It is useful to understand the fundamental aspects of a medical school curriculum as a prospective student. A commonly overlooked or misunderstood component of the curriculum is the medical student portfolio.
A medical student portfolio is a virtual or physical record of clinical, research-based or academic experiences. It is a personal account of both academic and clinical achievements for you to look back on throughout your time at medical school. It is worth prefacing this article by saying that the portfolio requirements for each medical school will vary, therefore this article will discuss the broad similarities seen across different medical schools.
A portfolio may be organised in various ways, all your experiences may be collated in one area, or it may be divided according to the various rotations or modules in a particular year of medical studies.
Each medical school will have guidance on the quantity and quality of the skills recorded in a portfolio. This may also change throughout the course as you become more knowledgeable and competent in a clinical environment. It is important to confidently meet your medical school’s requirements, through maximising your time on placements, being aware of your progress and staying organised.
Monitoring student activity and attainment of achievements is also of great benefit to the medical school as it helps them make more appropriate changes to parts of the curriculum and consequently optimise student learning.
Arguably, one of the most important skills the portfolio aims to develop is the ability to reflect. Not only is this skill important as a student, but it is very valuable later in life as a doctor. As well as keeping account of the various opportunities you have undertaken, reflecting on these and writing about how they benefited you or what you learned from them is an important process which aids personal and professional development throughout medical school.
Furthermore, there are certain professional skills which are required to be taught and practiced, as described in the ‘outcomes for graduates’ document by the General Medical Council (GMC). Each time these skills are practiced it is recorded in the portfolio as evidence for the medical school. These may be practiced in simulation, in sessions facilitated by the medical school but outside of the clinical environment and usually on actors or mannequins, or during clinical patient rotations on real patients.
The portfolio may also require the student to demonstrate their ability to take patient histories, complete clinical examinations and/or read up further on medical knowledge taught in lectures or tutorials through presentations or essays.
These achievements must be signed off by a supervising clinician, who will generally provide the student with a few sentences of feedback to include in the portfolio. This helps the student identify their strengths and weaknesses, reflect on the experience, and make improvements the next time they attempt something similar.
The portfolio can also be used to provide evidence of other medical school learning opportunities such as supervisor meetings or extracurricular achievements ie. research opportunities. Experiences may not be directly related to the required list of clinical skills to graduate as a doctor, however, if they are in some way relevant to the medical school curriculum, they are certainly worth including in the portfolio. Meetings with key clinical staff and the outcomes of such meetings can be used as a log of important developments in the medical student’s progress. Non-description observations seen on placement, such as an interesting ward handover or a multi-disciplinary meeting can also be logged. A portfolio is a personal account of your time at medical school and should be treated as such. Personal and professional experiences and your thoughts, feelings and emotions about these experiences allow you to be distinguished from other students. Personal endeavours such as conferences you have attended are also valuable to describe and reflect on. This can help to build up your CV in preparation for future job applications.
How the portfolio is assessed can influence the type of work submitted. In a publication by the GMC linked to assessments (the GMC oversee the safe and effective education of medical students), they advise the medical schools to think carefully about how they take into account the portfolios. If they are summative (count towards your progression through the years or completion of medical school), this may affect the quality of reflection, for example, the student may not discuss their weaknesses in as much detail when reflecting about a particular medical event as they do not want to compromise their overall assessment. However, it is important to learn that the basis of reflection is identifying weaknesses and strengths and providing learning points from a particular event. The portfolio is often used to see your progression throughout your time at medical school, it is helpful to record ALL experiences, not just the ones that you will perform well in. Progress is an indicator of your professional development, a core process that occurs throughout your future career as a doctor. This is especially important in clinical skills. On starting medical school, when first learning to take medical histories on placement, you may not be as accurate or follow the situationally appropriate medical history structure initially. As you start to develop the communication skills and get used to the adaptive structure of a history, you will improve. This progression is better demonstrated if honest reflection regarding each history taking event occurs.
Although this may seem far in the future, it is worth getting to grips with this important part of medical school, especially when thinking about reflection. Reflection is a lifelong skill which will help you to process challenging situations as well as progress through your career as a doctor.
Extra reading:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8902199/
https://www.gmc-uk.org/-/media/documents/outcomes-for-graduates-2020_pdf-84622587.pdf
Author: William Coni
Editor: Allegra Wisking
