Do medical courses adequately prepare interns for safe and effective prescribing in New South Wales public hospitals?
OBJECTIVE
To assess ability of interns immediately before starting clinical practice in New South Wales (NSW) teaching hospitals to prescribe medications safely and appropriately and to describe their impressions of the adequacy of their clinical pharmacology training in medical school.


METHODS
A cross-sectional study was performed on all interns (n= 191) who attended intern orientation programmes at four NSW hospitals in January 2008. A clinical case scenario that tested prescribing ability and a survey investigating impressions of clinical pharmacology training in medical school were administered to the interns in exam format. Outcome measures were: (i) ability to prescribe medications safely and appropriately for the clinical case scenario and (ii) interns' impressions of their training in clinical pharmacology at medical school.


RESULTS
No intern completed all prescribing tasks correctly. No intern charted the patient's usual medications on admission completely correctly, only six wrote an accurate discharge medication list, and none wrote both an accurate discharge medication list and a legal Schedule 8 discharge script. None of the respondents strongly agreed that they felt adequately trained to prescribe medications in their intern year and 84% would have liked to have more training in pharmacology as medical students.


CONCLUSIONS
Interns about to commence clinical practice in NSW teaching hospitals demonstrated significant deficits in prescribing of regular medications, initiation of new therapies, prescribing of discharge medications, and particularly prescribing of Schedule 8 medications. Most interns recognized these deficits and would have liked more clinical pharmacology training at medical school.
Hilmer
S N
SN
Royal North Shore Hospital, St Leonards, New South Wales, Australia. shilmer@med.usyd.edu.au
Seale
J P
JP
Le Couteur
D G
DG
Crampton
R
R
Liddle
C
C
D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D003479:Curriculum / Q000592:standards* / Q000639:trends; D004504:Education, Medical, Undergraduate / Q000592:standards* / Q000639:trends; D005260:Female; D006779:Hospitals, Public / Q000592:standards* / Q000639:trends; D006801:Humans; D007396:Internship and Residency / Q000592:standards* / Q000639:trends; D008297:Male; D009517:New South Wales; D010601:Pharmacology, Clinical / Q000193:education / Q000592:standards; D055656:Prescriptions / Q000592:standards*; D055815:Young Adult