# Addressing multiple long-term conditions in the undergraduate medical school curriculum: a focus group study

## TL;DR

Newly graduated doctors in the UK feel unprepared to manage patients with multiple long-term conditions, highlighting gaps in medical school curricula.

## Contribution

This study identifies specific educational gaps and learning needs for managing multiple long-term conditions in undergraduate medical training.

## Key findings

- Newly graduated doctors emphasized the need for better preparation to handle the complexity of patients with multiple long-term conditions.
- Undergraduate curricula were found to lack consistency and interprofessional learning opportunities for MLTC management.
- Senior clinicians were identified as key resources for improving learning experiences related to MLTC.

## Abstract

Patients with a chronic physical disease accompanied by other disease types or biopsychosocial factors– multiple long-term conditions (MLTC)– represent a major and growing clinical challenge. 17% of the population of England are forecast to fit this definition by 2035. The aim of this study was to understand and explore desirable MLTC-related learning outcomes identified by newly graduated doctors in the UK.

Focus groups were conducted across sites at two NHS trusts in Northern England with doctors in their second postgraduate year (Foundation Year 2 (FY2)). An iterative thematic analysis was applied to transcripts to identify and organise key themes.

Twenty-six participants across three focus groups reported their experience in primary and secondary care placements. The two overarching themes identified were: 1) ‘Practice needs’ for managing patients with MLTC. 2) ‘Education needs’ including limitations in undergraduate curricula. FY2s emphasised the concepts of uncertainty and complexity in practice, the variability of undergraduate learning experiences and gaps left by single-disease models of learning. Senior clinicians were highlighted as being key sources of support who modify learning experiences.

Newly qualified doctors find MLTC care challenging and feel ill-prepared to manage patients on entering the medical workforce. Suggested improvements for undergraduate curricula include enhancing interprofessional methods of learning and ensuring consistency of exposure to, and focus on, MLTC patient-related complexity across undergraduate placements and curricula.

Clinical Trial Number: Not applicable.

The online version contains supplementary material available at 10.1186/s12909-025-07484-1.