School of Clinical Medicine School of Clinical Medicine Stage 3 An overview of the year ahead. Jessica White Stage 3 Coordinator

School of Clinical Medicine School of Clinical Medicine There is life after Pathology!

School of Clinical Medicine School of Clinical Medicine Preparing for Practice Knowledge Skills – clinical, practical and communication Professional attitudes

School of Clinical Medicine School of Clinical Medicine 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!)

School of Clinical Medicine School of Clinical Medicine Preparing For Practice Key facets Self Directed Learning Responsibility Reflection on Practice

School of Clinical Medicine School of Clinical Medicine Preparing for Practice Responsibility –Final OSPE Venepuncture,Cannulation,ABGs,Suturing –Senior Students (teaching junior students) –Presenting patients with management plan, following up –Integral part of team

School of Clinical Medicine School of Clinical Medicine Preparing for Practice Reflection on Practice –Portfolios –Case based discussions with reflection –Team working essay –Palliative care essay

School of Clinical Medicine School of Clinical Medicine 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

School of Clinical Medicine School of Clinical Medicine 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

School of Clinical Medicine School of Clinical Medicine 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

School of Clinical Medicine School of Clinical Medicine Senior Surgery 2 students per firm, present patients on rounds Direct patient care – ward and theatre ENT and Opthalmology

School of Clinical Medicine School of Clinical Medicine 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)

School of Clinical Medicine School of Clinical Medicine Ophthalmology, ENT and Dermatology R&I week lectures and seminars Senior GP Senior hosp attachments: clinics, web based learning materials, final MB questions Logbooks Cases on VLE

School of Clinical Medicine School of Clinical Medicine Cambridge based Seminars - CCS seminars, 2 half days - Management & Leadership High Fidelity Simulator -Crisis management and team working

School of Clinical Medicine School of Clinical Medicine 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

School of Clinical Medicine School of Clinical Medicine 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

School of Clinical Medicine School of Clinical Medicine 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

School of Clinical Medicine School of Clinical Medicine Radiology Patient investigation theme Radiology Tutorials 9 hot topics MDTs integrated into 3 attachments

School of Clinical Medicine School of Clinical Medicine 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

School of Clinical Medicine School of Clinical Medicine Student Teaching Formal Teaching course beginning of year Various options to undertake teaching –To 1a Students –As Associate Supervisor for Stage 1 students

School of Clinical Medicine School of Clinical Medicine Ethics and Law Research ethics End of life decisions ICU ethics - brain death, PVS, organ donation and resources

School of Clinical Medicine School of Clinical Medicine Timetabling Susan Coyle and Dawn Ellis

School of Clinical Medicine School of Clinical Medicine VLE Information – all on web Problems – contact Dr White or Dawn Ellis Feedback - essential

School of Clinical Medicine School of Clinical Medicine Problems! Contact Dawn Ellis/Dr Jessica White Complaints – send straight away don’t leave to end of placement

School of Clinical Medicine School of Clinical Medicine Application to Foundation School

School of Clinical Medicine School of Clinical Medicine 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

School of Clinical Medicine School of Clinical Medicine 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…

School of Clinical Medicine School of Clinical Medicine 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

School of Clinical Medicine School of Clinical Medicine 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

School of Clinical Medicine School of Clinical Medicine So a lot of marks on the SJT

School of Clinical Medicine School of Clinical Medicine 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

School of Clinical Medicine School of Clinical Medicine Choose the THREE most appropriate actions to take in this situation A Instruct the nurse to give the medication to the patient B Discuss with the nurse why she disagrees with the prescription C Ask a senior colleague for advice D Complete a clinical incident form E Cancel the prescription on the nurse’s advice F Arrange to speak to the nurse later to discuss your working relationship G Write in the medical notes that the nurse has declined to give the medication H 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.

School of Clinical Medicine School of Clinical Medicine National Application Process Key dates – 2014 and 2015

School of Clinical Medicine School of Clinical Medicine 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

School of Clinical Medicine School of Clinical Medicine Key dates – 2014/15 pages/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 – 1 st and 2 nd SJT Late Jan Final SJT (London) Jan –Feb Academic FP offers March Allocation to FS April Match to programme complete

School of Clinical Medicine School of Clinical Medicine Any questions?