Department of Medical Education, Coleridge House, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK
We thank Dr Rothschild for the interest shown in our article. In particular, we would agree there is a need for more data from the postgraduate arena on the relationship between self-reported competence in managing musculoskeletal conditions and competence demonstrated, for example, in an OSCE (Objective Structure Clinical Examination). In response to widespread concerns about under-representation of musculoskeletal disorders in UK medical school curricula, the Arthritis Research Campaign (ARC) of the UK have organized a special curriculum conference in September 2003 for all UK medical schools. Consequently, they hope to be able to report on a change in musculoskeletal educational curricula across the UK.
Our musculoskeletal educational research group have recently conducted a national qualitative survey of community-based musculoskeletal services in the UK on behalf of the ARC [1]. The evolution of musculoskeletal services in primary care organizations shows a distinct trend towards the intermediate assessment and treatment of patients between primary care and the acute sector. There was emphasis on multidisciplinary and inter-agency team-working, and on the expansion in the traditional assigned roles for professionals, in particular physiotherapists and general practitioners, acting as community-based musculoskeletal specialists. Worryingly, there seemed little evidence to support a clear educational strategy for staff both within the service and those who would potentially refer to it. We suggest that there is a developing agenda to identify the learning needs of primary care specialists and devise a competency-based accreditation procedure.
The trend towards outcome-based curricula focusing on the needs of the newly qualified doctor is a powerful way of ensuring curricula meet the evolving needs of service providers such as the UK National Health Service [2].
Finally, we feel that the whole area of medical education with regard to musculoskeletal disorders is one in which there ought to be much more collaboration, including joint research studies between the USA and the UK.
Notes
Correspondence to: C. Roberts. E-mail: c.roberts1{at}sheffield.ac.uk
References