Street Medics: An innovative learning opportunity for medical students in a primary care outreach setting 

Problem

There is growing momentum to ensure that issues relating to health inequalities and the social determinants of health are run throughout undergraduate medical teaching (Williamson and Ayres, 2015). There is also a national drive to improve recruitment into General Practice (Wass, 2016) with recruitment problems most severe in deprived areas (Blane, 2018). Street Medics is an innovative scheme that was co-created by medical students and GP educators. This initiative provides voluntary opportunities for medical students to join GPs doing outreach work with deprived patient groups. It provides hands-on learning experience of the impacts of health inequalities. Despite being voluntary and occurring in the evenings, demand for places by students consistently exceeds capacity. This research project aims to explore the influences that motivate student engagement in this extra-curricular initiative and what the impacts are on the students involved. 

Approach

This is a qualitative study of medical students’ experiences of the street medics project. Two focus groups have been conducted with 8 medical students who have experienced the initiative. The focus group discussion was recorded and transcribed verbatim and then thematic analysis was undertaken. A third focus group is planned to ensure data saturation.

Findings

The preliminary data analysis has revealed the following key themes. Motivating factor themes are: appetite to explore; altruism; perceived lack of exposure in undergraduate teaching; and previous observation of perceived sub-optimal care to socially disadvantaged patients. Experience and impact themes are: increased understanding of social determinants of health; change in perception of vulnerable patient groups; influence on career intentions and future practice; desire to incorporate into undergraduate curriculum. 

Consequences

This experiential approach to learning about health inequalities and the social determinants of health has the potential to challenge pre-conceived perceptions, to ignite enthusiasm and to influence career intentions of medical undergraduates. The popularity of this initiative and the research findings strengthen the case for widening the experiential learning opportunities within the primary care setting. This is particularly relevant at a time when recruitment into general practice is paramount to sustain the future workforce. If we can identify the reasons that undergraduates are self-selecting to experience primary care outside of their delivered curriculum, we can then propose a model to be shared across medical undergraduate courses. References: Blane, D.N. (2018). Medical education in (and for) areas of socio-economic deprivation in the UK. Education for Primary Care. 29:5, pp. 255-258. Wass V (2016) By choice — not by chance: supporting medical students towards future careers in general practice (Health Education England and the Medical Schools Council, London)Williamson, A. Ayres, R. (2015) Core intended learning outcomes for tackling health inequalities in undergraduate medicine. BMC Medical Education 15:66