Students will spend 6 weeks in full-time clinical attachments in Primary Care, Medicine and Surgery. This will involve patient-based experiences, independent learning and structured teaching. Students will be required to keep a logbook record in all three placements, in which they will document their learning, clinical competencies and associated reflections. In each attachment students must complete 2 reflections of no more than 500 words each. One reflection should be based on a practice Assessment of Clinical Competence (ACC) and the other should incorporate aspects of either patient safety or multi-disciplinary working. These will form the focus of a discussion with their tutor at the end of each placement.
In addition to the eighteen weeks spent in Medicine Surgery and Primary Care there will be a week prior to the commencement of the first placements where sessions will be run in Winchester focussing on Clinical Skills required for the start of the placements. Following the final placement there is a week allocated to allow students to make up any sessions they may have missed and complete outstanding assessments or obtain outstanding signoffs in the logbooks.
In addition there will be opportunities in this week for students to undertake a “student-selected unit” whereby experience can be gained in a clinical environment that interests each student. Co-ordination of these units will be done by the BM4 Team in Winchester and is subject to availability in each clinical area.
Within each week of teaching on the Medicine and Surgery Attachments it is proposed that the students have the equivalent of 1 full day for tutorials and 1 half-day for self-study. The half-day of self-study can be spent away from the hospital or can be spent seeing patients, attending clinics or seeking out additional learning opportunities to suit individual student needs.
The tutorials are held on Thursdays, predominantly in Winchester and take the form of student-directed teaching in the style of plenary sessions. These sessions are hosted and co-ordinated by the Medical and Surgical Leads for BM4 and are integrative and may include 3rd-year BM5 students when appropriate. These sessions would include morning case presentations and seminars rather than didactic teaching and would cover material across all the medical and surgical subspecialties. The afternoons include sessions in Radiology, Pain Management, Anaesthesia, Palliative Care, and Critical Care as well as sessions focussed on teaching Clinical Skills not covered elsewhere in the curriculum.
Medicine and Elderly Care (6 week placement): Each student will be allocated to two medical subspecialties for 2 weeks each. The medical specialities that they could be allocated to are as follows:
- Care of the Elderly
- Respiratory
- Endocrine
- Cardiology
- Gastro-intestinal. The time in these specialties would be spent as part of the clinical team providing care to all patients within that subspecialty. This would include attending regular ward-rounds, led by both Consultants and Registrars, as well as attending outpatient clinics. In addition to this, students will have a week on the Acute Assessment Unit and an “elective” week, which will allow students to attend a number of sessions in the following in Medicine:
- Critical Care (ICU / HDU)
- Emergency Medical Assessment Unit (EMAU)
- Cardiac catheter laboratory
- Accompanying ECG / Echocardiography technician
- Endoscopy / Bronchoscopy
- Pulmonary function testing
- Dialysis unit
- Microbiology ward round
- Outpatient Clinics. Sessions in these areas will depend on availability of sessions and time spent can be during the sessions set aside for self-study and learning. Students who actively seek out opportunities will get more from their placements.
Surgery (6 week placement): Each student will spend 2 weeks in Trauma & Orthopaedics, 1 week in each of Hepato-Biliary Surgery, Colo-Rectal Surgery and Urology and 1 week covering Surgical Emergencies. During these rotations there will be sessions allocated to cover aspects of Breast Surgery, Vascular Surgery and some exposure to Anaesthesia.The time in these subspecialties would be spent as part of the clinical team providing care to all patients within that subspecialty. This would include attending regular ward-rounds, led by both Consultants and Registrars, operating theatre sessions, outpatient clinics and participation in the acute surgical “take”. It is not expected that students will cover the smaller surgical subspecialties of Ophthalmology, Otorhinolaryngology, Maxillo-facial Surgery or any of the tertiary surgical subspecialties of Cardiac, Neuro or Plastic Surgery.
Primary Medical Care and Long term Conditions (6 week placement): Students will be placed for 7 sessions per week in a General Practice and have a facilitated small group session each week with a GP teacher. In addition, they will have one day of self-study to enable them to undertake additional community based health care learning experiences to suit their individual needs as well as to work on other aspects of their logbooks and personal study.