Long-Thin Induction at the University of St Andrews School of Medicine
Authors
ALUN HUGHES
Associate Dean Curriculum
University of St Andrews
Summary
St Andrews Medical School wanted students to understand their options and next steps before receiving formal letters about resits or termination of studies. It introduced early meetings following poor assessment results and a "long-thin" induction that spreads key information throughout the year rather than concentrating it in Freshers' Week.
The challenge
The University of St Andrews School of Medicine manages a significant volume of difficult communications around student academic progression issues, including resits, appeals, and termination of studies. The school was concerned that students were receiving formal letters of undesired outcomes without sufficient understanding of what these meant or what options were available to them. In response, those involved in supporting student progression (i.e. the Director of Teaching and the school’s student support team) set out to ensure no student was ever surprised or confused by an official communication.
There was also a more subtle challenge. Medical students often arrive with a strong sense of a single correct path and can experience any setback as a personal failure. Even considering options outside medicine can feel like an admission of weakness. The school wanted to create an environment where students felt able to have open, non-judgemental conversations about all their options, including those that diverged from their original plan.
The approach
The cornerstone of the school's approach is early intervention. Rather than waiting for formal outcomes to initiate contact, the school begins conversations with students at the first sign of difficulty. A student who performs poorly in a mid-semester assessment meets with the module controllers to discuss what the result means and what comes next. If a student fails the semester one module, a conversation takes place at the start of semester two. Students who reach a certain threshold of absences are also contacted proactively to check in and make sure they are alright. These precede or supplement existing University formal “academic alert” processes, ensuring appropriate central University support teams are also involved.
Underpinning all this is what the school calls a “long-thin induction,” where information is distributed in small, timely doses when it becomes relevant, rather than in a single intensive block in Freshers’ week. This approach ensures information is communicated when it becomes relevant and it helps students get to know key staff including their module controllers so they feel more comfortable approaching them when something goes wrong. The use of in-person lecture theatre slots allows for open discussion, and these sessions are supplemented with online materials such as short explainer videos and “frequently asked question” guides that are provided on the release of exam results.
The underlying philosophy is one of compassionate communication through awareness-raising. The aim is to ensure students always understand what is happening, know that it is acceptable to talk about their options, and never receive a formal letter as the first indication that something is wrong. By the time an official letter arrives, students should already know what it means and what they need to do. The school has also worked closely with registry to ensure that letters themselves are clear and signpost students to specific, appropriate support.
The impact
The shift in culture has been tangible. Students who attend early check-in meetings often arrive nervous, but the experience is typically reassuring. Subsequently, students tell each other about the supportive nature of the meetings, and this informal peer communication has helped build a broader culture of openness around academic difficulty and the discussion of options.
There have also been measurable changes in student behaviour. Students are more aware of relevant policies, and the school has seen an increase in appropriate use of support mechanisms such as deferrals and S-coding, alongside a reduction in appeals based on students claiming they were unaware of relevant information. Based on viewing statistics, approximately 10-20% of registered medical students engage with at least one video on support mechanisms each year.
Looking ahead, one area the school is keen to develop further is student understanding of the appeals process itself. More students are now using appeals, which in many ways reflects the increased engagement the approach was designed to foster, but not all have realistic expectations of what an appeal can achieve. The school is mindful that students in difficult circumstances have limited time and emotional energy, and does not want them investing significant effort in pursuing outcomes that the process cannot deliver. The next challenge, then, is not simply encouraging students to engage with the processes available to them, but helping them understand what those processes can and cannot accomplish.