Undergraduate Medical Education

Luton and Dunstable University Hospital

Background

The Luton and Dunstable hospital (L&D) is one of five District General Hospital site for University college hospital medical students and is the one most often requested by students as we have an excellent teaching record and are well known for supporting students in the lead up to finals

Each academic year the L&D welcomes 126 Year 5 and 90 Year 6 MBBS (Bachelor of Medicine; Bachelor of Surgery) students from the University College Hospital (UCL) Medical School. Throughout the year, and by arrangement with the Medical School, we provide a programme of clinical placements to support the students’ medical education.

Medical students also benefit from the support and guidance of our Clinical Teaching Fellows, who contribute to their experience by assisting in the delivery and ongoing development of our undergraduate programme; including teaching and mentoring, clinical skills and simulation sessions and OSCE (Objective Structured Clinical Examinations) practice. The L&D is also an Examination Centre for UCL students’ final CPSA (Clinical and Professional Skills Assessment) which is held in March each year.

Our Undergraduate team includes:

Undergraduate Director- Dr Dattani
Undergraduate Deputy Director- Dr Agrawal
Undergraduate Supervisor- Zaheer Afsar
Year 5 Manager- Qaiser Pervez

Year 6 (Final Year) Student Placements

We host final year medical students for their 20-week placement programme.

During each placement the students are supported by speciality leads and clinical teaching fellows. They rotate through different specialties; spending four weeks in each of the following departments: Medical, Surgery, Long-Term Conditions, and Accident and Emergency.

We have comprehensive teaching programme which is lecture based once a week. Regular bedside and small group teaching is provided by specialty leads and clinical teaching fellows. We organise MOCK CPSA (previously known as OSCE). In March 58 students attend for the Final CPSA exams.

Year 5 Student Placements

Year 5 medical students attend clinical placements at the L&D in placement groups of 12, rotating through Paediatrics, and Obstetrics and Gynaecology.

Paediatric rotation is 6 week placement and is delivered as 1 week in Great Ormond street, 1 week in Child and Adolescent Mental health centre and 4 weeks in the hospital. At the end of the placement, MOCK CPSAs are organised to consolidate their learning.

Obstetrics & Gynaecology

Obstetrics and Gynaecology student placements are 3 weeks in DGH and 3 weeks at central site.

In each academic year we welcome twelve cohorts of medical students to our Women’s Health Unit. The hospital attachments are for three weeks and during each placement UCL students rotate through different areas with learning opportunities in gynaecology and delivery suite theatres, on gynaecology, antenatal and postnatal wards, and in specialist clinics such as early pregnancy and foetal medicine. Students gain experience in history taking and case-based discussions, developing their clinical skills, performing examinations and supporting women during labour in the delivery suite. They also receive guidance and supervision from the O&G Lead Consultant and their timetabled activities include both ward-based learning and tutorials.

Child Health

Following a week’s placement at Great Ormond Street Hospital, Year 5 medical students join our General Paediatric and Neonatal Unit for a 5-week clinical placement under the guidance of our Joint Paediatric Specialty Leads. We host six cohorts over the year and during their time with us students gain experience in a variety of paediatric conditions, history taking, examination and case presentation. They have the opportunity to interact with children and parents and to observe clinical skills. The students rotate to different areas within paediatrics and are provided with a range of learning opportunities on the wards, in PAU, in the Children’s Outpatient Department and within the Neonatal Unit. They also observe CAMHS and community placement cases and get the opportunity to present cases in weekly paediatric Grand Rounds. Their timetables during placement include both bedside and small group teaching sessions.

Neonatology

The Neonatal Unit at the Luton and Dunstable Hospital is one of the three tertiary level Neonatal Intensive Care Units in the East of England region providing intensive care for infants not only from the Beds-Herts Perinatal Network but from the East of England Region. We have 38 cots (18 ITU/HDU and 20 SBCU)) and are equipped to provide a full range of neonatal intensive care services including inhaled nitric oxide, high frequency oscillation as well as conventional ventilation and CPAP and hypothermia therapy for neonatal encephalopathy. Surgical services are provided off site (GOSH and Addenbrookes hospitals) with onsite ROP services which include laser treatment provided by the local ophthalmology consultant. Subspecialty neonatal interests include cardiology, gastroenterology, respiratory, palliation, neurology and neurodevelopment. General and specialist neonatal clinics which include neurodevelopment, cardiology, chronic lung disease and metabolic disorders are provided by local neonatologists.

A comprehensive educational programme with protected time for trainees covers foetal medicine, radiology, genetics, ophthalmology, physiotherapy, dietetics and journal clubs. A MDT neonatal simulation programmes takes place every 2 weeks providing training on neonatal emergencies and challenging communication scenarios. Pathology within the local population is particularly extensive and complex providing excellent opportunities for foetal medicine, perinatal mortality/morbidity and genetics education which is supported by twice yearly multidisciplinary perinatal pathology meetings with visiting perinatal pathologist and geneticist.

We are actively involved in local and multinational multi-centre research projects and provide opportunities and support for medical staff to be part of this academic work. Audit and quality improvement project are available to provide training opportunities for medical staff also.

Anaesthetic, Intensive care and Integrated pain services

The Anaesthetic, Intensive care and Integrated pain services department is the largest department in the hospital. There are about 43 consultants, 40 trainees (both deanery and locally appointed doctors) and 08 SAS doctors in the department. The department is responsible for safe provision of anaesthesia for emergency surgeries, paediatrics, ENT, major max-fax/ airway surgeries, orthopaedics, spinal surgeries, dental surgeries, gynaecological surgeries, urological surgeries, robotics, colorectal and upper GI surgeries, bariatric surgery, eye surgery and obstetric surgeries. These services are provided in 17 dedicated theatre suites. Also, we provide anaesthesia and sedation for CT, MRI, cardiac Cath lab, ECT and interventional radiology procedures as required. There is an anaesthetic preassessment clinic run by consultants and preassessment nurses Monday to Friday daytime.

Intensive care has 12 bed capacity at the moment with maximum of 6 level 3 beds and 6 level 2 beds. Critical Care Outreach team provides 24/7 service helping the team outside the ITU to manage critically unwell patients. Patients discharged from ITU are followed up by the Critical Care Follow-Up service as outpatients.

The maternal service is a busy unit with over 5000 deliveries annually and there are 2 dedicated maternity theatres. There are also consultants run clinics for high risk pregnancies and maternal patients with cardiac diseases.
There are chronic pain clinics and procedures conducted by a pain specialist and acute pain service headed by an anaesthetist consultant runs Monday to Friday daytime.

The department is recognised by the East of England deanery for Special Interest Area (SIA) training for stage 3 trainees (ST6 and ST7) in difficult airway surgeries, obstetrics and major general duties. We are also recognised for higher paediatrics and bariatric surgeries. Currently we have deanery trainees from ACCS, core anaesthetics, Intensive Care Medicine, A&E and IMT ranging from CT1 to ST7. We have locally employed doctors as clinical fellows, senior clinical fellows, MTI and CESR fellows. The trainees will have named educational supervisor to support their training needs. There is a named wellbeing lead and a clinical phycologist attached to the department providing pastoral support for the team.

The department conducts regular teaching on weekly basis on every Tuesday and journal clubs monthly where trainees participate actively. There is regular clinical governance meetings conducted both in anaesthesia and ITU providing ample opportunities for juniors to highlight their portfolios. Primary and final FRCA mock exams courses are conducted twice a year with excellent feedback from participants. There are multiple clinical trails and research work happening at present where trainees could participate and the department also support for trainees to become associate PIs in some of these studies. Presently we are preparing to recruit patients for the POPPY study and plans are made to involved in the ABBRPT study in ITU.

The department is expanding rapidly and provisions are made to incorporate a newly built ITU with 21 beds, new maternity unit and 6 more additional theatres by 2025 in the acute services block. We are a friendly and dynamic department and welcome new colleagues to join our team to provide safe and caring service to our patients while enjoying and get well trained during your at L&D hospital.

Preparation for practice

We are also one of the sites to offer “Preparation for practice” module after passing Final MBBS exams. We currently offer placements for Accident and Emergency, Paediatrics, Acute medicine, Ophthalmology, Radiology, Anaesthetics and Intensive care. During Preparation for practice, students are encouraged to act as a foundation doctor, with supervision, and are shown the roles and responsibilities of a fully qualified doctor.

Boot Camp

Last year, we were the chosen site for Boot Camp for the students who had to re-sit Final exams. Our clinical teaching fellows did a marvellous job in supporting them and preparing them the students. All of these students passed and we received excellent feedback. As a result of this we have been asked to take Boot Camp students again in 2024.

We have appointed 8 clinical teaching fellows who support medical students in their placements. Our CTFs are allocated Educational Supervisor and mentored by Undergraduate leads to guide them in their career pathway. They also attend a mentoring course to equip them with the skills needed to support medical students.