Cooperation key to successful medicine programme in Uppsala

In 2019 the government announced its decision to introduce a six-year medicine programme, in which students are registered as practitioners directly upon completing their education. The primary reason for this was to bring Swedish programmes into line with the international situation, a set-up of this kind having long existed in other European countries.

“Much the largest challenge of the six-year programme is precisely that students can start to work as registered doctors immediately after graduating. This makes far higher demands on clinical training than previously,” says Bertil Lindahl, chair of the programme committee for the medicine programme, who has been involved in designing the new programme from the start.

New needs demand innovative thinking

From the outset, Lindahl was driven by the vision of using the reorganisation to change the medicine programme for the better. Recent decades have seen major changes in healthcare, with which education and training have not always kept up. With the rapid growth of technology such as AI, healthcare is set to change even more rapidly in future.

“If we compare with the situation when I myself was training, we now have virtually twice as many students for half as many places in healthcare – and at a hospital like Uppsala University Hospital that is far more specialised. As a result, we have needed innovative ideas to ensure that all students have a chance to learn properly. We’ve become better at making use of the entire hospital region, working in simulated environments and more at clinics than departments,” Lindahl elaborates.

Long placements inspired by Trondheim

Early on in the process, the programme committee in Uppsala visited Trondheim, which has had the new educational model since 1993. They have successfully employed relatively long placements of 4–6 weeks, with the students more or less working as assistant physicians and part of the team. These relatively long placements are unique to Uppsala University, as other higher education institutions have not organised it in the same way.

“Since the programme has previously been criticised for lacking extended practical placements, we took the opportunity to change that in the new programme. In semesters 10–11, the students will therefore be sent on placements in the region with their own place on the staff list, where they can gain experience of the role of assistant physician. As we know Trondheim has positive experiences of doing this, we believe strongly in this idea,” says Joakim Svartheden, project coordinator for the implementation of the new medicine programme and educational developer for the programme.

More than half the programme has run

The students have now reached the eighth semester in the new system, and according to course evaluations they are remarkably satisfied with the new programme so far. According to Lindahl, most of the courses have received equally good, or better, evaluations than in the previous programme. Students’ grades have also improved slightly in the new system.

“It has gone better than anyone expected! I am pleased that we have managed to make such major changes and so far it looks to have turned out well. Many teachers have put a lot of effort in and we have also involved students more than in the past, which has led to good results,” Lindahl says.

Svartheden agrees with the positive comments and emphasises one of the greatest challenges in the process: the purely practical business of putting together double instruction sessions with lecture halls and placements, where students from both the new and the old programme have taken the same course.

“But it has worked out really well and I think the primary reason for this is the transparency we have had from the outset, where Bertil has worked hard to get everyone on board and create a climate where we have been able to discuss the problems that have shown up along the way,” says Svartheden.

Cooperation crucial

Cooperation has clearly been crucial. The programme committee has done its utmost at all levels to ensure smooth cooperation – with students via the Medical Student Council, with all involved teaching staff, with study advisers and administrators, with the regional authorities and with programme committees at other higher education institutions.

“I think we all realised at an early stage that the success of the programme would depend on how well we managed to put it all together. And we have created an even better climate of cooperation than previously, including new forms of cooperation between doctors with different specialisations. We have become a more well-oiled machine, with all parts more in sync than previously. This has been much easier and much more fun than I could ever have imagined,” Svartheden enthuses.

Sharing experiences

The introduction of the new medicine programme has also led to clearer collaboration between the various higher education institutions that offer medical training. During the pandemic, weekly meetings were started on Thursdays, where the chief coordinators of the programme committees met on Zoom for half an hour to discuss various issues. These meetings have continued. According to Lindahl, they are characterised by a positive atmosphere and a willingness to share experiences – both good and less good.

“The crucial success factor has been the great commitment from the entire teaching body and the students to participating in creating the programme. Many people are determined that it will go well, and together in the programme committee and other working groups we have really succeeded there in getting many people to work towards the same goal. It’s been great fun and tremendously inspiring and it’s rewarding to play a part in creating something that really works,” Lindahl concludes.

Jenny Asp