Introduction to Clinical Years
First Clinical Year Orientation Presentation Class of 2016
Edited and Presented by Rani D. Sittol President, MBBS Class of 2015 Prepared by Dr. Neggo-Shane Powell Past President - JAMSA
Year 3 • First Clinical Year • New Experiences • New ways of learning • New ways of teaching • Perhaps...new ways of fun
Year 3 • Junior Clerkships: – Junior Medicine – Junior Surgery – Aspects of Family Medicine
• Each will last eight weeks. • Class will be divided into three groups – A, B & C
Attire • Whites – Males – white bush jacket with dark coloured trousers. – No earrings, open toe/heel shoes, or jeans.
– Females – white bush jacket over blouse and skirt, pants, dress, – No shorts/skirts above the knee, no open midriffs or cleavage, no jeans – Modest jewelry
– FOR ALL : Please try not to show tattoos!
Approach – The Reality • You will only have 18 weeks of clinical experiences for Internal Medicine for your entire undergraduate career. Use everyday wisely. • You will only have 18 weeks for Surgery as well. • You will only have 14 weeks for Child Health • 8 of these weeks will be completed in your first Clinical year for Medicine and Surgery and 4 for Child Health.
Approach • You may never be a surgeon, internist, or paediatrician • Focus on every clerkship: – Learn enough to become a primary care physician! (i.e., internship, G.P.) – Learn enough so that you know which conditions are critical and are for urgent referrals!
Junior Medicine • You will spend 8 weeks doing internal medicine • You will be on the wards and in clinics • Divided into: – 2 week segment – 3 week segment – 3 week segment
• 2 segments will be spent on General Medicine (UHWI & KPH), and • 1 segment spent on a subspecialty. (UHWI)
• Assessment: – MCQ – Usually the last Tuesday of the Clerkship – OSCE – on the last Friday – Ward Assessment – Case Notes
Junior Medicine Structure
• Everyday at midday, there will be a class for all the students. • Usually a case based teaching. • Individual firm teaching (ward rounds) • Residents may also teach as well
Medicine Resources • Preclinical Lectures • Davidson's Principles and Practice of Medicine • The Clinician’s Guide to the Cardiovascular Exam by Prof. Denbow, UWI—Excellent book!! • Aids to Undergraduate Medicine • Oxford’s Clinical Handbook of MedicineMust buy • Medscape Number 1 resource
Junior Surgery • Clerkship is 8 weeks • You will be on the wards and in clinics • Students will spend time at UHWI, KPH and CRH – 4 weeks on a firm at a hospital – 4 weeks on ‘Teachings’
Junior Surgery Keep a good Notebook… dig it up in year 5
• There will be combined classes with set teaching objectives. • There will be individual firm teaching (ward rounds) • Students can be asked to scrub during surgery: Open and close wound. Practice suturing
• Get your scrubs now if can • Hospital scrubs?
Surgery Resources
• Preclinical Lectures • Browse's Introduction to Symptoms and Signs of Surgical Disease by N.L. Browse and John Black • Scott: An aid to Clinical Surgery Lange: Current Surgical Diagnosis and treatment by Gerard M. Doherty • Bailey and Love’s Short Practice of Surgery • Lecture Notes on General Surgery • Medscape
Surgery Assessment •
MCQ – Covering topics taught
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Trauma (important section of the exam.)
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Hepato-pancreatico-biliary
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Vascular
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Urology etc.
OSCE – 2 Consultant stations – Short answer for the remaining 10 stations –
Reading x-rays
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Fluid management
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Trauma
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Case Notes (discussed later)
•
Procedure Card
Aspects of Family Medicine • 8 week clerkship – Paediatrics for 4 weeks ●
1 week on Casualty
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1 week on Well Baby Clinic & Domiciliary Services
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2 weeks on the ward (BHC or UHWI)
– Community Health & Psychiatry ●
Week 1 - all stay together
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Week 2 & 3 –
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– Psychiatry: Case Notes – Community Health: & Presentations Week 4 - presentations
Paed ward rounds are infamously LONG. Eat. Wear comfortable shoes.
Aspects of Family Medicine Textbooks
Paediatrics • Paediatrics: A Primary Care Approach – Adequate coverage of topics. • Illustrated Textbook of Paediatrics - Lots of nice pretty diagrams and pictures. • Nelson: Essentials of Pediatrics by R.M. Kliegman and K.J. Marcdante • Notes transcended through the years ;) Community Health and Psychiatry • The department provides notes which are relevant for this rotation so no textbook is needed
Assessment • Paediatrics – MCQ – Done online in the library usu. the last Thursday of the clerkship
– OSCE – History-taking OSCE
• Community Health and Psychiatry – Case Presenations & Discussions – MCQ Last Friday of the clerkship
Get My Med Books
1. Aids in Undergraduate Medicine [$600.00] 2. Notes in Paediatrics [$800.00] 3. Notes in Surgery [$600.0] 4. Lecture Notes on General Surgery [$1100.00]
Students on a Firm
• You will choose a group leader who will assign patients to the members of the firm • EVERYONE on a firm is expected to have patients • You WILL clerk patients (and occasionally dockets) • You WILL follow the patient’s management and be able to update the consultant • You WILL read around the patients
Students on a Firm
• If a student does not know about his patient the group leader will be expected to know the patient. • Therefore you WILL clerk patients (and occasionally dockets) • You WILL read around patients Consultants CAN and WILL send you off their Ward Round “If the student will not see their patients, I will not see the students.”
Duties • Medicine: – Go when you are assigned. (UHWI only. – Not expected for KPH students, though you can).
• Surgery – Go whenever the firm is on duty. – Accommodation provided for KPH students’ to overnight. Make plans to with the Secretary.
Procedures and Procedure Cards • You will be asked to do procedures (for e.g. Site IVs, suture, clean a wound, etc.) and see procedures (MRI, CT, etc.) • Procedure Cards will be provided to be filled out. – Do not lose them – Read up on procedures before you go to get them signed. (Some consultants wont sign if you are clueless) – You have not completed the Clerkship until you handed in the filled out procedure card.
Case Notes
• Follow the example given to you on IMP • Discussion (with references) on the condition, or something interesting surrounding the condition.
Case Notes • Surgery 4 cases (from any 4 patients at any hospital. Students can share patients) • Medicine 3 cases – 1 at the end of each segment • Psychiatry (1 case) • Note the differences in detail when taking histories for paediatrics, psychiatry, medicine and surgery
Transportation • The buses leave the Dean parking lot every morning at 6:30 a.m. and 7:30 a.m. sharp (NOT JAMAICAN TIME) • Students will be taken to KPH, BHC • The buses return at ~3 p.m. • The bus for CRH goes down on a Sunday Morning (time TBA) • YOU WILL SHARE THE BUS WITH NURSING STUDENTS
Useful Tips • Wear comfortable shoes. • In “free time” practise clerking patients & presenting to peers or read around topics and present topics to each other. • Medscape <3 • Be polite!!! • Find out from the nurse which pathologies patients have on the wards, clerk these patients & pass on the information to your peers • Remember you are learning for your life, and for saving many other lives
Clerkship
• It is an apprenticeship • The more you put in the more you get out. • The patient is the most important aspect. • DO NOT DEMAND THE PATIENT’S TO LET YOU EXAMIN THEM • DO NOT TAKE UNAUTHORIZED PICTURES • DO NOT TALK ABOUT PATIENTS OUTSIDE THE MEDICAL TEAM • Going to the lounge for a “5 minute nap” instead of clerking patients is a TRAP!
4th Year Schedule
5th Year Schedule
Electives • Two 5 week periods – 4th year – 3 weeks compulsory
– 5th year – All 5 weeks compulsory
Electives Abroad • Current contracts – AMSA- Austria – AMSA-USA – ANEMF-France – CFMS- Canada – HelMSIC-Greece – IFMSA- Brazil – IFMSA-Spain – IFMSA-Peru – Quebec-Canada
• International Students’ Office – King’s College London
Electives Abroad • Volunteer! – Host families – Social Contacts
Contact: neojamsa@gmail.com scope_ja@yahoo.com
Research • Opportunities available on campus within the faculty • Past projects – Epidemiology – Virology
Study Abroad • USMLE Workshops • Career Day
Advice
Questions