Congratulations on getting through your preclinical years and welcome to your first clinical year! This is going to be a short blog covering the structure of year 3, the assessments, and some tips and tricks on how to get through it. Please bear in mind everyone tackles year 3 differently and there is no right way, but I hope this blog is a helpful guide!
Let’s start off with going through the structure of year 3. Year 3 starts off with a three-week introduction that is filled with online and in-person introduction lectures. The third week is an introduction week at your Firm site. The year is then split into 3x 8-week rotations: MICA (GP), Medicine, Surgery. After each rotation, you will have 2 weeks of consolidation lectures.
Year 3 is a lot less structured than year 1 and 2. A lot of the learning is independent and done in your own time. On Sofia, you have a list conditions and presentations that you could be tested on in your written exam at the end of the year. You are expected to mainly know the presentations, investigations, and management of these conditions. You are also tested on Law modules that you will be taught in your consolidation weeks.
You are taught the 4 Practical examinations (Respiratory, Cardiovascular, Neurological, Abdominal) in your first 2 weeks of lectures. These examinations will be repeatedly covered with teaching fellows on firms at your sites.
Whilst on placement, you will also have weekly clinical skill sessions at a hospital site with your clinical skills tutor.
These are assessed in your OSCE examination.
You will have two exams at the end of the year, each worth 50% of your final grade:
- Written(50%): This is a 3 hour exam that consists of 150 questions. 135 questions are case-style questions about the conditions and presentations on Sofia. The remaining 15 questions are Law questions based on lectures you are given in your 2-week consolidation after every rotation.
- OSCE(50%): This is a 2 hour exam with 12×10 minute stations:
- Cardiovascular Examination
- Respiratory examination
- Abdominal examination
- Neurological Examination (Upper Limb OR Lower Limb OR Cranial Nerves)
- 4x History stations. These tend to be presentations on one of each of the 4 systems. (E.g. Headache for neuro, Breathlessness for respiratory, Chest pain for cardiovascular and Epigastric pain for Abdominal – not guaranteed it will be these)
- 4x Clinical Skill Stations. These will be based off the skills you learn at the sites you are placed at across the 3x 8-week rotations and are also listed on Sofia. It typically includes stations such as Suturing, venepuncture, cannulation, otoscopy etc.
You will also have a CSI case at the end of every term in your two-week consolidation period- so 3 cases in total. The iRAT no longer contributes to your final CSI Grade. The tRAT consists of 15 VSAQ questions. The tRAT and tAPP make up your overall CSI Grade.
You will also have DOPS/DOCS to complete throughout the year. These are skills you need to perform whilst on placement and get signed off for by medical professionals. You will also have a project to complete whilst on each placement:
- Medicine: Case-presentation. This is a presentation you need to complete and present to your consultant whilst on your medicine placement. It is on a patient’s case you followed throughout your placement.
- Surgery: Quality Improvement Project (QIP): You need to carry out a quality improvement project with your group and present it in a poster to your teaching fellows at the end of the placement.
- MICA(GP): Community-Action Project: You need to carry out a project with your partner within the community your GP Practice is placed in and present it to your GP at the end of your placement.
You will be given more guidance on all of these when you start those placements.
CSI, your projects and DOPS/DOCS do not count to your overall final Year 3 grade but MUST be completed to progress to Year 4.
ONE WAY OF APPROACHING THE YEAR:
Put yourself out there and get involved in as much as you can. Be keen and you will be surprised at how many healthcare professionals are so willing and eager to teach you. But be polite and keep in mind the workload they have and don’t take it personally if sometimes everyone is very busy. On the wards, spend your time clerking as many patients as you can. You’ll hear faculty say it again and again. You learn a lot from speaking to patients, taking histories, and performing examinations if they are happy for you to do so. You also get the chance to practice a lot of your skills such as taking bloods. On MICA(GP), you will get to run your own clinics and relay your findings back to your GP.
Term 1 may feel overwhelming and daunting but please don’t worry- everyone feels that way initially. Term 1 is a good time to try find what way of learning is best for you. It is also a good time to try get as many of your sign offs done and out the way as possible so that in term 3 when you are closer to exams- you don’t need to be chasing doctors and nurses around for sign offs. Towards the end of the term could be a good time to start looking at the common conditions and grasping an understanding of the main presentations using the Oxford clinical cases book. You may also feel like doing some multiple-choice questions in books such as Laz and Oli to pick up Buzzwords for conditions. Whilst at your sites, you will start practicing and learning the 4 main examinations with your teaching fellows.
In term 2, spend time focusing on your OSCE and work on feeling confident with the 4 examinations. Practice clerking as often as you can to work on your history and examination skills. Practice your common skills such taking bloods and cannulation whilst on placement. Keep on working on your conditions and start doing questions to test yourself on them. Make sure to look after yourself and be reasonable with how many conditions/OSCE practice you can get through a day.
This term should be all about question, questions, and questions. The best way to consolidate your knowledge and prepare yourself for the written exam is by doing questions. Practice lots of OSCE with your friends and family and speak to your clinical skills tutors at your sites about coming for some extra sessions to practice your skills.
This is a good chance to get some extra time to consolidate your learning. I strongly recommend attending your lectures such as those run by Amir Sam’s and Professor Meeran’s. You learn how to tackle presentations and narrow down your differentials.
HOW TO STUDY + RESOURCES:
Keep in mind that everyone studies differently and here are just of the few resources you can use throughout the year to help you prepare for your exams.
For the written exam:
- Passmedicine: The final year pack on passmedicine is a common resource people use. I strongly recommend using the textbook on passmedicine as summaries for the conditions. Please keep in mind that the final year pack is aimed at Year 6 students and so lots of questions are not relevant for Year 3 but there are good case-style questions.
- Quesmed: Just like passmedicine, quesmed is also a common resource used and has a good textbook with great summaries on what you need to know for the conditions listed on Sofia. The questions on quesmed are more representative of the difficulty of questions for year 3. BMJ has an overload of information whereas both quesmed and passmed more or less will have what you need to know for your exams. As you do questions, you’ll start to notice that common conditions are common and those are the ones that are tested most and should be focussed on.
- Oxford Clinical Cases: This book has a list of the main presentations and works through cases to help you narrow your differentials for each presentation. It is also a great way to grasp a general understanding of the main conditions and is a good resource to use in Term 1. A lot of books are available as PDF versions and don’t need to be bought!
- Geekymedics: Has a question bank.
- Osmosis: Has summary videos for conditions. It can be helpful watching videos for conditions you are finding hard to understand.
- Flashcards: Everyone has their own way of actively revising, but one way is making short flashcards for the presentations, investigations, and management for each condition. Just make sure whichever method you use to actively revise you do regularly.
- PPQs: There are lots of past paper questions from previous years. Try do them in term 3 closer to exams as they are the closest representation to your final exam.
- Question Books: There are lots of question books such as Laz and Oli which have lots of multiple-choice questions.
For the OSCE:
- Geekymedics: Has videos for the 4 main Examinations and clinical skills.
- Imperial Checklist: Imperial provides and uploads checklists for the 4 examinations on Insendi.
- Imperial Clinical Skills videos: Imperial has a drive with Clinical skills videos performed by the clinical skills tutors.
- Clincal Skills equipment from sites: Closer to exams I highly recommend asking clinical skills tutors for equipment or purchasing some to practice your skills in timed conditions eg. A suture kit.
Refer to MM’s Year 3 page for links to Drives with these resources.
Please remember to be kind to all healthcare professionals you speak to on placement and keep in mind that they have a lot of work and sometimes might not be able to help. Be nice and polite to all members of the MDT and it will serve you endlessly.
Remember patients are people too and are not there for your own personal gain. Treat them with respect and always remember to check that they are okay with you speaking to them and performing a skill or examination.
Lastly, I want to reiterate to please not worry. I’ve gone through quite a bit in this blog, and it might feel overwhelming and feel like there is so much to learn but so many of us at ICSM are here to support you. You will pick up so much by being at placement, going to lectures and just doing questions – you won’t even realise it. Remember to enjoy the year, get involved with socials, spend time with friends and family. Take time for yourself to rest and do things you enjoy. You can have fun and do well in the year! Most importantly- look after yourself.
I hope this was a helpful overview of the year ahead. MM is here to support you so please feel free to contact any of us for help!