Students' and supervisors' experiences of a placement with a medical deputising service: An expanded clinical setting for urban students

Introduction: Few studies have examined the benefits of using after-hours locum doctors (ALDs) for medical student placements. Aim: To explore the views of urban undergraduate medical students and ALDs in February 2011 and February to March 2012. Methods: One focus group with five students and in-depth interviews with three after-hours locum doctors employed by one medical deputising service were undertaken in 2011. A questionnaire was administered to students and ALDs in 2012 to quantify these findings. Findings: Students and ALDs reported feeling safe. They considered the placement an engaging and useful learning experience and found the opportunity to debrief during the travel time between visiting patients beneficial. Students reported gaining insights into social circumstances affecting patient health, saw medical problems not seen in conventional placements and felt there were unique skills required to work as an ALD. ALDs reported that medical students provided moral support in this environment; however, they also said that the student slowed them down and mentioned that they are not provided with any financial incentive to encourage them to educate students. Students reported logistical issues in meeting ALDs at the start of the shift and getting home from the placement at unsociable hours. Clearly defining student and supervisor roles would improve this experience. Conclusion: Clear guidelines, financial incentives and a solution to enable students to safely meet the ALD and get home on completion of the session would make it more viable for the student to gain from the unique learning that occurs in this environment, increasing placement opportunities for urban students.