Polished Gems

As the UL Graduate Entry Medical School (GEMS) marks a decade in operation, Professor Deirdre McGrath spoke to Áine Freeman on its progress to date and on the future of the facility. 

Now approaching its 10- year anniversary, the Graduate Entry Medical School (GEMS) at University of Limerick began in rather humble surroundings.

Originally situated in the C block of the main university building, it has expanded into its own state-of-the-art facility. Student numbers have grown from 32 in 2007 to more than 500 in 2017. International interest is at an all-time high, with nearly one third of the student population comprising non-EU students, predominantly from Canada and North America.

Students who have completed an undergraduate degree in any discipline can apply for the graduate entry Bachelor of Medicine, Bachelor of Surgery course, as GEMS director Professor Deirdre McGrath explains.

“The graduate entry model is the model the Canadian and North America schools work on. It encourages mature and motivated individuals to study medicine so that, when they do interact with patients in the real-life clinical setting, they are experienced, mature and empathic.”

 For some students, it is a complete divergence from their original career path.

“Our programme accepts students from any background, so we have people who have come from arts and humanities, business and law, learning together with engineers, nurses, physiotherapists and basic scientists. We even had a fashion and design student in the programme,” says Professor McGrath.

The difference does not usually put students at a disadvantage. On the contrary, their diverse backgrounds tend to complement each other.

“Students coming from different academic backgrounds bring a range of strengths to the table. At the start, science students do hit the ground running, as there is a strong emphasis on basic science in the early years of the programme. What we see, however, is that non-science students, particularly those from the arts and humanities, often have a more holistic understanding of a patient’s problems.

So, by the end of the second year, the non-science students perform equally as well,” she continues. 

The cornerstone of the programme is problem-based learning. “The process is facilitated by a medically-qualified tutor who is there to guide the learning and to ensure that students are grasping difficult concepts. Students are introduced to a patient problem. They bring their prior knowledge and experiences to the table; they identify any gaps in their knowledge with respect to that problem and then fill those gaps through a process of self-directed learning. The learning is consolidated by a small number of lectures and seminars,” Professor McGrath explains.

Clinical and communication skills training are other important aspects of the programme. “Students learn how to examine, communicate and perform procedures on each other and on mannequins, trained actors, members of the public and, ultimately, on patients.” In the first two years, students work through an early patient contact programme, which focuses on people in the community who have a chronic illness and on women going through pregnancy. “It’s very much about learning about illness from the patient’s perspective. They go out into the community and meet with the patient to see the difficulties they might have in everyday life. It is something we don’t always get to see as a doctor.”

Third year students also spend 18 weeks working within a general practice, the only placement opportunity of its kind in the country. “We are very fortunate in that we have overwhelming support from our general practice colleagues. There are 120 GPs in the community that support the programme,” Professor McGrath outlines.

“Students can see what happens patients from their initial presentation to a GP and on through their investigative and management processes. It’s seeing the patient as a whole, as opposed to just an organ or a disease, which often happens in hospital medicine, due to the constraints that hospital doctors are working under”.

Technology has hugely impacted the teaching at GEMS, as students learn much of their skills from procedural equipment, including high fidelity mannequins that simulate normal and abnormal patient scenarios. They are the only medical students in the country who do not use dissection of real cadavers when learning anatomy. Technological resources now allow students to virtually dissect on their computer or tablet. An Anatomage table recently introduced to the school features virtual bodies, letting students learn anatomy and dissect life-size digital cadavers using a touchscreen. This is the most technologically advanced visualisation system worldwide for teaching anatomy.

Professor McGraths notes, “Students are also making the switch from books to mobile devices in their daily education. In an age of mobile devices, this is huge. Students want to be able to sit on the bus and learn and not be restricted to libraries.” GEMS has not only grown in size on the UL campus but its clinical teaching network has also expanded, with more than 300 adjunct teaching staff across the UL Hospitals’ Group and five affiliated teaching hospital sites. It has a joint academy with the Royal College of Surgeons at St Luke’s Hospital, Kilkenny and with NUI, Galway at Portiuncula Hospital in Ballinasloe.

The school also has buildings for academic use when students are on clinical placement in Tullamore, the Midland Regional Hospital in Portlaoise and South Tipperary Hospital in Clonmel.

New courses are constantly being developed. “We are working with partners within the Faculty of Education & Health Sciences in developing new programmes. One such programme is the innovative Community Wellness and Empowerment in Leadership & Life Skills Programme (CWELL), which aims to empower people in socially deprived areas to become leaders.

“We are also currently in the process of developing new masters programmes, including Health Professions Education, which will be launched in September 2018. “

As more graduates enter the workforce and make their impact, the opportunities for growth within GEMS are endless. “Those of us within the school can see the incredible potential that GEMS has, if allowed to grow. We are nowhere near yet achieving our potential,” Professor McGrath concludes.