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The University of Southampton
Medical Education

Demise of the Firm

‘The firm’ is ubiquitous within clinical teaching – it is the key mechanism and organisational unit for apprenticeship style learning.

Despite its centrality within clinical medical education, it has rarely attracted sociological (or historical) scrutiny. Medical staff, in particular, tend to take ‘the firm’ for granted, for they themselves have undergone training within it. The term and its usage, however, effectively hide historical speciality and local variations of the ‘firm’ concept and masks the way in which the concept and its real life organisational practices have changed over time.

This project seeks to define the firm and make commonly held assumptions explicit. Through interviews it seeks to investigate what ‘the firm’ was – as an organisational unit with varied membership and tasks and, most importantly, as a site and mechanism for clinical teaching. The research attends to the way in which it has changed over time and endeavours to identify characteristics and differences between ‘firm’ structures, depending on locality and speciality.

Including medical students and nurses
A firm in 1935


Internally, the projects' findings were fed back through the Medical Education Research Forum and by presentations at the Away Days for Y3 and final year. Most importantly, this project has inspired our thinking in terms of the Beyond Competence project.

We gratefully acknowledge the research assistance provided by Sarah Bignold.

This project is subject to ethics approval from the School of Medicine Ethics Committee (reference: SOMSEC028.09 / Research Governance Reference: 6275)

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Seeking to define the firm and make commonly held assumptions explicit.

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