Bridging the Gap: Supporting the Transition from Medical School to Early Career Training
- Tess
- Nov 4
- 3 min read
The transition from medical school to early career training is a pivotal and often challenging phase in a doctor’s development. Early career doctors must adapt to the demands of the clinical environment, integrate and apply their growing clinical knowledge and skills, and manage significant workload pressures while maintaining their well-being. This period also requires balancing the dual identity of being both a learner and a contributing member of the healthcare workforce, navigating expectations from educational institutions and healthcare systems alike. These challenges are backed up by extensive research.
As an ePortfolio provider, we wanted to explore how digital portfolios can play a role in easing this transition, not just as repositories of evidence, but as tools that actively support learning, reflection, and assessment alignment across the continuum of medical education.
To explore this, we surveyed medical schools who are customers and non-customers, to learn more about their current practices. To understand the current landscape, we conducted a survey of medical schools, we received 9 responses from medical schools in Australia, UK, Sweden, and Czech Republic.
Here are the questions we asked, and the responses we received:
What We Learnt
Portfolios Are Common — But Not Aligned
Our research found that 78% of medical schools currently use portfolios as part of their undergraduate programs. If a portfolio is used, in all cases it’s introduced at the start of an undergraduate program, in Year 1. This is encouraging, showing widespread recognition of the portfolio’s role in supporting reflective practice and assessment.
However, most (67%) do not align their undergraduate portfolios with the systems used in prevocational or foundation training. This means that, while portfolios are widely adopted, they often exist in isolation — with different structures, assessment tools, and learning philosophies between undergraduate and early postgraduate stages.
A clear distinction emerged between:
the alignment of the tools or assessments they use with their students in practice, e.g. Mini-CEX or EPAs which were consciously aligned, vs.
the overarching portfolio approach and systems which were less aligned.
This misalignment creates friction at the transition point, where learners must adapt not only to new professional environments but also to entirely new systems for recording, reflecting, and being assessed.
What Medical Schools Are Saying
When we asked how the transition could be better supported, there was strong consensus among respondents, particularly from Deans of Medical Schools across different countries.
Their advice was clear:
“Align assessment.”
“Aim for continuity of portfolio and assessment frameworks.”
These succinct but powerful comments underline a shared recognition that alignment matters. When educational frameworks, assessments, and portfolios are designed to connect seamlessly, learners experience greater clarity, consistency, and confidence as they progress into clinical practice.
Why Alignment Matters
At its core, alignment helps to create a continuous learning journey rather than a series of disconnected stages. It allows students to build on their undergraduate experiences using familiar tools and reflective structures rather than starting from scratch as junior doctors.
Aligning workplace-based assessments (such as Mini-CEX, DOPS, and EPAs) across medical school and early postgraduate years ensures that learners understand what is expected of them and how to demonstrate competence in real-world settings.
ALL medical schools surveyed aligned clinical undergraduate assessments with the requirements/standards expected in pre-vocational or early-career roles., with one commenting; “Our year five teaching prepares students for their early-career roles, and the eportfolio accredits this preparation”.
However when it comes to portfolio alignment, the majority of medical schools surveyed do not align final year student portfolios with early career requirements. Less than half of medical schools align or partly align final year student portfolios with early career requirements.
The opportunity goes beyond assessments alone. True alignment means connecting the underlying pedagogy, reflective processes, and digital systems that support learning. When these elements are consistent, students don’t just learn to use a new platform, they develop professional habits that carry forward into their early careers.
A Shared Responsibility
Improving transition is not just the responsibility of medical schools or postgraduate training bodies alone, it’s a shared task. Collaboration between universities, health services, and ePortfolio providers can help create a more coherent educational experience for future doctors.
For example:
Medical schools can embed early exposure to workplace-based assessments and reflective portfolio use.
Training programs can ensure their systems build on, rather than replace, undergraduate experiences.
ePortfolio providers (like us) can design platforms that support longitudinal learning, data portability, and consistent assessment frameworks.
When all these elements come together, the result is a smoother, more confident transition, one that sets the foundation for lifelong learning and professional growth.
Consistency Is Key
The message from our research is simple: consistency is key.
Consistency in tools, in frameworks, in pedagogy, and most importantly, in the learning journey that supports new doctors from the classroom to the clinic.
As the boundaries between undergraduate and postgraduate medical education continue to evolve, the opportunity to create truly connected learning systems has never been greater.
To learn more, contact us.
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