What I Wish I Knew In Third Year

MSA Medical Students’ Association

What I Wish I Knew:

Becoming a Clinical Medical Student

Advice for students from

GKT MSA


Welcome to Third Year

•  The fun stuff starts here… “putting in to practice all you’ve learnt from first and second year” “the start of proper medicine”


In Today’s Talk

•  How Year 3 works •  How to get the most out of your

placements •  What you need •  Useful Resources


Getting started – what do I do now?

•  Learning in hospitals is an art in itself, and it can take a bit of time to get comfortable.

•  Things to do in the first week:

-  Meeting the Firm (if applicable) -  Find out how to bleep and the relevant

bleeps for your firm -  Confirm timetabled teaching


Clinical Learning •  Timetabled teaching •  Self-organized Teaching

- Firm Head Teaching -  Grand Rounds -  Ward Rounds

-  F1/SHO/Reg teaching

•  Independent Learning on the Ward -  On Call Clerking

-  History & Examination on the Ward -  Presenting to a clinician

•  Home

-Notes -Start early! Core cases


Formal Teaching –Top Tips!

•  On the wards clinicians will often ask what you want to learn about, have topics ready!

•  You will be expected to think in a clinical

way – when asked to give a differential diagnosis refer to VITAMIN MEN C


Firm Head Teaching

•  Your timetable should incorporate at least an hour of teaching each week from your firm head or a senior staff member

•  Bedside teaching is often most beneficial, so suggest this to your consultant if he/she asks what you want to do – remember, many of these consultants are OSCE examiners…


Registrar Teaching

•  Registrars will often offer in-depth teaching on essential topics

•  Asking questions is essential •  Don’t be afraid to clarify!


FY1/SHOs

•  Your friends on the wards •  They still remember being at medical

school •  Excellent for hands on experience, jobs

and sign offs!


Grand Rounds

•  You will be expected to do a presentation on a patient with an interesting learning point –ie Mr A with decompensated liver failure and a special teaching topic of Liver Failure

•  These will be marked and contribute to your overall ICA mark


A note… on ward rounds •  Ward rounds can be a lot of fun, especially

as you get to know your firm. •  There can be opportunities to meet some

interesting patients to clerk later and get some jobs

•  You can also learn to take notes and begin to understand patient management

•  Don’t waste your time though…


On the wards

•  Lots of histories and exams •  Try to spend as much time on the wards

as possible •  Try to clerk acute patients (ie on call) •  Present to a clinician – this is where the

real learning is!


Going On-Call •  On-call shifts can be a lot of fun •  They can also be really dull •  It doesn’t matter because you have to do one

anyway •  Some hospitals have sign-up systems; others

go through your firm •  On the general medical firms (A and C

Rotations), try and do at least one night shift and then come in for the post-take ward round


Clerking Patients

•  History Taking – get this right early – make it organised and complete

•  Develop your style of talking to patients –and remember it’s only a snapshot of our day


Things to Practice on Patients

•  Examinations – Ask a junior doctor whether they know of any

patients with interesting signs (and ask your peers – medicine is a team game, and you gain nothing from withholding information from your friends)

– The goal for practicing your examinations is to make them slick – you do not have a lot of time in OSCE’s to do an examination!


Working at home

•  A good set of notes is essential for the end of year

•  Volume is vast •  Have a relevant structure: ie Epidemiology, Clinical Features, Pathological Features, First Line Investigations, First Line Treatments


The Gordon Museum

•  The Gordon Museum can be a valuable resource or a complete chore, depending on your predilection towards anatomy and pathology.

•  However, it is vital that you know some pathology and it is better that you do it early and often than at the end of July

•  You will not get your books signed off if you are there for twenty minutes


What Do I Need?

•  A pen (bring two because an F1 will invariably appropriate one of yours)

•  Something to write on •  A pen torch (there are often loads of

freebees knocking around the hospital) •  Stethoscope •  Neurological stuff •  A watch with a second hand


Neurological Stuff

•  For your NOP rotation, you will need: – A Queen’s Square tendon hammer – A pen torch (try and find a free one in hospital,

but remember you will need one) –  (Optional) An ophthalmoscope (these are

expensive, and you will have adequate opportunity to get to use one)


Textbooks to buy •  People learn in different ways, but the following

books are pretty popular: –  Oxford Handbook of Clinical Medicine –  Kumar and Clark’s Clinical Medicine –  A clinical examination textbook – Macleod’s or

Hutchinson’s are the two popular texts –  ECG Made Easy –  Data Interpretation for Medical Students

•  Try before you buy! The library carry most of these


What Should I Wear •  You are going to work and your attire should

reflect your professional image •  Staff members will shout at you if you are

dressed inappropriately •  This means:

– Bare below the elbow – Tuck in all extraneous paraphernalia (excluding

lanyards) –  Ladies, be aware of varying attitudes towards low

cut blouses


Exam/OSCE revision

•  MasterPass •  PassTest – History books •  Youtube •  Data interpretation


What comes up in exams?

•  Common things, more depth •  Path and Therapeutics •  Clinical Relevance

•  Pot Luck


Useful Websites:

www.almostadoctor.com www.geekymedics.com www.meducation.net Question Banks : PassMedicine, BMJonExamination


MSA Peer Assisted Learning PAL

•  Being a tutor: –  Team up in groups of four tutors to deliver Phase 2

scenario-based teaching sessions throughout the year –  Practice essential skills such as making presentations and

having interactive teaching sessions –  Relearn important pre-clinical topics by teaching them!

•  Being a student: –  Receive teaching sessions from Phase 4 and 5 students –  Cover the need-to-know clinical topics in small groups –  Work on all your skills: examinations, histories, clinical

reasoning, presentation skills, and working in a team


Finally (1)

bit.ly/clinicaltalk


Finally (2)

•  Thank you for listening. •  Any questions, don’t hesitate to get in

contact: [email protected]

[email protected]

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What I Wish I Knew In Third Year