Can someone explain the "Clinical Years"? (Last 3 years of med school)

1. You're based in various hospitals in the (sometimes not so local) area. For my medical school, the distances between the hospitals allow for convenient living somewhere equidistant from them all, give or take. In other medical schools, this may not be the case with some placements requiring students to take up hospital accomodation for that rotation.

2. No, we still have teaching at the medical school, but sporadically compared to pre-clinicals. In my case, this is one day every other week. In the mean time, there is often teaching/tutorials/bedside teaching/teaching clinics available at the hospital I'm currently at.

3. This depends on your consultant, what rotation you're on, the department you're in etc. Generally, it's up to you to find learning opportunities. This may mean attending the morning ward round, compiling a jobs list for the day and helping the juniors work through it (bloods/cannulas/kardexes/referrals/requests etc). You can also attend clinics, assist/observe in theatre, observe practical procedures, attend MDTs, attend grand rounds.

You can also get involved with on calls, where you're more likely to see acute patients. You can clerk them yourself and present your findings to the junior or reg and suggest a differential and start a management plan.

4. This will vary widely between rotation, let alone medical school. For me, it meant fewer formal examinations but we are signed off by our consultant at the end of each rotation. They're expected to assess us on various things during their time observing us. We're also expected to present a number of cases during this time and perhaps do a few bedside OSCE type things. Some rotations have a formal written/clinical examination at the end.

That's about it really. Once you've hit clinicals, you've basically on easy street. Just learn by osmosis and don't be afraid to ask questions. Also expect to feel lost a lot.

Hi there,

So the way med school works in the UK is 2 years pre clinical and 3 years clinical where you're based in different hopsitals?

Can someone please explain how exactly these last three years work?
I have some specific questions



Please feel free to add any information Iv forgotten to ask about. Would really appreciate any responses
Thanks

A lot of universities do not use that breakdown. Many now have clinical work from year one. Obviously at the start it is low level and very controlled. The majority of schools now have integrated courses where there is a mixture throughout. From year 3 the amount of clinical increases and many units will be taught in a variety of locations alongside lectures etc.

I think clinical work from year one is truly not effective. I do appreciate some introduction to clinical skills and taking a history but I do not believe your knowledge in first year makes it remotely useful for you to be on the wards.

Having a strong background in basic sciences in my opinion is still a very useful thing to have. You continue to learn clinical medicine your entire working life, but you don't ever return to the basic sciences. I don't see the rush in pushing students onto the wards in first year. Especially from a research point of view I think the basic science connection should be maintained, because fundamentally all clinical work has its foundations in the basic sciences.

I think clinical work from year one is truly not effective. I do appreciate some introduction to clinical skills and taking a history but I do not believe your knowledge in first year makes it remotely useful for you to be on the wards.

They are not the wards! They have patient contact in controlled situations and family attachments. Off course they do the science but they get used to dealing with people,

Would love if others could share their experiences with hospital placements in clinical years as I enjoyed reading Etomidate's post and it's gotten me really excited for next year!

Clinical was more enjoyable for me than pre-clin, because it felt like you were finally doing proper medicine (I was at Cambridge, so a fairly dry, hands-off first three years). Not as much fun socially as pre-clin, but still enjoyed it most of the time.

Cambridge sends its students on placements all over East Anglia, so a lot of the time we would stay in hospital accommodation in the week and come back to our own place for the weekends. Most of the time this was quite fun, though the quality of accommodation was highly variable! Got a bit wearing in final year when I was also in a LDR with my boyfriend in London, so seemed to live out of a suitcase for the whole year. It is much more like having a job than being a pre-clinical student, you are generally expected to be in hospital 8/9-5ish, plus occasional on-calls, and you rapidly go off the idea of getting outrageously drunk during the week because doing a ward round with a hangover is fairly unbearable. However, I don't think anything really prepares you for how stressful being an actual doctor is!

We had a formal lecture week at the end of each block, and during the placements we would have a variable number of smaller lectures and seminars on relevant topics. The rest of the time you were expected to be on the wards or in clinics. Some placements were a lot more structured than others, and would allocate you to a particular ward/clinic/theatre list each day. Both approaches have their pros and cons - some of my best learning experiences were just from being on the ward or following "my" team on-call, but if there's not much going on, it's easy to feel a bit lost and like you're just in the way. Knowing that you have to be in a particular clinic can be helpful, but if the clinic is cancelled, or too many students turn up, or it's just not very interesting, then you're stuck there and it's hard to know where else to go. My top tip is to try to get to know the junior doctors on your firm/ward, and be enthusiastic about helping them out on the ward round and with jobs - you're much more likely to get teaching that way.

Our exams were a mixture of written (MCQs and short answers) and OSCEs, which are practical exams of your communication/examination/practical skills. We had one big set each year, and a couple of smaller ones at the end of certain modules. I got less stressed over them than I did over pre-clinical exams, but they're not easy.

Hope that's vaguely helpful!

do you think the stress is worth it to do the job you do?

So what really is the difference between a so called traditional school and a so called early clinical contact school then? It just seems like everyone is the same. St Andrews (which is supposedly traditional) does have acting patients, real patients (patients who are here to talk about their past illnesses) to come in and talk to students in 1st year and there are clinical skills, granted there aren't clinical days in hospital until 2nd year but that just sounds no different from a so called early clinical contact school.