A medical student curriculum on functional medical disorders

Background

Functional medical disorders (FMDs) refer to persistent physical symptoms that cause impairment or disability, but which cannot be explained by routine medical testing. Negative perceptions towards FMDs exist amongst a variety of healthcare professionals, including medical students. The aim of this study was to develop and evaluate a course addressing FMDs for medical students in their first year of clinical training, which was integrated within the formal medical school curriculum.

Approach

A multidisciplinary team of eight healthcare professionals delivered seven teaching sessions, each two hours in length, over six weeks. The curriculum was delivered via a combination of didactic teaching, small group tutorials and sessions with simulated patients. Pre- and post-course validated questionnaires assessed knowledge of, attitudes towards and confidence around irritable bowel syndrome (IBS). Students undertook a two-station objective structured clinical examination (OSCE), which assessed their ability to take a clinical history from and communicate a diagnosis to simulated patients with IBS and fibromyalgia.

Evaluation

Twenty-seven students completed the pre- and post-course surveys, which demonstrated an increase in knowledge of FMDs at course conclusion (88.89% vs. 57.50%, p < 0.001). Students' confidence ratings increased in all (100%) domains relating to FMDs: pathophysiology, symptoms, investigations for diagnosis and communicating a diagnosis (p < 0.001, all analyses). There was a statistically significant improvement in attitude ratings towards FMDs in 11 of 12 (91.7%) questions. All (100%) students passed the OSCE.

Implications

A course integrated within the formal medical school curriculum may be a helpful way to improve knowledge and reduce stigma around FMDs.