The Balint Group Scheme for Medical Students
at King's College London GKT (Guy’s, King’s and St Thomas’)
School of Medical Education
GKT School of Medical Education is the largest medical school in Europe and the only medical school in the UK running mandatory Balint groups for all 3rd year (first year clinical) students. The groups began as an optional SSC (Student Selected Component) in 2017/18 and then as a mandatory component of longitudinal psychiatry placements from 2018.
Around three hundred 3rd year medical students have their longitudinal placements and Balint groups at SLaM (South London and Maudsley) NHS Trust; a parallel scheme provides for a further one hundred GKT students at Oxleas Trust. Each group meets approximately fortnightly during the 2 academic terms (September to December and January to May) providing at least 12 sessions during the year. The groups last for 50 minutes and are followed by a 50-minute leadership supervision group, with an intervening break of 20 minutes allowing for discussion between the co-leaders.
In SLaM we run twenty-eight Balint groups with around twelve students in each group. The groups are co-led by a consultant psychiatrist and a specialty trainee in psychiatry (ST). All co-leaders attend a training session before groups start. Most consultants lead groups as part of a broader teaching role in the medical school so participate every year, whilst the majority of the STs co-lead for a single year as part of their mandatory psychotherapy training. This has allowed substantial leadership experience to develop over the five years that the scheme has run with more experienced leaders now being paired with those new to the leadership role (although STs will all have been participants in Balint groups for 2 years during core training).
Supervision groups comprise of two or four co-leader pairs and two co-facilitators. Both facilitators are accredited with the UK Balint Society – one a Consultant Psychiatrist in Psychotherapy (Medical Psychotherapist) at SLaM and the other an external supervisor with a medical background and experience in psychiatry. Supervision sessions are run on a Balint model with one group being presented as a ‘case’ by a co-leader pair who later sit back whilst other co-leaders discuss the group before they re-join. Whilst the patient interaction that the student has presented in their group is briefly described, the discussion is focussed on how the student group worked with it rather than considering the case itself. So, the supervision group explores issues such as student attendance, individual student behaviour, type of cases brought, themes arising, student identifications, group dynamics and how the co-leadership pair is functioning.
Feedback from students and group leaders outside of the two years most impacted by the pandemic (2019–21 with all groups undertaken online in 2020/21) has been largely positive but has also identified several areas for attention. Some challenges are likely to pertain to all medical student Balint group schemes, and others more applicable to large cohorts of students and mandatory attendance.
We continue to refine our scheme accordingly, most recently by focussing leadership training on engagement including promoting better understanding of the rationale and ‘learning objectives’ of this unique experience in their training. Leaders have also been advised to encourage students to consider how groups form and work well and the relevance of group work to their future career in medicine.
Dr Barbara Wood
Consultant Psychiatrist in Psychotherapy
Maudsley Medical Psychotherapy Service
Psychotherapy Tutor SE Thames Training Scheme
Undergraduate Lead for Reflective Practice GKT School of Medicine
December 2023