Barriers to student access to patients in a group of teaching hospitals

Objectives: To determine the number of patients in our teaching hospitals who were, on any given day, both available and willing to see medical students. Design and setting: Repeated cross-sectional audit in four teaching hospitals in the greater Newcastle area of New South Wales (one tertiary referral hospital, two district general hospitals, and one hospital combining general medicine and surgery with specialised oncology services). Audits were conducted three times, 2 months apart. Participants: All adult inpatients in the four hospitals. Main outcome measures: Numbers of patients present and accessible to students, present but inaccessible, absent, or unfit to be seen for clinical reasons; numbers of patients who agreed to history-taking and physical examination by a medical student. Results: Of 1960 patients, 959 (49%) were present and accessible to students. Only 11% were absent, and the most common reason students could not see patients was that the patients were said by nursing staff to be unfit to see medical students (25%). Of those present and accessible, 70% said they would agree to provide a history, and 67% that they would agree to physical examination. Conclusions: Across all four teaching hospitals about 200-250 patients are available and willing to see medical students on any given day. This is too few to provide our current student population of 500 with extensive clinical experience.