What I Wish I Knew In 4th Year

4 rotations Paediatrics and Child Health Women’s Health Emergency Medicine and Critical Care Long Term Conditions Assessments (Progress Tests and OSCEs) QIP

Ice berg – What you see as an individual student is only the tip of the iceberg Different students will have very different experiences, and you won’t see everything you need to know about Therefore you need to read around a lot as you go along

Some general points Be prepared in advance Bookwork, histories, examinations etc before you start Introduce yourself and be proactive Going in out of hours can be useful Seek out extra learning Be flexible

Paediatrics It’s normal to be apprehensive Paediatric ED/short stay ward is a great place to gain confidence around children (and their parents!) When on neonates, find out who the on-call delivery reg is and ask to shadow them You will end up spending lots of time playing/drawing/making silly faces – embrace it!! Step up to general paeds from ED/short stay Clerking with juniors is really helpful – get stuck in with the ward rounds

Women’s Health Prepare to be frustrated on the delivery ward! Early Pregnancy Assessment Units are a good place to practice obstetric histories and examinations You will have to ask personal questions – find ways of asking that you are comfortable with Intimate examinations Surgery Sexual Health clinics On the ward Babies choose when they come, and it’s often not 9-5! Early morning can be a good time to see natural deliveries as apparently lots of inductions happen then. The midwives are your friends – be proactive, say why you’re here and what you want to do Sexual/other personal histories – only ask as much as you need to know, but make sure you don’t miss out on key info because it’s embarrassing to ask GTA sessions are bizarre but helpful Practice on models early Everyone finds it easy to do in different places Make sure to get consent (written forms for surgery) Do it as a Mini-CEX

EMCC Know your ABCDE assessment ED is a great place to learn, but you have to be smart Buddy up with a Junior Dr in majors Resus is a good place for practical skills Don’t spend too long on ITU Spend time with the Critical Care Outreach team if possible Get hands on with the anaesthetists

Long Term Conditions Covers A LOT of different specialties – be prepared Learn and practice the rheumatology and orthopaedic examinations before your placements Be proactive in seeing the cases you need to see It may seem less exciting – take the time to consolidate your knowledge

Portfolio Learn how to use DEBRIEF Be proactive in seeking out SLE’s Read the relevant Anchor Statements so you know what a good SLE should look like Have the Anchor Statements to hand for the Dr to look over Make sure to cover all discussion points Learn how to use DEBRIEF It will make reflections much easier

Progress Tests 3 throughout the year Only the 3rd is summative, but all appear on your transcript! 3rd and 4th year content came up fairly equally for us Don’t try and guess what might come up based on previous PT’s Tortoise and hare

OSCEs Prepare based on what you’ve covered Some common ones include moulage/ALS, difficult communication, obstetric history and examinations, collateral histories and orthopaedics/rheumatology examinations Practice throughout the year We had some curve balls this year, but knowing the basics will stand you in good stead

QIP Start early and make sure you have a plan in place Keep it simple! Follow the guidance from Kings

Learning Resources Masterpass (Finals and Specialties) A lot of Finals Courses are coming up in spring for people in the year above at other medical schools – go to them now as you won’t get another chance before finals Masterpass (Finals and Specialties) Online questions banks Lots of courses (too many to name here)

Key take home points Be prepared, be proactive and make the most of the time you have Read up as you go along Have fun!