school of clinical medicine school of clinical medicine stage 3 an overview of the year ahead....

School of Clinical Medicine


Stage 3

An overview of the year ahead.

Jessica WhiteStage 3 Coordinator



There is life after Pathology!



Preparing for Practice

• Knowledge• Skills – clinical, practical and

communication• Professional attitudes



Stage 3 overview

• Elective SSC• Review & Integration weeks 9-10• SSC (4 weeks)• Senior GP, Palliative Care (4 weeks)• OSPE • Senior Medicine (9 weeks)• Senior Surgery (9 weeks)• Acute Care ( 9weeks)• Self-Directed Study (several days!)



Preparing For Practice Key facets

• Self Directed Learning

• Responsibility

• Reflection on Practice




• Responsibility– Final OSPE

• Venepuncture,Cannulation,ABGs,Suturing

– Senior Students (teaching junior students)

– Presenting patients with management plan, following up

– Integral part of team




• Reflection on Practice– Portfolios– Case based discussions with

reflection– Team working essay– Palliative care essay



Senior GP, Palliative Care

• Supervision by GP tutors• Supported clinical decision making• Follow up of patients• Reflective portfolio case of a patient

with terminal illness• ENT/Ophthalmology/Dermatology• CCS - Health behaviour change



OSPE(Objective Structured Practical Evaluation)

Demonstrate competence in the practical procedures at the beginning of final 3 senior attachments

Hurdle for progression to final MB



Senior Medicine

• 2 students per firm at Addenbrookes, 1 / 2 per firm in 5 regional hospitals.

• Senior students with roles and responsibilities, including practical procedures, clerking + follow up.

• Dermatology



Senior Surgery

• 2 students per firm, present patients on rounds

• Direct patient care – ward and theatre

• ENT and Opthalmology



Acute Care• Assessment and management of the

critically ill patient• Emergency med/ Perioperative care• Follow through of patients, practical skills• Role of supervised FY1 with mentors• Same hospital for whole attachment• ILS (hosp based)• Death + Dying Course (2 days)



Ophthalmology, ENT and Dermatology

• R&I week 9 +10 lectures and seminars • Senior GP• Senior hosp attachments: clinics, web

based learning materials, final MB questions

• Logbooks• Cases on VLE



Cambridge based

• Seminars - CCS seminars, • 2 half days - Management &

Leadership • High Fidelity Simulator

-Crisis management and team working



Palliative Care

• R&I week 9 – 1 hour lecture, plus introduction to 2 reflective portfolio cases – 1 for GP and 1 for Senior Med/Surg/Acute Care

• Senior GP – Meet pt in palliative phase at home, portfolio case D/W GP Tutor

• Acute Care - Death and Dying Course



Clinical Pharmacology and Therapeutics

• Completion of 4 student drug charts– Standard, insulin, warfarin and IV infusion

• 4 hour on line practical prescribing programme• R&I week 9

– Drug discovery , development and interactions

• R&I week 10– Poisons and drugs used in treatment of OD – Management of anaphylaxis

• Prescribing exam March 2015: Mandatory for progression to Final MB



Public Health

• R&I week 9 1 half day – – Emergency planning– Communicable disease

• R&I week 10– interactive seminars

• Management and Leadership Course – 2 half days



RadiologyPatient investigation theme

• Radiology Tutorials • 9 hot topics

• MDTs integrated into 3 attachments



Clinical and communication skills

• Working in teams• Shared decision making and informed

consent• Health behaviour change• Communicating beyond the patient• Working with interpreters• Death and Dying• Presentation Skills• Focused history taking and clinical

reasoning



Student Teaching

• Formal Teaching course beginning of year

• Various options to undertake teaching– To 1a Students– As Associate Supervisor for Stage 1

students



Ethics and Law

•Research ethics

•End of life decisions

•ICU ethics - brain death, PVS, organ donation and resources



Timetabling

Susan Coyle and Dawn Ellis

[email protected] [email protected]



VLE

• Information – all on web• Problems – contact Dr White

[email protected] Dawn Ellis

[email protected]• Feedback - essential



Problems!

• Contact Dawn Ellis/Dr Jessica White • Complaints – send straight away

don’t leave to end of placement



Application to Foundation School



Overview of FPAS

• Selection for FY1– Exam-based assessment rather than

‘white space’ questions– The Educational Performance

Measure (EPM)

• National Application Process– Academic Foundation application– Key dates



The SJT vs White space questions

• Multiple choice/ multiple answer

• 2 sittings per year• Tests

professionalism• Uses everyday

situations FY1 doctors will face – test of aptitude

• Worth 75% of application score

How I saved lives and brought about world peace…



Advantages of SJT

• Standardised across all medical schools

• Exam conditions therefore reduced risk of outside help

• Just 2 ½ hours not 2 weeks• Well validated in medical and non-

medical spheres



Educational Performance Measure (EPM)

25% of application score– Ranking in medical school – class

split into deciles (34-43 points)– Additional degrees (max 5 points)– Academic achievements – Pubmed

recognised publications– Presentations do not count – Prizes do not count



So a lot of marks on the SJT



Example SJT Question

Two question formats:

•Rank the five responses in the most appropriate order

•Choose the three most appropriate responses from eight

Answer what you ‘should’ do in the scenario described, not what you ‘would’ do



Choose the THREE most appropriate actions to take in this situation A Instruct the nurse to give the medication to the patientB Discuss with the nurse why she disagrees with the prescriptionC Ask a senior colleague for adviceD Complete a clinical incident formE Cancel the prescription on the nurse’s adviceF Arrange to speak to the nurse later to discuss your working

relationshipG Write in the medical notes that the nurse has declined to give

the medicationH Review the case again

You review a patient on the surgical ward who has had an appendicectomy done earlier on in the day. You write a prescription for strong painkillers. The staff nurse challenges your decision and refuses to give the medication to the patient.



National Application Process

• Key dates – 2014 and 2015



Academic FP 2014

• National timeline/deadlines – aligned with FP timeline

• Single, generic application – Oct, not June• Applicants all sit the SJT• Select maximum of 2 Academic Foundation

placements• Local short-listing & interviews



Key dates – 2014/15http://www.foundationprogramme.nhs.uk/p

ages/home/how-to-apply/SJT-FAQs

End June – Applicant info published

Sep - Register and enrol on FPAS and F programmes available to view

Oct - FP and AFP application period

Dec 5 + Jan 9 – 1st and 2nd SJT

Late Jan 2015 - Final SJT (London)

Jan –Feb 2015 - Academic FP offers

March 2015 - Allocation to FS

April 2015 - Match to programme complete



Any questions?

school of clinical medicine school of clinical medicine stage 3 an overview of the year ahead....

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