Former RCP associate college tutor Dr Zahra Ravat reflects on a year spent championing resident doctor voices at University Hospitals Birmingham, where she and colleagues, including Dr Premal Patel, Dr Zachary Pierrepont, Dr Melyda Melyda, Dr Midhat Asif and Dr Rujina Begum, led educational improvement projects to shape training for the better.
When I first became an associate college tutor (ACT), I thought the role would be about supporting resident doctors with practical training issues and representing their views in meetings. Over the course of my time in the role, I have come to appreciate that it encompasses much more.
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The ACT role offered a unique opportunity to bridge resident doctors and the educators responsible for shaping our training experience. The role allowed me to understand not only the day-to-day challenges facing resident doctors, but also how to enact and embed change within organisations.
‘Most importantly, it showed me what can be achieved when resident doctors are given the opportunity to lead.’
Reflecting upon the past year at University Hospitals Birmingham (UHB), I'm incredibly proud of what our ACT team achieved together. The projects our team launched were meaningful but only demonstrate part of the story. The most impact came from fostering connections, building trust and ensuring that resident doctors felt their voices were heard.
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The importance of community became a recurring theme throughout the year. Medicine can be demanding and training can sometimes feel isolating, particularly in large organisations. One of the projects we relaunched was the IMT Fix-It! clinic, providing informal monthly drop-in sessions where internal medical training (IMT) resident doctors could seek advice, troubleshoot problems and connect with colleagues across different stages of training. Although initially established to address practical issues, the sessions quickly evolved into a space for honest conversation about our shared challenges, which helped to cultivate a sense of belonging among the resident doctors.
We were also given the opportunity to chair the IMT resident doctor forums, supported by the postgraduate team. These forums provided a regular peer-to-peer space for resident doctors to discuss concerns, share experiences and suggest improvements. We took minutes, tracked recurring themes and worked closely with college tutors and the postgraduate education team to ensure issues were acted upon. This work highlighted the importance of closing the feedback loop: ensuring that concerns were not only heard but also followed through with meaningful action.
I also had the opportunity to support the redevelopment of our Grand Rounds programme. Attendance had fallen significantly in the years following the pandemic, and there was a risk that an important educational tradition could be lost. By helping to automate processes and improve promotion through digital channels, we were able to contribute to a gradual recovery in attendance. The experience reinforced an important lesson: educational culture requires active investment.
‘Valuable learning opportunities do not thrive on their own; they need people willing to champion them.’
Witnessing the breadth of initiatives delivered by my fellow ACTs was truly inspiring. These included career support events, educational teaching, quality improvement projects and work to help resident doctors build confidence in future leadership roles, including a shadowing programme, ‘Acting up as the medical registrar’. Whether focused on education, wellbeing or professional development, each initiative shared a common goal: improving the training experience of resident doctors.
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Some of my fellow ACTs championed an extensive project focused on improving access to outpatient learning opportunities. They identified that many resident doctors felt overwhelmed by the sheer number of clinics available within a large tertiary centre. Information about which clinics offered valuable educational experiences was often difficult to find. Developing a clinic directory helped make those opportunities more visible and easier to access. While the intervention itself was relatively straightforward, it made a meaningful difference by removing barriers that prevented resident doctors from making the most of their training time.
Yet much of the important work happened behind the scenes. Throughout the year, ACTs delivered regional teaching, supported the PACES programme, participated in IMT peer mentoring, attended monthly meetings with college tutors and postgraduate education teams, and represented resident doctors at regional and national events. These activities rarely generate headlines, but they form the foundations of effective educational leadership. They create opportunities for collaboration, ensure resident doctor perspectives are represented and help build lasting improvements that extend beyond a single training year.
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Evaluating the impact of our work was an important part of ensuring that our initiatives delivered meaningful improvements. I established the annual ACT impact report to document our shared projects, capture quantitative outcomes and incorporate testimonials from the ACTs who delivered these initiatives as well as the resident doctors who had benefitted from them. The report serves as a record of what we collectively achieved and offers a foundation upon which incoming ACTs can build.
Personally, the role has also been a significant source of professional development. It has strengthened my confidence as a leader, improved my ability to influence change and introduced me to an incredible network of colleagues who are equally passionate about education. Some of my favourite memories from the year are not linked to a particular project or meeting, but to the friendships formed and the shared sense of purpose that developed within our ACT team. The IMT end-of-year social, which brought resident doctors together to celebrate the year and connect outside the workplace, felt like a fitting reflection of that spirit.
‘If there is one lesson I have taken from being an ACT, it is that resident doctors should never underestimate the value of their perspective.’
The ACT role was created on the idea that those experiencing training every day are often best placed to identify what is working well, what could work better and where change is needed. As I hand over to the next generation of ACTs at UHB, I feel optimistic about the future. Our projects will continue to evolve, and the culture of resident doctor engagement and leadership will continue to grow. The improvements made this year were only possible because resident doctors, educators and postgraduate teams worked together with a shared commitment to making training better.
‘For anyone considering becoming an ACT, my advice is simple: get involved.’
You may begin the role hoping to make a difference to your fellow resident doctors. What you might not expect is how much the experience will change you too.
Dr Zahra Ravat
Former RCP associate college tutor
