness (A) and conscientiousness (C). The NEO-FFI

has respondents rate their agreement with statements on

5-point Likert scales, which are balanced for acquiescence

effects. Validity and reliability data are published in the manual

(Costa & McCrae 1992).

Demographics. Students reported their age and sex.

Procedure

Questionnaires were administered in November 2006 and the

optional nature of participation was stressed. Completed

questionnaires were put in envelopes and returned to JR.

Students had been given written information regarding each

SSC and had already chosen their SSC. Some SSC tutors had

also given oral presentations.

SSC categorisation

The medical school in which this study took place offered 25

different SSCs in the first year. To facilitate analysis, six faculty

members were asked independently to create categories into

which these SSCs could be placed, which they did on the basis

of the SSC titles. All of the faculty members independently

created categories called biosciences, language and medical

humanities; however, there were discrepancies in the other

categories created. One of us ( JR) therefore used SSC

descriptions (provided on the medical school website) and

previous category suggestions to derive three further cate-

gories of sociology of medicine; medicine in the community;

and generic skills. All six faculty members agreed with this

categorisation. Two further clinical faculty members put each

SSC into one of the six categories, based on each SSC title, with

good inter-rater reliability (kappa¼ 0.86).

Ethics

Ethics approval was granted by UCL ethics committee.

Students received written participant information and were

asked to sign a consent form before completing the

questionnaire.

Analyses

The motivation question responses were treated as numeric

and subjected to a principle components analysis with

Varimax rotation. Factors were identified and factor scores

calculated. Relationships between the resulting motivation

factor scores, type of SSC chosen, personality and sex were

investigated using t-tests, ANOVA and multiple regression.

SPSS v12.0 was used for all analyses.

Results

Response rate

A total of 268/326 (82%) participants completed the ques-

tionnaire. This number excludes returns from two students

who completed little of the questionnaire. The age range of

respondents was 18–43 years (median¼ 18.5; n¼ 206). Of this

52% (140/266) of respondents were male, which was

representative of the year. Two participants did not state

their sex.

First choice of SSC

A total of 77% (n¼ 206/268) respondents were studying their

first choice of SSC (Table 1). A first choice was not received

if too many or too few students requested a particular SSC:

for example, 56 students wished to do an SSC in Child

Psychological Traumas. The median number of students

wanting to study any SSC was 13 (range 0–56). All further

analyses focused on students’ first choice, regardless of

whether they were able to take it.

Motivations for SSC choice

The motivation items were rated on a scale from 1¼ strongly

disagree to 5¼ strongly agree. The items that participants were

most likely to agree with were ‘It sounded interesting’

(median¼ 4) and ‘It sounded enjoyable’ (median¼ 4). The

motivations that students were most likely to disagree with

were ‘I did not choose it, it was allocated’ (median¼ 1) and ‘My

family influenced me’ (median¼ 1) (Table 2). A Friedman test

showed that there were statistically significant differences in the

responses to the motivation items (�2(17)¼ 1747, p5 0.001).

Very few students (n¼ 10; 3.7%) completed the optional

‘other’ motivation item to produce meaningful results and, of

those who did, no commonalities in motivations emerged.

Factor analysis of motivations for SSC choice

A matrix of ranked correlation coefficients (Kendall’s �b)

between the motivation items was calculated, which showed a

large number of significant relationships. Thus a principal

components analysis with Varimax rotation was carried out.

Variables with loadings above 0.5 were included in the

interpretation of a factor. Kaiser’s criterion (Dancy & Reidy

2004) and the scree plot both suggested six factors, which

together accounted for 63% of the variance in the data

(Table 3). The item ‘I did not choose it, it was allocated’ was

excluded as it differs from the others in that personal choice is

J. Richardson

e420

not involved and few students agreed with this statement.

Re-running the analysis with this item included does not

change the outcome and it loads on factor six.

(1) Factor one: Future achievements. This factor empha-

sises the importance of planning for a successful future

in medicine including current success at medical

school, which is necessary for a successful future in

medicine.

(2) Factor two: Prior Information. This factor represents

the influence of prior personal and factual information

known about an SSC before the decision to choose it is

made.

(3) Factor three: Internal motivation. The two positive

loadings for this factor show the importance of personal

intrinsic motivations for taking an SSC.

(4) Factor four: Personal recommendation. The positive

loadings for this factor show the importance of personal

contact and affirmation from others on SSC choice.

(5) Factor five: Convenience. The positive loadings for this

factor emphasise the importance of convenience and a

strategic approach to studying. It is assumed that the

importance of the site relates to the proximity to student

accommodation or usual study. The influence of family

may relate to how convenient it is for students to study

that SSC if they are living at home with family. We

called this convenience, but it could also be called

strategy.

(6) Factor six: Certainty. The loadings for this factor

indicate active decision making in choosing an SSC.

‘I know about the topic already’ is related to a prior

interest, or to put it another way, a prior decision to be

interested, in a topic. The negative loading of the item

‘I had to choose something’ indicates positive and firm

decision making.

For each student, a score on each factor was calculated by

taking the mean score of the items loading onto that factor.

‘I had to choose something’ was reverse scored because of its

negative loading on the Certainty factor. The factor scores

approximately followed a normally distribution and are

treated as such.

One way analyses of variance showed that students who

chose different types of SSC had different motivations for their

choice (Table 4).

Post hoc Tukey honestly significantly different (HSD) tests

indicated that those wishing to study generic skill and

medicine in the community SSCs scored significantly higher

on future achievements than the other groups. Those wishing

to study languages scored lower than all other groups on prior

information, and also scored lower on convenience than those

wishing to study generic skills. Those wishing to study

Table 3. Factor analysis loadings for reasons of SSC choice (values below 0.5 not shown).

Futureachievements

Priorinformation

Internalmotivation

Personalrecommendation Convenience Certainty

It will help me with my other studies 0.70

It will look good on future job applications 0.71

It is useful for developing skills for practising as a doctor 0.68

It is related to my planned career choice 0.59

The person/people running it influenced me 0.68

The oral presentation given influenced me 0.66

Written information about it influenced me 0.68

It sounded interesting 0.83

It sounded enjoyable 0.86

Other people I know are doing it 0.73

Staff recommended it 0.62

Other students recommended it 0.76

It sounded like the least work 0.60

My family influenced me 0.64

The site it is held on was significant 0.65

I had to choose something �0.64

I know about the topic already 0.75

Variance explained by factor 22.4% 11.8% 7.8% 7.7% 6.9% 6.4%

Table 2. Median responses to questions regarding motivationsfor SSC choice (1¼ strongly disagree; 5¼ strongly agree).

Motivation MedianLowerquartile

Upperquartile

It sounded enjoyable 4 4 5

It sounded interesting 4 4 5

It is useful for developing skills for

practising as a doctor

4 3 4

It will look good on future job

applications

4 3 4

It will help me with my other studies 3 3 4

I know about the topic already 3 2 4

It is related to my planned career

choice

3 2 4

Written information about it

influenced me

3 2 4

I had to choose something 3 2 4

The person/people running it

influenced me

2 1 3

The oral presentation given

influenced me

2 1 3

It sounded like the least work 2 1 3

Other students recommended it 2 1 3

Staff recommended it 2 1 3

Other people I know are doing it 2 1 3

The site it is held on was significant 1 1 3

My family influenced me 1 1 2

I did not chose it, it was allocated 1 1 2


e421

medicine in the community SSCs scored significantly higher on

personal recommendation than those wishing to study

medical humanities, medicine in society and languages.

Those wishing to study bioscience SSCs scored significantly

lower on certainty than those wishing to study languages and

generic skills. There were no group differences in the post hoc

tests on the internal motivation factor.

Personality and sex

Scores for the NEO-FFI questionnaire were normally distrib-

uted. Independent t-tests indicated females scored significantly

higher on neuroticism (mean difference¼ 3.6; t (264)¼ 3.9);

p5 0.0001), extraversion (mean difference¼ 1.6; t (264) ¼ 2.5;

p¼ 0.01) and agreeableness (mean difference¼ 1.5; t (264)¼

2.03; p¼ 0.04).

Weak but statistically significant correlations were found

between personality traits and the motivation factors (Table 5).

Students higher on openness scored lower on personal

recommendation (r¼�0.12, p¼ 0.04). Those higher on

agreeableness scored lower on convenience (r¼�0.21,

p¼ 0.001). Those higher on conscientiousness scored higher

on future achievements (r¼ 0.13, p¼ 0.03) and certainty

(r¼ 0.13, p¼ 0.03). There were no significant sex differences

on the motivation factors.

One way analyses of variance showed personality did not

statistically significantly vary by type of SSC chosen. More men

chose bioscience (n¼ 30 versus n¼ 13) and generic skills

(n¼ 17 versus n¼ 11) and more women chose medicine and

society (n¼ 40 versus n¼ 30) (Table 4); however, these

differences were not statistically significant [�2(5)¼ 8.8,

p¼ 0.12].

Discussion

The reasons that motivated these first year medical students to

choose their first SSC were statistically significantly related

both to the type of SSC that the students chose, and to their

personality traits. Although there were significant sex differ-

ences in personality, sex was not directly related to motiva-

tions or SSC choice. An excellent response rate of 82% was

achieved using a survey containing both newly created items

relating to the motivations for SSC choice and a well-

established validated tool to measure personality traits. These

provide a new tool for studying the motivations underlying

SSC choice in junior medical students.

Table 4. Mean scores (standard deviations in parenthesis) on each motivational factor by chosen SSC type.

Motivation factor SSC type N Mean (SD) 95% CI F (5, 261) p

Future achievements Bioscience 43 3.26 (0.7) 3.1–3.5 7.26 50.001

Medical humanities 24 2.99 (0.9) 2.6–3.4

Medicine and society 72 3.01 (0.8) 2.8–3.2

Medicine in the community 28 3.41 (0.5) 3.2–3.6

Languages 72 3.00 (0.8) 2.8–3.1

Generic skills 28 3.81 (0.6) 3.6–4.0

Prior information Bioscience 43 2.72 (0.7) 2.5–2.9 9.15 50.001




Languages 72 1.81 (0.9) 1.6–2.0

Generic skills 28 2.39 (0.9) 2.0–2.6

Internal motivation Bioscience 43 4.12 (0.5) 4.0–4.3 2.68 0.022




Languages 72 4.01 (0.9) 3.8–4.2

Generic skills 28 4.04 (0.6) 3.8–4.3

Personal recommendation Bioscience 43 2.17 (0.8) 1.9–2.4 3.61 0.004




Languages 72 2.01 (0.8) 1.8–2.2

Generic skills 28 2.16 (0.8) 1.9–2.5

Convenience Bioscience 43 1.90 (0.7) 1.7–2.1 3.40 0.005




Languages 72 1.69 (0.7) 1.5–1.8

Generic skills 28 2.27 (1.0) 1.9–2.6

Certainty Bioscience 43 2.74 (0.8) 2.5–3.0 4.53 0.001




Languages 72 3.33 (1.1) 3.1–3.6

Generic skills 28 3.56 (0.8) 3.2–3.9

J. Richardson

e422

Students motivated by future achievements were more

likely to choose generic skills SSCs than any other type except

medicine in the community. This seems logical, given the

transferable nature of generic skills to other studies and clinical

practice. Medicine tends to be a people-focused profession

and medicine in the community SSCs provide the opportunity

to meet patients – something relatively rare for first year

students at this London medical school with its more

traditional-style curriculum. Students motivated by certainty

were more likely to choose generic skills and language SSCs

than bioscience SSCs. This may be because those students

believed they already have some knowledge of some of the

subjects being taught on those SSCs, although this would need

to be verified. It could also be that those lower on certainty

were more likely to choose biosciences, which are closely

related to the core syllabus in Year 1, and thus may have

seemed like a default option. Students who scored highly on

those two motivation factors were also likely to be higher on

the personality factor conscientiousness. Conscientiousness is

known to be associated with high academic achievement at

medical school (Ferguson et al. 2002) so its positive relation-

ship with these motivation factors fits with the picture of the

conscientious student who chooses to make and is able to

carry out concrete plans to work towards a successful future.

Students motivated by prior information and convenience

were less likely to study languages. Nearly all students have

some experience of studying languages and thus may feel that

the specific prior information given about SSCs is less relevant

to their choice than their language ability. The relationships

with convenience may relate to how, at this medical school,

language courses are held at a different location to medical

school campuses. Being motivated by convenience was

associated with low agreeableness scores. It is not clear why

this may be and it may be a spurious result (Type I error).

Students motivated to study an SSC by personal recom-

mendation were more likely to want to study medicine in the

community than other types of SSC except bioscience and

generic skills, probably reflecting the fact that medicine in the

community options are held at local venues and those who

chose these options may have been more influenced by talks

given by representatives for these SSCs. Being motivated by

personal recommendation was related to scoring low on the

personality trait openness to experience. There was also a

trend for high openness students to score higher on the

internal motivation factor (r¼ 0.11; p¼ 0.07). This may reflect

a tendency for high openness individuals to engage in

independent and creative thought and be more motivated to

study an SSC by their own personal interest in a subject than

by other people’s opinions.

Although personality was related to motivations for

choosing SSCs and to sex (as is typically found, e.g. Costa

et al. 2001), it was not directly related to the type of SSC

students chose. This is unexpected bearing in mind previous

studies suggesting personality influences choice of medical

specialty (Friedman & Slatt 1988; Borges & Osmon 2001;

Borges & Savickas 2002). It is possible that students who are

further on in their medical training may show a relationship

between personality and SSC choices as the demands of the

profession for which they are training become clearer and

possible career choices become more informed. It is also

worth noting that medical students choose many SSCs during

their time at medical school. This study chose to investigate

their first ever choice of SSC. However, as we are unaware of

the SSCs they chose later, it was not possible for us to explore

first SSC choice in the context of subsequent, perhaps planned,

choices. We recognise that, as students travel through medical

school, their own experiences, insights and motivations

change considerably. First-year medical students are generally

younger in the UK than, for example, the US and how their

level of maturity affects their choice is not answered by this

study. Longitudinal work would help us further understand the

relationship between personality, motivation and SSC choice at

different points in the course.

In terms of sex, it is interesting that there was a trend for

women to choose medicine in society and men to choose

generic skills and bioscience SSCs, which is to be expected as

women are typically more motivated to choose specialties

involving people (Stilwell et al. 2000).

Like many studies of those in medical training, this study

covers students from a single institution at a single point in

time which limits any generalisable conclusions; however, the

aim of this preliminary study was to prompt reflection by

Table 5. Correlations between personality trait scores (neuroticism, extraversion, openness to experience, agreeableness andconscientiousness) and the six motivation factors.

Futureachievements

Priorinformation

Internalmotivation

Personalrecommendation Convenience Certainty

N r¼0.24 r¼�0.09 r¼�0.02 r¼0.01 r¼0.10 r¼�0.00

p¼0.69 p¼0.16 p¼0.75 p¼0.88 p¼0.11 p¼ 0.97

E r¼0.08 r¼�0.01 r¼0.12 r¼0.01 r¼�0.08 r¼ 0.06

p¼0.21 p¼0.87 p¼0.06 p¼0.93 p¼0.17 p¼ 0.31

O r¼0.01 r¼�0.03 r¼0.11 r¼�0.12 r¼�0.11 r¼ 0.03

p¼0.92 p¼0.68 p¼0.07 p¼ 0.04 p¼0.07 p¼ 0.64

A r¼0.00 r¼�0.02 r¼0.11 r¼�0.06 r¼�0.21 r¼ 0.02

p¼0.95 p¼0.76 p¼0.07 p¼0.36 p¼0.001 p¼ 0.76

C r¼0.13 r¼�0.01 r¼0.00 r¼0.02 r¼�0.07 r¼0.13

p¼0.03 p¼0.92 p¼0.95 p¼0.74 p¼0.27 p¼ 0.03

Note: Results in bold are significant at p5 0.05.


e423

medical educationalists and policymakers, and to inform future

research. Further studies from other medical schools with

different curriculum structures and different SSC choices

would provide useful comparative data. The motivation factors

indicated by this study are a useful starting point for follow-up

qualitative studies, which we believe would be valuable in

further exploring the issues. For example, the finding that 56

students wished to study one particular SSC, many more than

for any other SSC, is pertinent here (Table 1). While

discussions with the course leader suggest that the clinical

nature and relevance of this option plays a part, clear insight

into students’ motivations for this preference will only be

obtained through discussion with those who chose it.

Likewise, qualitative study may help explain why some

modules were not chosen by any of the students.

Within the context of increased student choice within

undergraduate medical curricula, this study offers a prelimin-

ary insight into the nature of influences on a medical student’s

initial choice of modules. This is a first step towards ensuring

appropriate provision of and helping students choose between

modules that students wish to study and that enable them to

develop the skills required by the modern medical profession.

Declaration of interest: The authors report no conflicts of

interest. The authors alone are responsible for the content and

writing of the article.

Notes on contributors

JANE RICHARDSON is a Senior Lecturer in medical education and lead for

the Teaching and Professional Development Unit at the University College

London Medical School, UCL. Her research interests include peer assisted

learning, the student experience and postgraduate training in the early

years.

HENRY POTTS is a Lecturer in the Centre for Health Informatics

and Multiprofessional Education (CHIME) at University College

London. His research interests are in the use of the Internet by students

and patients.

KATHERINE WOOLF is a Research Associate in medical education in the

Academic Centre for Medical Education at University College London

Medical School. Her research interests relate to the factors that influence

medical student performance, with a particular focus on the reasons that

medical students from ethnic minorities underperform academically.

PIPPA BARK is Principal Research Fellow at the Centre for Health

Informatics and Multiprofessional Education (CHIME) at University

College London. She is Course Director of the postgraduate programmes

in clinical risk management. She is currently doing research for the General

Medical Council on assessment of poorly performing doctors.

DEBORAH GILL is a clinical academic in undergraduate medical

education and Director of the Academic Centre for Medical Education

at the University College London Medical School, UCL. She is sub dean for

professional development and her research interests include peer assisted

learning and how curricula are constructed and enacted.

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