AN ACADEMIC GUIDE TO FIRST YEAR MEDICINE Contents Welcome!
Frequently Asked Questions
SECHI and ISBM
PfPA and general advice
Please note that the information contained in this guide is advisory, and is correct as of August 2019.
WELCOME! Hello and welcome to medicine at Cambridge! I’m Ramya, a third year medic at Clare, and your Medsoc Academic Officer. Firstly, massive congrats on getting here; as we all know, the medicine application process is far from easy and now you’ve got through it, celebrations are definitely in order. Well done!!! Studying at uni is different from being at school, and whilst this is a really exciting change, it can be tough at times. That’s where Medsoc comes in—we’re here to support you every step of the way, whether that’s by being a point of contact for any academic queries (that’s me!), providing welfare support, or organising amazing events like Medsoc Ball. This guide is a whistle-stop tour of each component of the course in first year, and along the way I’ll provide handy tips and tricks from students that came before you. There’s textbook recommendations too, but please don’t go and buy them right away, as your college library will be well stocked.
My advice is to pace yourself and try out different styles of learning. From flashcards to making essay plans, there’s a whole host of ways that people can learn the same content. It’s worth experimenting to see what works for you, especially since the type and volume of information to learn is quite different from A-Level. The trick is to focus on what is helpful for YOU, rather than what others around you are doing. As Academic Officer, I’ll be organising talks from experts that enhance and complement the medicine course. This year’s series is called ‘Reimagining Medicine’ and is all about the huge changes that are shaking up the field- I’m so excited, and hope to see lots of you there! I’ll also be representing you on the Part 1 committee that includes all the course organisers, and I’d love you all to help me with this by giving me lots of feedback that I can take back to them to make a real change. So all that’s left to say is enjoy Cambridge! It’s truly an incredible place to study our subject, meet new people and try new things, and I have had a wonderful time so far. If you have any questions, drop me an email, send a Facebook message, or even just stop me in the street—I’d be so happy to help!
FREQUENTLY ASKED QUESTIONS Should I prepare for the course before I arrive in Cambridge? Short answer: you don’t need to feel obliged to do anything! Enjoying the rest of the summer holidays is far more important– after all, you’ve had a tough year prepping for A-Levels and it’s crucial to relax and look after yourself. Some colleges might set a little bit of reading or work before term starts, but if yours doesn’t then that’s absolutely fine, don’t worry at all. If you’re super keen to do some reading, then have a look at this page which gives some suggestions, but as I said this is completely optional: https://www.biology.cam.ac.uk/undergrads/MedST/Current/Freshers/ Prepwork. You won’t be expected to know loads when you get here, I promise you’ll learn it during your time at Cambridge!
How is the course taught and what will my timetable look like? The course is taught through a mixture of lectures (approx. 10 hours a week), practicals (around 4 hours a week) and dissections (6 hours per fortnight). In addition, there are small group supervisions organised within your college to help consolidate the material, and you’ll usually have 3 or 4 of these a week. Timetables are released by the Faculty of Biology in September, and you can download your timetable onto your laptop/phone calendar.
Will I have time to take part in extracurricular activities? Yes, absolutely! Medics enjoy taking part in a whole range of activities at both college and university level. From sports to music, from dance to arts and crafts, there’s so many societies on offer here, and being at uni is about far more than just studying the course. Definitely take advantage of the opportunities available!
What should I bring in terms of study materials? Usual stationery for example pencil case, paper, files etc. There’s no need to bring along your A-Level notes. Most people like to have a laptop– though every college has good computer rooms if you aren’t bringing one along. You’ll also have the opportunity to purchase a lab coat and safety glasses in the first week of term.
COURSE OVERVIEW The medicine course structure can be hard to get your head around (especially with quirky Cambridge specific words and acronyms) so here’s a quick overview of the next six years—to summarise, they’ll be fabulous! The preclinical component (i.e. 3 year undergraduate course) of the medical degree is called the Medical Sciences Tripos (or MedST) and is taught by the School of Biological Sciences. It is split into three parts: Part 1A (first year), Part 1B (second year) and Part II (third year). In Part 1A and 1B, you learn the basic sciences required to become a doctor. Part II is a compulsory intercalation year which allows you to specialise in a particular area of science or to explore a completely different subject– there’s loads of choices, and you’ll get plenty of advice on this closer to the time. You then progress onto clinical training for the last three years, where you will be based at the Clinical School located on the Addenbrooke’s Hospital Site.
It’s also worth knowing how Cambridge’s academic year is organised. In each year, there are three terms. Each term lasts eight weeks: Michaelmas (Oct—Dec), Lent (Jan—March) and Easter (April—June). You therefore get five week vacations at Christmas and Easter and a 3½ month long vacation over the summer. Also, for some odd reason that has never become clear to me, Cambridge weeks begin on Thursday. So, for example, Week 1 of Michaelmas Term this year will begin on the 10th October 2019. MedST Part 1A—this is what you’ll be doing in first year!
Part 1A is split into six courses and each will be explained in more detail later. I can’t stress how important it is to use every opportunity you have to give feedback on each course, as the organisers are genuinely willing to listen and many positive changes have been made to the content and exams in the past. Your courses in first year are: • FAB (Functional Architecture of the Body) - ANATOMY • MIMS (Molecules in Medical Science) - BIOCHEMISTRY • HOM (Homeostasis) - PHYSIOLOGY Plus the clinical strands of the course which are: • SECHI (Social and Ethical Context of Illness) • ISBM (Introduction to the Scientific Basis of Medicine) • PfPA (Preparing for Patients A)
FAB (Anatomy) Functional Architecture of the Body (FAB) is essentially the study of anatomy, and is taught via dissections and lectures. Learning comes mainly from dissection in the dissection room (DR). In first year, the upper limb, thorax, abdomen, pelvis and lower limb are studied. The anatomy of head and neck is covered in second year. There are three DR sessions per fortnight, each lasting 2 hours. You will share one cadaver with 5 or 6 other students for the year and demonstrators will always be on hand to help. There will be a dissection manual on Moodle (the Cambridge Virtual Learning Environment where all your resources are located) which will have the information you need to know for each dissection session and the exam. There will also be Applied Anatomy sessions for each body region where you can look at relevant clinical cases– most people really enjoy these as they give us a taste of what it’s like to be a doctor or surgeon! A note from Will, the Cambridge MedSoc Welfare Strategy Officer – as medical students ourselves, only a couple of years ahead of you lovely freshers, all of us on the MedSoc committee really do understand that the idea of starting dissection can be extremely daunting, so please don’t worry that you’re the only person who might be apprehensive in the run up to your first session. Ask any medic you can find – whether they’re a 2nd year medical student or a grizzled old transplant surgeon nearing retirement – and they will almost certainly say to you that their first time in an anatomy lab freaked them out, but that they did adapt surprisingly quickly. The DR staff will try really hard to make sure that you feel as comfortable as possible, and they’re all fantastic people. Learning anatomy through dissection is a great opportunity and lots of fun, but if you have any concerns at all then please chat to your anatomy supervisor in college, friends or anyone on the MedSoc committee. Ana and Az, our lovely Medsoc Welfare Officers, can be contacted at firstname.lastname@example.org. Lectures are once or twice a week and cover topics such as embryology, clinical anatomy and functional anatomy (i.e. the how the structures of certain parts of the body relate to their function), as well as skeletal, lymphatic and nervous systems. Exams (more info later on): This course is examined by multiple choice questions (MCQS, combined Section I/II) and essays (Section III). The MCQs are in a ‘steeplechase’ format– you move between stations and answer questions in a particular time period at each one, and there might be specimens or photos at the stations too. Don’t worry if it sounds confusing now, you’ll get plenty of practice at this format over the year. In addition, there’s the essay paper where you’ll answer two questions, one functional and one clinical.
Advice for FAB •
PRE-READ FOR DISSECTION—it’s important to have a good look through the notes in your dissection manual before going into each session. This will help you gain the most from each session, as you’ll be going in with a good idea of what to expect. By all means experiment with this approach though; some people pre-read extensively before a session whilst others prefer to pre-read quickly and spend longer consolidating the information after each session.
MAKE THE MOST OF DISSECTION SESSIONS—the demonstrators are an amazing source of knowledge and mnemonics, and as most of them have been practising doctors or surgeons at some point, they have some incredible stories to tell. Ask plenty of questions, and get involved in the dissecting itself.
DON’T NEGLECT THE LECTURES—though the dissecting room is the most memorable part of the FAB course, it’s crucial that you learn the material covered in lectures well (especially embryology) as this tends to feature very heavily in the exams.
ESSAYS—diagrams are wonderful to include in anatomy essays, and they don’t need to be complex or artistic at all. Planning is key– aim for a few clear and concise paragraphs with a strong introduction and conclusion.
Textbooks and Resources Textbooks are probably most useful for FAB out of all of the subjects– here are a few good ones:
Gray’s Anatomy for Students—an absolute staple book for med students everywhere. Great for diagrams and functional anatomy.
Clinically Oriented Anatomy (Moore & Dalley) - I loved this one for essays as it’s got amazing explanations that link directly to clinical applications.
Instant Anatomy (Whitaker) - fab for learning nerve and vessel pathways.
Anatomy atlases (e.g. McMinn’s, Rohen’s) - really good for steeplechase revision as they’ve got photographs of specimens.
The Developing Human (Moore) / Human Embryology (Larsen) - both good reference books for embryology which can sometimes be tricky to understand.
MIMS (Biochemistry) Molecules in Medical Sciences (MIMS) is the study of biochemistry and genetics. Teaching is divided into lectures, practical classes and problem based learning (PBL) sessions. The lectures each term are based around a certain disease, and you will have three each week. In Michaelmas, the lectures are based around diabetes, so topics will include metabolism, biological macromolecules, cell signalling and molecular recognition. In Lent, the main focus is cancer, therefore topics will include DNA replication and repair, gene expression, the cell cycle, genetics and cancer imaging and treatment. There are three day-long practical classes throughout the year, in which you will carry out a series of experiments. For each practical day, you’ll then have a debrief session two weeks later where you will discuss the results you have obtained. There is also a bioinformatics session during Easter term. There are two PBL sessions in the course, one in Michaelmas and one in Lent term. These are an opportunity for you to research and present information about a topic that you will be assigned, and are a good chance to practice presenting information to a small group. Exams: • Section I: MCQs and extended matching questions. These test detailed knowledge of the subject from the lecture notes. •
Section II: the written practical paper. Often considered the most challenging paper in first year, these questions relate loosely to the practicals you’ve done through the year but require lots of independent thought. Don’t worry though, everyone finds it challenging and doing practice papers can definitely help you feel a little more prepared.
Section III: in this section you will write three essays– one essay from Michaelmas term content (biochemistry), one from Lent term content (genetics) and one which will require you to think outside the box and combine information from both terms. The best prep you can do for this paper is essay plans to get used to thinking about the content, and practising writing timed essays.
Advice for MIMS •
DIAGRAMS AND MNEMONICS: just like for anatomy, it’s useful to draw diagrams and flowcharts for MIMS to summarise the content. There’s good diagrams for metabolism and genetics that can be found in textbooks or make your own. Similarly, mnemonics can be really helpful for learning pathways.
DON’T FORGET NUTRITION AND PBL: nutrition is not actually taught anymore, but there are a few pages on it in the handbook, and it does feature in the exams sometimes. The PBL sessions can also feature in the exam, and you’ll be given a summary of the information needed at the end of each session so don’t worry!
THINK OF THE BIG PICTURE: MIMS is full of little details, so I found it useful to get an overview of the topic first before focusing in on the specifics. This will help with the essay writing and aid your understanding of the topics as a whole. Learn the prologue and epilogue lectures after you have learnt the lectures from that term as they neatly summaries what you have covered.
PRACTICE PAPERS: these are so useful for MIMS, especially for the Section II paper. They really give you a feel for what you can expect in the exam.
Textbooks and Resources 1.
Principles of Biochemistry by Voet, Voet and Pratt (this is often simply referred to as VVP) - this book is so detailed and you definitely don’t need to know everything in it! However, I found it extremely useful for first term—it’s handy for clarifying lecture content and finding extra bits to include in longer essays you’ll be writing for supervisions (rather than the shorter, exam style essays)
Essential Cell Biology by Alberts - this is another HUGE textbook, but is worth the effort lugging it back from the library as it’s helpful for second term content. The diagrams are great, especially for topics like DNA replication which can be hard to visualise and conceptualise.
HOM (Physiology) The Homeostasis (HOM) course is concerned with the study of physiology and histology. Teaching is divided into lectures and weekly physiology and histology practical sessions. There are usually three lectures each week and these will cover a range of physiology topics. During the course of the year, you will study the nervous, musculoskeletal, cardiovascular, respiratory, renal, digestive, endocrine and thermoregulatory systems. The practical classes will allow you to see physiology in action and are a great chance for you to fully understand the subject. The histology (microscope) classes focus on the structure of the systems that you will be studying, helping you appreciate how structure relates to function.
Section I: MCQs testing lecture content. Like all the MCQ papers, detail is really important.
Section IIa: MCQs testing knowledge from the practicals. Some will be calculations and some will be questions based on the experiments you’ve performed through the year.
Section IIb: the histology paper, which is set up in stations with MCQs at each stations. One station will have a microscope and slides, whilst the others will have electron and light micrograph pictures.
Section III: essays. You choose two essays, which allow you to integrate different components of the course. Planning is so important for HOM essays to ensure you’re actually answering the question. The essays require understanding of the content rather than factual recall (that’s tested by the MCQs!)
Advice for HOM •
WHY, NOT HOW—in your essays, think about why things are the way they are, as opposed to listing how things happen. Place the topic before the facts– it’ll be a lot easier to understand the details.
FOCUS ON THE BIG THREE—the most examined topics tend to be cardiovascular, respiratory and renal physiology so check you know these well by the end of the year.
GRAPHS—these are great to add into essays! They don’t need to be super detailed; even just a quick sketch is sufficient.
GET TO GRIPS WITH ELECTRICITY—the first topic in HOM is neuronal physiology, and I personally found this really difficult at the time. If I could give my first year self some solid advice, it would be to look through basic electricity concepts and spend time understanding the equations from the practicals. Remember to practise using these equations as calculations do crop up on Section IIb.
HISTOLOGY IS IMPORTANT—the histology exam is the last one in first year so it’s really tempting to put off revising for it until the weekend before. However, it’s very easy to prepare for in advance so I’d recommend making good notes beforehand and taking the time to learn the content in the sessions themselves.
IT’S ALL LINKED—remember that all the systems are linked together and see the big picture! Try not to think of the systems as separate entities.
Monographs (books that only focus on one topic) • • • • • •
Nerve and Muscle by Keynes, Aidley and Huang / first two chapters of Neurophysiology by Carpenter Cardiovascular Physiology by Mohrman and Heller Pulmonary Physiology by Levitsky Vander’s Renal Physiology by Eaton and Pooler Gastrointestinal Physiology by Barrett Endocrine Physiology by Porterfield and White
Textbooks Medical Physiology by Boron and Boulpaep—a very large book that has good explanations and diagrams for the difficult concepts Berne and Levy’s Physiology by Koeppen and Stanton—an alternative to Boron. A thinking approach to physiology by Sabir and Usher-Smith—lovely clear explanations of physiology. Wheater’s Functional Histology—an invaluable resource for histology revision.
SECHI and ISBM Note: the exams for these two subjects are at the end of Lent term rather than the end of Easter term. SECHI The Social and Ethical Context of Health and Illness (SECHI) course addresses the way that social and behavioural factors are implicated in the course of disease and treatment, and also introduces ethical questions arising for the medical profession, both in hospital and in the community. Teaching is via lectures throughout Michaelmas and Lent terms. Small group seminars will also be given throughout the year, which give you an opportunity to discuss and debate themes in more detail.
The exam paper is divided into two parts, and you must answer one question from Part A and one from Part B. Each question carries equal marks. You should draw on the reading that you have done as well as lecture material to answer these questions. Part A also requires you to use examples of patient experiences (for example, in lectures, Preparing for Patients A or voluntary work). The SECHI Moodle page has recommendations for relevant studies, and these are more than sufficient to pass the exam.
ISBM The Introduction to the Scientific Basis of Medicine (ISBM) course teaches elements of medical statistics and epidemiology. As with SECHI, teaching is via lectures throughout Michaelmas and Lent terms. ISBM lectures aim to provide you with tools for critical assessment and evaluation of the quality of scientific literature, and appropriate application of these findings to medical practice. The two lecture series are epidemiology and medical statistics. The medical statistics lectures provide understanding of calculations associated with the interpretation of scientific literature.
The ISBM exam requires you to answer 15 MCQs in 45 minutes.
Exams It may be pretty daunting thinking about exams right now but don’t worry, they’re a long way off! Therefore this is not an exhaustive summary of the exam system– it’s just an overview of how they work to clear up some common questions. The full breakdowns of how much each exam is worth etc. can be found in the course handbook you’ll receive from your college. Now, just to make things interesting (and very confusing), the exam system for Cambridge preclinical medics has two different components – “2nd MB” and “Tripos”. In addition to Tripos being the name for a three year undergraduate course (you’re doing the ’Medical Sciences Tripos’ for example), it also refers to graded exams at Cambridge, from which you get a 1st, 2:1, 2:2 or a 3rd. Your grade for the year is calculated by adding up all your marks from all the papers you sit for HOM, FAB and MIMS and then converting this figure into a percentage, with an total score of approximately ≥ 70% earning you a 1st, ≥ 60% a 2:1, ≥ 50% a 2:2 and ≥ 40% a 3rd. Your marks for SECHI and ISBM have no contribution to your Tripos grade. On the other hand, MB is the name given to the pass/fail exam system that determines whether you have the level of knowledge to allow you to legally qualify as a doctor. 2nd MB refers to passing the necessary preclinical exams (in years 1 and 2) and Final MB refers to the Clinical School exams you have to pass in years 4, 5 and 6. To pass 2nd MB for each year, you have to pass each course (i.e. pass each of HOM, FAB, MIMS, ISBM, SECHI and PfPA in first year) separately, which is judged according to a pass mark specific to that subject. SECHI and ISBM only have one exam each, so if you pass that exam then you’ve passed 2nd MB for that course. For HOM, FAB and MIMS, only Section 1 (MCQs) and Section 2 (Practical) count towards 2nd MB. Basically, your essays in HOM/MIMS/FAB don’t count for 2nd MB– they only count for your Tripos grade. 2nd MB exams can be resat in September so you’ll have two attempts at each exam. Please, please don’t panic if you have found this explanation confusing! The exam system is very complex and though I’ve tried my best it’s hard to communicate on paper. Once you’re here, I promise that it will start to make sense and you’ll be able to get your head around it! If you are worried about anything or have any questions, please email me (email@example.com) and I’ll be happy to help.
Medical school exams do have a bit of a reputation for being quite tough, and to an extent this is true. Don’t worry, there are masses and masses of people here who have been through it and will support you along the way. For now, it’s best to concentrate on enjoying uni life, making new friends, and learning about some really interesting stuff from experts in their field.
PfPA and General Advice PfPA The Preparing for Patients (PfP) course runs through the first three years, and gives you preclinical patient contact. PfPA runs in first year and gives you an opportunity to meet patients in GP surgeries around Cambridge. The course consists of an introductory session to discuss how to approach patients, followed by two GP visits (one in Michaelmas and one in Lent) and then a final debrief session. During one of the visits, you will meet patients within the GP surgery, whilst on the other you will visit a patient of the surgery at their own home. You’ll carry out the visits with a partner. These visits are a great way to practice a medical interview and will let you feel like a doctor for an afternoon! PfP isn't examined by exam like the other modules. Instead you will be expected to submit two online assignments after each GP visit. More information can be found in the PfPA handbook.
Some general advice •
The supervision system—supervisions are there to help you so make them work for you! Never be afraid to ask your supervisors to clarify things from lectures that you didn’t understand or equally explain something you found interesting in more depth. Towards exam time, it’s perfectly ok to ask your supervisors to cover specific topics you’re worried about, or even to ask for more supervisions. The supervision system is unique to Oxbridge, so use it to your advantage. • Learn as you go along—try not to leave all the revision for later in the year. Instead, do your best to understand each topic as you cover it in lectures/ dissection sessions. • Mocks—some colleges will set mock exams in January, so it’s a good idea to have a little look through your work from Michaelmas term over the Christmas holidays. However, it’s crucial to remember these are only mocks, so don’t feel the need to spend your entire Christmas revising! It’s much better to have a good break and relax after your first term. • Ask for help if you need it or want it—this is so important. You’re absolutely surrounded by people who are there to help you if things get difficult– if you’re struggling, talk to your supervisors, DoS, Tutor, the Medsoc committee, college welfare support or literally anyone in the years above. We’ve all been through it, and the medics are a supportive bunch of people; we actively WANT to make your time here as pleasant as possible, so please don’t feel nervous about reaching out. MOST OF ALL: I hope you enjoy your first year here in lovely Cambridge and hope you found this guide useful. We can’t wait to meet you all in October!