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What I Learnt From my First Year of Clinical Medicine

I found third year to be one of the toughest years of my life (you can hear all about that here) because I had to adapt to the different style of teaching and learning all while applying to intercalate, building a non–profit, being involved in various extracurricular activities, etc etc.


Now that I have made it through my first clinical year of Medicine and will be intercalating, I present to you my top tips to ace the year!


Clinical Placements:

What you see on placement varies from day to day. On some days all your patients might be unwell and are unable to let you examine them or take a history, on other days they may all be very well and you have a very productive day in terms of your sign-offs.


Learning opportunities come and go because of this variability. For example, I stayed back later than some of my peers one day and got the chance to perform + sign off a skill that I missed out on earlier that day. On the other hand, I wasn’t able to get a different skill signed off because there was no suitable patient there that week. I noticed that what I planned to do each week didn’t match what I actually got done in the end, and it frustrated me when things didn't go to plan. My advice? Have a plan for your learning on placement but keep it flexible. Get a good idea of what you need to get done on placement, whether this is a weekly requirement or skills you need to get signed off throughout the year.


I preferred going into placement earlier because that gave me the opportunity to figure out my game plan for the day. Ward rounds and the morning handover helped me get a general idea of which patients are good to talk to, whereas being around during team introductions when I was in the operating theatre made me known to the rest of the team.


Which brings me onto my next point. Making yourself known to the team and letting healthcare professionals know what you would like to accomplish while you’re around pays off. This way they can keep you in mind if a patient who could facilitate your learning comes along. For example, a nurse on one of my placements knew I was around and went searching for me when there was an opportunity for me to do a skill I needed to get signed off.


Revision/Time Management:

You will wait around a lot on placement. Sometimes the healthcare professionals you have an appointment with are late or don’t show up for their own reasons so it is helpful to keep some spare work that requires less attention with you to fill that time. Examples of these include reviewing flashcards, doing practice questions, and admin tasks e.g. replying to emails.


Having work that is portable on a mobile device is so important - while I still do some work on my laptop which is a bit clunkier, having an iPad has allowed me to bring most work around with me.


Use a calendar app to keep track of commitments and some form of note-taking for record-keeping. Keep track of important dates and deadlines you have in the year. Examples of this for me last year included deadlines for my intercalation applications, exam dates and portfolio review meetings/dates.


How I Revised:

When I learn about a new condition, I use the acronym “DR APSIMO” to remind me of what I should cover: Definition, Risk factor(s), Aetiology, Pathophysiology, Signs/Symptoms, Investigations, Management, Outcome. One of my tutors in second year taught me this and I have been using it to this day!

To consolidate my theoretical knowledge of conditions, I implemented active recall and spaced repetition using flashcards on Anki. I also did practice questions from question banks - I used PassMed and QuesMed. Given my stage of training at the time, I personally felt that QuesMed was more appropriate as PassMed was more focussed on finals (I’m not sponsored by either platform by the way).


I spent a lot of time working on my practical skills. I learnt a lot of new examinations in third year and also had to re-learn some of the examinations I was taught in pre-clinical years. I wasn’t very confident with examinations since I didn’t get much opportunity to practise while I was in pre-clinical years (thank you COVID).


I practised my examinations on the wards with patients and I also practised a lot on my own with a pillow so I would keep to time limits in exams. My cool tip for examination skills is to get someone with more experience than you to watch you while you examine. Throughout the year, I had doctors, students in years above and even a Physician Associate student watch me - this improved my technique immensely and I got to practise under pressure regularly. I attribute my success in examination stations during assessments to this.


Life:

Life doesn’t stop for medical school, and medical school doesn’t stop for life. Rest. Placement isn’t everything, neither are exams. See your friends and do things that make you happy. I definitely didn’t rest enough last year and I learnt the importance of doing so the hard way.


Failures and rejections will come. But you will dust yourself off and come back stronger. At the end of the year, you will look back and realise how far you’ve come. If you are starting your clinical years, I wish you all the best! You got this.


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