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    Hi,

    I'm a 4th year medical; student. I did a v. traditional course with a clear pre clinical - clinical divide and this year is our first year on the wards. I'm finding wards really hard. Often I just feel like a spare part and all the doctors and nurses seemed so rushed on their feet that I feel like I'm constantly in the way.

    I don't really get how to 'learn' either. Everyone keeps telling me that I don't need to make notes because they'll take up too much time, but then I don't see how I'll get stuff to stick in my head?

    I'm just lost... and so confused. We have some mock OSCEs and written exams coming up and I feel like I'm going to bomb
    • #2
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    Normal. I felt like wards were only useful in consolidating knowledge I had learnt from books and videos, not for learning things from scratch because no one has time to teach you properly unless your consultant has a heart of gold (rare) or lots of spare time (even rarer).

    I'd cut your time spent on the ward as much as possible without getting in trouble with the med school and start using books more. Then when you come to the wards you will remember what you learnt and it'll stick.

    If med students spent all their time on the wards they'd no doubt fail their exams I think. It has to be balanced with the bookwork.
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    (Original post by Anonymous)
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    I'm sorry you feel this way, and that's why if I see a med student who is looking lost I will always take him / her with me to see patients with me. Usually the offer is well received (it helps that I am doing the specialty that is extremely poorly taught at med school - neuro).

    When I was in 4th year, I ended up going to the hospital after hours (especially when I was on an outblock - i.e. staying in accomodation) and I would just stick with a doctor starting their night shift at say 8pm for 2-3 hours clerking patients. I found that I really learnt a lot that way. You don't even have to do that for long - maybe 2-3 weeks? I found that it really boosted my confidence and allowed me to apply the knowledge that I got from the books. Hope you are ok with your exams. If you have any questions just leave me a message!
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    (Original post by Anonymous)
    Normal. I felt like wards were only useful in consolidating knowledge I had learnt from books and videos, not for learning things from scratch because no one has time to teach you properly unless your consultant has a heart of gold (rare) or lots of spare time (even rarer).

    I'd cut your time spent on the ward as much as possible without getting in trouble with the med school and start using books more. Then when you come to the wards you will remember what you learnt and it'll stick.

    If med students spent all their time on the wards they'd no doubt fail their exams I think. It has to be balanced with the bookwork.
    Agree with this.
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    There is some very good advice on this thread. Feeling "in the way" is part and parcel of being a medical student. With the exception of commitments you have to fulfil to get signed off, you should generally only spend time doing things that are useful. If you are genuinely standing around like a wallflower for a while, then you are probably in the wrong place.

    Ideally, you should go in with a plan for what you need to get out of each day. Some days this will be "I need to get an X clinic signed off" and others it should be "I want to site my first intravenous cannula" (on the ward) or "I want to become good at distinguishing between types of systolic murmur" (in the cardiology/cardiothoracic clinic). When you've achieved your goal then go home and have a nap, meet some friends, play squash, or whatever else it is you want to do with your spare time as a student.

    You will feel a lot more comfortable on the wards as you become more senior/experienced and can actually be useful, e.g. bloods, forms, carrying notes, pulling curtains around beds, scribing, etc. These tasks take some pressure off the FY1s/SHOs/SpRs and will make them more likely to actively teach.

    ecolier's idea of sticking to the on-call junior doctor out of hours is excellent and works very well. They often like the company and you will learn lots. You would be better off doing this a little later on, though, when you can actually help them and feel a little more as if you are helping manage the patients. The things you learn will make you a much better FY1 but won't necessary be high yield for exams. I would definitely spend some of your time doing this in the final year.
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    I hate not having the time to engage students. Ward rounds could be useful learning experiences, but frequently the students are just ignored in favour of getting the round done before 3 for once. In that circumstances, the wards aren't useful, you are right. At least, not in the medical knowledge sense.

    My advice would be that you do need to spend some time on the wards, as it gives you some 'in real life' practical knowledge of how things will work come FY1. You will observe communication with patients and nurses etc (both good and bad), you'll pick up how to survive your first job. But for actually passing exams... don't just hang around on a ward if its not useful. Ask to see patients. Ask to be involved. And if that doesn't work, get some library work done. A good structure is to look up questions and read around topics you saw from the ward round.

    And yes often out of hours is good. I'd personally try to target the doctor you follow beforehand if at all possible though - on calls are stressful and still a big source of anxiety for many juniors.
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    I would take as many histories/examinations as you can, work on your bedside manner and while you're doing this you are also learning what questions are important/rule out diagnoses to help with OSCEs.

    I find in my second year when we had to get 30+ histories taken and written up (and portfolio signed after handing over info to a doctor where you had to give investigations/differentials/most likely, and why) I remembered so much! all the barn door gall stones, or UTIs, or pneumonias are great but then you also have a case/a persons face to remember the rarer stuff you'll see like.. peutz jegers or temporal lobe stroke and this is the kind of **** you remember in an exam.. oh yeah mrs jones had that bloody diarrhoea and lip pigmentation it's that answer!

    like others say you don't necessarily learn from scratch unless you get a nice doctor to teach you, but if you take a history and you're like... umm wtf is wrong with the person then go home and read up on those symptoms and come up with a list of differentials, it may be that your patient had the perfect triad of symptoms but you didn't know they were characteristic of that disease ..from then on you'll always remember it!
 
 
 
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