ORGANISATION AND MANAGEMENT OF MEDICAL SCHOOLS: A …

ORGANISATION AND MANAGEMENT

OF MEDICAL SCHOOLS:

A SURVEY OF TEN U.K. UNIVERSITIES

August 2012

Report prepared by

Professor David Wynford-Thomas, Pro-Vice Chancellor and Dean of Medicine, University of

Leicester

With the collaboration of

Professor Paul Stewart, University of Birmingham

Professor Peter Mathieson, University of Bristol

Professor Paul Morgan, Cardiff University

Professor David Cottrell, University of Leeds

Professor Ian Greer, University of Liverpool

Professor Chris Day, University of Newcastle

Professor Ian Hall, University of Nottingham

Professor Tony Weetman, University of Sheffield

Professor Iain Cameron, University of Southampton

INTRODUCTION

From being at one time some of the most stable organisations in the country, UK universities (and

their medical schools) have over the last few decades been undergoing change at an ever-increasing

pace. Many of the drivers have of course been external– notably successive research assessment

exercises (RAEs) and the introduction of student fees. Increasingly, though, internal competition

within the sector has also become a major factor, as universities fight for league table rankings in the

struggle to attract the best students and staff.

Of course adaptive change can be beneficial, and indeed often essential, for survival. There is,

however, a down-side if change is reactive as opposed to planned. The last few RAEs provide a good

example of how relatively arbitrary decisions by an external body - in this case the way in which

research areas were grouped into Units of Assessment (UoAs) - led some biomedical faculties to

restructure along the same lines, only to find that the rules had changed again (or even reverted !)

by the next assessment exercise. The internal market can also trigger such “knee-jerk” responses as

when an unexpected fall in the league table ranking leads a university to believe that “restructuring

must be the answer”.

Change therefore has a tendency to become self-perpetuating and infectious – which might not

matter if it did not also incur massive costs, both in time, money and, not least, staff morale. There is

a need therefore to take a more scientific approach to evaluating the need for change and

determining the most cost-effective models of organisation, if this potentially endless spiral is to be

kept in check.

This report is an initial step towards this goal, focussing specifically on Medical Schools. It is

essentially a descriptive cross-sectional study, comparing and contrasting the current organisational

structure and modus operandi of a sample of provincial medical faculties and their host universities.

It is intended to lay the foundations for subsequent work which will analyse the rationale behind the

choice of models and their subsequent effectiveness.

METHODS

Ten provincial universities with medical schools from across England and Wales were chosen to

represent as homogeneous a group as possible with respect to potential confounding factors such as

size and history (hence excluding for example the “new” Medical Schools, as well as Oxford and

Cambridge). These institutions are: Birmingham, Bristol, Cardiff, Leeds, Leicester, Liverpool,

Newcastle, Nottingham, Sheffield, and Southampton.

Information on organisational structure was initially gathered by searching sources in the public

domain - including university and faculty/school web sites, and annual reports. Draft organograms

were then sent for comment and correction to Heads of Medical Schools/Faculties and/or their

Senior Administrators.

Since structure does not always allow accurate prediction of function (which was ultimately the

purpose of this survey), we next sought information on policies and processes (particularly relating

to strategic decision making and resource management) by means of a structured questionnaire

sent to the above staff (reproduced in Appendix C).

RESULTS AND DISCUSSION

The organograms in Appendices A and B set out the organisational structures pertaining at the time

of writing in the ten universities included in this survey. Appendices A describe the structural units

while B shows the corresponding senior staff posts and their reporting lines. Based on this data and

the responses to questionnaires, we have compared and contrasted the institutions with respect to

the following features: 1) internal structure and function of the Medical School; 2) its organisational

relationship with the wider university; 3) strategic planning and resource management.

1. Internal structure and function of Medical Schools: relationship between Teaching and

Research

The traditional model which operated in most schools until the late 20th century was for

departments to be based around the major clinical specialties (the “-ologies”), with each responsible

for all aspects of teaching (as well as research) in its own field. Overall co-ordination of teaching was

achieved through a Board/Committee structure, with administrative support from a “Medical School

Office” (often seen by students as the core of the “Med School”). Major external pressures affecting

both teaching and research over the last two decades have now led all schools to move away from

this model to a greater or lesser extent.

One of these external drivers has undoubtedly been the UK Research Assessment Exercises. These

have forced Medical Schools to focus their research on ever more specific areas in order to achieve

the critical mass needed for international excellence (indeed the RAE was originally termed the

Research Selectivity Exercise). A key consequence has been that only the very largest institutions

could attempt to maintain research excellence across all the traditional clinical specialties. Hence

nearly all institutions have instead created units (“Schools” or “Departments”) based on research-led

groupings. In some cases (eg Nottingham) these resemble the units of assessment of RAE2001 i.e.

Laboratory, Clinical and Community-based research. In most cases, however, they represent cross-

cutting research themes such as “Cancer Studies” or “Infection & Immunity”, resembling more

closely the Units of Assessment of RAE2008 (and in some cases, eg Leicester, mapping exactly to

these – see Box 1).

In parallel with (and in part probably due to) the above, an equally significant change has occurred in

the organisation of undergraduate medical teaching in most schools, with a move towards much

greater centralisation. Following the lead of universities such as Newcastle, most have now

established dedicated units responsible for some or all aspects of the organisation and management

of the MBBCh, including the coordination of delivery of the curriculum, assessments and quality

assurance (Table 1). In many cases (such as Leicester, Liverpool and Leeds), these units have the

status of full departments, equal to their research-based counterparts described above (see Box 1),

although terminology varies (an increasingly common variant being Research “Institutes” and

Teaching “Schools”). One obvious advantage of this model is that the existence of a specialist

teaching department should strengthen the management and organisation of the MB BCh

programme and gives a clear identity and visibility to the unit (and staff) responsible.

One driver for this model has undoubtedly been the increasing “professionalization” of medical

education over the last two decades, resulting of course from external changes (led by the GMC) but

also from an increasing awareness of the importance of pedagogic principles by medical schools

themselves.

An additional, more indirect driver, however, has probably been the parallel change to research

theme based departments described above, since one (unwanted) consequence of the increase in

research selectivity resulting from this has been that, in any given School, some of the traditional

clinical specialties will no longer be included in the research portfolio and hence may not have

clinical academics associated with them. This creates an inherent risk of gaps in the coverage of the

curriculum which can only be filled by “commissioning” the relevant teaching from NHS partners.

The presence of a “professional” Teaching department with responsibility for overall coordination of

teaching is clearly valuable in managing such scenarios.

Not surprisingly, therefore, the majority of universities in this survey have now established

Departments/Units of Medical Education (exceptions include Bristol and Birmingham and until very

recently, Cardiff). Indeed the popularity of the model is underscored by the current demand for

leaders of such units -usually designated “Directors of Medical Education”; at the time of writing

there were no fewer than four national advertisements for such posts !

The evolution towards R-led departments plus a dedicated T department is well illustrated by Cardiff

- which was one of the last in our survey to adopt this model (see Box 2).

While the split “R + T” model is an understandable response to external drivers, it has led to some

unwanted effects, resulting from the quasi-disappearance of at least some traditional clinical

academic specialties in most schools. This is sometimes ad hoc, determined by the historical

distribution of research strengths (for example, orthopaedics and dermatology are no longer

represented in Leicester). Some “–ologies” however have been more universally disadvantaged,

notably pathology and radiology. While the negative effect on undergraduate education can and has

been mitigated by Medical Education Departments commissioning provision from the NHS, this does

not apply to post-graduate training, where the absence of visible clinical academics undoubtedly

deters would-be academic trainees in these specialties. This is particularly relevant to the ACF/ACL

programme where opportunities in any given school are potentially more restricted than would have

been the case in the traditional specialty-based model. (Interestingly, Newcastle has addressed this

issue by establishing a Clinical Academic Office led by a “Dean of Clinical Medicine”)

BOX 1 The split “R and T” model of Medical School organisation: Leicester as an example

This increasingly common organisational model consists of predominantly Research-based

departments together with a separate dedicated Teaching department. In this example, the R-based

departments (created by a major reorganisation in 2004) are based clearly on the Units of

Assessment of RAE2008. Prior to this there were no fewer than 32 departments representing all

clinical specialties (and sub-specialties) !

Research* Teaching

RAE2008: UoA1 UoA2 UoA3 UoA6, 7, 8

*note that some MB BCh delivery is still provided by these departments but all the organisation and

management of the course (including “commissioning” from NHS partners) is carried out by the Department of

Medical Education.

Table 1 Patterns of internal organisation in ten Medical Schools

[NB does not include units in other faculties/schools eg bioscience]

University Pattern of organisation

Split R plus T models with dedicated unit for MBBCh

curriculum delivery and management (see Box 1):- Leeds 3 R institutes plus 1 T institute

Leicester 4 R departments plus 1 T department

Liverpool 5 R institutes plus 1 T institute Sheffield 5 R departments plus 1 T academic unit

Cardiff (since 2011) 6 R institutes plus 1 T institute

Nottingham 4 R Schools plus 1 Medical Education Unit Southampton 4 R-based Academic Units plus 1 T Unit

Models with “Board of Studies / Committee” model for MBBCh management:-

Newcastle 7 R-based Institutes * Birmingham 4 R-based Schools, no dedicated T School

Bristol 2 R/T Schools

*The Medical Education “unit” in this case is not primarily responsible for running the MB programme, but contribute inter

alia to development (of the curriculum, learning environments etc), evaluation and pedagogic research

Cancer

Studies &

Molecular

Medicine

Cardio-

vascular

Sciences

Infection,

Immunity &

Inflammation

Health

Sciences (Primary care,

Public Health etc)

etc

Medical &

Social Care

Education

BOX 2 Evolution of Medical School organisation: the Cardiff example

In 2004, Cardiff Medical School contained no fewer than 25 departments of widely varying size, each

with its own academic leadership and administrative support. Delivery of the MB teaching was

distributed across departments, with coordination and management of the course being carried out

largely by Boards and Committees. Through a process of merger of cognate departments, their

number was progressively reduced eventually reaching 9 roughly equally-sized departments by

2008. At the same time there was a firming up and centralisation of the management of the MB BCh

course, culminating in the establishment of a Medical Education Unit. During this time, research was

organised through a series of cross-departmental “Interdisciplinary Research Groups” (many

corresponding to the UoAs of RAE2008). In 2011, however, the clinical specialty-based model was

finally abandoned in favour of the R + T model, with the creation of 6 Research Institutes plus 1

Teaching Institute responsible for managing all aspects of the MB BCh programme.

2004: 25 departments based on clinical specialties

2008: 9 departments based on groups of cognate specialties

2011: 6 Research Institutes + 1 Teaching Institute

Cancer &

Genetics

Infection

&

Immunity

Molecular &

Experimental

Medicine

Psychological

Medicine &

Clinical

Neuroscience

Primary

Care &

Public

Health

Institute of

Medical

Education

Gen

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s

Path

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Hae

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Surg

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Car

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Re

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End

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Ger

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Translation,

Innovation,

Methodologies

& Engagement +

2. Location of the “Medical School” within the wider University structure: organisational

relationship with other disciplines

Nearly all universities in the survey have now adopted a “divisionalised” organisational structure,

based on a relatively small number of multi-departmental “Faculties” or “Colleges”. Particularly in

those which have re-organised more recently (where the term “College” is the norm), this is

associated with devolution of budgetary control and other management functions (see Section 3 for

further discussion). The notable exception to this pattern is Cardiff University, which has retained a

“flat” structure of 26 separate Schools with no higher-level unit of organisation (and is hence treated

separately in some of the analysis below).

The overall organisational pattern of 9 out of the 10 HEIs in this survey is therefore broadly similar,

with Medicine forming a large part of one Faculty/College, typically bearing a title such as “Medicine

& Health”. There are nevertheless subtle differences in the internal composition of such

Faculties/Colleges (Table 2a), which have a potentially significant “functional” impact.

Dentistry and Professions Allied to Medicine (PAMs)

One common feature of Medical Faculties/Colleges is that where the university also has

Departments/Schools of Dentistry and/or PAMs eg nursing or physiotherapy (which is true of all

except Leicester in this survey), these are nearly always co-located with Medicine. The one exception

is Southampton, which is unusual in having Medicine as a “single-discipline” Faculty, with PAMs in a

separate “Faculty of Health Sciences”.

Biological Sciences

In contrast to the above, another discipline closely linked to Medicine – Biological Sciences – is more

often than not separated off into a different Faculty/College, usually with Chemistry and the Physical

Sciences. This is the case in five universities in this survey (Table 2a). Only in two institutions

(Leicester and Liverpool) is Biological Sciences wholly grouped with Medicine. In the remaining two

(Nottingham and Newcastle) there is a split, with the more bio-medical (cell/molecular) areas of

Biological Sciences co-located with Medicine, while the ecology/plant sciences component is located

in a Faculty of Science.

The latter observation reflects the inherently dual-facing nature of Biological Sciences in most

universities (i.e. medical vs non-medical) which is potentially one factor explaining why the choice of

“partner” discipline and Faculty “home” for Biological Sciences is not as straightforward as with

Dentistry and PAMs. However, as discussed below, there is a more pragmatic explanation, based

simply on the size and balance between Faculties/Colleges in a given university.

Table 2b shows that the number of Faculties/Colleges per university in this survey varies from three

(Liverpool and Newcastle) to eight (Southampton and Leeds). There is a clear (and statistically

significant) trend (Fig 1a) for Biological Sciences to be grouped with Medicine in those university

with the fewest (and hence relatively largest) Faculties, with a “tipping point” at n=5, above which all

universities have Biological Sciences in a different Faculty from Medicine. Furthermore, of the three

institutions having five Faculties, in the two which have Dentistry plus PAMs (Birmingham and

Sheffield) Biological Sciences is separated from Medicine, whereas in the university with only PAMs

(Nottingham), they are grouped together (Table 2b, Fig 1b).

Although the numbers are small (and too low for any formal “cluster analysis”) these observations

suggest that the co-location of Biological Sciences in the same Faculty as Medicine is dependent

largely on the capacity remaining in that Faculty once Dentistry and/or PAMs have been included

(the assumption being that these disciplines are given first priority since they have no logical

alternative Faculty “home”). Or, in other words, in universities with numerous, “small” Faculties,

adding Biological Sciences to Medicine (+/- Dentistry and PAMs) would create a Faculty whose size

would be disproportionately large in relation to the other Faculties.

This conclusion is indeed consistent with the historical accounts obtained from several institutions

contacted in this survey.

We have not attempted here to explore the reasons why the number (and hence relative capacity)

of Faculties varies so widely between universities in our survey. It would be interesting however to

explore the unintentional consequences this decision may have had on the effectiveness of

collaboration between Medicine and Biological Sciences, given the key importance of this synergy in

both biomedical research and teaching and the inevitably greater practical difficulty of working

across as opposed to within Faculties/Colleges.

Psychology

In contrast to the above disciplines, the organisational location of Psychology in universities in this

survey appeared to follow no logical pattern (Table 2a), being unrelated to either the number of

Faculties or the nature of their other component parts. Thus Psychology is grouped with Medicine in

four institutions - having numbers of Faculties/Colleges ranging from three (Liverpool) to eight

(Leeds). Conversely it is in a separate “Science” Faculty in five universities (and in Southampton in a

separate “Faculty of Social & Human Sciences”).

Table 2a Composition of Faculties/Colleges containing Medical Schools

HEI Disciplines co-located in “Medical” Faculty

Medicine Dentistry PAMs Biological Sciences

Psychology

Group 1: Biological Sciences co-located with Medicine

Liverpool X X X X X Leicester X X X

Newcastle X X X* X

Nottingham X X X*

Group 2: Biological Sciences in separate Faculty/College from Medicine

Sheffield x x x Birmingham x x x

Bristol x x

Leeds x x x X

Southampton x

Cardiff N/A (26 separate Schools)

Table 2b. Relationship between Faculty/College number and composition and the “location” of

Biological Sciences

HEI Number of Faculties/Colleges Dentistry (D) or PAMs (P) in HEI ?

Biological Sciences co-located with Medicine ?

Liverpool 3 D+P YES

Newcastle 3 D YES

Leicester 4 - YES Nottingham 5 P YES

Sheffield 5 D+P NO Birmingham 5 D+P NO

Bristol 6 D NO

Leeds 8 D+P NO Southampton 8 P NO

(Cardiff N/A (26 Schools) D+P NO)

Fig 1a. Relationship between number of Faculties/Colleges and location of Biological Sciences in

nine HEIs

There is a significant trend for Biological Sciences to be co-located with Medicine where Faculties are

fewer in number, and hence relatively larger in relation to the whole university

0

1

2

3

4

5

6

7

8

9

Nu

mb

er o

f C

olle

ges

/Fac

ult

ies

in H

EI

Group 1: Biological Sciences in

SAME Faculty as Medicine

Group 2: Biological Sciences in SEPARATE faculty from Medicine

0.02<p<0.05

Fig 1b. Relationship between number of Faculties/Colleges, and presence of Dentistry +/- PAMs

on location of Biological Sciences

The overlap between Groups 1 and 2 in Fig 1a is “split out” according to the presence or absence of

both Dentistry (D) plus PAMs (P), improving discrimination between the groups (data from Table 2)

3. Role of the “Faculty of Medicine” in University leadership and management

In this section, we turn from “structure” to “function” and look at the role of the

“Faculty/College/School of Medicine” (and indeed the Dean or equivalent) in the development and

implementation of strategy in the ten universities surveyed, focussing in particular on the extent to

which strategic decision making and management of resources are devolved within the organisation.

3.1. Strategy (Table 3a)

In all ten medical faculties/colleges surveyed, there appears to be an acceptable degree of autonomy

in strategic decision-making in teaching and research, provided that local strategies broadly align

with central University strategy and policy. Such decisions might include for example the

introduction of a new MSc course or the prioritisation of a research area for investment. In no case

was there a feeling that such decisions were dictated by the “centre”.

However, there were variations in the exact level at which such local strategy is set. In five

universities, this was reported as being at the level of the “Medical” Faculty/College and in just two

at School/Department level. In the remaining three cases, there was a hybrid model with oversight

by the Faculty/College but extensive devolution to School/Department level.

0

1

2

3

4

5

6

7

8

9

Nu

mb

er o

f C

olle

ges

/Fac

ult

ies

in H

EI

Group 1: Biological

Sciences in SAME Faculty

as Medicine

Group 2: Biological Sciences in SEPARATE faculty from Medicine

NIL D or P D + P

Moreover, there were also significant differences between universities regarding the “upward”

influence of the Medical School/Faculty on central university strategy and policy. In five cases, there

is direct representation of the Medical School through the Dean (or equivalent) being a Pro-Vice

Chancellor and a full member of the University’s Senior Management Team. In the other five

however, the link is much more indirect, usually through a “functional” PVC (eg PVC Research or PVC

Teaching) who is given responsibility for the Medical / Bioscience faculties/colleges without

necessarily having any professional background in these fields. Historically, this used to be the

predominant model in most of the universities surveyed, and perhaps not surprisingly, where

respondents had experienced the switch to the newer “direct representation” model, this was

perceived as a major advance from a Medical School perspective.

Table 3a. Factors affecting development of Strategy in Faculties/Colleges/Schools of Medicine

HEI To what level is strategic decision-making affecting the Medical School devolved ?

What is the upward link between the Medical School and central University decision-making bodies?

College/Faculty School/Dept Direct, via presence of Dean (or equivalent) on University Senior

Management Team

Indirect, e.g. via a

“non-medical” PVC

Birmingham + + +*

Bristol + +

Cardiff n/a + +

Leeds + + Leicester + +

Liverpool + +

Newcastle + + Nottingham + + +

Sheffield + + +

Southampton + +

TOTAL 5 5 5 5

*via non-medical Head of College Arrows indicate further devolution within Faculty/College. TOTALS relate to lowest level of devolution

3.2. Resources (Table 3b)

Budget setting

In the majority of Faculties/Schools in this survey, annual budgets are now determined on a

formulaic basis, linked to Teaching and/or Research activity, i.e. a Resource Allocation Model (RAM).

Only one institution (Liverpool) reported retaining fully the traditional model in which budgets had a

“historical” basis, adjusted by an annual “bidding” process managed by the University centrally. One

university (Bristol) was in the process of moving from this older model to a RAM and another

(Birmingham) operated a “hybrid” model.

Devolution of budgetary control

There was considerable variation between institutions in the level at which budgets (once set) are

managed (Table 3b). Non-staff budgets were, in all but three cases, devolved down to

School/Department level. In contrast, staff budgets were more often controlled at Faculty/College

level. In four cases, control was entirely at this level; in another three, there was some further

devolution to School/Department level. In only three was there full devolution to this level (and in

one of these – Cardiff – this was inevitable due to the absence of Faculties/Colleges). Notably, in

many cases, irrespective of the above, Professorial posts are considered an exception, requiring

authorisation at University level.

Table 3b. Resource management in Faculties/Colleges/Schools of Medicine

HEI To what level are budgets devolved ? How are budgets set ?

Staff Non-staff Historical basis

Formula (RAM) College/

Faculty School/

Dept College/ Faculty

School/ Dept

Bham + + + + +/- +/- Bristol +/-* + +***

Cdiff n/a +** n/a + +

Leics + + + +

Leeds + + + + + Lpool + + +

Ncastle + + +

Nttham +** + + Sheff + + + + +

Stton + + +

TOTAL 3(4) 6 3 7 2(3) 7(8)

*University authorisation required for all posts **University authorisation required for Chairs ***Moving to Formula basis Arrows indicate further devolution within Faculty/College. TOTALS relate to lowest level of devolution (figures in brackets take account of “partial” status)

CONCLUSIONS

UK medical schools have been undergoing a period of “convergent evolution” over the past two

decades, as a result of which they now share many common features (or at least variations on a

common theme).

For example, most schools have adopted a model of internal organisation based on discrete

“research” and “teaching” units (although the exact remit of the T unit varies from full responsibility

for programme delivery to a more supportive role in development and educational research).

Likewise, most institutions now operate a devolved system of management and budget allocation

(though the exact “level” of control varies from Faculty/College to School/Department).

Nevertheless, there remain some major differences, in both form and function.

Apart from the single exception of Cardiff (which is itself now under review), in all institutions

Medicine forms part of a larger faculty or college. However, there is a major difference in the choice

of related disciplines, with roughly half of our sample grouping Biological Sciences in the same

faculty/college as Medicine and half not.

There is also a similar 50:50 split in relation to an important functional issue – the direct

representation (or not) of the medical school/faculty on the university senior management team.

Anecdotally, there is a strong preference for this newer model amongst Medical Schools, but with

potentially opposing views from an institutional perspective.

Clearly, the present cross-sectional survey does not allow an objective assessment of the relative

merits of any of the different models described here. It does, however, highlight major, persisting

differences between institutions whose potential functional impact, we believe, is of sufficient

magnitude to justify further work designed to enable such evaluation.

APPENDICES A1 to A10:

Organograms showing the structural organisation of each of the ten universities surveyed and the

position occupied by the units responsible for teaching and research in medicine and related

subjects (including in particular Biological Sciences)

(Note that only top-level information is shown for faculties/colleges not containing biomedical

schools or departments.)

KEY:

Principal units responsible for

organisation and management

of Medical Education

APPENDIX A1:

Organogram showing structural organisation and relevant sub-units: University of Bristol

University of Bristol

Faculty of Engineering

Faculty of Science

School of Biological Sciences

School of Experimental Psychology

School of Chemical & Geographical

Sciences

School of Earth Sciences

School of Mathematics

School of Physics

Faculty of Medicine & Dentistry

School of Oral & Dental Sciences

School of Social & Community

Meidcine

School of Clinical Sciences

Faculty of Medical & Veterinary Sciences

School of Biochemistry

School of Cellular & Molecular Medicine

School of Physiology & Pharmacology

School of Veterinary Science

Faculty of Social Science & Law

Faculty of Arts


organisation and management

of Medical Education

Core of “The Medical

School” as seen by

undergraduates

Note: Split of “biomedical” schools

across THREE faculties

APPENDIX A2:

Organogram showing structural organisation and relevant sub-units: University of Birmingham

University of Birmingham

College of Arts & Law College of Engineering

& Physical Sciences

College of Life & Environmental

Sciences

School of Biosciences

School of Psychology

School of Geography, Earth &

Environmental Sciences

School of Sport & Exercise Sciences

College of Medical & Dental Sciences

School of Dentistry

School of Cancer Sciences

School of Immunity & Infection

School of Health & Population Sciences

School of Clinical & Experimental

Medicine

CVS & Respiratory Sciences

Endocrinology, Diabetes &

Metabolism

Neuropharmacology & Neurology

Reproduction, Genes & Development

Medical Science & Education

College of Social Sciences


organisation and management of

Medical Education

APPENDIX A3:

Organogram showing structural organisation and relevant sub-units: University of Leeds

University of Leeds

Faculty of Business Faculty of Education

& Social Sciences Faculty of Biological

Sciences

School

of Undergraduate Studies

School of Graduate Studies

Systems Biology

Molecular Cell Biology

Integrative & Comparative Biology

Faculty of Medicine & Health

School of Dentistry

School of

Psychology

School of

Healthcare

School of

Medicine

Leeds Institute of Genetics, Health &

Therapeutics

Leeds Institute of Molecular Medicine

Leeds Institute of Health Sciences

Leeds Institute of Medical Education

Faculty of Maths & Physical Sciences

Faculty of Engineering Faculty of Performing

& Visual Arts Faculty of

Environment

Core of “The Medical School”

as seen by undergraduates



Medical Education

APPENDIX A4:

Organogram showing structural organisation and relevant sub-units: University of Leicester

University of Leicester

College of Science & Engineering

College of Medicine, Biological Sciences

& Psychology

Dept of Biochemistry

Dept of Genetics

Dept of Cell Physiology &

Pharmacology

Dept of Biology

Dept of Infection, Immunity

&Inflammation

Dept of Cardiovascular

Studies

Dept of Cancer Studies

Dept of Health Sciences

Dept of Medical & Social Care Education

School/Dept of Psychology

College of Social Sciences & Law

College of Arts & Humanties


as seen by undergraduates

Principal unit(s)

responsible for

organisation and

management of

Medical Education

APPENDIX A5:

Organogram showing structural organisation and relevant sub-units: University of Liverpool

University of

Liverpool

Faculty of Science &

Engineering

Faculty of Health &

Life Sciences

Institute of Learning

& Teaching

School of Dentistry

School of Health

Sciences

Scholol of

Psychology

School of Veterinary

Science

School of Medicine

Institute of

Integrative Biology

Dept of Evolution

Ecology & Behaviour

Dept of Functional &

Comparative Genomics

Dept of Biochemistry

& Cell Biology

Dept of Structural &

Chemical Biology

Dept of Plant

Sciences

Institute of

Translational Medicine

Dept of Biostatistics

Dept of Cellular &

Molecular Physiology

Dept of Molecular &

Clinical Cancer

Medicine

Dept of Molecular &

Clinical Pharmacology

Dept of Women &

Children's Health

Institute of Infection

& Global Health

Dept of Infection

Biology

Dept of Clinical

Infection, Microbiology

& Immunology

Dept of Epidemiology

& Population Health

Institute of Ageing &

Chronic Disease

Dept of

Musculoskeletal

Biology

Dept of Eye & vision

Sciences

Dept of Obesity &

Endocrinology

Institute of

Psychology, Health &

Society

Dept of Health

Services Research

Dept of Health

Inequalities & Social

determinants of Health

Dept of Mental

Health & Well-being

Dept of Biological &

Developmental

Psychology

Dept of Risk, security

& Decision-making

Faculty of Humanities

& Social Sciences


as seen by undergraduates Principal unit(s) responsible for


Medical Education

APPENDIX A6:

Organogram showing structural organisation and relevant sub-units: University of Newcastle

University of Newcastle

Faculty of Humanities & Social Sciences

Faculty of Science, Agriculture & Engineering

School of Biology

School of Chemistry

School of Chemical Engineering

School of Civil engineering &

Geosciences

Schol of Mechanical & Systems

Engineering

School of Computing Science

School of Mathematics &

Statistics

School of Electrical Electronic &

Computer Engineering

School of Marine Scinece

School of Agiculture Food & Rural Development

Inst for Research on Sustainability

Digital Institute

Faculty of Medical Sciences

Inst for Cell & Molecular

Biosicences

Inst of Cellular Medicine

Inst of Genetic Medicine

Inst for Ageing & Health

Inst of Neuroscience

Nothern Inst for Cancer Research

Inst of Health & Society

School of Biomedical Sciences

School of Dental Sciences


School of Medical Sciences Eduation

Development

Board of Medical Studies/Med student

Office

Units responsible for

organisation and

management of

Medical Education



undergraduates

Primarily

Research

Primarily

Teaching

APPENDIX A7:

Organogram showing structural organisation and relevant sub-units: University of Nottingham

University of Nottingham


Faculty of Science

School of Biosciences*

School of Pharmacy


School of Chemistry

School of Mathematical

Sciences

School of Computer Science

School of Physics & Astronomy

Faculty of Medicine &

Health Sciences

School of Biology**

School of Biomedical

Sciences

School of Molecular

Medical Sciences

School of Community

Health Sciences

School of Clinical Sciences

Medical Education Unit

School of Nursing, Midwifery &

Physiotherapy

School of Veterinary Medicine

Faculty of Social Sciences

Faculty of Arts

Principal units

responsible for

organisation and

management of Medical

Education



undergraduates

*Mainly agriculture / crop sciences

**Mainly genetics

APPENDIX A8:

Organogram showing structural organisation and relevant sub-units: University of Sheffield

University of Sheffield

Faculty of Arts & Humanities

Faculty of Social Sciences

Faculty of Science

Dept of Biomedical Science

Dept of Mol Biol & Biotech

Dept of Animal & Plant Science

Dept of Psychology

Other Depts

Faculty of Medicine,

Dentistry & Health

School of Health & Related Research

(ScHARR)

Dept of Human Communication

Science

School of Dentistry

School of

Nursing

School of

Medicine

Dept of Oncology

Dept of Cardiovascular

Sciences

Dept of IInfection & Immunity

Dept of Human Metabolism

Dept of Neuroscience

Academic Unit of Medical Education




undergraduates



Medical Education

APPENDIX A9:

Organogram showing structural organisation and relevant sub-units: Cardiff University

Cardiff University

School of Welsh

School of English

School of European

Studies

School of Journalism

School of Music

School of History &

Archeology

School of Law

School of Business

School of Social

Sciences

School of City

Planning

School of Archi

tecture

School of Postgraduate Med &

Dental Education

School of Dentistry

School of Biosciences

School of Medicine

Institute of Molecular & Experimental Medicine

Institute of Public Health & Primary Care

Institute of Cancer & Genetics

Institute of Neuroscience & Mental Health

Institute of Infection and Immunity

Institute of Translation, Innovation, Methodologies &

Engagement

Institute of Medical Education

School of Nursing

School of Healthcare

Studies


School of Cptometry

School of Chemistry

School of Physics &

Astronomy

School of Mathemati

cs

School of Computer Sciences

School of Engineerin

g

School of Earth

Studies

School of Lifelong Learning

Principal units responsible

for organisation and

management of Medical

Education



undergraduates

Note extreme “flat” structure with no

faculties or colleges

APPENDIX A10L:

Organogram showing structural organisation and relevant sub-units: University of Southampton

University of Southampton

Faculty of Business & Law

Faculty of Humanities Faculty of Social & Human Sciences

Faculty of Medicine

Cancer Sciences Academic Unit

Clinical & Experimental Sciences Academic Unit

Human Health & Development Academic

Unit

Primary Care & Population Sciences

Academic Unit

Medical Education Academic Unit

Faculty of Natural & Environmental Sciences

School of Chemistry

School of Ocean & Earth Sciences

National Oceonography Centre

School of

Biological Sciences

Cellular & Molecular Biosciences

Neuroscience

Ecology & EnvironmentI

Faculty of Health Sciences

Faculty of Engineering & the Environment

Faculty of Physical & Applied Sciences



undergraduates

Principal units

responsible for

organisation and

management of

Medical Education

APPENDICES B1 to B10

Organograms based on Appendices A, showing the principal academic posts and reporting lines in

the university, drilling down to the level of “Head of Department” or equivalent in the bio-medical

faculties/colleges

KEY:

Senior academics responsible for

Medical Education

Head/Dean of Medicine representing Medical

School externally e.g. on Medical Schools Council

University Senior Management

Team (University Executive Group)

[academic members only]

APPENDIX B1

Organogram showing principal reporting lines: University of Bristol

Vice-Chancellor

PVC Education

Dean, Faculty of Engineering

Dean, Faculty of Science

Head, School of Biological Sciences

Head, School of Experimental Psychology

Head, School of Chemistry &

Geographical Sciences

Head, School of Earth Sciences

Head, School of Mathematics

Head, School of Physics

Dean, Faculty of Medicine & Dentistry

Head, School of Oral & Dental Sciences

Head, School of Soical & Community Medicine

Head, School of Clinical Sciences

PVC Research & Enterprise

Dean, Faculty of Medical & Veterinary

Sciences

Head, School of Biochemistry

Head, School of Cellular & Molecular Medicine

Head, School of Physiology &

Pharmacology

Head, School of Veterinary Science

Dean, Faculty of Social Science & Law

Dean, Faculty of Arts

Deputy Vice-Chancellor



[academic members]


Medical Education

Head/Dean of Medicine

representing Medical School

externally eg on Medical Schools

Council

APPENDIX B2

Organogram showing principal reporting lines: University of Birmingham

Vice-Chancellor

PVC & Head of College of Arts &

Law PVC & Head of

College of Engineering &

Physical Sciences

PVC & Head of College of Life & Environmental

Sciences

Head, School of Biosciences

Head, School of Psychology

Head, School of Geography, Earth & Environmental

Sciences

Head, School of Sport & Exercise

Sciences

PVC & Head of College of Medical & Dental Sciences

Head, School of Dentistry

Head, School of Cancer Sciences

Head, School of Immunity &

Infection

Head, School of Health &

Population Sciences

Head, School of Clinical &

Experimental Medicine

Director of Research & Knowledge

Transfer

Director of Education

Dean of Medicine & Deputy Head of

College

Vice Dean (Medical

Education)

Vice Dean (Student

Development & Support)

Vice Dean (Applied Health

Research)

PVC & Head of College of Social

Sciences

PVC Research & Knowledge

Transfer PVC Education

PVC Estates & Infrastructure

Provost & Vice Principal

Senior academics responsible

for Medical Education

Academic members of University Senior

Management Team (Executive Board)

MDS College Board




Council

APPENDIX B3

Organogram showing principal reporting lines: University of Leeds

Vice-Chancellor

PVC Staff DVC

Dean Faculty of Arts Dean, Faculty of

Business

Dean, Faculty of Education & Social

Sciences

Dean, Faculty of Biological Sciences

Head, School

of UG studies

Head, School of

Graduate Studies

Director,

Systems Biology

Director,

Mol Cell Biol

Director, Integrative & Comparative

Biology

Dean, Faculty of Medicine & Health

Head, School

of Dentistry

Head, School

of Psychology

Head, School

of Healthcare

Head of School & Dean of Medicine

Director, LIGHT

Director, LIMM

Director, LIHS

Director,

Leeds Institute of Medical Education

Dean, Faculty of Maths & Physical

Sciences

Dean, Faculty of Engineering

Dean, Faculty of Performing & Visual

Arts

Dean, Faculty of Environment

PVC International Partnerships

PVC Research & Innovation

PVC Student Education

University Senior Management Team

(VC’s Advisory Committee) [academic

members]


Medical Education




Council

APPENDIX B4

Organogram showing principal reporting lines: University of Leicester

Vice-Chancellor

PVC Resources PVC Research PVC Students PVC College of Medicine, Biological

Sciences & Pscyhology and

Dean of Medicine

Head, Dept of Biochemistry

Head, Dept of Genetics

Head, Dept of Cell

Physiology & Pharmacol

Head, Dept of Biology

Head, Dept of

Infection Immunity & Inflamm

Head, Dept of

Cardiovascular

Sciences

Head, Dept of Cancer

Studies

Head, Dept of Health Sciences

Head, Dept of Medical & Social Care Education

Head, Psychology

PVC College of Science &

Engineering

PVC College of Social Sciences

& Law

PVC College of Arts &

Humanities


Team (VC’s Advisory Committee)

[academic members]


Medical Education Head/Dean of Medicine



Council

APPENDIX B5

Organogram showing principal reporting lines - University of Liverpool

Vice-Chancellor

PVC Student

Experience

PVC Science &

Engineering PVC Health & Life

Sciences*

Head, Institute of

Learning & Teaching

Head of School of

Dentistry

Head of School of

Health Sciences

Head of Scholol of

Psychology

Head of School of

Veterinary Science

Head of School of

Medicine**

Head, Institute of

Integrative Biology

HoD, Evolution

Ecology & Behaviour

HoD, Functional &

Comparative

Genomics

HoD, Biochemistry &

Cell Biology

HoD, Structural &

Chemical Biology

HoD, Plant Sciences

Head, Institute of

Translational Medicine

HoD, Biostatistics

HoD, Cellular &

Molecular Physiology

HoD, Molecular &

Clinical Cancer

Medicine

HoD, Molecular & Clinical

Pharmacology

HoD, Women &

Children's Health

Head, Institute of

Infection & Global Health

HoD, Infection

Biology

HoD, Clinical

Infection,

Microbiology &

Immunology

HoD, Epidemiology &

Population Health

Head, Institute of Ageing

& Chronic Disease

HoD, Musculoskeletal

Biology

HoD, Eye & vision

Sciences

HoD, Obesity &

Endocrinology

Head, Institute of

Psychology, Health &

Society

HoD, Health Services

Research

HoD, Health Inequalities

& Social determinants of

Health

HoD, Mental Health &

Well-being

HoD, Biological &

Developmental

Psychology

HoD, Risk, security &

Decision-making

PVC Humanities &

Social Sciences PVC International

DVC


[academic members]


Medical Education

** Includes role of

“Director of Medical

Education”

Head/Dean of Medicine representing

Medical School externally eg on Medical

Schools Council

APPENDIX B6

Organogram showing principal reporting lines: University of Newcastle

Vice-Chancellor

PVC Learning & Teaching

PVC Planning & Resources

PVC Research & Innovation

PVC, Faculty of Humanities & Social

Sciences

PVC, Faculty of Science, Agriculture &

Engineering

Head, School of Biology

Head, School of Chemistry

Head, School of Chemical Engineering

Head, School of Civil engineering & Geosciences

Head, School of Mechanical & Systems

Engineering

Head, School of Computing Science

Head, School of Mathematics &

Statistics

Head, School of Electrical Electronic & Computer Engineering

Head, School of Marine Scinece

Head, School of Agiculture Food & rural Development

Director, Inst for Research on

Sustainability

Director, Digital Institute

PVC, Faculty of Medical Sciences and

Dean of Medicine

Director, Inst for Cell & Molecular Biosicences

Director, Inst of Cellular Medicine

Director, Inst of Genetic Medicine

Dir ector, Inst for Ageing & Health

Director, Inst of Neuroscience

Director, Nothern Inst for Cancer Research

Director, Inst of Health & Society

Head, School of Biomedical Sciences

Head, School of Dental Sciences


Head, School of Medical Sciences

Eduation

Director of Medical Studies

(Board of Medical Studies)



(University Executive Board)

[academic members]


Medical Education




Council

APPENDIX B7

Organogram showing principal reporting lines: University of Nottingham

Vice-Chancellor

PVC Research & Engineering

PVC International & Science

Dean, Faculty of Science

Head, School of Biosciences

Head, School of Pharmacy



Head, School of Mathematical Sciences

Head, School of Computer Science

Head, School of Physics & Astronomy

PVC Teaching & Learning plus Medicine

& Health Sciences

Dean, Faculty of Medicine & Health

Sciences and Dean of Medicine

Head, School of Biology

Head, School of Biomedical Sciences

Head, School of Molecular Medical

Scineces

Head, School of Community Health

Sciences

Head, School of Clinical Sceinces

Director of Medical Education

Head, School of Nursing, Midwifery &

Physiotherapy

Head, School of Veterinary Medicine

PVC Enterprise & Social Sciences (exc. Law &

Business)

PVC Infrastructure & Law and Business

Schools

PVC Human Resources and Arts


(University Management Board)

[academic members]



Medical Education




Council

APPENDIX B8

Organogram showing principal reporting lines: University of Sheffield

Vice-Chancellor

PVC, Faculty of Arts & Humanities

PVC, Faculty of Social Sciences

PVC, Faculty of Science

Head, Dept of Biomedical Science

Head, Dept of Molec Biol & Biotech

Head, Dept of Animal & Plant Science

Head, Dept of Psychology

Other HoDs

PVC, Faculty of Medicine, Dentistry & Health

Head, ScHARR

Head, Dept of Human Communication Science

Head, School of Dentistry

Head, School of

Nursing

School of

Medicine

Head, Dept of Oncology

Head, Dept of CVS

Head, Dept of I & I

Head, Dept of Human Metabolism

Head, Dept of Neuroscience

Director, Academic Unit of Medical Education

PVC, Faculty of Engineering

PVC, Research PVC, Learning & Teaching PVC, International


Team (VC’s Advisory Committee)

[academic members]



Medical Education




Council

APPENDIX B9

Organogram showing principal reporting lines: Cardiff University

Vice-Chancellor

PVC Staff

HoS Welsh HoS

English

HoS European

Studies HoS Music

HoS History

PVC Students

HoS Journalism

HoS Law HoS

Business HoS Social Sciences

HoS City Planning

HoS Architectur

e

DVC

HoS PGMDE

HoS Nursing

HoS Health Care

Studies

HoS Medicine

Director, Inst of Exp Med

Director, Inst of Public Health & Primary Care

Director, Inst of Cancer & Genetics

Director, Inst of Neuroscience & Mental Health

Director, Inst of Infection & Immunity

Director, Inst of T.I.M.E.

Director, Inst. of Medical Education

HoS Bioscience

s

HoS Dentistry

Hos Pharmacy

PVC Research

HoS Optometry

HoS Psychology

PVC International

HoS Chemistry

HoS Physics

HoS Mathemati

cs

Hos Computer Sciences

HoS Engineerin

g

Hos Earth Sciences

HoS Lifelong Learning

University Senior Management [academic members] (also includes: PVC

Estates, Dean of Interdisciplinary Studies, and one elected Head of School)



Medical Education

Note: PVCs/DVC act as “links” between

Heads of School and University Board –

they do not have executive/budget

holding roles




Council

APPENDIX B10

Organogram showing principal reporting lines: University of Southampton

Vice-Chancellor

PVC Education PVC, Research PVC, International Dean, Faculty of

Humanities

Dean, Faculty of Social & Human

Sciences

Dean, Faculty of Medicine

Head, Cancer Sciences Academic

Unit

Head, Clinical & Experimental

Sciences Academic Unit

Head, Human Health & Development Academic Unit

Head, Primary Care & Population Sciences

Academic Unit

Head, Medical Education Academic

Unit

Associate Dean, Education & Student

EXperience

Dean, Faculty of Natural &

Environmental Sciences


Head, School of Ocean & Earth

Sciences

Head, National Oceonography

Centre

Head, School of

Biological Sciences

Cellular & Molecular Biosciences

Neuroscience

Ecology & EnvironmentI

Dean, Faculty of Health Sciences

Dean, Faculty of Business & Law

Dean, Faculty of Engineering & the

Environment

Dean, Faculty of Physical & Applied

Sciences




[academic members]



Medical Education




Council

APPENDIX C

Questionnaire sent to Heads of Medical Schools +/- senior administrators

UNIVERSITY / MEDICAL SCHOOL ORGANISATION & MANAGEMENT PROFORMA

Name of University: Click here to enter text.

1. Resources

1.1 To what level are financial resources (budgets) devolved within the University ?

Examples:

College/Faculty, School, or Department

Response: Click here to enter text.

1.2 How is the annual allocation to the above unit(s) determined ?

Examples:

a) on a historical basis, adjusted through an annual “bidding” process managed by a central

University budget-setting group, or

b) by a formula-driven Resource Allocation Model linked tightly to the devolved “unit’s” financial

forecasts of income and expenditure (HEFCE T and QR income etc)


1.3 Once the annual budget is set, what degree of flexibility / autonomy does the devolved unit

(and its head) have in deciding how to spend it?

Examples:

a) freedom to spend non-staff as appropriate, but use of staff budget restricted to specific posts

approved by “central” university group, or

b) freedom (within the agreed strategic plan for the “unit”) to decide on use of all budgets, including

changing the “mix” of posts in the staff establishment, and virement from staff to non-staff budgets


1.4 Specifically to what extent does the Dean of Medicine have executive powers over staff

budgets?


2. Strategy

How is strategy developed in the University and its Colleges/Schools/Departments?

2.1 At what level in the organisation are key decisions on strategic priorities taken (eg deciding

which research fields to focus on - and conversely which to disinvest in; deciding whether to develop

a major new teaching programme etc) ?

Examples:

University, College/Faculty, School or Department


2.2 If strategic decisions are devolved (eg to Schools), how are the resulting multiple strategies

integrated across the University?

Examples:

a) a “centralised” model – while “wish-list” plans may be solicited from component parts of the

organisation, a single University Strategy is produced, with all decisions taken at the “centre” (eg by

a University Board or Strategy sub-committee), or

b) a “devolved” model – at the agreed level of devolution (eg School) there is wide freedom to

develop strategy (within the devolved budget). The “centre” takes only a light-touch overview to

ensure general compatibility with the mission of the University. Apart from special pan-university

initiatives, the strategy of the University is largely made up of the sum of the individual unit

strategies.


2.3 Specifically, what part does the Dean of Medicine play in strategy development ?


Documents

ORGANISATION AND MANAGEMENT OF MEDICAL SCHOOLS: A …