SECOND YEAR

Second Year – by Rian Hayes

Well done, you survived first year! Just four more years of fun to go. The good news is that second year actually is fun. Just like second year in school you’re a good bit more confident now; you’ve all gotten the lie of the land, you know what a module is, you know the TBSI, and you have a set of first years to act knowledgeable in front of. Here’s a guide to how the year works that I’ve definitely made way too long. There’s also a bit about schols at the end for anyone who’s interested.

The social side

I won’t bang on about it too much but the advice for the year is the same as ever; grab it by the balls. There’s plenty opportunity to get to know people even better, and plenty of couches to crash on now that a good portion of the year are living out around town. It’s also the last year that you’re based on campus and your best chance to get involved in campus life if there are any clubs or societies that you think look like a bit of craic (seriously just go and try something  if it looks good, we all spend far too long worrying about embarrassing ourselves). Second year is also a great chance to get away on a few trips if you’re lucky enough to scrape the cash together; the Biosoc Christmas trip, the Ski trip in January, and Wind Wave Rave are all very popular. Plus Biosoc have a surprise or two in store this year to add to the usual social schedule (woo!!). Finally, looking ahead to your next summer, it’s the last long one so it’s never too early to think about what way you want to make use of that time.

 

The academic side

There was a bit of re-jigging last year, so bear with me while I try to explain how it all works.

There are first semester modules and second semester modules, with the exception of Pharmacology which runs across both semesters: 30% of the mark is for Semester 1 and 70% of it is for Semester 2 (subdivided into 16% for a research project and 54% for the end of Sem. 2 exam). For us the Clinical Skills module also ran across both semesters, but the only exam for it was in summer, I don’t think it will run across both semesters for you guys. The Semester 1 modules are Pharmacology (Pharm), Head and Neck Anatomy (no you haven’t left the DT yet), Clinical Biochemistry, and Infection and Immunity (I&I). Semester 2 is definitely the easier of the two, everyone was a bit frazzled by Christmastime in our year, as Semester 1 is fairly busy. Semester 2 is pretty chill, the modules being Neuroscience, Molecular Medicine and Pathology, and for you guys I think Clinical Skills will be exclusively Semester 2. Don’t worry, you’ll be fine in Sem. 1, but if you can keep on top of things from the start then do because you’re in for a very stressful month leading up to Christmas exams if you let stuff pile up. Here’s a rundown of each module:

 

General Advice

Find the lecture timetable for each module, print it off and stick it on your wall at the start of the year. Tick off the lectures as you go, and keep an eye on them because they’ll pile up. I’ve done my best to give the correct breakdowns of modules and exams as it was true for our year but it could well vary for your year, so the best thing to do is to have a look at the assessment section of the Module Overview under the ‘Welcome to [this module]’ tab once you click into each different module on Blackboard. Lastly, I’ve probably made it sound like a silly amount of work and no fun, but just stay on top of things and remember to work hard and play hard. It’s a very fun year.

 

(Semester 1)

Pharm

This was my favourite module, it’s pretty interesting. The teaching for us consisted of 25 lectures and some tutorials on Thursday or Friday afternoons. The single best thing you can do for your understanding of pharm is to go and read over how the nervous system works in week 1, if you know how the sympathetic/parasympathetic nerves work and where they distribute to + know the NMJ then you’re well set to actually understand Michael Rowan’s lectures (the first ones of the term). He’s a nice guy, but he can be a bit high brow, and his lecture notes are useless for studying off, so take good notes at the time and you won’t be sweating when it’s Christmas (yes his stuff does come up on the paper). Paul Spiers is a hero and his lectures are good, so go to them. Again, you’ll learn the pharm way more easily if you know the physiology, so it wouldn’t hurt to pull out Sherwood’s again when you see a new system (CVS, renal) coming up on the lecture timetable. Also, remember to print out Spiers’ lecture notes before the lecture, because he likes to fill in the blanks on his slides as he goes (you’ll see what I mean).

If you’re not a big fan of lectures and prefer to work out of a textbook (or if half a lecture went over your head and you need it explained) then Rang & Dale’s Pharmacology is the place to go. Some people like Lippincott’s but I’m a big advocate of Rang & Dale’s. Pretty much every lecture or couple of lectures you get in pharm corresponds to a chapter of Rang and Dale’s, so it’s a great place to get more detail or have it explained if from the basics. Ignore Rowan when he advises getting the latest edition of Rang & Dale’s, the only difference is some skin stuff and new cancer drugs, neither of which are covered this year. You’ll be able to pick up a cheap copy at the Biosoc booksale that will do you perfectly for the year.

The pharm tutorials aren’t too important, but you can learn from them if you want to. They’ll start off hilariously quiet just like your first PBL sessions because everyone is too nervous to speak in front of one another. It’s better for everyone if a few of you just pipe up with an answer when the tutor asks a question though, means way less awkward silences and the thing finishes much quicker.

The exam: The exam has an MCQ and an SAQ section (you can check the exact breakdown in the module description on blackboard, I think it was 50 MCQs and 10 SAQs for us, and together the exam was worth 30% of the overall module mark for the year). The number one piece of advice here is that drug names are very important for the SAQ section. You can know all about Class III antiarrhythmics, but if they ask you to write about amiodarone and you can’t remember what that one is, you’re goosed. A good way to study as you’re going along is to take note of the drug names mentioned in each lecture and make a set of flash cards or something like that so you can test yourself on each drug name and method of action. The other reason you want to make good notes now is because the Semester 1 lectures are examinable on the summer exam, and when you get to 3rd year pharmacology, loads of it is just adding bits on to your second year knowledge. Learn it well now and you’ll thank yourself later.

 

Head and Neck

Lol you haven’t escaped the clutches of PT and Mahony yet. Although Mahony had nothing to do with teaching us Head and Neck last year. There were 20 lectures all given by PT last year with the exception of some embryology/clinical stuff from another guy. Ignore the embryology – it’s useless for the exam and three lectures isn’t anywhere near enough to properly introduce someone to embryology, nevermind teach them all the way up to head and neck formation. If you’re one of those people who feels that you couldn’t bear to take such a risk with your first class honours and so decide to ignore this advice, then focus on the pharyngeal arches and which cranial nerves and facial structures derive from which arch, that’s largely what they’ll care about if you have some spare time at the end of a viva or schols paper. If you really want to study it, ignore the books they recommend too, ‘The Developing Human’ by Moore is the best place to start off, but this should be very low down your list of priorities.

How to study head and neck: Just get on top of it from the start and stay on top of it is my advice, if you can read up on a topic before PT’s lectures on that topic and the DT session for it then do because the sessions will be way more useful then. Let’s face it though, about five people in the year will manage that. Hopefully all PT’s notes are floating around in a drive somewhere, they’re a brilliant resource and it’s very sound of him to put them together for everyone. They’re also the best indicator of what’s coming in a lecture, in fact, they’re pretty much PT’s script for a lecture, and it’s what he wants handed back to him in an exam. If you can’t find the notes, just shoot me or some one of the other third years a message (we don’t bite, I promise) and I’m sure there are old sets that can be lent to you guys. Beware the notes are quite dense, very detailed in places, and are sometimes not the best for giving a general overview of a subject, so it’s good to refer to a textbook from time to time. Clinically Oriented Anatomy by Moore, Agur, and Dalley is definitely the best one, and I think even the anatomy dept. are coming around to that point of view, don’t bother with Grey’s for Students, Last’s or Grant’s Atlas. In case you didn’t already know, PT’s notes are largely based on Last’s, and he likes taking diagrams (including exam diagrams) from Grant’s Atlas. You’ll be fairly lost on the first day in the DT, as far as I can remember PT doesn’t give a big lecture on the cranial bones and cranial foramina + their contents, but that’s what you’re looking at on your first day in the DT, so a book is particularly useful for learning those basics in the first week. On that note, the cranial foramina and their contents (nerves, arteries), do come up quite frequently in vivas, so know learn them at the start and don’t have forgotten about them come exam time. Also, know the larynx, they love the larynx in the anatomy dept.

The exam: For us at least there were 5 sets of MCQs that happened on Monday afternoons which were worth 4% each of the total head and neck grade (i.e. 20% of the total H&N grade altogether). These are well worth studying for and tend to focus on the material covered in the weeks since the last exam. Just accept that PT will include one or two arsey questions on ridiculously obscure anatomy that no one on this planet can definitively answer, and there’s no point fighting him on it. You can still get a healthy 18/19% if you do a bit of revision for them. The MCQs made for a nice cushion going into the Christmas exam. At Christmas, the viva made up 30% of the overall module mark and the written paper made up the remaining 50%. The viva was a good opportunity to pick up marks so that hopefully you were near enough to passing by the time you’re doing the written paper. On the written paper there were MCQs, diagrams to label, and SAQs, and beware that you’re very pushed for time. I remember the day before or so, PT sent around an email warning us that the written paper was a searching exam designed to push us (From what I remember, the MCQs were pretty fiendish, and the diagrams were illegible, so the SAQs were the best opportunity to do well). Try to cover all the big areas, because a wide spread of subjects comes up on the exam.

 

Clinical Biochemistry

This module was one of the nicer ones, but remember to afford it the respect it deserves. There are five series of lectures within Clinical Biochem: Extracellular Matrix (4 lectures), Coagulation (6 lectures), Diabetes & Obesity (4 lectures, given by Richie Porter), Clinical Biochemistry (7 lectures) and Clinical Endocrinology (8 lectures).

The exam: This is the module where good exam tactics are probably most applicable. Section A of the exam deals with the first three (ECM, Coag, D&O) lecture series, there’s a Question 1 A or B, Q.2 A or B, and Q.3 A or B. Question 1 is on Coag, Question 2 is on ECM, and Question 3 is on Diabetes and Obesity. Of the six questions you answer 2, you just can’t answer part A and B from the same question (e.g. Q.2.A and 2.B) but for example you could answer Q.1.A and 2.A, or Q.2.B and 3.B, or Q.1.A and 3.B. This means that if you’re really stuck in the run-up to exams you can be get quite selective about what you study, i.e. pick two of ECM, Coag, D&O, and you can afford to leave out one lecture in each of what you pick, since in each question there’s a choice of 2 questions. Coag definitely has the most material, so for example I picked ECM and D&O, left out the cancer lecture in ECM and left out one of Porter’s obesity lectures in D&O, leaving 6 lectures to study for all of Section A at Christmas time. Section B has a Q.4. A or B (Clinical Biochemistry), and a Q.5.A or B (Clinical Endocrinology).

How to study: The easiest way to prepare for Section B is to go to the lectures and take good notes, the material is actually interesting enough and the two lecturers go through it slowly enough to get all the explanation down. What you’re looking to do is focus on why different measurements (electrolytes, hormones) get thrown off in different diseases, because that’s what the questions will focus on in the exam. You’ll be given a sample set of measurements and asked to explain them, or given a disease and asked to explain what kind of measurements you’d expect to see.

On the Section A lectures, beware the lectures can sometimes not have all the detail you’d want to write a good exam answer on it, so Junquiera’s histology (look for 13th/14th edition) is a good place to go to do some reading on ECM (esp. collagen processing which is basically what the first lecture is, and the rest of the matrix which is lec. 2), and there are a couple of pages in Stryer’s Biochemistry that explain the metabolic changes in diabetes really well (don’t get lost in Stryer’s though, because it’s incredibly dense and over-detailed). Beware, Porter’s lectures a bit scant on concrete detail in some places last year, so a little bit of reading for the sake of bulking out an exam answer wouldn’t go amiss. Also beware that on Porter’s exam question, he usually gave a question on obesity and a question on diabetes, but last year we got a little bit shafted when he decided to put on two obesity questions. That probably bodes well for you guys though, I’d imagine diabetes will come up again this year and it’s the meatier of the two topics (no pun intended). I never really revised coag properly once it came to the very busy few weeks before exams so I can’t recommend a textbook I know for sure is good, but most people seemed to be happy enough to just go through the lecture notes. Otherwise I’m sure any good physiology book would go through coag well enough. Coag is alsoworth doing well at some point anyway because it’s relevant for pharm and it’ll come up again and again in your clinical years.

 

Infection & Immunity

This was a new module last year, and seemed to get off to a fairly good start. Beware of one thing, it’s combined of microbiology, immunology, and parasitology, which makes it a fairly mammoth module at 37 lectures (and plenty of them are 45/50+ slides long). Again, afford it the respect it deserves and don’t let it pile up. The lecturers are all legends in their own way, very helpful (which is a general rule for most of your other lecturers too), and very accommodating – they want you to do well.

How to study: It’s often given advice, but it’s true – the best way to learn the material is to go to the lectures; when you’re in an exam you’d be surprised at how much you remember just off the back of having been in the lecture hall for that topic. I found with immunology, and parasitology, the lecture notes were very easy to follow and had plenty of detail for an exam answer. In microbiology, the lectures were great (Stephen Smith is the most enthusiastic microbiologist you’ll meet), but when it came to revising a book would have been a great adjunct to add some detail where you wanted it, and explain some things that went over your head in the lecture (micro can be tough to get a grip on, as it’s a very different topic to most of what you’ve already studied). Some recommendations include the ‘sketchy micro’ videos that can be found online (highly recommended by most), ‘microbiology made ridiculously simple’ was a recommended book, and Murray and Rosenthal’s Microbiology also got a look-in as well.

The exam: Our exam was very fair, there was an even spread of topics and no nasty surprises. Your exam might be a wee bit trickier than ours given ours was the first year of the module, so the dust has settled and everyone is happy with how it all works. Listen to Stephen Smith if he’s telling you what direction he’s taking things this year, drops a hint or advises looking at something in particular, his word is that of a demi-god. Go to the labs, you will remember what a Gram stain is once you’ve done one, also the throat cultures are fun and it’s your first chance to use a Bunsen burner since secondary school.

 

Christmas

Take the opportunity to enjoy the holidays and really relax over the break (unless you’re doing schols, hahaha). The schols advice is at the bottom. Most people are wrecked by the Christmas exams, so recharge the batteries before you come back, and if you’re going on the ski trip then make sure you catch up on sleep before you go.

 

Semester 2 – General advice

Semester 2 in my view was a lot more chill than Semester 1, although if they’ve moved your clinical skills module to Semester 2 entirely then they’ve probably evened out the workload a bit for you guys, which is good (for us Clinical skills meant we were in the hospitals every Tuesday throughout the year). For the first time what the School of Med did for us was to split the Semester into essentially two mini terms. Neuroscience was taught from week 1 to week 6, with a study week in week 7 and the neuro exams at the start of week 8. Then the rest of week 8 was dedicated to lab skills and research skills lectures and workshops for your pharm project. Weeks 9 and 10 were dedicated to working on the pharm project. Weeks 11 to 16 were back to lectures for the rest of the year, with 6 weeks of the rest of pharmacology (approx. 20 lectures), and Mol Med + Pathology rolled into one 50 lecture module. Week 17 was a study week and Weeks 18-20 were set aside for exams. Our written papers were finished by mid-Week 19, and the Clinical Skills OSCE was midway through Week 20, which was June 1st, so you can probably expect to be finished sometime similar to that.

 

Neuroscience

Neuroscience (consists of neurophys, neuropharm, neuroanatomy, neuropsyh, and neurobiochemistry, each worth 20% of the module mark) is a pretty interesting module, and one you can do well in.

How to study: for neurophys, go to the lectures and use the lecture slides to make good notes, that’s all you need for a very high exam mark (mid 80s or so). Go to the neuropharm lectures, and study the relevant chapters in Rang & Dale’s. Neurobiochem is concise and very manageable, go to the lectures and have a look around the drive for the very good summary of all the neurotransmitters. It probably makes the pharm easier to learn if you do the biochem first, and you can get a book for the biochem if you like but there’s no real need to. For neuropsych, go to the lectures and take good notes, there’s some good stuff in the drives, well worth a look. The 20% of the module that neuroanatomy was worth was split into 10% for the MCQs and 10% for a viva that was just spotter stations (no actual viva stations) because there weren’t enough anatomy staff available to run viva stations. The spotters were very fair and were a good opportunity to do well and pick up marks. To balance that out, the anatomy MCQs were fairly fiendish. PTs notes, Acland’s, and a couple of the recommended books are the best resources to learn neuroanatomy from.

The exam: there were two papers; paper 1 was 2.5 hours long and consisted of neurophys, neuropharm, and neurobiochem. Each subject had a choice of two essay questions, of which you did one. Paper 2 was 2 hours long (takes a good bit less than 2 hours to do) and consisted of neuropsych EMQs and the neuroanatomy MCQs. The neuroanatomy vivas (just spotter stations) were spread out across the week. It’s worth pointing out that the pass mark was 50% overall, you didn’t have to get over 50% in each individual subject, but you had to get over 50% across the whole module, and over 30% in each individual subject. For example, if you get 57% overall in the module but scored 28% on the neuroanatomy section, that would be deemed a qualified fail, and you’d have to do supplementals for neuroscience (that means doing all five subjects again, not just neuroanatomy).

 

Pharmacology

The project: The pharm project is worth 16% of the total module mark. Just because it’s a pharmacology project, doesn’t mean it’s a project on pharmacology, in fact it’s probably not. It could be anything from a couple of weeks’ lab-based work on embryological tissue markers, to a literature review of herbal medicines, to a clinical audit on hand-hygiene or opiate prescription. You don’t need to worry about any of this until it comes to signing up for the projects after Christmas. When you’re signing up for one, you can filter them according to what you want to get out of it. Not all the projects take an equal amount of work, some take way more work than others. On the other hand, you can get a lot more out of some than others. If you want to be really keen, you can look for a project where there’s a high chance of getting a publication out of it in an area you’re interested in. If you just want a quiet couple of weeks then you can probably look for something where it looks like you can do a portion of your work from home and not have too high a chance of the work continuing on past the end of the research weeks. I wouldn’t be too concerned about where the project is based (TBSI, James’, Tallaght). You’re going to be travelling to the hospitals enough over the next three years, you may as well get used to it now, it’s really not that bad. You spend weeks 9 and 10 doing the project, and you’ll have the chance to meet the people running your project a couple of times in the weeks running up to that just to get an outline of the project and be briefed on any work you’d need to do before the research weeks start.

The rest of the module: There are another 20 pharm lectures that we got in the 6 weeks (weeks 11 to 16) after the research weeks. They were grand, again Rang & Dale’s is the place to go for most of this material, and the summer exam was in week 18. The thing to remember about the summer exam for pharm is that all the material from the 25 lectures before Christmas is also examinable in the exam, and it does come up. The structure is similar to the Christmas exam, and it’s very manageable if you just keep on top of it and make decent notes that you can come back to.

 

Molecular Medicine and Pathology

This was a big ol’ module, 50 lectures long, and like pharm it ran from week 11 to week 16. Sometimes it’s not clear what lectures are mol med and what are path, so it’s a good idea to print the lecture timetable for the module and have it handy for the couple of weeks. The best way to study this one really is to just go to the lectures and make notes, then look at the structure of the exams and try to decide what areas to focus on. The path lectures aren’t so much one long coherent lecture series as they are a hodge-podge of sets of 2 and 3 lectures on different areas, all given by different people. All are interesting and useful, but it becomes quickly apparent that there will be a bigger emphasis on some core areas in the exam, e.g. cancer. There wasn’t any particular textbook that dealt effectively with the lecture material, so the lecture notes themselves proved to be the best thing to work off + a bit of googling + a bit of whatever you’re having yourself.

The exam: The structure of the exam was quite forgiving; there were two papers, each 2 hours long and worth 50% of the module grade. Material from both mol med and path was spread across the two papers. Of the 50% going for Paper 1, 30% was going for Section A (answer 1 of 4 essay questions), and 20% was going for Section B (4 SAQ questions, each with an A or B, do either part A or B of the 4 SAQs). Paper 2 was made up of 100 MCQs, choose 1 of 5 single best fit answers, no negative marking as far as I remember. The best way to approach the MCQs is to have read over each lecture once or twice and then look around for some practice MCQs to test yourself with.

 

 

Clinical skills

I don’t know how this module will for you guys, I’ve just heard rumour that it’s been changed from how it was for us, and some talk that it’s been moved entirely to Semester 2. Either way, I’ll explain how it worked for us and you can take from that what you will. Every Tuesday we used to go out to either James’ hospital or Tallaght hospital for the day. Half the year started in James’, the other half started in Tallaght, and we swapped locations at Christmas. In the hospitals we were based in the Clinical Skills centre, which is located in the teaching centre in either hospital. You’re new to the hospitals this year so I’ve included some info on transport/food and drink. There are also libraries in each of the SJH and Tallaght teaching centres if you ever feel the mad urge to study while you’re out there. I used to get the Luas out to both SJH and Tallaght; the James’ teaching centre (the Old Stone Building and the big red brick Trinity Centre across from it are the two buildings you’re looking for) are just around the corner from the James’ Hospital Luas stop, and the best stop for going to Tallaght Hospital is actually to get off at Cookstown stop. If you walk 100 yards up the Luas line from the stop there’ll be a gate on your left that leads into the back of the hospital (the teaching centre end), and you’ll have to try and follow someone with a swipecard in the door directly in front of you, or else follow the little road around to the left and the main revolving door for the teaching centre is there and it’s always open. You’ll very quickly figure out where to go for everything anyway, if you arrive 5 mins early on your first day you’ll find someone in an older year to follow around.

Food and drink around James’: There’s a café in the Old Stone Building where most people get coffee on their breaks, they also have scones and muffins, and some hot breakfast stuff in the morning. In the afternoon you can get salads, sandwiches, rolls and that kind of thing. A good roll probabaly costs €3.50/€4. Beware though, extremely annoyingly, they tend to stop serving food by 1:30/2pm, and they also only take cash. If you go over to the main hospital (ask someone for directions, you’ll learn your way around soon enough), go into the reception area and there’s an over-priced Londis and two coffee shops on the ground floor, there’s also an ATM. If you go upstairs, the stairs is over on the left, opposite the reception desk, there’s a Kylemore café that does hot food, as well as a Quiznos sub. There are also a few chippers and the like around if you go off the hospital campus back towards the main road.

James’ transport: It’s close enough for a lot of people to cycle, there are plenty of bike racks around by the teaching centre. The Luas is dead, handy and very frequent, so I take the train to town and hop on the red line from Busaras. If you’re travelling between James’ & TBSI, the Luas is the easiest. Take the red line to George’s dock (next stop past Connolly going towards The Point), get off there and walk through the CHQ centre to the quays, head over Seán O’Casey bridge (right in front of you), and up Lombard St. to the corner with Pearse St. (Camile, Goldsmith, and the gym). It’s about a 7 minute walk on top of a 20 min Luas journey. A load of buses go to James’, all I know is that the 123 is one of them, I don’t think many people tend to get the bus though – they tend to be fairly slow getting down to SJH on account of the morning traffic. You can drive, but if you want to know where’s best to park ask some of us older years (not me though), who know the best cheap/free spots around the hospital.

Tallaght food and drink: There’s a café in the teaching centre that has decent coffee and bagels, if you want a full dinner at lunchtime head down to the hospital canteen (halfway down Hospital st., just ask someone to show you). You can expect to spend about €5 on a hot dinner there. There’s also an ATM and a Londis further down Hospital St. in the main hospital reception. I’ve never had any need to go further afield, but I’m pretty sure The Square shopping centre isn’t too far from the main hospital doors down at reception.

Tallaght transport: Most people get the red line out (see above for directions for getting off at Cookstown). Some people living on the southside find cycling is alright, or even cycle to a red line stop and hop on the Luas (don’t try cycling down the hard shoulder of the M50 though). You can drive, again ask some of us older years (again not me though) if you want to know where’s best to park. You can also bus it, but it’s definitely slow and awkward. I don’t know what routes go there and I’m not bothered checking it for the sake of rounding out this paragraph.

A day in the hospital: We usually had some teaching seminars/lectures in the morning (of varying interest and relevance) and then we’d be broken into groups for the afternoon to take histories from patients or practise exams (you learn how to do a cardiovascular, respiratory, abdominal and musculoskeletal (MSK/GALS) exam this year). We’d also have history presentations in the morning where two groups that had taken histories from patients the previous week would present the histories to the other groups (don’t worry it’s not hard at all, and someone will show you what to do if you’re one of the first few groups up – everyone else just follow their lead). At various points you also learn clinical skills in the clinical skills rooms where you practice on dummies (taking blood (phleb), putting in cannulas (IV cann), basic life support (BLS), point of care testing (POCT), the Eye and Ear exam and vital signs (measuring blood pressure, taking a pulse, respiratory rate, temperature, O2 sats, and filling in an early warning score sheet)). Basic life support is how to do CPR, and point of care testing is using a glucometer to measure a patient’s blood glucose with a finger prick test, urinalysis using the little dipsticks is also included here. We also got farmed out to various out-patient departments on some afternoons to see how the clinics worked (basically a consultant and their team would spend the afternoon seeing patients of theirs that come in by appointment to have their case reviewed or to have a minor procedure or something like that).

Dress: This one’s not hard, you look smart if you’re going to see patients. If you know for sure you won’t have any patient contact/be on the wards or in an out-patient department across a whole day then you can wear whatever you like, they don’t mind what you wear in lectures. If there’s a chance you’ll be seeing patients/patients will be seeing you then dress professionally.

Infection control, mobility, and appropriateness mostly govern how people dress in hospital. Infection control means be bare below the elbow (i.e. be sure your sleeves roll up and stay up if they’re long), don’t have any frills or ties or necklaces that will dangle and rub off patients/other surfaces if you’re bending over a bed or something. Mobility means don’t wear impractical clothes really, doctors (and med students) do a fair amount of running around, and moving patients around when they’re examining them and stuff, so just don’t wear anything that’s going to restrict your movement, or be tottering around in 6 inch heels. Appropriateness is a little harder to define and it’s important to note that it’s not political – no one’s trying to censor what you wear, it’s just important to remember that we’re all obliged to dress in a way that’s going to put our patients at ease and assure them that we act professionally. That basically means keep the tone of your dress reasonably formal, no mad/inappropriate designs or prints, no midriffs on show, hemlines below the knee, and no plunging necklines (especially conscious of the fact that you’ll be bending over patients when examining them).

For lads, this means wear a decent pair of shoes (i.e. not runners), a pair of trousers (not jeans, slacks or chinos in most colours are absolutely fine), and a shirt with a collar. You can wear a tie if you like, you’ll notice a lot of doctors don’t, or have it tucked in for infection control. For the same reason, everyone has their shirt tucked in. That said, some older, more traditional consultants might bark at you if you don’t have a tie on, don’t worry about that happening though, they won’t get you kicked out for it. If you’re cold, a decent jumper or cardigan or something is fine (just don’t wear a hoody). Generally speaking people secretly like to dress up a bit, so you’ll notice the year looks pretty sharp when they turn up to the first few clinical sessions.

For ladies, it’s a lot harder to define what the ideal way to dress is, and I’m certainly not the one to make any decisions on what is and isn’t ideal, I’m just going to tell you that most of the girls seem to wear dresses, or trousers/skirts and a decent top/blouse.

The exam: This year you learn what an OSCE is. It stands for Objective Structured Clinical Exam, and in second year it was an exam we had in summer to test our clinical skills that we’d learned throughout the module. There were 14 stations, 12 exam stations and 2 rest stations, all stations lasted 6 minutes, and you rotated each in turn. The kind of material that could come up on each station were each of the 4 clinical examinations (CVS, Resp, Abdo, MSK), i.e. you have 6 minutes to perform one of these exams on a fake patient in front of an examiner. Not all of them necessarily come up in one OSCE. All the clinical skills listed above could be tested (POCT, BLS, Phleb, IV Cann, Vitals, Eye & Ear exam), each of these would be an individual station, for example on my exam I had one station where I had to take BP, pulse, RR, and fill them in on an EWS sheet, on another I had to draw blood from a dummy, another was BLS, and on another I had to interpret two simple made-up urinalysis strips. Eye and ear tends not to come up often, the rest do frequently enough though. The rest were history taking (one was a clinical history, the other was a communications history – you’ll learn the difference, don’t worry), simple Chest X-Ray interpretation, simple ECG interpretation (we had a lecture on each of these), and a simple written ethics station (not sure we even had a lecture on this but it’s all common sense stuff, like the first year ethics tutorials). The OSCEs are very fine, and very difficult to fail, so don’t worry too much about them.

 

Again, the year is actually great craic even though it seems like a load of work, and be sure to take the opportunity to skive off the odd lecture and go day-drinking together while you still can.

 

 

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