year 3b overview (presentation for mumus introduction to clinical years day 2013)
TRANSCRIPT
Introduction to clinical
years: year 3 overview
How do you feel about the upcoming VIA?
Perspective on assessments
40% MED2031 40% MED3051
10% Y1 20%Y2 30%Y3 30% Y4 10% Y5
For the VIA, the difference between receiving the
median 70% mark and the top 90% mark makes :
20% to your VIA score
4% to your year 2 score
0.8% to your MBBS scoreLearning is important. Study well, do the best you can. Don’t stress!
Content delivery
Year 2
• Lectures• Tutorials• Written assignments
• Exams• OSCEs• Patients
Year 3• Lectures• Tutorials
• Written assignments• Exams• OSCEs
•Patients
Travelling to year 3
Sites and rotations
Where?
Metropolitan• Central Clinical School
o Alfred Hospitalo Epworth Hospitalo Sandringham Hospital
o Cabrini Hospitalo Frankston Hospital
• Eastern Health Clinical Schoolo Box Hill Hospitalo Maroondah Hospital
o Angliss Hospital
• Southern Clinical Schoolo Casey Hospital
o Cranbourne Hospitalo Dandenong Hospitalo Monash Medical Centre
o MMC Moorabbin
Rural• Bendigo Regional Clinical School
o Bendigo Health• East Gippsland Regional Clinical
Schoolo Central Gippsland Health Service
(“Sale”)• Gippsland Regional Clinical School
o Latrobe Regional Hospitalo West Gippsland Healthcare Group
(“Warragul”)• Mildura Regional Clinical School
o Mildura Base Hospital
Clinical school liaisons
• New positions (previously clinical site liaisons) – will be elected with other MUMUS positions
• Liaison between you and the clinical school if you have any issues (mini academic rep)
• Run smaller social events (mini social rep)
Logistics
• Accommodation: at home, at a residential hall (Clayton, Berwick), student accommodation apartments, sharehouse
• Travel: public transport, parking• Tips can be found in the MUMUS Year 3B
Guide
Rotations
• Medical or surgical• General or specialty• 2-7 weeks depending on site• ‘Home’ team of doctors for: – Ward rounds– Outpatient clinics– Theatre/endoscopy– Answering questions if they’re free
A typical week (surg rotation)Monday Tuesday Wednesday Thursday Friday
7:30 Ward round Ward round Ward round Ward round Ward round
9 Theatre Outpatient’s clinic, radiology meeting, consultant ward round
Anatomy, radiology, pathology, pharmacology etc. lectures (all clinical schools)
Theatre
10 Case presentations
11 PBL
12
1
2 Medical bedside 5th year mentorship tute
EBCP, occupational medicine, PBL etc. lectures (all clinical schools)
Theatre Theatre
3 Theatre/ endoscopy
4 Site-specific lecture
Surgical bedside
5 Site-specific lecture
A typical week (med rotation)Monday Tuesday Wednesday Thursday Friday
8 Ward round 7:30 startGrand round
Ward round Interdisciplinary meeting
Interdisciplinary meeting
Morning Anatomy, radiology, pathology, pharmacology etc. lectures (all clinical schools)
Case presentations & PBL
Afternoon Medical bedside & site-specific lectures
Outpatients clinic EBCP, occupational medicine, PBL etc. lectures (all clinical schools)
Surgical bedside
PBL
Patient cases and paper cases
Patient cases
• Similar to PBL in second year except the ‘case’ is a real patient seen and presented by a group member
• Based on conditions• Run in small groups• Depending on your tutor your group may
research an aspect of the task each and present or the tutor may give a PowerPoint presentation.
List of patient cases 2013• Chest Pain• Acute Glomerulonephritis (GN)• Breathlessness • Cough and weight loss• Deep Venous Thrombosis/Pulmonary
Embolus• Abdominal Pain• Diarrhoea• GI Bleeding• Obstructive Jaundice• Anaemia • Breast Cancer• Splenomegaly and lymphadenopathy
• Pneumonia • Thyroid Disease• Osteoporosis• Type 2 diabetes• Delirium• Stroke• Peripheral Neuropathy• Seizure• Movement Disorder/Parkinson’s
Disease• Peripheral Vascular Disease• Urinary Obstruction• Skin rash/ulcer
Paper cases
• Run in larger groups• Based on a set of symptoms• Depending on your site, these will either be
run as a lecture by a doctor or a group of students, who will be given the topic about a week in advance to prepare. An expert facilitator will discuss aspects of the topic and provide feedback to the presenting group.
List of paper cases 2013• Mr Lance Patrick - swollen legs• Ms Ghelani Singh - breathless on
exertion• Mrs Jessie Johnson - calf pain• Ms Sophie Panopoulos - tired and out
of sorts• Mr Peter Hood - cough and loss of
breath• Mr Michael Todd - jaundiced• Mr Stephen Tsagakis - severe stomach
pain• Mr Maxwell Jacobs - fever and night
sweats• Mr Tony Spencer - severe headache
and flu symptoms
• Ms Jenny Randall - muscle aches, fever and cough
• Mr Josh Felix - extreme lethargy• Mr Simon Smith – cannot get out
of bed• Ms Siu Jung - rash• Mr Peter Paunch - knee pain and
swelling• Mr Jules Brady - health check• Ms Anne Smith - history of
headache• Mr Branco Vladic – motor vehicle accident
Bedside tutorials
• The style of bedside tutorials varies between tutors• Format 1: No preparation required, tutor picks a
patient and everyone gets a chance to examine the patient
• Format 2: Tutor asks group to find a couple of patients, someone who has not interacted with the patient examines them
• Format 3: Tutor sends group leader a shortlist of patients and every patient is seen by someone in the group before the tutorial and we present back
Great opportunity to:
• See patients not related to rotation• Get feedback on a range of clinical skills• Ask questions about content• Learn from watching peers• Practice MCRs in almost exam conditions• Have MCRs assessed (don’t worry, not during
actual tutorial)
5 final tips for third year
Spot the difference
See a patient every day
• Find a patient (ward rounds, day procedure unit patients or a friend from another unit)
• History: 8 minutes• Examination: 8 minutes• Look at drug chart, notes: 4 minutes• Read more about the condition (Kumar & Clark’s or
BMJ BestPractice): 10 minutes• If they’re really sick you might spend more time on their investigation
results and less on the examination
• You should complete this in 30 minutes
30 minutes of extra ‘work’ a day
• Potentially on the wards in year 3: 36 weeks in the year
• Allowing for orientation/consolidation/study weeks: 32 weeks
• Allowing for Wednesdays and weekends: 128 days
• 128 patients• That’s more conditions than on the curriculum!
What’s wrong here?
Three year job interview? Perhaps, but if at the end of it all, you’re too burnt out to
care for your patients, what’s the point?
The last time something will be summarised on the final slide for you :p
1. Not everyone in the hospital knows what you’re after so don’t be afraid to ask nicely
2. The content is very manageable if you do a little bit steadily throughout the year
3. You are colleagues, not competitors4. Look after yourself first, seek help when you
need it5. [This line has been intentionally left blank. What
are your hopes/goals for the year?]