Hey there! Sign in to join this conversationNew here? Join for free
    Offline

    4
    ReputationRep:
    (Original post by Kinkerz)
    . But to reiterate: as second years, I imagine that people on 'non-traditional' courses are the better communicators, but by the end of the course, I'm sure it balances out.

    If in your opinion it all balances out, what's the problem?

    In my opinion, being on the wards for three years after 2-3 years of preclinical science leads to "high-yeild" clinical education. On starting clinical school, you are able to ask pretty much whatever I want and understand most disease processess and drug mechanisms from first principles, therefore making the best use of contact-time.

    Trust me, I absolutely HATED the preclinical course here due to the lack of patient contact, but recently, I've begun to appreciate that time spent poring over Robbins waybackwhen. It's all coming together nicely.
    Offline

    16
    ReputationRep:
    (Original post by xXxBaby-BooxXx)
    However, at UEA the majority of our teaching for rheum + ortho is this module - we are taught everything all at once and then don't really go back to it unless it relates to another disease that comes under a different speciality, so we are actually taught the sciency stuff behind the diseases as well as the social effects etc. So basically, if I see a patient with Paget's/SLE/RA etc etc then I actually know about the disease, know to ask for specific symptoms within specific diseases, so I actually find it very beneficial when it comes to remembering disease for exams and such, as I can just remember the patient and the symptoms they had.
    that sounds horrendous!

    Glasgow is v PBL but it certainly seems like we're doing basic sciences before doing anything like that.
    Offline

    1
    ReputationRep:
    You don't get more non-traditional than Peninsula, and from what I've heard our F1s are getting a lot of praise for being excellent and technically capable. I'm going to put that down to the fact we do F1 things from the start. I was suturing in surgery yesterday on my SSU attachment to a Dermatology ward. I'm only a first year, and I was watching Junior Doctors and the F2 hadn't done suturing on a real person before. Even if you only pick up bits, even if the science goes over your head, if you look you can always gain something from placement. Whether it's watching how different teams work, seeing how patients react to things, a nice phrase you heard you'd like to use yourself. You can look up the science and learn it for yourself later if what you saw sparked an interest and you didn't know it because you hadn't covered it yet. It would be a lot harder to get the experience yourself if it wasn't facilitated by the medical school. I don't know about you, but it was really difficult to get clinical work experience, and then to try and persuade them to let you do something hands on? Not likely.
    Offline

    13
    ReputationRep:
    (Original post by visesh)
    If in your opinion it all balances out, what's the problem?
    I'm the one saying there is no problem! Just that I think it's a good idea to infuse some clinical skills into the first few years.

    In my opinion, being on the wards for three years after 2-3 years of preclinical science leads to "high-yeild" clinical education. On starting clinical school, you are able to ask pretty much whatever I want and understand most disease processess and drug mechanisms from first principles, therefore making the best use of contact-time.

    Trust me, I absolutely HATED the preclinical course here due to the lack of patient contact, but recently, I've begun to appreciate that time spent poring over Robbins waybackwhen. It's all coming together nicely.
    I think basic science is important. This is why I spend hours of my own time going over aspects that aren't all that emphasised on my course. I haven't said: screw the science, it's irrelevant, all being a good doctor requires is a good bedside manner.

    I just assumed, and perhaps wrongly*, that a lot of students from traditional courses forget much of the detail driven in during preclinical years.

    *based on some observation: the consultants that teach us have often forgotten the details.
    Offline

    13
    ReputationRep:
    (Original post by Kinkerz)
    I'm not branding all people on traditional courses as anything. If you read my post properly, you'd see that I said that I'm sure things balance out in the end. But to reiterate: as second years, I imagine that people on 'non-traditional' courses are the better communicators, but by the end of the course, I'm sure it balances out.


    Congratulations? Doesn't sound particularly high-yield to me. I'd prefer to have that replaced with early exposure to clinical and communication skills personally.


    Learning relevant science allows the person to think of a treatment plan from first principles. I don't see how not being on a traditional course rules that out.

    What is the point of pitching up to a ward looking at patients if you don't know whats wrong with them? Or what could be wrong with them? Or with no idea about the basics of normal function? Yes, you could say to students this sound is bad, that thing is bad, other things are really bad - but then you're not doing medicine, you're just being a clipboard pen pushing tixbox consultant, you don't need medical school to teach you that, all you need is a protocol, there medical education on the cheap.

    Theres' no point being a good communicator if you can't manage your patients. Very very few people are actually on the extreme end of the ineptitude scale to require such intense comms skills coaching over and above clinical school exposure.

    Yes, preclinical science is a long hard slog - I mean, who wants to learn about Hexamethoium or cytokine mediators, or the potential side effects of x? Its not all that 'cool' and 'hands on', or 'multidicipliniary learning' - but it is bloody important. I'm not sure it does equal out, if you havent spent the hours doing the stuff, you haven't done the stuff. Whether having that base makes you a better doctor? Well up until very very recently, all medical curriculums were science heavey, until things like dissection became too expensive. Most consultants these days are fairly good at communicating. I don't see too much of a problem.
    Offline

    2
    ReputationRep:
    It seems that those who do surgical SSCs open doors for themselves to get a whole lot more shadowing/experience, I regularly hear friends talking about surgery they now get to observe, it's like an extended SSC for as long as you're in contact with the surgeons and as long as they're willing to have you

    A friend's comment following his plastic surgery SSC:

    I raise you my microsurgery course the plastic guys have put me on. I can sew tendons and nerves together by the end of it. Hopefully. Otherwise they've just wasted 2k
    what the hell???

    end of rant, they're bloody lucky, I guess if I was that keen to do that same I'd just have to somehow ask a doc at the royal london/barts..
    Offline

    13
    ReputationRep:
    (Original post by Kinkerz)
    I'm the one saying there is no problem! Just that I think it's a good idea to infuse some clinical skills into the first few years.


    I think basic science is important. This is why I spend hours of my own time going over aspects that aren't all that emphasised on my course. I haven't said: screw the science, it's irrelevant, all being a good doctor requires is a good bedside manner.

    I just assumed, and perhaps wrongly*, that a lot of students from traditional courses forget much of the detail driven in during preclinical years.

    *based on some observation: the consultants that teach us have often forgotten the details.
    You remember alot. I think re consultants, they've reached the unconsciously competent stage, so some of the reasoning dosn't have to be thought through - the reasoning is probably still there somewhere.
    Offline

    13
    ReputationRep:
    Groan.
    (Original post by Wangers)
    What is the point of pitching up to a ward looking at patients if you don't know whats wrong with them? Or what could be wrong with them? Or with no idea about the basics of normal function? Yes, you could say to students this sound is bad, that thing is bad, other things are really bad - but then you're not doing medicine, you're just being a clipboard pen pushing tixbox consultant, you don't need medical school to teach you that, all you need is a protocol, there medical education on the cheap.
    Because there's more to medicine than that? Talking to patients early on makes you more confident at talking to patients when you reach clinical years, in my opinion.

    Theres' no point being a good communicator if you can't manage your patients. Very very few people are actually on the extreme end of the ineptitude scale to require such intense comms skills coaching over and above clinical school exposure.
    Not saying there is a point. But, again, I don't see how early patient contact makes you assume managing patients takes some kind of back seat. I suspect it's probably because most 'early contact' schemes are run by modern, PBL medical schools and they have some degree of stigma attached. I once saw vazzyb say that people at Keele only had to know the names of the cranial nerves. What utter nonsense. We do the science... perhaps not in quite as much depth as you guys (though it is debatable [yes, excluding Oxbridge... we don't know as much as you guys]), but it gets done.

    Yes, preclinical science is a long hard slog - I mean, who wants to learn about Hexamethoium or cytokine mediators, or the potential side effects of x? Its not all that 'cool' and 'hands on', or 'multidicipliniary learning' - but it is bloody important. I'm not sure it does equal out, if you havent spent the hours doing the stuff, you haven't done the stuff. Whether having that base makes you a better doctor? Well up until very very recently, all medical curriculums were science heavey, until things like dissection became too expensive. Most consultants these days are fairly good at communicating. I don't see too much of a problem.
    Well, I do actually :p:

    And, again, I haven't said - not once - that basic science is unimportant. Or even that it is less important than clinical exposure during preclinical years.

    I think the science should come first during these years, but I also think that some clinical and communication skills experience is important.
    Offline

    13
    ReputationRep:
    (Original post by Wangers)
    You remember alot. I think re consultants, they've reached the unconsciously competent stage, so some of the reasoning dosn't have to be thought through - the reasoning is probably still there somewhere.
    Possibly, but I don't think that's anything to celebrate about. The number of times I've heard "it's a matter of physiology" from clinicians when asked a scientifically-probing question...
    Offline

    2
    ReputationRep:
    (Original post by visesh)
    Trust me, I absolutely HATED the preclinical course here due to the lack of patient contact, but recently, I've begun to appreciate that time spent poring over Robbins waybackwhen. It's all coming together nicely.
    So you used Robbins as a path textbook? I haven't been able to find one that I like. All of them don't match the course and most are systems based, which is good for clinical but not great for IB Pathology. Also, any advice on Part II subjects?
    Offline

    14
    ReputationRep:
    Actually quite enjoying this haematology scenario, this is surprising.

    Along with this debate, I don't think a small amount of clinical exposure (i.e. a couple of days at a GP practice/ward over preclinical years) is a bad thing - for us these are based more on psychology/sociology teaching, with second year being more based on public health. We also get a small amount of communication skills/basic history taking - which I guess is useful in preparation for clinical years, also this is mainly aimed at exploring social effects of ill health and illness behaviours too. My only issue is when it gets as much focus as preclinical science at this stage - as in having full firm attachments so early on before you've gained enough science to really take anything away from it.
    Offline

    19
    ReputationRep:
    (Original post by JordanCarroll)
    It seems that those who do surgical SSCs open doors for themselves to get a whole lot more shadowing/experience, I regularly hear friends talking about surgery they now get to observe, it's like an extended SSC for as long as you're in contact with the surgeons and as long as they're willing to have you

    A friend's comment following his plastic surgery SSC:
    what the hell???

    end of rant, they're bloody lucky, I guess if I was that keen to do that same I'd just have to somehow ask a doc at the royal london/barts..
    What an absolute waste of money. They (almost certainly) don't have the surgical skills to survive on a course like that, and I very much doubt it would be accepted later in their career, they'd have to redo it.
    (Original post by It could be lupus)
    So you used Robbins as a path textbook? I haven't been able to find one that I like. All of them don't match the course and most are systems based, which is good for clinical but not great for IB Pathology. Also, any advice on Part II subjects?
    I never found one I really liked tbh. I did almost all of my revision from lecture/practical notes, which back in my day were pretty comprehensive.
    Offline

    2
    ReputationRep:
    (Original post by Helenia)
    I never found one I really liked tbh. I did almost all of my revision from lecture/practical notes, which back in my day were pretty comprehensive.
    Yeah thats what I am doing atm. I'm just writing out my own notes from the lecture notes along with the stuff we covered in supervision. Its a pity I can't find a textbook I like, pathology is probably my favourite subject
    Offline

    2
    ReputationRep:
    (Original post by Jessaay!)
    It's entirely possible I was being a complete retard. If it's not there this time I'm at a loss to what I'm doing, but I tried again :p:
    yeah I got it thanks again, much appreciated! just tomorrow left for you guys isn't it.. you going home or?
    Offline

    14
    ReputationRep:
    (Original post by ilovehotchocolate)
    You don't get more non-traditional than Peninsula, and from what I've heard our F1s are getting a lot of praise for being excellent and technically capable. I'm going to put that down to the fact we do F1 things from the start. I was suturing in surgery yesterday on my SSU attachment to a Dermatology ward. I'm only a first year, and I was watching Junior Doctors and the F2 hadn't done suturing on a real person before. Even if you only pick up bits, even if the science goes over your head, if you look you can always gain something from placement. Whether it's watching how different teams work, seeing how patients react to things, a nice phrase you heard you'd like to use yourself. You can look up the science and learn it for yourself later if what you saw sparked an interest and you didn't know it because you hadn't covered it yet. It would be a lot harder to get the experience yourself if it wasn't facilitated by the medical school. I don't know about you, but it was really difficult to get clinical work experience, and then to try and persuade them to let you do something hands on? Not likely.
    No offence, but to say you are doing 'F1 things' from the start is total bollox.
    You could teach a monkey how to suture. What doctors get paid for is seeing patients, diagnosing things and carrying out effective management.

    Yes, it may seem cool and exciting to play doctor in theatre all scrubbed up and doing a few stitches, but it is actually of zero importance to your medical training. When you do surgery in third year, you won't be scrubbed in for hours practising your AAA bypass technique, you will be learning how to examine surgical patients, take good histories and learn how to keep them alive when they turn septic. That's F1 stuff.
    Offline

    20
    ReputationRep:
    Early patient contact is a waste of time. It's just making small talk with patients slipping in the odd buzz word/jargon that we don't really know much about. Time in bed is much more productive.
    Offline

    14
    ReputationRep:
    (Original post by It could be lupus)
    Yeah thats what I am doing atm. I'm just writing out my own notes from the lecture notes along with the stuff we covered in supervision. Its a pity I can't find a textbook I like, pathology is probably my favourite subject
    Robbin's is good. BRS path is a nice review book. And if you are really keen, there are audio lectures available to download, search 'the usual sources' for "goljan audio"
    Offline

    2
    ReputationRep:
    (Original post by digitalis)
    Robbin's is good. BRS path is a nice review book. And if you are really keen, there are audio lectures available to download, search 'the usual sources' for "goljan audio"
    Oh broski - how's the stuff regarding USMLE and all that going? Did you get anywhere?
    Offline

    1
    ReputationRep:
    (Original post by Kinkerz)
    I mean amongst students. I felt similarly blasé about preclinical exposure to patients until I actually experienced what it was like to be a patient with a doctor who couldn't communicate well.


    It's not as if it's 'good communication or good understanding of science'. I genuinely think the disparity in terms of science isn't as great as people might think. I also think that good clinical skills are more difficult to acquire than the knowledge... science is the easy bit as far as I'm concerned.

    Either way, I'm not really talking of course layouts, I'm more talking about attitudes amongst students.


    I'm not saying people won't catch up. I just think it's useful for students to be exposed to patients prior to clinical years, despite not necessarily knowing much clinical medicine. Preclinical exposure isn't about the science. It's about building communication and clinical skills. I know these can be acquired later on in the course, but it's hardly a bad thing to have an idea earlier on. It doesn't really get in the way.

    Also, that student may well have had more knowledge at the time; how much do you think she remembers of the minutiae of anatomy etc. she was taught?


    Why has this turned into a "preclinical exposure = cushy doctor knows no science vs. clinical exposure = brilliantly rounded doctor with excellent communication skills and a vast knowledge of medical sciences"?

    It doesn't really work like that, as I'm sure you well know. I would look with scepticism if someone at a more scientifically orientated school (other than Oxbridge) claimed to understand and know lots more science than I do and I'm sure the communication and clinical skills will balance out after the duration of the course too.

    I'm a bit confused as to what your point IS then. There is definitely a disparity between the knowledge of different med schools- some have more preclinical, clinical knowledge and some have more scientific knowledge in their preclinical years. You're basically saying non-traditional start out with a beneficial head start in terms of communication but this is caught up with quite easily, but we all have the same level of science. I don't believe the same level of science thing is really true and that's kind of the point of the difference between our courses. I'm not sure which is more beneficial and which is not, but considering the difference in time we focus on different things, we can't be as even as you're saying, really.

    initially your point was that good communication makes you a better medical student and I definitely don't despute this, but we said we do learn communication and stuff, but there's a lower focus on this and clinical aspects of the course and more focus on the science.

    What I'm trying to say, is that science knowledge can't be as "easy" or as even between schools as you're saying, really. Considering in our most recent module alone I believe there were around 60 hours of lectures (not including PDS) as well as other styles of teaching (computer labs, case study exercises, actual lab work, dissection etc...) all equating to probably about 80 contact hours, there must be a difference in scientific knowledge base to those who don't have as much of a focus on science. Otherwise we spend an incredible amount of unneccessary time studying science that others do in a shorter period of time to the same level.
    Offline

    1
    ReputationRep:
    (Original post by Tech)
    yeah I got it thanks again, much appreciated! just tomorrow left for you guys isn't it.. you going home or?
    We were done at the same time as you were all done! so we finished last week. Or at least I hope so as I haven't been to a single thing this week :p:
 
 
 
  • See more of what you like on The Student Room

    You can personalise what you see on TSR. Tell us a little about yourself to get started.

  • Poll
    Would you like to hibernate through the winter months?
  • See more of what you like on The Student Room

    You can personalise what you see on TSR. Tell us a little about yourself to get started.

  • The Student Room, Get Revising and Marked by Teachers are trading names of The Student Room Group Ltd.

    Register Number: 04666380 (England and Wales), VAT No. 806 8067 22 Registered Office: International House, Queens Road, Brighton, BN1 3XE

    Quick reply
    Reputation gems: You get these gems as you gain rep from other members for making good contributions and giving helpful advice.