Major education and research consequenses when Karolinska University Hospital receives fewer patients

The medical programme and eight other programmes at Karolinska Institutet will be affected when fewer patients and patient groups are cared for at the new Karolinska University Hospital Solna. This is what has been revealed in Karolinska Institutet's internal impact assessment analyses. Research will also be affected.

Karolinska University Hospital Solna, will become a highly specialized hospital, and large patients groups will be transferred instead to other care- and specialist units. This is just one of the changes in healthcare services being implemented by the Stockholm County Council, SLL.

An internal analysis shows how these changes affect Karolinska Institutet’s education and research. The Board of Higher Education, on behalf of the acting vice-chancellor, has analysed the consequences for education at KI. One of the most significant consequences is that, if no action is taken, students who undertake so-called “clinical training” (VFU), or courses at Karolinska University Hospital Solna, no longer will achieve certain learning- and examination goals. The medical programme is the programme most affected, when, among other things, the new intensive emergency care unit will receive fewer patients and with a limited range of diagnoses.

”Medical students need to encounter patients with common and acute conditions in order to be able to independently diagnose and treat these patient populations. Furthermore, there must be arenas for interdisciplinary learning in order for students to learn the ability to work in a multidisciplinary environment. In some cases, all students in a specific course will be affected,” says Annika Östman Wernerson, Dean of Higher Education at Karolinska Institutet.

The Board of Higher Education suggests several measures. Among other things, the number of diagnoses performed in the hospital should be increased, and the departments of clinical education (KUA) and clinical education clinics (KUM) should remain at Karolinska University Hospital Solna. The number of places within specialist outpatient care, should also increase through the establishment of new academic specialist centres. In the agreement, where new care providers receive a care assignment, a training and research task must also be clearly included.

“We must, naturally, adapt to changes in society, but one must also have real respect for the fact that when we make such extensive changes, it takes time – it’s not like moving chess pieces. In the long run, if you have to move large student groups and educational assignments, you also have to move teaching resources and resources for teachers,” says Annika Östman Wernerson.

Clinical research is also affected

Annika Östman Wernerson also states that since the teachers also conduct research, this also affects clinical research, and the risk is that the mandatory research link in education will be threatened when students are moved to new care units.

“Ultimately, if our students do not receive good or sufficient clinical training, then there is a risk that they will not develop optimum skills and techniques. Furthermore that the transition from student to active practitioner will be more complicated. Consequently, KI and SLL must actively work to achieve this in a satisfactory manner,” says Annika Östman Wernerson.

The Department of Molecular Medicine and Surgery (MMK) is one of the clinical departments at KI that has contributed to the impact assessments. Among other things, MMK runs education at bachelor’s and master’s level for students in medicine and physiotherapy, and has 25 research groups within preclinical and clinical research.

“Our research groups generally experience great uncertainty about what the changed care landscape will actually involve, which activities will be conducted within the new Karolinska University Hospital, and which will be conducted nearby? What will the dimensions of the emergency ICU be, and with which new care providers will it be important to interact with?,” says Anders Franco-Cereceda, Head of Department at MMK.

Since emergency care services at Karolinska University Hospital Solna constitute an important basis for research and training, the principal investigators at MMK see significant problems in continuing the activities.

He also states that the key problem is that the physical distance to patients will be greater, which will be difficult during a transition period.

Mid-June management meeting on next steps

“KI’s management has just received the impact assessments and is working on them. It is still too early for us to comment on this,” says Anders Ekbom, acting Pro-Vice-Chancellor at KI.

In mid-June, an internal meeting will take place, whereby the management at KI, together with representatives from the Board of Higher Education, the Board of Research and affected heads of department, will discuss the analyses and determine how KI will move forward.

Text: Helena Mayer

(To date, not all clinical departments have submitted their reports; they will be published when available)