What clinical exposure is available to students through an attachment to a Medical Assessment Unit in a small general hospital?

Introduction In recent years and for many reasons, the educational environment for undergraduate clinical teaching has begun to shift from major urban teaching hospitals to smaller hospitals and to community settings. There may be uncertainty about the breadth and depth of clinical exposure available to students in relatively novel clinical settings. This study aimed to measure the level of clinical exposure that would be available to undergraduate students through a short attachment to a Medical Assessment Unit (MAU) at a small (118-bed) acute general hospital. METHODS Over a four-week period, all presenting clinical problems, co-morbidities and past medical problems were recorded for all patients presenting to the MAU at Bantry General Hospital. The problems identified were compared with a list of 96 key clinical problems relevant to the discipline of Medicine which the Medical Council of Canada (MCC) and the Australian Medical Council (AMC) consider that a graduating doctor should be able to assess and manage in a competent manner. RESULTS Over the four week study period, 165 new patients with a mean age of 63 years (range: 17 - 95 years) presented to the MAU. A total of 1046 active or inactive clinical problems were identified (mean: 6.3 problems per patient; range 1 – 18 clinical problems). Overall, 17 (18%) of the 96 key medical problems identified by the MCC/AMC were encountered on more than 20 occasions; 34 (35%) were encountered on between 5 and 20 occasions; 26 (27%) were encountered on between one and four occasions while 19 (20%) were not encountered. CONCLUSION Over a relatively short time period, a single clinical area in a small general hospital can provide undergraduate medical students with a high level of exposure to patients with a broad range of important medical problems.