Student-to-Tutor Ratio: if things are to change, why not for the better?

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This article was exclusively written for The European Sting by Mr. Francisco Franco Pêgo, a fourth-grade student at the Faculty of Medicine of the University of Porto, Portugal. He is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.


The Covid-19 pandemic put many things into perspective in our lives. The “modus operandi” of a Medical School was no exception to this effect and medical students felt – for the better or the worse – the differences.

If the theoretical parts of the course had adequate alternatives such as online classes, the classes which take place in the wards with actual people were cancelled. Now that this component is lost, its benefit need for the teaching of Medicine is even more obvious.

If Covid-19 is to change something in every part of our society – and it will – we better make that change be positive rather than negative, starting from these practical classes that now are missed.

To answer the question in the title, we must define an optimal student-to-tutor ratio. It doesn’t seem that difficult. I guess you never heard anything like “It’s so great I only had 4 seconds to auscultate that person in order for every colleague to do it” or “I’m so glad all 10 of you are touching that sensitive part of my body”…

So, one can assume that “as small as possible” is a good way to define the optimal student-to-tutor ratio. Not forgetting that 1 or 2 colleagues in a group might add to confidence exchange of knowledge for students, unfortunately we are far from having to decide between those small numbers.

Therefore, what can we do to address the problem?

Of course, there are the always-obvious methods, suggested repeatedly: providing teachers-doctors a schedule considering both professional and educational activities, remunerating teachers, making them feel part of an educative plan. All those would incentivise a better prospect for practical classes. However, focusing on things that may come out of the pandemic, I lay down two not-too-matured ideas, which I expect to be subject to constructive scrutiny:

  1. Make theoretical teaching asynchronous and place emphasis on practical classes.

If students manage to record and assist to theoretical classes by themselves at home, they will have time to distribute themselves through the various days of the week for practical classes. Just as well, teachers will have fewer faculty obligations during those mornings at the faculty and hospital. More time to teach and learn means a more favourable student-to-tutor ratio.

  1. Plan and make teaching in wards efficient.

If there is one change being implemented in hospitals already is the need to think ahead and make no unnecessary moves. In many practical classes, students wait long times for the tutors to search for the available person or move between beds looking for adequate physical exam opportunities. Frequently a group does things in double or triple the time needed for those tasks.

If Covid-19 restrictions will make us anticipate what we are doing in a ward for safety reasons, maybe teaching and learning in this context will become efficient, allowing students to be in smaller consecutive groups. This could be a learning to maintain in the future.

About the author

Francisco Franco Pêgo is a fourth-grade student at the Faculty of Medicine of the University of Porto, Portugal. He has been involved in the organization of various activities at the local level an integrated two national Organizing Committees of his NMO. Besides studying, he has focused his activities also in clinical research at one of the faculty’s departments and participating and coordinating volunteering activities. Medical Education is, for him, an utmost topic of debate, especially among students.

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