MB BS Student Handbook 2014/15
Transcription
MB BS Student Handbook 2014/15
MB BS Student Handbook 2014/15 1 Contents The Head of School’s Welcome ............................................................................................ 3 The Course Director’s Welcome ........................................................................................... 3 Two MB BS Graduates’ views on making the most of UEA ................................................... 4 How the course is organised ................................................................................................. 6 The modules in the MB BS degree and Student Recommended Books ............................ 6 Term dates....................................................................................................................... 14 Outcome of the course .................................................................................................... 15 How you will be taught ........................................................................................................ 16 Problem Based Learning (PBL) ....................................................................................... 16 Lectures and Seminars .................................................................................................... 17 Research Methods and Clinical Audit .............................................................................. 18 Student Selected Studies (SSS) ...................................................................................... 19 Consultation Skills ........................................................................................................... 21 Interprofessional Education & Learning (IPL)................................................................... 22 Primary Care ................................................................................................................... 23 Secondary Care .............................................................................................................. 25 Clinical Skills ................................................................................................................... 26 Dress code for Clinical Placement (Primary and Secondary Care) .................................. 27 Portfolio and reflective practice. ....................................................................................... 29 Studies Allied to Medicine (SAM)/Studies Outside Medicine (SOM) ................................ 30 How you will be assessed ................................................................................................... 31 Objective Structured Clinical Exam (OSCE) .................................................................... 31 Logbooks......................................................................................................................... 32 End of Year Written Exam ................................................................................................ 34 Research Methods .......................................................................................................... 34 Portfolio Reports .............................................................................................................. 34 Primary Care and PBL tutor reports ................................................................................. 35 Self and peer assessment of professional standards ....................................................... 35 Student held records ....................................................................................................... 36 Intercalation to complete an MRes, MClinEd or Intercalated BSc .................................... 37 Referencing your work ..................................................................................................... 37 Plagiarism and collusion .................................................................................................. 38 A student’s guide to coping with constant assessment ........................................................ 39 Course Progression, Fit to Sit and Reassessment .............................................................. 40 School Feedback ................................................................................................................ 42 How assessment results are given .................................................................................. 43 Student feedback/evaluation and the Student Staff Liaison Committee ............................... 45 Course Evaluation ........................................................................................................... 45 Student Representation ................................................................................................... 46 Module teams .................................................................................................................. 46 Who’s who on the MB BS ................................................................................................ 47 What the School expects from you ...................................................................................... 52 Where you can seek help .................................................................................................... 55 How to avoid burn-out ..................................................................................................... 57 2 The Head of School’s Welcome I want to extend you the warmest possible welcome to Norwich Medical School. Medicine is a degree course (MB BS) but it is so much more. It is the entry qualification for one of the greatest professions. To be allowed to practise medicine, to come close to patients when vulnerable; to have responsibility for those who cannot defend themselves; and to cure or prevent disease; these are the greatest privileges anyone can be given. Our course is one that not only will prepare you for your first day as a doctor, but will teach you the skills needed to learn throughout your career. It is now your responsibility to not only become a good doctor, but stay one. Our course will put you in the strongest position for learning during the rest of your career. Being a doctor requires you to be a professional. Much is written about this. However, I can make this easy for you – you can always calibrate your behaviour at anytime. Ask yourself whether you and your parents would be proud of what you are doing. When with a patient, behave as if you were treating a close relative and you won’t go far wrong. But also behave well to your teachers, and to each other. Norwich Medical School and the GMC expect you to behave professionally from day one. So, can I give you some advice? Work hard, read widely, learn widely, and behave well. Listen to what the patient tells you, the history of their illness is the key to diagnosis and management. If you struggle with the course ask for help early; and remember, “A journey of a thousand miles begins with the first step”. That step is today. I give you my best wishes for what will be a fantastic life. Professor Nigel Norris Acting Head of Norwich Medical School The Course Director’s Welcome Studying medicine at UEA will be exciting and rewarding. Medicine is ever changing and constantly fascinating. The people you will meet: students, academics, clinicians, as well as the many patients you will see, make medicine a special course and a wonderful, if demanding, career. So what do you really need to know to get started? Our course depends on your enthusiasm to learn from others; academics, clinicians and patients – and, as importantly, from your fellow students. We rely on you sharing that learning with your colleagues. If both elements are there you will thrive, but if either is missing you will struggle. To succeed you also need to study hard outside timetabled sessions. This involves preparing for your Problem Based Learning (PBL) sessions – by writing up work you have been set, and reading up about your colleagues’ objectives from their work, or from textbooks, course material etc. Additionally, make the most of all your clinical attachments so you become competent and confident in your clinical skills. These skills, whether it’s learning how to take a history from a patient, examining them, or undertaking a procedure, take a huge amount of practice and cannot be learnt from books. The course is five years short (not long). It will fly by! Make the most of the opportunities to learn; work with your colleagues; study hard but also make time to enjoy yourself outside medicine by participating in sport or clubs, and time with your friends. I look forward to meeting you and wish you the best of luck with the start of your course. Professor Richard Holland Course Director 3 Two MB BS graduates’ views on making the most of UEA Welcome to our excellent school and to this lovely university. During my time at UEA I never ceased to be impressed by this institution’s continued efforts to make their students excel. Here you will have a chance to be inspired, to work hard and to grow as a person and as a medical professional. The next few lines include a few words of advice that I hope you will find useful. Medical school is often advertised as a daunting experience, filled with endless coursework, stressful deadlines and the pressure to be flawless. Despite this, I cannot help feeling that this has been the time of my life. Yes, there is a considerable amount of coursework but if you’re organised and you work smartly you will find the time to socialise or even to pursue a long-lost interest. The 5 years are split into 13 system-based modules plus the electives, and clinical scenarios set the base for learning. Most students find this enlightening as they become aware of how core science adds to clinical practice. Problem-based learning makes this possible. I find it engaging to learn from weekly scenarios, group discussions and patient contact. To make the most of your days at this medical school, I would encourage you to be a team player and be enthusiastic and self-driven. Working well as part of a team will be an asset, if not a requirement, throughout your career. In your groups, or clinical placements you will cross paths with people who have different attitudes, beliefs and morals from your own, but learning to work together towards a common goal is a real challenge, and one that will help you become a better doctor. Being enthusiastic doesn’t necessarily mean staying overtime or working relentlessly (unless you want to…). It means you will benefit more if you read up on what you are learning that week (not just from other people’s PBLs or from seminar slides but from core textbooks) preferably before you go on placement. Clinical placements (both in general practice and hospitals) should consolidate the information you have been fed and put it into context, so make sure you read beforehand. Also, after you see patients it is infinitely helpful to read about their condition, adding a palpable experience to your brain’s imprint of it. However, if you do choose to take this advice into practice, beware that even as a medical student, the day only has 24 hours so you will need to plan and be organised. I find it helpful to pinpoint my weakest areas of knowledge and allow myself to spend more time with those. It is easy to get ‘bogged down’ with details and spend too much time with one subject. In retrospect, I now see that I don’t need to know every detail on one topic but, more importantly, I should grasp the overall picture of as many topics as I can. Even with busy academic timetables, most medics strive to fit in special interests, be those sporting activities or other recreational pursuits. The Union of UEA students provides over 100 student run sports and non-sporting societies, so you will easily find something to interest you. University life may also be the perfect time to get involved in voluntary work. My best advice to you is: enjoy yourself, make friends, get involved and create the foundations for a healthier body and mind. This will make you more human and that’s what a better doctor ultimately is. Good luck! Dr Inês Fernandes Soares UEA Graduate July 2011 4 The UEA offers a unique environment in which to study medicine – if you’re enthusiastic, it’s a fantastic place to be and rife with opportunities! Here are a few words on how to make the very best of the time you have here: Work hard and keep up to date – unlike other didactic courses, UEA affords the opportunity for self-study, which is an important skill and well worth perfecting for your post-graduate studies. So where possible, aim to learn everything you can at the first opportunity, because you may not get another chance! Maintain a life outside of medicine – studying on the MB BS degree programme is great fun but also tiring and occasionally stressful too. It is remarkably easy to become exhausted through completely focussing on study; therefore it is vital that you maintain regular interests and hobbies outside of medicine, in order to sustain a healthy and enduring work-life balance. Take every opportunity that comes – life is short and many situations only present themselves to you once. Be they academic, social or otherwise, try to experience as much as you can whilst at UEA and avoid the temptation to simply cruise through. Medicine at UEA will: teach you facts of life and death and how to manipulate them as a doctor; deliver unparalleled patient experiences as an undergraduate; make you laugh and very probably cry; bring you closer to some people and light years from others; nurture extreme happiness and success, but possibly also deliver some failure to boot. Being a medical student today is a whirlwind and akin to nothing else, so be prepared for anything, strive on tenaciously as “nothing ventured, nothing gained” and know that for every endeavour, luck favours the well prepared. I wish you all the very best of luck and future success. Dr Ryckie G Wade UEA Graduate July 2011 A Note from the Editor This guide is intended to give you the key information that will help you in the next 5 years of your life as a medical student. It will give you an introduction to some of the key people and aspects of the UEA MB BS degree. However, it is impossible to include all the information you need in such a small space, thus you will also have access to a wealth of information on Blackboard as well as from members of Faculty and other students. Almost every entry below has more detailed information about it on Blackboard – your ‘Virtual learning environment’ – which you will gain access to when you start at UEA. You should access that information as and when you need it. Dr Ian Pope UEA MED Graduate (2012) and Student handbook editor (2012/13) This handbook is based on a version previously put together in 2009. It was significantly updated for 2012/13 with help from four other medical students: Antonia Clarke-Sturman, Dominique Lentchou Mbiadjeu, Rebecca Neal, Sarah Ayton, and a wide variety of academic and administrative staff on the course. It has been updated again for 2014/15. Several of the Module Handbooks have been updated with student input as well and we hope you find all the handbooks both instructive and helpful. 5 How the course is organised The modules in the MB BS degree and student recommended books Your first year contains two modules: modules 1 and 2, referred to as M1 and M2. Each subsequent year has three modules, with the exception of year 4 which now contains four modules as it includes your external elective. Almost all modules have two components – a UEA one, and a Secondary Care (hospital) placement. Three exceptions to that are the two elective modules: external [M12] and internal [M15]; and the student assistantship [M14]. During the UEA component you receive lectures, seminars, Consultation Skills training, PBL and spend one day/week in a General Practice, consolidating your learning and developing your clinical skills. With each module below is a number of student recommended books. Please note that these are from students and there is a very detailed separate list of recommended texts provided by the Academic and clinical staff leading this course. That list is available on Blackboard and you are strongly advised also to look at that list before purchasing any book in a given subject area. In particular, there are also recommended texts on: Biochemistry, Immunology, Genetics, Statistics, Public health and epidemiology, Ethics and Law, Sociology, Psychology and health psychology, Radiology, Geriatrics, Psychiatry, Primary Care and Consultation Skills. We recommend that you do not buy any books until you have taken them out of the library and decided you like their content and style of writing. The library normally has most key texts available so some people settle for just having a general medicine textbook and then borrowing everything else as and when they need it. Textbooks are expensive if bought new so don’t forget to look on eBay and other second hand book shops. (All prices are approximate from Amazon.co.uk, but you can always try Waterstones which does 3 for 2 on Crash Courses and other books, typically at the start of the academic year and often at other times.) General medicine textbook Clinical Medicine (7th Edition) by Kumar & Clark (£46) Davidson’s Principles and Practice of Medicine (21st Edition) (£43) Medicine and Surgery: An integrated textbook by Lim and Loke (£47) General examination book Macleod’s Clinical Examination 11e (£31) Anatomy Gray’s Anatomy for Students (2nd Edition) Drake (£35) Moore & Dalley Clinically Orientated Anatomy 6e (£60) Pathology Pathology (2nd Edition) Stevens & Lowe (£29) General and Systemic pathology (4th Edition) Underwood (£38) Flesh and Bones of Pathology: Batemann & Carr (£19) 6 Pharmacology Clinical Pharmacology (10th Edition) Bennett & Brown (£50) Pharmacology (6th Edition) Rang, Dale & Ritter (£37) Physiology Human Physiology – The Basis of Medicine (3rd Edition) Pocock & Richards (£31) Medical Physiology (Updated Edition 2004) Boron & Boulpaep (£52)Textbook of Medical Physiology (11th edition) Guyton & Hall (£69) Flesh and Bones of Medical Cell Biology: Norman & Lodwick (£19) Psychology Psychology for Medicine Ayers & Visser (£26)Psychology of Medicine and Surgery: A guide for psychologists, counsellors, nurses and doctors. Salmon (£38) Health Psychology: Biopsychosocial Interactions (6th Edition) Sarafino (£42) Microbiology Medical Microbiology 7e: Greenwood The Flesh and Bones of Microbiology Guyot, Schelenz & Myint (£19) Principles and Practice of Infectious Diseases (7th edition) Mandell, Douglas & Bennett Antibiotic and Chemotherapy: Anti-infective agents and their use in therapy (9th edition) Finch, Greenwood, Whitely & Ragnar Norrby Revision PasTest: EMQs for Medical Students Series (£18 each) PasTest: OSCEs for Medical Students (£18 each) Specialties: 100 EMQs for Finals (£15) Lippincott’s Illustrated Review Series [http://www.lww.com/Series/?seriesid=15] (£24-£30) 7 YEAR 1 Module 1: The Human Lifecycle: An Holistic Approach Module 1 is a great introduction into medicine, taking you on a journey through the human life-course from conception to death. Multiple perspectives are brought to bear on each part of the life-course, spanning both academic and clinical approaches, including how academic disciplines such as the biological and behavioural sciences are relevant for and can inform clinical practice. The focus of Module 1 is on the ‘big picture’: on how a diverse range of academic disciplines, professions and skills together comprise the field of medicine. You will also begin to learn basic clinical skills, what it is like to be a patient and a doctor in primary and Secondary Care settings and develop Consultation Skills by talking to patients and health professionals, as well as learning in a university setting. The MB BS curriculum is centred on problembased learning. As part of a group of students you will cooperate to organize inquiry into clinical cases each week. In Module 1 students develop the aptitudes necessary to work successfully in a problem-based learning environment which requires elements of both group-working skills and self-directed learning within a group of peers. Module 2: Locomotion During Module 2 students learn about the normal musculoskeletal system, how the skeleton is maintained and how the movement of joints occurs. Pathological processes affecting bone muscle and joints are explored to demonstrate the clinical features of musculoskeletal disease. Students are taught how to gather, interpret and present information given to them by patients, how to perform a musculoskeletal examination and how to interpret physical signs. Students are given the opportunity to see patients with specific complaints. The aim of clinical teaching is to cover the common and important diseases which affect the musculoskeletal system eg arthritis, fractures, bone pain and mobility. During this module, students are taught about interpretation of blood tests and different modalities of imaging (eg x-ray, MRI and ultrasound) of the various joints and muscles of the body and how these change in different conditions. Although students are early in their medical careers, they are taught to form management plans for patients, including therapies offered by members of the multidisciplinary team, drug therapies and surgical techniques. Recommended books: Crash Course: Rheumatology and Orthopaedics (2nd edition) Coote and Haslam (£24) Apley’s Concise Orthopaedics and Trauma (3rd Edition) (£26) 8 YEAR 2 Module 3: Blood and Skin Module 3 comprises Haematology and Dermatology, or more succinctly “Blood and Skin”. In Primary Care, in dermatology you will learn that skin problems are one of the commonest reasons for consulting a GP. Patients may present with primary skin disorders or with lesions that may be a marker of systemic disease. You will learn how to recognise common skin complaints and organise appropriate investigations and treatment. You will observe minor surgery in the Primary Care setting. In haematology, you will learn the many different ways in which disorders of the blood and blood-forming organs present to the GP. You will take a history, perform clinical examination and interpret the results of laboratory investigations. You will observe the teamwork involved in caring for those with serious illness, but will also discover that many patients with blood disorders require expertise from other disciplines such as radiology, oncology, gastroenterology, gynaecology and many more. http://www.fi.edu/learn/heart/blood/red.html Recommended books Essential Haematology (5th Edition) Hoffbrand (£30) Atlas of Dermatology 5e: Lionel Fry Module 4: Circulation The Circulation module consists of three domains: cardiovascular, cerebrovascular and peripheral vascular disease domains. Heart and vascular disease is the UK’s biggest killer, but at the same time we have many tools to prevent and treat circulatory disease. This module is delivered by three closely related disciplines of Cardiology, Stroke Medicine/Medicine for the Elderly and Vascular Surgery. Recommended books: ECG Made Easy and ECG In Practice: Hampton (£14/£22) Cardiology 8e: Julian & Cowen (£26) Illustrated Colour Text – Cardiology (£28) Module 5: Respiration Lung diseases cost the NHS more than any other disease area. They are the most common reason for a GP consultation, cause of chronic childhood illness and cause of cancer mortality. In this module you will learn how to take a history and examine a patient with lung disease, understand the pathophysiology, presentation, management and psychosocial impact of common lung diseases, and gain experience of respiratory related clinical skills. Recommended books: Lecture Notes in Respiratory Medicine (7th Edition) (£24) 100 Chest X-Ray Problems Corne & Pointon (£18) Illustrated Colour Text – Respiratory (£30) ABC of Palliative Care (2nd Edition) Fallon & Hanks (£22) Treatment and care towards the end of life: good practice in decision making: GMC 9 YEAR 3 Module 6: Homeostasis and Hormones This module comprises endocrinology, diabetic medicine, renal medicine and urology. Endocrinology and diabetic medicine encompasses the concept of hormone homeostasis and the clinical management of patients with abnormal endocrine function. By the end of the module you will be able to understand the concept of hormone regulation on growth and metabolism and recognize presenting features of hormone overproduction and deficiency and their management. Diabetes medicine highlights the spectrum of disorders of carbohydrate metabolism and the impact of diabetes and its complications on personal and social health. Renal medicine covers the diagnosis and management of patients with acute and chronic renal disease, and acid/base and fluid/electrolyte regulation. Clinical skills sessions include teaching on venous cannulation and prescribing fluids. In Urology students learn about the surgical and medical management of conditions affecting the urinary tract in men and women. Recommended books: Crash course in renal and urinary systems (3rd Edition) Datta (£24) High Yield – Kidney: Dudek (£15) Crash course Endocrine & Reproductive System (2nd Edition) Sanders (£24) Module 7: The Senses This module is demanding because it contains three linked but separate specialities: neurology, ophthalmology and ear, nose and throat (ENT). These specialities are all centred round the physiological receptors and processes that allow us to sense the environment in which we live. During this module you will discover how these three systems work in health and how each can malfunction in a great variety of diseases. The brain is considered the most complex of the organs and yet in neurology you will discover how by careful history taking and examination the site and probable nature of the problem can be pin-pointed. In ophthalmology you will learn of the huge variety of diseases that can affect the eye and surrounding structures and how modern cataract surgery and laser treatment can restore or preserve sight for many. ENT is in itself three separate and yet interrelated specialties, focussing on Ear, Nose and Throat conditions, each with its own fascination and problems. Recommended books: Neurology & Neurosurgery Illustrated 4e: Lindsay & Bone (£51) Clinical Neuroanatomy 4e: FitzGerald & Folan-Curran (£31) 5e Ear, Nose & Throat and Head and Neck Surgery: An illustrated colour text (4th Edition): Dhillon & East (£31.99) An Illustrated Colour Atlas of Ophthalmology 2e: Batterbury & Bowling (£64) Ophthalmology: an illustrated colour text (3rd Edition) Batterbury, Murphy & Bowling: Churchill Livingstone – Elsevier (ISBN: 9780702030598) 10 Module 8: Digestion and Nutrition This module is wide in scope, covering all aspects of digestive disease, in all settings, over all ages. This encompasses both medical and surgical disease of the gastrointestinal tract. This is a key opportunity to gain general surgical experience within our course, as well as developing your gastroenterological knowledge. Our bodies are amazing and in Module 8 we look at the science behind our bodily functions. Have you ever wondered how your stomach communicates with your brain to say it is empty? Or how your bowels tell your brain you need to find a toilet? Pretty vital stuff! You will also study what happens to our organs when things go wrong eg how alcohol can damage the liver. Recommended books: Essential Surgery (4th Edition) Burkitt & Quick (£47) Abdominal X-Rays Made Easy: Begg (£18) YEAR 4 Module 9: Reproduction This module covers reproduction and women’s health including breast diseases. Human reproduction is a fascinating subject. Obstetrics is the branch of medicine and surgery concerned with childbirth and midwifery. Gynaecology is the science of the physiological functions and diseases of women. You will appreciate that to understand childbirth and its complications and manage diseases in women at different stages of their life, it is essential you have a good grasp of knowledge in basic anatomy and physiology concerning human reproduction. Recommended books: Clinical Obstetrics & Gynaecology 2e: Magowan, Drife & Owen (£34) Langman’s Medical Embryology 9e (£24) Module 10: Growth and Development Module 10 gives the opportunity to learn about child health and disease and to reflect on and revise previous modules in order to appreciate the similarities and recognise the differences in dealing with children and their families in a healthcare setting. The spiral, reflective learning style that is encouraged at Norwich Medical School is very apparent in Module 10 and students are encouraged to use knowledge from previous modules to help them understand the complex nature of child health. Recommended books: Pocket Essentials of Paediatrics (2nd edition) (£25) Illustrated Textbook of Paediatrics: Lissauer & Clayden (£26) 11 Module 11: The Mind and Body Module 11 comprises Mental Health, Medicine for the Elderly and Oncology/Palliative care. Theoretical learning in the module provides the basis for understanding how biological, psychological and social factors contribute to mental health problems. Lectures and seminars cover diagnosis, pharmacological and psychosocial treatments, and legal and ethical aspects of depression, anxiety, eating disorders, schizophrenia, learning disabilities, child and adolescent mental health, medically unexplained symptoms, substance misuse, and old age psychiatry. Module 11 gives you the opportunity to observe clinicians within primary and Secondary Care assessing and treating mental health problems. You will also undertake sophisticated mental state and needs assessments which will provide a real opportunity to contribute to the delivery of care. This module also contains a component covering Older Peoples’ Medicine and Oncology/Palliative Care. Both are integrated into our course throughout previous modules; so this two week period allows you to consolidate your knowledge and have dedicated placement in these two increasingly important specialities. There are a number of seminars for these areas together with the opportunity for interactive workshops. In total there are six dedicated clinical placement days in Norfolk and Norwich University Hospital, Norwich Community Hospital and James Paget Hospital, with the possibility of visiting Priscilla Bacon Lodge to see the palliative care setting. Recommended books: Psychiatry Psychiatry: Neel Burnton (£27.54) Medicine For the Elderly Lecture Notes on Geriatric Medicine by Nicholas Coni, Stephen Webster, Claire Nicholl and Jane Wilson (15 Jul 2003) Oncology/Palliative Care Symptom Management in Advanced Cancer by Robert G. Twycross, Andrew Wilcock and Clare Stark Toller (1 Aug 2009) Module 12: The External Elective The external elective is a 4 week, work-based, placement that is undertaken by all students at the end of the 4th year. Unlike other modules, it is selected and organised by the student with minimal input from the School. However, the placement chosen has to be approved by an Elective Tutor. The placement can be in any aspect of medicine and can be held anywhere in the world as long as the choice does not endanger the life of the student. During this period, the student is expected to engage in self-directed learning, reflect on his/her professional development, and experience medical practice in a context that is different from that provided by the Norwich Medical School and its teaching hospitals. There will be lectures on how to prepare for an elective, how to stay healthy during the placement and trends in global public health. 12 YEAR 5 Module 13: Emergency Care This module is designed to inform and instruct you in the management of the acutely sick patient and includes accident and emergency, as well as emergency medicine and surgery. For those who are craving excitement, Module 13 is the place where you get hands-on practice dealing with acutely ill patients. It is a high-octane journey through the Emergency Department, the Acute Admissions Unit, Intensive Care and Anaesthetic rooms. Here you will learn how to deal with a wide range of really sick people in the quickest and most efficient way possible, and witness important, potentially life-saving procedures. You will also find out how to calmly and safely put someone to sleep for a procedure, and then ensure a speedy recovery. Module 14: Student Assistantship Lectures and seminars are incorporated in a three week introductory period at the start of year 5. These cover practical aspects of becoming a junior doctor eg how to request investigations, certify death and write in the medical record. You will complete nine weeks of clinical placements, working within both medical and surgical teams in an apprentice-like style. During these 9 weeks there are only a handful of timetabled small group tutorials and you are therefore free to participate fully in ward work, and to help your clinical team wherever possible with day to day clinical activity. Assessment – during module 14 we utilise 3 types of workplace based assessments alongside the standard OSCE assessment (which in this case is combined with M13), these are: Tutor report forms (one medical one surgical), Case Based Discussions (one medical and one surgical) and Procedural skills logbook (to demonstrate competency to perform simple and common procedures, such as venepuncture, in the workplace setting with real patients). Module 15: The Internal Elective This new module follows your Final Clinical exams. Module 15 has been developed to give students the opportunity to explore or further develop an aspect of their future medical career. 6 weeks’ experience in one or more of the following: clinical placement research management patient safety and effectiveness Public Health 13 Themes Within each module you will find the work falls into a series of neat groups, Anatomy being the easiest to recognise, these are called the ‘themes’. Each theme will appear in every module, and often you will notice overlap. So for instance, the anatomy of the chest appears in modules blood, circulation, respiration, digestion (modules 3, 4, 5 & 8). For most themes (eg pathology) in the early part of the course you learn and understand basic concepts of normality, health and disease. Understanding of these core concepts is essential to the study of all modules and over the course you will add to the knowledge and refine your understanding as you revisit topics. This is called spiral learning, and is an important part of our course. By calling upon your understanding and application of concepts from earlier parts of the course you will be able to deal effectively with unfamiliar topics and apply the knowledge to diagnosis and treatment. The themes have formal theme leads who supervise the curriculum within their area. By-andlarge these leads also organise the SSS studies in their theme, though they may have sub-leads for each year. The full list of themes is: Anatomy; biochemistry; clinical skills; diet and health; epidemiology and public health; ethics; genetics; health economics; immunology; law; microbiology; pathology; pharmacology (including pharmacy and prescribing skills); physiology; professionalism; psychology; scientific methods and sociology. In your SSS studies you will be attached to a particular theme and develop your knowledge and understanding by studying that subject in more depth. Term dates Please be aware, the term dates for the MB BS do not follow the standard University term dates. The term dates for year 1 for 2014/15 are as follows: Monday 15 September 2014 – Friday 12 December 2014 Module 1 Monday 15 December 2014 – Friday 9 January 2015 Christmas holidays Monday 12 January 2015 – Thursday 22 January 2015 Module 1 continued Friday 23 January 2015 – Friday 20 March 2015 Module 2 Monday 23 March 2015 – Friday 10 April 2015 Easter holidays Monday 13 April 2015 – Friday 29 May 2015 Module 2 continued Monday 1 June 2015 – Friday 12 June 2015 Integrative (exam) period 14 Outcome of the course At the end of the undergraduate course you will receive your MB BS degree, which is a primary medical qualification (PMQ). Holding a PMQ entitles you to provisional registration with the General Medical Council. Provisionally registered doctors can only practise in approved Foundation Year 1 posts: the law does not allow provisionally registered doctors to undertake any other type of work. To obtain a Foundation Year 1 post you will need to apply during the final year of your undergraduate course through the UK Foundation Programme Office selection scheme, which allocates these posts to graduates on a competitive basis. So far, all suitably qualified UK graduates have found a place on the Foundation Year 1 programme, but this cannot be guaranteed. For instance, if there were to be an excessive number of competitive applications from non-UK graduates. Successful completion of the Foundation Year 1 programme is normally achieved within 12 months and is marked by the award of a Certificate of Experience. You will then be eligible to apply for full registration with the General Medical Council. You need full registration, with a licence to practise, for unsupervised medical practice in the NHS or private practice in the UK. Almost, all UK graduates go on to take their second Foundation year (F2 year), before entering specialty training to become a GP or Consultant. 15 How you will be taught Problem Based Learning (PBL) Problem Based Learning is one of many learning opportunities at Norwich Medical School. You may, at first, feel that learning medicine is quite difficult. It may be in some ways different to the learning you have done before. One thing students often struggle with is that there is a huge amount of information available and you may feel quite overwhelmed. An additional problem is that because medical research is continually published, information can change. To complicate matters further, sometimes medical opinion is divided on a particular issue and there can be more than one right answer. Over time you will come to accept that this is part of the nature of medical knowledge. Studying medicine is a life-long learning experience – there will always be something new to learn. PBL tutorials offer an opportunity for you to discuss clinical cases with your colleagues, research the medical literature, share knowledge, and learn from each other. Doctors learn in this way on a daily basis in the work environment as well as at conferences. In PBL, you will be expected to work to a high standard and develop professional attitudes towards your work and colleagues. Each PBL tutorial group stays together for one academic year. PBL groups consist of 10 students and a facilitator or tutor. The PBL process is split into 3 main phases: 16 After an initial discussion of a clinical case and sharing of your existing knowledge, you will find there are knowledge gaps and so you will identify areas for further study. During the following week you will be expected to research and learn these topics. You will attend lectures, seminars, and clinical attachments and of course be expected to do a lot of reading. If you make sure you have a sound understanding of all topics you will gain more from the follow up discussion with your colleagues and learn more. You may, to begin with, find it very difficult to identify the resources that you need for PBL. Being able to identify and evaluate information is a vital skill for a 21st century doctor but, as with many other skills, it will take time to develop. Through repeated practice in PBL you will become proficient at searching and critically evaluating medical literature. In the following week’s PBL session, all students should explain their new knowledge to the group, via a presentation or other teaching method. You should discuss the case again in light of new knowledge. By the end of the week you should have reached a point where you have acquired a new raft of knowledge, be able to explain it to others, and have integrated it with your existing knowledge. To get the most out of these sessions you need to be able to work with a range of other students, be a good communicator and also be able to work independently. You need to be able to research a topic thoroughly and discriminate between differing qualities of information. You need good writing skills, including grammar and presentation, and you need to be prepared to stand up in front of people (albeit a small group), to explain your subject and answer questions from the group and tutor. You will develop critical thinking abilities, clinical reasoning capabilities, teaching and presentation skills, teamwork skills and of course will acquire an enormous amount of medical knowledge and understanding. These attributes will set you in good standing for life as a doctor. The PBL tutor’s role is to guide and facilitate the group’s learning rather than to teach. The tutor will not be a subject expert on the case so will not be able to provide answers. Lectures and Seminars Lectures and seminars are 50 minute teaching sessions that are provided by academics from within the Faculty of Medicine and Health Sciences and by senior clinicians from the surrounding general practice and hospitals. Most lectures are delivered to the whole cohort studying a particular module while most seminars are delivered to fewer students. A selection of seminars run in parallel for a given timetable slot during Module 1. This means that you may sometimes have to select which seminar to attend; your choice may be governed by agreements made within your PBL group about which learning objectives you will be reporting back at the end of the week. In general, lectures are the most didactic of our teaching sessions. Seminars can be didactic too and certainly provide information from experts that will help you to understand key topics within the PBL presentations; however seminars are often interactive, with opportunities for student questions and learning exercises. You will find electronic resources to support these teaching sessions in folders on Blackboard. These include PowerPoint files, MP3s and PDFs that summarise the main points. The documents often give you a reading list to accompany the lecture or seminar. These reading lists should certainly guide your background reading because they have been carefully selected to provide you with appropriate depth and detail. Lectures and seminars cover many aspects of the curriculum including: Clinical sciences, Psychological sciences, Biological sciences, Public health, Social sciences, Consultation Skills, and Research methods. The latter are often timetabled at different times to other seminars/lectures but are nevertheless core to our teaching programme. You will find that research methods seminars are given in parallel – with the same teaching provided by different tutors across a number of different rooms. This allows for small group discussion of worked examples. 17 The following tips will help you to enjoy and make the most of these valuable teaching sessions. Be well prepared by planning your week and regularly checking times and venues on your personalised timetable, available to view on the Portal Arrive promptly to each session Have a look at the resources on Blackboard relating to each lecture and seminar prior to the date it is given Check Blackboard for reading lists and keep up to date with background reading each week (complete this in advance of teaching session where indicated/appropriate – this is particularly important before most Consultation Skills sessions) Research Methods and Clinical Audit This course provides an introduction to key ideas and methods in medical research and clinical audit. We aim to provide the skills to allow you to competently engage in our Student Selected Studies (eg to search and appraise medical literature) and to prepare for writing a research protocol in year 3, and conduct a clinical audit in year 4. Research Methods sessions also provide skills needed to complete Analytical Reviews (see assessment). We also want to prepare those of you who are interested in medical research to undertake this, either alongside your studies (eg in your summer holiday or within the elective periods), as a formal intercalated Masters programme (ie as a year out of your medical studies), or as a future doctor. More generally, we aim to allow you to: (i) interpret medical research for yourself, your colleagues and for patients (ii) apply evidence-based medicine in your practice, and (iii) undertake both research and clinical audit The course will deal with the notion of uncertainty in medicine, including communicating risk to patients, understanding uncertainty in research results and in our medical knowledge base. Various research study designs will be considered (including clinical trials, epidemiological studies and qualitative studies) along with data analysis and interpretation. These sessions will be a mixture of didactic, full-group lectures, smaller group seminars, and self-study of materials placed on Blackboard. Typically, interactive seminars will be used to reinforce learning from previous lectures and the self-study material. There is an expectation of students to pursue ideas and understanding further through their own reading. In years 1 and 2, these sessions are designed to support your preparation for our analytical review (AR) assessment. This assessment is a critical appraisal of a published article reporting a medical research study selected by the Research Methods team. The AR is usually in the form of a series of short answer questions and has to be submitted at the end of each module for modules 1 to 4 in years 1 and 2. Articles selected for appraisal will reflect the extent of knowledge and skills expected at that stage of the course. In your first module of year 1 the AR is a compulsory formative assessment. By formative we mean that your work must be submitted, and you must participate in any feedback sessions, but your mark will not affect your progression that year. All other analytical reviews are summative. By this we mean that your work is formally marked, and you must gain at least a Pass to progress to the next year of the course. In year 3, the Research Methods sessions are designed to support your writing of a Research Project protocol and, in year 4, to carry out a Clinical Audit. 18 Student Selected Studies (SSS) Throughout the MBBS, there are Student Selected Studies (SSS) components which cover a variety of subjects and disciplines. SSS is the part of our course where you will develop academic skills such as literature review and critical thinking; presentation and teaching skills; and develop a clinical or research question. In years 1 to 3 these skills are acquired whilst focusing on topics from a specific theme of study, such as anatomy, epidemiology or sociology. In year 4 the focus shifts to your undertaking an evidence-based case presentation. SSS Sign Up Years 1 to 3 In years 1 to 3 students will be asked to choose 4 SSS themes of interest, using an online sign up system. There will be a specific deadline published for SSS sign up each academic year. The students will always be allocated to one of their 4 chosen themes (and we will endeavour to match most students to their nominated first theme choice). Once the selection process is complete students will be introduced to an appropriate tutor for the academic year. The student will usually choose one or more learning outcomes from the theme lists to generate an SSS question (in consultation with their tutor). In year 4 each student will identify a clinical case to study in detail alongside any chosen evidencebased aspect of aetiology or disease management. The system for Anatomy SSS and SSS as a Pathway to Research in years 2 and 3 is different; students usually sign up for these in the previous academic year of study and all students will be notified of the procedure in the spring semester. This is to ensure that students have the anatomy resources or lab attachments in place prior to the start of the new academic year. Selecting an SSS Theme Students need to study at least one life/clinical science and one social/population science (please see the list below) within the first 3 years. Some of these SSS theme options include practical, clinical or laboratory experience; others are literature based studies. Please see the theme-specific descriptions posted on blackboard (see SSS Information) for detailed information that should help each student select the SSS themes of interest. SSS in year 4 You do not need to sign up to pre-specified themes of study in year 4. There are two learning objectives for this SSS: Present a full clinical case from your module of study. Present published evidence about the aetiology or diagnosis or treatment or prognosis of that patient’s condition; include a critical appraisal of two or three primary studies/meta-analyses. You can independently study any aspect of the year 4 curriculum that fits with your selected clinical case. There will be tutor and e-learning support available for year 4 students. 19 SSS Themes 2014/15 Some themes are specific to particular academic years. The availability of each theme is indicated by the filled blue boxes in the table below. SSS Theme Year Year 2 1 Life Sciences and Clinical Sciences Year 3 Anatomy* Biochemistry Clinical Biochemistry Clinical Pharmacology and Therapeutics Colorectal Surgery Diet and Health Genetics and Haematology Microbiology and Immunology Pathology Physiology Plastic Surgery Radiology SSS as a pathway to research (laboratory and clinical science)* Social and Population Sciences Epidemiology and Public Health Ethics Health Economics Law Medical Education Psychology Sociology SSS as a pathway to research (social and population science)* *Sign up for Anatomy and SSS as a pathway to research for years 2 & 3 will take place in the Spring semester in preparation for the following academic year. 20 Consultation Skills Learning to listen and talk to patients and colleagues is one of the most important skills a doctor must acquire. We all know how to listen and to talk but we rarely have the opportunity to consider in depth how our individual style of communicating influences the people we talk with. The term ‘communication skills’ in medicine is used to indicate a range of evidence based behaviours which are known to impact on a consultation with an individual patient seeking advice, or a discussion with a colleague. In the MB BS programme we consider that the conduct of the consultation is the fundamental process of all medical practice and we have adopted the structure and skills-based model known as the Calgary Cambridge Model, devised by Silverman, Draper and Kurtz to guide our understanding and teaching. This model is patient-centred and proposes that the consultation should address both the bio-medical aspects of a patient’s presentation, which we call ‘disease’, and the psycho-social aspects, which we call ‘illness’. Over the five years you will learn a range of different skills, which not only enhance the likelihood of a favourable outcome to the consultation, but can also be applied to communication in other situations, such as referring patients to colleagues or talking to relatives or other carers. When you graduate, we want you to be competent in a number of areas including the following: establishing and maintaining trusting, respectful relationships listening to patients, relatives/carers/partners, and to other healthcare professionals explaining, and providing patients and others with well-timed and understandable information negotiating mutually acceptable outcomes recording, storing and managing clinical information presenting information clearly in written, electronic and oral forms, and communicating ideas and arguments effectively From the very beginning of your course of study, you will start to work toward these objectives. As well as being offered a series of lectures you will have the opportunity to role-play with trained actors in a small group setting, receive feedback and reflect upon your own developing style and learning needs. 21 Interprofessional Education & Learning (IPL) All doctors work in teams with other health and social care professionals. The IPL programme provides a unique opportunity for medical students to learn about the theory behind effective team working, as well as gain practical experience of working with other allied health professionals in a safe, structured environment. IPL1 and 2 (First and Second Years) In the first year, healthcare students attend a two-hour team-working session with allied health and social care professionals. You will have access to the “Interprofessional Role Map” – an excellent online resource, enabling you to discover the roles of each profession and how they interact. Prior to IPL2, you will be required to shadow a health or social care professional in a clinical setting. IPL2 takes a more clinical focus working through a clinical case scenario in a multidisciplinary group. As a group you will present your work to other groups, peer-assess your contributions, and reflect on your learning by means of a written formative assignment. IPL3 and 4 (Third and Final Years) IPL3 and IPL4 are half-day interactive inter-professional conferences involving service users of the NHS. They are an exciting, interesting and highly informative way of learning about areas of medicine associated with stigma, sensitivity, or rare patient groups, which you might not ordinarily come across in your medical training. Topics covered so far include; domestic abuse, substance misuse and eating disorders. We cannot recommend it enough in order to enhance your compassion and understanding of these areas of medicine and to improve your skills for life as a doctor in the future. IPL5 – Interprofessional Clinical Skills (ICS) (Fourth and Final years) ICS –MPh (Medical students (M) + Pharmacy (Ph) students): As a junior doctor, one of the key challenges you will face will be related to prescribing medication. We have been running a teaching-type OSCE (not assessed) between fourth year medical students and final year Pharmacy students for this purpose. Scenarios based around prescribing in acute medical emergencies and in the community, stimulate interprofessional learning about drug interactions, side effects of medications and prescribing. You will also gain confidence in using key resources such as the British National Formulary (BNF). The overwhelming majority of students who have already participated in the ICS, have enjoyed this way of learning and come away feeling more positive about prescribing. ICS – MAdN (Medical student (M) + Adult Nursing (AdN) students): One of the key Interprofessional interactions you will experience as a doctor is with nursing staff. An invaluable way of learning about this is our ICS-MAdN! In this ICS, final year medical students are paired with final year adult nursing students to cover 6 teaching OSCE stations covering scenarios relating to patient care on the wards as a junior doctor. Medical students are able to interact and learn with and from nursing students, and the feedback received from students has been overwhelmingly positive. We know you will enjoy this way of learning and find it helpful for your future as doctors. 22 Primary Care The teaching in Primary Care consistently receives very positive evaluations from students. There are two main reasons for this. Our doctors: we have a group of enthusiastic general practitioners who are committed to teaching; have protected time to do the job; are trained to teach the undergraduate curriculum; and are supported by a team of practice development tutors. Patients: the first patients you ever meet will be in primary care. We have hundreds of patients who are very willing to talk to students and be examined by them. Their evaluations of contact with our students are almost invariably positive. Some examples of what you do in Primary Care: Practicing taking Blood Pressure Learning and practicing the musculoskeletal examination What do we want you to learn? The overall Primary Care learning outcomes will be available as part of the wider collection of learning outcomes, but essentially the placement in Primary Care is about learning medicine in a community setting. It is not about teaching you to be a GP, nor about persuading you that general practice is more attractive than any other medical career. We want you to understand what it is like to be a patient/doctor and recognise the presentation of illness in the community. You will learn about the diagnosis of disease in patients presenting for the first time. You should become familiar with effects of chronic illness on the patient and their family, the relationship between medical, psychological and social factors in illness. There will be opportunities to understand how the primary health care team works, the relationship between Primary and Secondary Care and the relationship between health care and social services. Primary Care is an excellent setting in which to acquire some of the skills of a doctor. Patients in Primary Care do not generally mind being “guinea pigs”, and you should have many opportunities to practice talking to patients and examining them, dealing with common medical, social and psychological problems, and multidisciplinary working and education. You will be able to rehearse how to give accurate information, enable patients to play a role in their own care, and assist their decision making. There will be opportunities for receiving and giving of feedback on interactions with patients. By working in groups and observing practice teams we expect you to develop the professional attitudes necessary for carrying out the duties of a doctor, for self-directed learning, professional and personal development and self-care. 23 How are you going to learn it? Each week your GP Tutor will recruit suitable patients for you to interview and examine. Some of these will be selected to reflect the week’s learning outcomes; some may be deliberately “random” to test your developing clinical reasoning! Patients are a valuable opportunity to practice and hone your skills, and in general you should find these contacts very rewarding. Patients are almost invariably pleased to be invited to participate. As in PBL, it is important that you engage in the group, agree objectives and that you share, reflect, interpret and integrate your experiences and information. Where does it fit in? Primary care is generally an integral part of the PBL weekly timetable, and is scheduled so that by the time you spend the day in primary care you should be primed with the knowledge you need to make sense of the clinical experience you are going to have. The exceptions are module 11 and module 13 which are taught in blocks of 6 days over a fortnight rather than a weekly basis. From 2014 onwards students will also spend a further 3 days shadowing a GP in module 13. These placements are referred to as “GP apprenticeships” and are part of your preparation for life as a foundation doctor. You will be doing this in pairs and it should be a much more personal experience as a result. Feedback and Concerns Your GP Tutor should regularly ask for feedback about how the teaching is going. This will be both informal as you go along, but we also expect GP Tutors to collect formal evaluations at the end of the day. Most tutors choose to use a standard template that we provide. Please give honest and constructive feedback so that our tutors can improve the experience, for you and for the students who follow you. From time to time you might experience things that you may find uncomfortable, either for yourself or on behalf of patients, or occasionally which you feel to be unsafe, morally wrong or inappropriate. If you have problems in primary care, your first contact should be your tutor there. Many of the things which may disturb or distress you may simply arise from not knowing the full picture, and a frank and friendly conversation with your Tutor may well help. However if you are unable to resolve the issue in the practice you can contact the Practice Development Tutor (responsible for overseeing teaching in Primary Care) for your year, as follows: Year 1 Year 2 Year 3 Year 4 Year 5 Dr David Barton: david.barton@uea.ac.uk Dr Charlotte Turner: Charl.Turner@uea.ac.uk Dr Hannah Innes: H.Innes1@uea.ac.uk Dr Jane Calne: J.Calne@uea.ac.uk Dr Lisa Jackson: L.Jackson@uea.ac.uk Or (in the case of absence of the relevant year PDT) the Lead Practice Development Tutor Dr Richard Young: d.young@uea.ac.uk Final message: like many other aspects of the course, what you will get out depends on what you put in. You will maximise your learning in Primary Care if you: Come prepared - making sure you know enough of the scientific basis (anatomy, physiology, pathology etc) of the cases you are going to see Talk to and examine the patients – that is the main reason you are there Build your understanding around the patients you see – so if you don’t understand something, ask or look it up. We know that doctors remember best from the real cases that they have seen. 24 Secondary Care Your Secondary Care placement is usually at the end of each module. During placement you will be based in one or more hospitals and will not have UEA lectures, PBL or seminars. Secondary Care time is spent in the hospital environment. It is a great chance, not only to learn lots of useful bits of medicine, but also to find out how hospitals work and what different people do. There will be a variety of different learning opportunities with the volume and type varying according to the speciality and the hospital. Broadly there will be 3 types of timetabled teaching held in the teaching resource areas including; Structured patient teaching sessions – similar to the model used in Primary Care. Patients (usually outpatients but occasionally inpatients) are invited to attend a session whose sole aim is educational. Under the direction of a clinicians you will talk to, examine or review the notes and investigations of patients with selected illnesses Clinical skills sessions – teaching on examination or procedural skills, often practising on each other or on models Seminars – small group teaching on clinical topics You will also be timetabled to attend various clinical sessions that are of educational benefit but where your role will be more observational and education is not the main aim. These are called Booked Sessions and are an important complement to your directly taught sessions. In these, you will pick up a lot of ‘informal’ learning about each speciality. Examples include going to outpatients, endoscopy, theatre, or following a specialist nurse, physiotherapist or a consultant ward round. Although these sessions can be a bit less predictable because they rely on what clinical material is available at the time, it is important that you do not underestimate the importance of these sessions to your medical education. All sessions in secondary care are compulsory. The sessions held in clinical skills areas often have a register and you should ensure you arrive on time and sign at the beginning - if you arrive too late to sign you MUST notify the admin team (Jane Nicholls see p26), or it will be marked as an absence. Although booked sessions don’t routinely involve a register we do know which students are scheduled to go where and when so if you don’t turn up as expected you will be reported as absent. You may not swap your timetabled secondary care sessions without specific permission from the administrative team Despite all these timetabled activities there will be ‘gaps’ and the key to making the most of Secondary Care is to be enthusiastic and proactive in finding additional opportunities, for example: Ask to shadow a junior doctor for part of their shift Ask if you can join an evening ward round Observe a patient’s journey through the hospital (from admission to discharge) If you want to know if there are any other opportunities offered within each block of Secondary Care ask your supervising Consultant or the any of the senior clinical staff you work with. You will also be given a Secondary Care Handbook which will act as a guide to which activities you should be undertaking whilst on placement. Always take the opportunity to go to clerk patients (a full examination is called a ‘clerking’) on the ward(s) you are attached to whenever you have free-time. This is a key part of your learning in every module and will pay dividends in exams. Many patients will be grateful to have someone to talk to and will often give you information about their condition that you won’t find in a textbook. However, always remember to ask the nurse in charge of the patient if it is all right for you to talk to them and ensure you get the patient’s consent. The more effort you put in when you are on placement the more opportunities you will receive, and the more enjoyment you will gain, as well as undoubtedly learning invaluable skills. 25 Clinical concerns You may very occasionally encounter events during your clinical training that upset you, or which you feel uncomfortable about in some respect. You should seek guidance from the clinician you are with at the time, or another clinician later about your concerns. You may also seek guidance from your adviser, Head of Year (for year 1 that is Dr Dominique Hubble), the Course Director (Professor Richard Holland: r.holland@uea.ac.uk), or Clinical Skills Director (Lesley Bowker Lesley.bowker@nnuh.nhs.uk) if you feel that there is a specific concern that you are unclear who else to raise it with. Clinical Skills Clinical Skills are at the heart of your medical training, they are the tools that you must master in order to practise effectively as a doctor. There are many types of clinical skills including: Consultation Skills (see section below) Examination skills (eg how to listen to and interpret a heart murmur) Procedural skills (eg how to take blood samples or insert a urinary catheter) Emergency management skills (eg resuscitation techniques) Prescribing skills (eg writing an appropriate drug or fluid prescription) Investigative skills (eg interpreting x-rays, blood or lung function tests) Clinical reasoning (eg discussing possible diagnoses and management options based on available evidence) Organisational, learning, teaching, team-working skills etc. Your clinical skills teaching is integrated into each module (eg you will learn how to examine chests and prescribe oxygen during your respiratory module) and is mainly provided by the specialist members of each module team, as well as in Primary Care sessions. The clinical skills curriculum document lists the learning outcomes for each part of the course but you should take any opportunity to practise and refine your skills, as and when, it arises. We start teaching skills early on but the spiral curriculum means that you will revisit and refine skills in future teaching and assessment for example we teach you how to take blood in year 2 but you can continue to practice in the skills lab and on suitable consented patients under supervision until year 5 when you will be signed off as competent to do this skill unsupervised. You are fortunate to have sole access to a state of the art Clinical Skills Resource Area (CSRA) situated adjacent to the Norfolk and Norwich University Hospital in the Norwich Medical Education and Research Building (NMERB). This area was moved from a site within the hospital to the brand new building in Autumn 2014 which has improved simulation teaching facilities. There is 24-hour-a-day open access to the skills laboratory area at the CSRA which allows you to use the equipment for selfdirected practice in your own time. Please see Blackboard for our Clinical Skills 24hr Access Protocol. There are also facilities at our partner teaching hospitals (James Paget University Hospital [JPUH] in Great Yarmouth, Queen Elizabeth Hospital [QEH] in King’s Lynn, and Ipswich Hospital). Dr Lesley Bowker is the Clinical Skills Director – she is a Consultant Physician based at the NNUH who oversees clinical skills teaching and OSCE assessment for the MB BS. There are three clinical skills coordinators based at the NNUH – Richard Wharton (a GI surgeon), Medha Sule (an Obstetrician and Gynaecologist) and Mike Lambert (revision support for year 5 re-sit students). Other staff at the CSRA include a clinical skills senior nurse (Barbara Spooner), Senior Technical Manager (Chris Bligh), a Health Care Assistant (Nicola Browne), Secondary Care Coordinator (Jane Nicholls), three administrators (Rebecca Ogden, Louise Terrington and TBA ) and one admin assistant (Caroline Coombs). James Paget University Hospital’s (JPUH) clinical skills’ teaching is overseen by Stephen Nirmal (a consultant paediatrician). Clinical skills teaching is delivered by Louise Barfield, the administrators are Carol Beamish and Linda Turner and admin/technical support is provided by Stacey Smith. Queen Elizabeth Hospital’s (QEH) clinical skills’ teaching is overseen by Dr R Mathialagan (a consultant physician). Clinical skills are delivered by Dawn Bould, and our administrator is Helen Bensley. Ipswich Hospital Clinical skills teaching is overseen by Kay Wilson, and the administrator is Sue Holroyd. 26 Dress code for Clinical Placement (Primary and Secondary Care) The practice of clinical medicine relies on mutual respect and confidence. Your appearance will affect your working relationship with patients and fellow professionals, and may also have infection control implications. Therefore, in general, your clothing should be smart and clean at all times whilst you are in the hospital or in GP surgery. We recommend you wear the sort of clothes you would wear to an interview and have the appearance that you would expect from others who are treating your parents or loved ones. The following guidance is in line with the Hospital Dress Code used for doctors in all the teaching Trusts. It would also generally apply in Primary Care, with the exception of the ‘bare below the elbow’ policy No Jewellery on the hands or wrists other than a wedding band Facial or tongue piercings other than simple earrings (ie no dangling earrings) Shirts with brand logos, names or unsuitable patterns Denim of any kind ‘Rainbow-coloured’ hair Dirty hands, nails or poor general hygiene Men A clean open-neck shirt either short sleeved or with the sleeves rolled up to above the elbow and one top button undone. If cotton/creased please ensure it is also ironed Smart trousers (suit trousers or Chinos) Smart shoes (leather or similar) If you have long hair this should be tied back Clean shaven or well kept beard. Avoid ‘designer stubble’ No Ties (except bow ties) Wrist watches Jewellery other than a wedding band Jeans T-shirts Trainers Suit jacket Women A high cut blouse or smart top with short sleeves or sleeves that can easily be rolled up to the level of the elbow In winter, a jumper may be worn as long as you still maintain the ‘bare below the elbow’ rule Trousers or a skirt that comes to 8cm above the knee or below Sensible smart shoes If you have long hair this should be tied back No Short skirts Low cut or tight tops (no cleavage on display) Exposed midriff (check that short tops do not leave you exposed when you stoop (get a friend to check what happens when you lean over a bed as if you were examining a patient) Excessive makeup or nail polish ‘Ugg’ style boots, trainers, flip-flops, open toed shoes, Stilettos or high heels 27 Some examples — SUITABLE SUITABLE Clean, short sleeved, ironed shirt. Long hair tied back Chino trousers. Smart, clean, leather shoes Short sleeved shirt & jumper obeying the bare below the elbow code Smart trousers Smart shoes UNSUITABLE UNSUITABLE Jeans Skirt is more than 8cm above the knee Shirt not tucked in and not obeying the bare below the elbow code Shirt is low cut and seethrough Trainers Not bare below the elbow Wearing a wrist watch Wearing dangling earrings Primary Care and OSCE Examinations You are expected to follow the same dress code as Secondary Care, but remember you will be involved in interacting with patients (including manual handling) so bear this in mind and make sure the clothes you are wearing are comfortable and don’t restrict your movement. 28 Portfolio and reflective practice A portfolio is a journal or a private collection of personal experiences and memories which you are expected to collect during this course. It is an important component of your professional development as it forms the basis for self-directed learning and reflective practice. Reflective practice was defined by Donald Schӧn, its originator, as “the capacity to reflect on action so as to engage in a process of continuous learning”. By writing a journal you will be thinking and processing your experiences or “reflecting” on them, thereby enabling you to take a deeper approach to your learning and development and heightening your levels of critical evaluation and self-awareness. Developing skills in reflective practice during the course is an important part of your professional development and will be useful to you in your future medical career since this is the model used both in the Foundation Programme (Year 1-2 after you have qualified) and the GMC’s Revalidation process. The portfolio will also help you to provide examples or ‘evidence’ for your annual assessment or Portfolio Report (see assessment section). In order to develop an effective portfolio it is suggested that you spend a minimum of 15 minutes per week creating a written record of memorable experiences. These may be derived from any part of the course but you will find that clinical placements provide a particularly rich source of appropriate material. You should also write some commentary on the contents of your student held record of assessments and any other feedback that you have received. During your course you will have the opportunity to collect feedback from various sources such as tutors, patients, actors and student colleagues. You should use your portfolio to explore how you are setting, progressing and achieving goals appropriate to your current and future professional practice. When writing your portfolio start by describing the experience as a succinct anonymised summary; then go on to consider the following if appropriate: How did it make you feel? Why do you think it happened? - try to see this from different aspects/points of view. What effect did it have? What was the effect on patients/team/organisation? What long term consequences might this have? On further reflection what have you learnt? How will this experience help you to progress? Which goals will you set yourself and how will you achieve them? What does the GMC say about this? What further reading will help you to expand on this topic? Remember that the portfolio is a private record so it will not be directly viewed by anyone else so it cannot be wrong; just write whatever is in your mind at the time without regard to grammar, punctuation or spelling. If you are limited for time write a brief description of the event including your thoughts and return to it at a later date. More information on this area can be found in the Handbook for Portfolio and Reflective Practice this can be found on Blackboard (assessment all years section on Portfolio Reports) 29 Studies Allied to Medicine (SAM) Academic Lead: Stefi Barna (s.barna@uea.ac.uk) Summary Studies Allied to Medicine (SAM) is a student-selected component which allows students to explore new knowledge areas, prepare for electives, and engage in creative personal development, career planning and CV-building. Options include languages, arts, counselling-related skills, global health, medical leadership and management. All options involve 20 hours of module time and are assessed by attendance (80% to pass). Format SAM classes can be undertaken in years 3, 4 or 5, whenever most convenient. Some students will want to develop foreign language skills for the elective; others may wish to explore a health-related topic in greater depth, or to develop their creative capacities. Modules are assessed by attendance and participation, rather than by exams. Topics Year Topics Year 3 Health: A Monday evening class consisting of two blocks of five weeks (Sept/Oct and Feb/ March) taught by popular tutors. Sample topics include Cognitive Behavioural Therapy; Global Health; Management & Leadership for Doctors; Violence, Medicine and Politics. Classes are expected to start at 6 pm. Creativity: A Monday evening class consisting of two blocks of five weeks (Sept/Oct and Feb/March). Sample topics include Creative Writing and Arts for Health. Classes are expected to start at 6 pm. Languages: A 10-week evening class to prepare for your elective placement or for clinical use of British Sign Language. Blocks start at either 6pm or 6.30 pm in September, January or April via UEA’s University Language Programme. Beginner or Improver options include: British Sign Language, French, Spanish, Mandarin Chinese, Arabic, Japanese, German, Italian, Russian Year 4 Languages: A 10-week evening class to prepare for elective placement or for clinical use of British Sign Language. Blocks start at either 6pm or 6.30 pm in September, January or April via UEA’s University Language Programme. Beginner or Improver options include: British Sign Language, French, Spanish, Mandarin Chinese, Arabic, Japanese, German, Italian, Russian Year 5 Immersive Exploration: An intensive week (20 hours over 4-5 days) to explore a healthrelated or professional development subject in depth and outside the classroom. It takes place after the Easter holidays and before Module 15. 同盟医学研究 راسات المتحالفة للطب Σπουδών συνδεμένος στην ιατρική Estudios aliados a la medicina 30 How you will be assessed All assessments in Module 1 are formative. Formative assessments are for your learning – so you can see how you are doing, but also so you can learn how we assess you. You must fully complete the assessment, but a grade of fail will not require reassessment or stop you progressing to the following year. We would still encourage you to take these assessments seriously, learning for them in the same way as you would any other exam that you have ever taken. Almost all of our other assessments are summative; this means that you do need to pass the assessment before you are allowed to progress to the following year. Note: we will inform you if assessments are ever formative, otherwise please expect them to be summative. We have the following types of assessment which are described in more detail below: Objective Structured Clinical Examinations (OSCEs) End of year written examination Student selected study assessments (SSS) Portfolio reports Research methods assessments including: analytical review, research protocol, and an audit project In addition, each module your PBL tutor and Primary Care (GP) tutor will each complete a tutor report on your progress with them for that module. Objective Structured Clinical Examination (OSCE) At the end of each Module your clinical skills will be tested in approximately 6 clinical stations related to that module. The format of each station will vary, but might include: taking part of a patient’s history (eg taking a history from a person who has fallen over) examining one or more aspects of a patient (eg examining a patient’s knee) interpreting an investigation (eg looking at an X-ray of the arm) performing a practical or clinical skill (eg taking blood pressure) formulating a management plan and discussing with a patient (eg discussing insulin with a newly diagnosed diabetic) assessment of your clinical knowledge on cases that you have seen and presented in your clinical logbook (so-called ‘logbook station’) Most OSCE stations are of 5 minutes duration, but some are 11 minutes long. In most stations there will be a single examiner and, depending on which station it is, there might be a patient or actor present. In certain years there may be more than one actor. Occasionally there will be an observer, moderator or external examiner present. In the end of year OSCE (Years 1-4), the clinical skills you have acquired in all the previous Modules, in that year as well as all previous years, will be tested in an OSCE of approximately 8 clinical stations. The format is slightly different to the end of module OSCEs with more 11 minute stations and linked stations (two different tasks for the same clinical scenario); as well as stations with content from any year to date (rather than just one particular module). We are more likely to use real patients (rather than volunteer ‘normal’ or models) in the end of year OSCEs. There is no logbook assessment station in the end of year OSCE however you MUST keep your logbooks (and logbook signature sheets) until the end of year and you have confirmed you have passed the year because if you have to resit the OSCES you will be asked to resit all your module OSCEs, including all the logbook stations, even if you previously passed this station. 31 Please note that your final OSCE grade for the year is calculated by adding all your end of module OSCE results plus your end of year OSCE results together. In effect this means that you perform one long ‘staged’ OSCE throughout the year. To pass, you must achieve the overall pass mark and have passed at least 70% of all OSCE stations that you have taken that year. More on this topic can be found on Blackboard. Logbooks The UEA uses Logbooks to encourage patient-based, self-directed study of clinical medicine which is a life-long habit that should continue throughout your whole medical career. This tool fits well into a fully integrated course and it should help you to integrate your basic science learning with the clinical medicine. We hope you will see as many patients as possible during your clinical placements and use them to learn at appropriate breadth and depth for each module. As you complete your logbook you are effectively building your own textbook based on personal experience. Ideally, you should take a full history, and perform a full examination (a so-called ‘clerking’), for every patient you enter in your logbook. Obviously in year 1 you will not be able to do this, but as you go through each module your ‘clerkings’ will become more comprehensive. Some diagnoses are relatively uncommon and you may not see a suitable patient for a one-to-one interview during your clinical attachments. In these cases, it is acceptable to record cases that you see in your structured patient teaching sessions. However you must not present ‘paper’ cases that you have not seen or that you have ‘borrowed’ from a colleague. You must write up your cases separately from your colleagues even if you see the same patient. Confidentiality is a vital part of medical practice and therefore you must not record anything in your logbook that could identify the patient – this includes their name, date of birth, address or hospital/unit numbers. For reasons of confidentiality and fairness of assessment you may NOT include patients who are friends or family. In order to verify that you have actually seen the patient you must collect a signature at the time you see the patient. This may be from any professional member of staff (eg supervising doctor, junior doctor, nurse, administrator etc). You must NEVER falsify signatures, and such behaviour would be regarded as a fitness to practise issue. Following up your patients’ management and progress is a key part of your learning. You will discover how patients progress, how diagnoses change over time or when new information is obtained, how problems are solved, and how some patients go on to suffer complications (eg hospital acquired infection, pulmonary embolus etc). You can follow up patients by seeing them again, by reading their medical records (eg discharge summaries) or by asking the clinical staff about their progress. Patients you follow up we call ‘longitudinal cases’ and you should try to get as many longitudinal cases as possible for your logbook. 32 You should collect as many patients as possible during your module but we only ask you to write up and present 11 cases for each module at your OSCE assessment. You should have a reasonable balance of cases from primary and secondary care and from different specialities where a module is subdivided. Up to 2 of these 11 cases may be ‘out of module’ cases (ie not related to the module you are currently studying). This allows you to make good use of ‘ad hoc’ learning opportunities that you come across in your clinical placements. However, these cases must have been seen during that particular module and the dates of your sign-off sheets will be checked during OSCE assessments. You will have an assessment of your clinical logbook during an 11 minute station in each end of Module OSCE. You should complete an index of cases for each module which clarifies which cases are primary/secondary care as well as highlighting which cases you have been able to examine and which you have followed up. The cases should be presented in a loose leaf folder with dividers. During the OSCE assessment, you are only expected to provide the case write-up which you may consult during the OSCE (it is not a test of memory). You should make your own notes about the background to the case (previously called proforma B) but you will not be able to show these to your assessor or consult them during the OSCE. The logbook assessment includes questions which may be clinical, or relate to the background science and social science. Blackboard contains full guidance. It is essential to check the logbook section on Blackboard for each year as our guidance might change in future. There are also example logbooks on Blackboard. End of Year Written Exam In the ‘Integrative Period’ of years 1-4 (scheduled at the end of each year), there is a written exam. This examination is sat in two parts in year 1, and three papers for years 2-4. In year 1 each part (A and B) lasts 2 hours. Part A consists of short answers questions (SAQ) whilst Part B consists of 120 Single Best Answer questions (either extended matching type questions, or ‘best of five’ multiple choice questions). Example questions are available on Blackboard. In years 2-4 we expect to give you two Single best answer papers, and one Short Answer paper, but this may change. The questions in your written exam may be drawn from any of the learning outcomes already covered up to that point in the course (including previous years’ topics when in years 2 and above). No notes or course material are allowed to be taken into this exam. More detailed guidance on preparing for the written exam and example questions are available on Blackboard. (NOTE: details about our Finals Examination is issued separately.) Student Selected Studies (SSS) The format of the Standard Assessments (excluding Anatomy which will use continuous assessment) Year of Study Assessment Year 1 PowerPoint Presentation Year 2 PowerPoint Presentation Year 3 Abstract (included in the formative exam) and Poster or 2000 word Essay (Ethics) Clinical Case Presentation Year 4 Time to present in summative exams** (for PowerPoint presentations and posters) 10 minutes (and up to 5 minutes to discuss with examiners) 10 minutes (and up to 5 minutes to discuss with examiners) Approximately 5 minutes to present poster (and up to 5 minutes to discuss with examiners) 15 minutes (and up to 5 minutes to discuss with examiners) ** There is additional time in these sessions for the set up/change-over of PowerPoint slides etc, and for the reading of the posters by students and examiners. Formative assessments will allow for shorter presentation times and longer discussions with the tutor. 33 Research Methods Analytical review: In years 1 and 2 research methods are assessed by review of an article selected by the research methods team. This assessment is called an analytical review (AR). There are three analytical reviews across your first 2 years of study – two in year 1: the first is a compulsory formative assessment, the second is summative; and one summative assessment in year 2. Again by formative we mean that your work must be submitted, and you must participate in the feedback sessions, but the grade awarded will not count towards progression to year 2. In Module 2, and again in Year 2, your analytical reviews will be summative, and you must gain at least a Pass to progress. Assessments consist of an open, written review of a selected research paper either as a series of short answer questions or in an essay format. Papers selected for appraisal will reflect the extent of knowledge and skills taught within that module. Research Protocol: Students use their learning from Research Methods sessions in years 1, 2 and 3 to design a research protocol. This promotes the spiral learning model of the course. Clinical Audit: In year 4 you will undertake a clinical audit, in pairs with another colleague. These audits occur in either general practice or hospital settings and you will be tutored by a clinician. Departments will give you projects which are relevant to an assessment of their clinical practices and services. Your audit could therefore make a direct contribution to improving patient care. Each year six sessions are allocated throughout the year for this module. The first day is to identify the guidelines, criteria, standards and measures for your project, plus design a data collection form. Subsequent days require data collection and presentation of your findings. On the last day you are required to give one presentation of each audit project in your pair and produce a written summary of your results. Following this you must write a report of your project, independently of your colleague, which will be formally assessed as part of your MB BS. This module requires excellent planning and organisation skills. At the start of the module, please double check the dates of the allocated times with your supervisor and ensure they are aware of deadlines for assessing your work. Please read the student audit handbook on blackboard for further details. Portfolio Reports The portfolio report is intended to help you develop skills in self-assessment and continuing professional development. It is an annual assessment which in years 1, 3 and 5 consists of two elements - a personal progress statement and reflective case studies; in years 2 and 4 you will be asked to complete only one element a formative personal progress statement. Your ongoing portfolio and student held record should provide you with appropriate examples and evidence for the report. A detailed description of the portfolio and the student held record has been given in sections of this handbook. Reflective case studies will be required in years 1, 3 and 5. This summative assessment will consist of two clinical cases; one patient from primary and one from secondary care. The cases should be discussed in the light of what you have learned about professional issues as defined by the GMC documentation – “Good Medical Practice”. Year 1 are encouraged to discuss one case as a formative assessment with their Personal Adviser. This is timetabled to occur prior to the year 1 summative assessment submission date. More detailed advice regarding portfolio reports is available in a Handbook on Blackboard and will also be given in lectures and seminars to each year group. 34 Primary Care and PBL tutor reports Periodically (once or twice each module) you will have a one to one interview with your current GP and PBL Tutors. These meetings will happen at the end of each module – when the tutors have completed their report for you; but tutors may also organise to meet their students earlier in their module too. These teachers have more contact with you than anyone else involved in our course, and are therefore best placed to assess how you are progressing, whether your attitudes are appropriate, and to give you feedback on how you might improve. For the great majority these interviews are an occasion for praise or reassurance. Sometimes they may be the opportunity for a tutor to tell you candidly what needs to change, or for you to flag up that you are having difficulties. The tutor report form (completed at the end of each module) has two parts; one requires an assessment of your ‘fitness to practise’ in line with GMC (this is an assessment of your professional behaviour), the other part gives feedback about your academic (and for Primary Care – clinical) progress and effectiveness within the group. At the end of the form you are graded as excellent, good, needs improvement, or unsatisfactory. Most of you will perform well or very well and will be graded as good or excellent. However, if your academic performance or behaviour falls short of expectation you will be marked as ‘needs improvement’ or ‘unacceptable’. In such situations there should be a clear plan of the steps you can take to address the difficulty. This process is intended to be an opportunity for reflection and feedback, and an “early warning system” in a few cases. Indeed, some tutors will get you to carry out your own self-rating using the headings on the form, in advance of the meeting. A “needs improvement” or “unacceptable” does not mean you will be automatically asked to leave the course, but it is an indication that things need to change. If you are unsure how you might go about this, you can ask your GP or PBL tutor, or your personal adviser for guidance. It is usual for those rated as ‘unacceptable’ to also meet with their Head of Year. In year 1 this is Dr Dominique Hubble, and she would also review the feedback with you and discuss your plans for improvement. Self and peer assessment of professional standards At some point during the course you may be asked to do a self and peer assessment activity, where you rate your own professional standards and those of your fellow PBL members using the first part of the Tutor Report. This has five professional categories of behaviour including: honesty, team-working, and ‘takes responsibility for personal behaviour’. This activity will give you opportunity to reflect on your own experience and to practise giving and receiving constructive feedback. This will help you develop the professional skills required to prepare reflective reports and conduct peer appraisals as part of your clinical role after graduating. Students will be introduced to this activity via a lecture on how to give effective feedback. This assessment would be formative and feedback provided by students will be presented to peers anonymously. You should then discuss the feedback you receive with your Personal Adviser, as part of a wider discussion of your personal development and academic progress at the end of the year. 35 Student held records First introduced in September 2012, the ‘student held record’ is a personal collection of documents which you are expected to make during the MB BS course to describe your progress and professional development. This reflects your future practice as a doctor, as each year you will be required to gather evidence of your work, feedback and training, which is then presented at a formal appraisal meeting. At UEA your ‘appraiser’ is your personal adviser. You and your adviser will review your performance and your adviser is there to support you through the course as you develop your skills to become a doctor. We think it is helpful to see your adviser three times per year, normally after each module. You are also free to see them at other times – as needed. Should you have trouble contacting them, or need urgent advice or support, you can contact one of the Senior Adviser team (led by Maggie Bunting) instead. We suggest the first adviser meeting each year is early on in September as that is a good time to reflect back on your past year’s achievements; your strengths and weaknesses; any health or personal issues that have arisen; your potential career plans and aspirations and what you are doing to investigate those; but also external activities both academic and non-academic etc. We ask that each year you complete an ‘annual review form’ to help inform that annual review meeting. The records you collect will help you complete the portfolio report assessment each year and will also form an important basis for one of the mandatory professional assessments towards the end of the course. It is therefore vital that you keep this record complete and up-to-date throughout the course from Year 1 forwards. The following documents should be included in your record and we have divided this folder into the necessary sections to help you with this (by all means also include copies of your own assignment material in each relevant section if you would find that helpful): PBL Tutor reports GP Tutor reports Secondary care reports (external elective [M12], student assistantship [M14], internal elective [M15]) SSS feedback Portfolio Report feedback Research methods feedback OSCE feedback Written Exams feedback Annual attendance summary Personal Adviser Annual Review feedback and notes from any meeting with your adviser Patient/staff/peer feedback and notes from any formal school meetings (eg with Head of Year) Personal Reflective notes Published papers/abstracts for posters/audit Other, including elective report, extra-curricular activities/achievements It is intended that your student record will be used as a basis for meetings with your personal adviser. You may also be asked by other tutors, such as PBL or GP tutors, if they can see previous reports from their particular area of the course. You are expected to review and reflect on the documents in your record as part of your personal portfolio, and you may find it helpful to summarise some of those thoughts in the ‘personal reflective notes’ section in this record. [Note: your personal portfolio is separate to this ‘student held record’ and is a private journal from which you select items to share with a wider professional audience in the form of evidence or examples when undertaking the written Portfolio Report assessments.] 36 Intercalation to complete an MRes, MClinEd or Intercalated BSc Competing for Foundation posts (your first medical job) and higher medical training is increasingly competitive. One way of giving your application a significant boost is by undertaking a higher degree. This is for two reasons. First those with additional qualifications gain more “points” when applying for foundation posts (and all future medical posts). Equally, those who intercalate are more likely to have the opportunity to publish research or present work at medical conferences. Again, publication and conference presentation makes your application stronger. We are keen to encourage as many students as possible to undertake an intercalated degree, for those interested in extending their knowledge of Clinical and Biomedical research or Clinical Education – do consider the three excellent degrees that UEA offers (see below). We would hope that as many as 20% of your year would take up this opportunity. MRes/MClinEd/MSc in Molecular Medicine The MRes is the bespoke intercalation degree at UEA and provides the opportunity to undertake a full year of research in a clinical or laboratory environment mentored by some of the top medical researchers in the world. The MClinEd is also offered by the Medical School: students explore advances in both theory and practice in clinical education and apply what they have learned through work based placements. The MClinEd teaches key educational skills invaluable for a future clinical career and provides a wide variety of career options such as a full time educator, a mentor or supervisor. Students undertaking either degree take a year out from their MB BS studies after year 3, or year 4, while they pursue their additional degree, returning to the MB BS course once they have completed their Masters degree. There is also an MSc in Molecular Medicine available at UEA in Biological Sciences which may be of interest to our students. Alternatively, depending on your interests, intercalation can provide one of your last opportunities to study a topic related to medicine in real depth (eg undertaking an intercalated year outside UEA to study a BSc in anything from sports science to medical humanities and from international public health to physiology, or a clinical topic such as endocrinology). The range of external one year BSc and Masters degrees available to UEA students is growing every day. When can I do this? Students can intercalate to complete one of these degrees after years 3 or 4. Currently, it is somewhat favourable financially to do this after year 4, but this may change. Information on your options is available via our intercalation website on Blackboard. If you are interested please contact the intercalations’ tutor: Dr Kevin Tyler (k.tyler@uea.ac.uk) for further details. Referencing your work In all of your work for the MB BS you need to acknowledge and cite the sources of information you are using and referring to. The policy for 2014-15 in MED is that the Vancouver or Harvard styles should be used universally for referencing sources. Both these styles consist of (i) an ‘in-text citation’ and (ii) a full citation in a reference list at the end of the document. For the in-text citation Vancouver style uses a number in the text in [square] or (round) brackets, or superscripted . This number indicates the order in your document in which sources are first cited, and refers to the corresponding full citation in the reference list, arranged in numerical order. Vancouver format has been used for this page. The BMJ uses a variant of Vancouver style, also acceptable in MED. 37 The Harvard style uses the surname of the first-author and the year of publication in round brackets for the in-text citation (author, date), and the full citation information is in the reference list at the end of the document, arranged in alphabetical order of the first author of each source. Either Harvard or Vancouver style may be used for any submitted work. Within each document, only one style should be used. However, assessment-setters may give guidance on the preferred style for that task. For oral presentations using PowerPoint, Harvard is the preferred style. More detail on, and examples of, the use of Harvard and Vancouver styles may be found in the John Squires Library guide (1), on the UEA Dean of Students (DoS) Learning Enhancement Service (LES) website (2), and on Blackboard, under ‘MB/BS General Information > UEA & MB/BS Regulations, Policies & Forms > Plagiarism & Referencing’. Please consult the DoS study guides to referencing (including referencing internet sources, secondary referencing, paraphrasing and quoting) (2). Note that when using Vancouver style, if you edit text containing in-text citations, the order in which references appear may change. Their numbering then needs to be changed accordingly. If you are organising your references manually then one way to keep track of this is to use an [author, date] in-text temporary placeholder, and convert to numbers when your text is finalised. If you use Bibliographic software such as ‘EndNote’, citation matching is all done for you: you enter your reference information only once into the software database, select the appropriate output style from dozens available, and then copy a reference entry into your text as you write it. It updates any numbering of references automatically, or on demand, and formats the reference list. ‘EndNote’ software is available on UEA computers and learning to use it is well worth the initial investment in time. For more information about ‘EndNote’ software, search on the Portal in the IT services section or ask at the IT helpdesk. Reference list 1. John Squire Library. Guide to Referencing. London: North West London Hospitals NHS Trust; 2011 [updated 15th July 2011; cited 9 July 2014]. Available from: http://www.johnsquirelibrary.org.uk/guides/ referencing.htm. 2. UEA Dean of Students Office. Study resources. 2013 [cited 9 July 2014]. Available from: https:// intranet.uea.ac.uk/services/students/let/study_resources/academic_writing_study_skills. Plagiarism and collusion Whatever you heard or learned about these topics before, you must make sure to learn the UEA rules, whether they are similar to or different from what you know. Students all too often get into trouble by not doing this. Definitions of plagiarism (the unacknowledged use of another person's work) and collusion (a form of plagiarism, involving unauthorised co-operation between at least two people) are expanded in the UEA policy document on these topics. The policy can be found on the Dean of Students’ Office website here: http://www.uea.ac.uk/plagiarism and you will also find here a wealth of useful information on avoiding plagiarism. The UEA policy on plagiarism and collusion applies to work of all types submitted for formative as well as summative assessment, including, for example, work produced for PBL. Please check guidance specific to different tasks for what is expected for each. What you submit needs to be a result of your own effort and representing your own ideas and understanding. If you are using the ideas of others then you just need to acknowledge them clearly by citing them specifically. If you use their words you need to show this by using quotation marks as well as the citation. The policy states that the University takes this very seriously, because “students who plagiarise or collude threaten the values and beliefs that underpin academic work and devalue the integrity of the University’s awards.” (p.1). These offences, and also self-plagiarism, which is undeclared re-submission for assessment of one’s own previously assessed or published work, are also considered a fitness to practise issue for medical students, because of the expectations of probity for doctors and medical students (1). 38 You are expected to familiarise yourself with the principles and definitions explained in the UEA policy document, and to use resources provided by UEA, including those on the DOS web pages cited above, to help you to develop good academic practice and to avoid committing plagiarism and collusion. Working in groups is encouraged and required in MED because learning can be enriched deeply by sharing ideas with others. What you share should be in a form that needs digestion and evaluation by your peer: this is what learning is about. It is risky and unhelpful to share work with other students in a form that could be submitted for individual assessment, as the provider could also be accused of collusion. All work of students in the MB BS and the MRes course that is suspected of containing plagiarised material may be submitted to the text-matching software ‘Turnitin’ to establish the extent of the offence and to help identify sources. More information about ‘Turnitin’ is available from the DOS website at the address given above. Even if not required to submit an assessment electronically, you must keep electronic copies of your assessments as submitted, in case you are required to produce them for checking with ‘Turnitin’. It is also advisable to keep copies (electronic or paper) of working drafts of assessments in order to show your ownership of the work, if required. Copyright law and sharing electronic resources A separate but related issue to plagiarism, pertinent especially to use of electronic resources, is that copying and pasting sources of electronic origin (eg images, diagrams and text on websites), is very likely to infringe copyright of the authors. This is true even if the source is acknowledged thus avoiding plagiarising it. Terms and conditions of many resources readily available on the internet often state that their use is free for personal use, but that copying, sharing or redistribution is not allowed, even for educational purposes. Posting on Blackboard, or emailing copies, are forms of redistribution and sharing. Websites popular for PBL work and PDF files of journal articles are included in this. The Terms and Conditions of use should always be checked before copying. The UEA’s copyright expert recommends that best practice to avoid infringing copyright is to share or post a link to the resource (pers. comm., Dave Palmer, UEA Library, March 2009). The electronic link allows each user to read and download or process the item as the copyright terms and UEA’s licence allow. Sources 1. General Medical Council, Medical Schools' Council. Medical students: professional values and fitness to practise. 2009. [Accessed 10 July 2014]. Available from: http://www.gmc-uk.org/education/ undergraduate/professional_behaviour.asp. A student’s guide to coping with constant assessment On all medical courses you get assessed a lot, and UEA is no different. The key to coping with constant assessment is to be organised. Know which assessments are coming up and roughly how long each one will take to prepare for. You can find this out by chatting to students in higher years. Don’t stress too much about upcoming assessments otherwise you will burn out. Just plan what you need to do and when you need to do it. It is a good idea that as soon as you are set an assignment to look over it, that way even if you don’t plan to do it immediately you can be thinking about it in the meantime. A student’s guide to preparing for OSCEs The key to success in OSCEs is to be systematic and to practise, practise, practise. It is very easy to miss easy marks just because it’s not second nature. The best way to practise is to put together a mark sheet of everything you think you need to do in each station including washing your hands and greeting the patient etc. then get together with friends and practise till you are perfect. A student’s guide to preparing for the End of Year Written Exam All students find the written exam daunting because of the body of knowledge students are expected to know. The key is to focus on the important bits and start early. At the end of each week take the time to look over the learning objectives for the week and those for the lectures and see if you would be happy you would be able to answer them as a short answer question. If not, try going through the seminars related to that objective and make notes on them. You will find that for the single best answer (SBA) paper a lot of the knowledge you will acquire simply by paying attention in seminars and teaching in Primary and Secondary Care. There are some useful books of questions, but remember some UEA SBAs are in a unique style so make sure you have a look at practice questions on Blackboard to get an idea from them. 39 Course Progression, Fit to Sit, and Reassessment In order to progress to the next year of the course you have to pass all assessments (except for formative assessments occurring in Module 1). Currently, you are permitted one further attempt (a 'resit') of any assessment that you fail assuming you are engaging adequately with the course. Please note that if you fail any summative component of our course twice, you will be withdrawn from our course. YEAR 1 ONLY Fit to Sit: during 2014/15 we will be bringing in a ‘fit to sit policy’ as a pilot for year 1. This means that by sitting an examination you are declaring yourself fit to undertake that exam. Our intention is that if there are extenuating circumstances (which can encompass a range of physical, mental health or social circumstances) which have occurred in the immediate lead up to the assessment which are sufficiently serious as to make you vulnerable to not passing – then you will be asked to declare yourself unfit to sit. Thus, the onus will be on you to judge your own extenuating circumstances. This mirrors the approach that you will have encountered when you took your UKCAT test. If in doubt, please seek advice from your GP as to your health, or the Senior Advising team can also give you advice as to course matters. We are introducing this as the GMC emphasise the importance of doctors having insight into their own health and that if they have any doubt that they should seek and follow advice from an appropriate professional. We believe it very important that you develop this judgment and self-awareness. As soon as you become an F1 doctor, you will be expected to make sound judgements about when you are fit to ‘attend’ work and manage patients. Thus, the fit to sit policy will parallel the clear professional expectations that you will face as you start a career in medicine Full information as to how you declare yourself unfit to sit will be available on our Assessment tab on Blackboard. If you do not sit an examination and have declared yourself unfit, you would retain the same number of attempts as before the exam. Your notification of being not fit to sit would also be forwarded to the Senior Advising team so support can be offered to you where that is appropriate. PROGRESSION CRITERIA to the final two years of the MB BS course (ie progression to years 4 & 5) Any student who fails to meet the progression criteria (see below) before, or at the end of, year 3 will be required to leave the course and will not be permitted to progress to years 4 and 5 of the course. Criteria: In the first three years a student sits six ‘examinations’: three ‘overall OSCEs’ and three ‘overall written exams’, in addition to other assessments. Note: each year you take one OSCE at the end of each module, plus one end of year OSCE. Your OSCE scores for that year are then combined to give an ‘overall OSCE’ score which you must pass. At the end of each academic year you will take several summative written papers (2-3 depending on year of study). These papers are combined together each year to give an ‘End of year written’ score which you also must pass. If at the end of year 3 a student has had 3 or more fails in those elements of assessment (Overall OSCE and End of year written examinations) at the first sitting then they will not be permitted to continue to years 4 and 5 of the course. Any student who has failed 3 or more of these assessments by the end of year 2 will not be permitted to continue to year 3. The first sitting will be considered to be the first time a student attempts an assessment and will remain classified as a first sitting even if this attempt result is voided due to extenuating circumstances. This policy does not restrict students from achieving the unclassified exit award [BSc (hons) in Medical Studies] from the MB BS, as the exit award is presented to any student who has passed all assignments up to the Integrative Period in year 3, whether at first attempt or at reassessment. 40 Repeat of a year In the following circumstances you would normally be required to repeat a year rather than to intercalate: upheld appeals following a fail at reassessment a fail at a delayed first sit taken during the reassessment period For the degree of MB BS where a student fails a module or any element of a module and is subsequently offered the opportunity of a reassessment, which is delayed until the next academic year, the student would normally be required to return for the entire academic year or such portion of the academic year as the School feels is necessary to ensure that professional and practical skills are maintained. In order to evidence their continuing competence in those aspects of the course, other than that which is being formally reassessed, students shall have to achieve a passing grade in all assessments which arise during their repeat period. Length of registration on the MB BS, or MB BS with a Foundation Year Any student registered on the MB BS or MB BS with a Foundation Year will only be permitted a maximum of two periods of intercalation or repeat of study, amounting to no more than 2 years, as a result of a fail delayed first sit, or delayed second sit, or the result of an appeal. In the event where a student has an outstanding reassessment opportunity but the period of registration would exceed the maximum permitted (5 + 2 for MB BS or 6 + 2 for MB BS with foundation) the student will not be permitted to undertake the reassessment and will be required to leave the course. Exception: Where there has been a period of intercalation to undertake an intercalated degree after year 3 or 4, this will add a year onto the registration as this is permitted within the regulations. This intercalated year will not count towards the above allocation. When does registration start? The start of registration will always be the first time you enter the course at UEA regardless of whether entering year 0 or 1, as relevant. YEAR 5 FINALS STAGE BOARD The Finals Exam Stage Board will consider overall performance for the 5th year after you have taken your Final exam in February/March of your Final year. This Board will consider: Finals performance in both the written and clinical examinations your Fitness to Practise assessment (including satisfactory attendance) Portfolio assessment performance all relevant tutor reports and other Final year activities. (Note the last bullet point currently consists of four tutor reports: M13 PBL, M13 Primary Care, M14 medicine tutor report, M14 surgery report, Case based discussion performance x 2, ALS [advanced life support] performance, and procedural skills logbook completion, and performance at the national prescribing skills assessment [PSA]). It is important to note that these elements may change as changes occur nationally, or internally within the course.) 41 Overall, the Board will be able to choose from the following options: No action – student has reached standard and therefore is permitted to undertake Module 15 (internal elective) as normal. Subject to satisfactory completion of Module 15, the student will graduate. For certain students the Board may judge that whilst they have passed Finals, their performance/ attendance during Final year is such that an additional period of remediation is required either instead of, or in addition to module 15, to demonstrate that the student has reached the required level to graduate. The student has failed Finals, but will be permitted to undertake Module 15 as remediation prior to undertaking a resit Finals attempt that academic year. The Board may judge that the performance of the student at Finals was insufficient to expect the student to be able to remediate over the 6 weeks of module 15, in which case the student would normally be expected to repeated Final year in full. School Feedback Throughout your course you will have many opportunities to gain feedback on how you are doing; much of this will be informal on a day-today basis within your hospital or your Primary Care placements; or during your group work (PBL or Consultation Skills in particular). Take note of this informal feedback as it is as crucial to you as any written feedback on your assessments. In addition, as mentioned earlier, you will have tutor report forms completed by your PBL tutor and GP tutor each module (see page 32). We expect you to keep all your feedback together, as part of your student held record. This is an important record of your progress through our course. It will also help you reflect on your strengths and weaknesses as you progress through the five years of the MB BS and identify if there are consistent areas that you have problems with (see page 33). Feedback will enable you to identify which topics and/or learning outcomes you need to study and strengthen your understanding of. You should also go through this feedback with your adviser, either on a termly basis, but certainly at least once a year. Check Blackboard for more information on the different kinds of feedback you will receive for each type of assessment, and how to make the most of the support of your adviser. 42 How assessment results are given The way in which assessment results are given back to students is constantly evolving and varies with different assessments. SSS, AR, Portfolio, Research Protocol, Clinical Audit and SAM/SOM Results are posted on E:vision (this is part of the student record system that you will have access to). Mark sheets with assessors’ comments will usually be placed in your pigeon hole in the MED building. Module OSCEs A breakdown of your marks for each station will be sent to you and your adviser via email. End of Year Written Exam and Overall year OSCE Results are posted on E:vision. A breakdown of your marks will be sent to you and your adviser via email. To access results on E:vision: go to Blackboard, click on the Academic tab, half way down the right hand side there is box called Student records – click on student view, then under assessment and award details click on provisional marks this year. These results are an essential part of your annual report and should form a part of your meetings with your adviser. We strongly advise that you hold on to all of your results AND tutor reports (GP and PBL) and keep them together in your student held record so you can discuss your strengths, weaknesses and progress with your adviser and your tutors. All feedback reports are kept on campus for 4 weeks then archived and sent off campus. It is possible to recall them but unfortunately the University is charged per box, so if you require another copy of your feedback this cost will be charged to you. What the bands/deciles mean: After all OSCEs and End of Year Written Exams we will publish decile cut-off scores. Deciles go from 1 to 10 for any exam. Students in the first decile have performed best, whilst those in the 10th have performed least well. Your decile gives you an indication of how you are doing, however it is important to remember that marks are in a bell shaped curve with a few students at both extremes and lots of people getting around the average mark, so the difference between being in the 3rd decile and being in the 7th decile is often very small. Also be aware that you will be compared to only the third of your cohort who took the same OSCE as yourself. You will be able to see that yourself as the mark ranges are often very tight. 43 If you are worried about your decile do chat to your personal adviser. When a distinction is awarded: This varies in different assessments. Details are available under assessment on Blackboard.. Overall OSCE: A distinction is awarded for a raw mark which is 15% above the final agreed pass mark percentage. End of Year Written Exam: A distinction is awarded for a raw mark which is 20% above the final agreed pass mark percentage. SSS, Analytical Review and Clinical Audit: achievement of stated distinction level for that specific assessment. Portfolio Report: distinction category removed in 2013/14. End of year distinction (years 1-4): this is awarded to those who achieve an overall distinction in their OSCE for the year, and gain a distinction in one other assessment (ie non-OSCE) that year. The distinction is not awarded if a summative assessment has been failed. End of year distinction (year 5): this is awarded to those who achieve an overall distinction in their Final Clinical assessment. The distinction is not awarded if a summative assessment has been failed. 44 Distinction at Finals Assessment (clinical and written): this is awarded to those who gain a raw mark of 20% above the pass mark for Finals. (Note: this will change from 2014/15 when it is likely that the written examination will be considered separately from the clinical examination.) End of course merit: awarded to those who are both in the top 25% of the ranking at the end of the year 4 and in the top 25% of our Finals exam. End of course distinction: This is awarded to those who are both in the top 15% of the ranking at the end of year 4 and in the top 15% of our Finals exam. Student feedback/evaluation and the Student Staff Liaison Committee It is very important for you to be able to have input into how the MB BS programme develops, and we really value this. There are a number of feedback mechanisms described below. Do please also consider becoming one of our student representatives as that is an excellent way to ensure you and your colleagues’ views are heard. Course Evaluation In Years 2, 3, 4 and 5 all our students are asked to provide feedback at the end of their first module each year (End of Module Evaluation). Whilst end of module evaluations are voluntary, they are really important to the course and so you are strongly encouraged to complete these evaluation forms. Clearly, we cannot get a valid overview of student opinion unless we get a majority of students responding to feedback requests, and it is only through these means that we can really see where changes need to be made. All students are required to complete an Annual Evaluation. This evaluation takes place around the Easter vacation for Years 0, 2, 3 and 4, and after both Modules 13 and 14 are completed for Year 5. In Year 1 the Annual Evaluation is split into two parts; the first part takes place at the end of Module 1, and the second part at the end of Module 2. The Annual Evaluation is a compulsory task for all our medical students. The findings are formally summarised, and fed-back to all students and staff on the MB BS and posted on Blackboard. Both the End of Module and Annual Evaluations are completed online by set deadlines. You will be sent further details nearer the time. Occasionally, there are other ad hoc requests to provide feedback during the year if staff need feedback about a particular aspect of the course urgently or in particular detail. You can also provide feedback at any time during the year, without prompting, using the ‘Student in-year evaluation form’ which can be found in the MB BS Coursewide Evaluations folder (see below). Please take evaluation seriously and spend time on it, consider positive as well as negative aspects of your experience to comment on. Try to be specific, and comment in such a way that it is clear why something is particularly good (or less so). Please do not be rude about staff or unprofessional, as they do receive these comments. We take your views very seriously and try to respond to your views by improving/changing things wherever we can. Full details of the MB BS course evaluation system, including changes made as a result of student feedback, can be found in the MB BS Coursewide Evaluations folder of Blackboard which all students have access to. You can contact Dr Susan Miles (susan.miles@uea.ac.uk) with any queries about the MB BS course evaluations. 45 Student Representation Student representation is a key way that students can give feedback about the course, be consulted with over proposed changes, and thus improve it. In 2014/15 we are working with MEDSoc to coordinate all the opportunities for student to get involved, so please look our for further details. Representation is arranged in a variety of ways within MED: Year PBL Rep Committee Each PBL group will elect one PBL representative, at the first PBL session of the year. All PBL reps then meet together. PBL reps can then put themselves forward for election to the Staff Student Liaison Committee (SSLC: see below). This group of reps should meet at least once/term to raise issues that their chair (and secretary) can take on to the SSLC. Staff Student Liaison Committee (SSLC) This is comprised of the chair and scribe from each year’s PBL representative committee, the Course Director and the School Manager as well as other senior teaching colleagues (ie about 10 students + staff). This is the main way for students to give general feedback about the course. You can contact one of your year’s SSLC representatives directly or give feedback to your PBL rep who will then pass it. All representatives are listed on Blackboard under General Information > Staff/Student Liaison, which will appear once the members have been elected. Chair of Staff Student Liaison Committee (SSLC) The student chair of the SSLC is a student elected from within the main SSLC. Their role is to oversee all student representation within MED and ensure any concerns or suggestions that students have are passed onto the appropriate members of faculty. They also act as student representative on the Curriculum Design and Development committee (CDD) alongside a specific CDD student representative. If you wish to get in touch with the SSLC chair their contact details can be found on Blackboard. Curriculum Design and Delivery representative (CDD) The MB BS course’s main committee is CDD. This committee discusses all key issues within the course. There are two student representatives – one is elected directly to this role for a two year period, the other is the current Chair of SSLC. Module teams There are 15 module teams each responsible for one of the modules (including both electives), in addition there are separate module teams responsible for Student Selected Study (SSS) programme, and Research Methods. Each team is led by a MED faculty member and each has 1-2 student members, ideally one from the relevant year of study, and one from the year above who has already completed that module. These students are elected to act on the module team for 2 years. The name and contact details for these reps can be found on Blackboard under general information > student/staff liaison. More information on this can be found on Blackboard. 46 Who’s who on the MB BS Starting a medical course is an adventure, but it can also be like entering a maze. Below is a brief description of some of the key people you will meet: Head of School/Dean: Professor Nigel Norris is Acting Head of School. As Head of School, he is responsible for all students attached to the Medical School (MED for short), undergraduate and postgraduate, and all our staff. We employ over 200 members of staff and are continuing to grow. Course Director: Richard Holland is Professor of Public Health Medicine and is responsible for managing the course, its development, and specifically leads Year 5. He heads the Medical Education department, and has a research programme in substance misuse and pharmacy practice. Heads of Year: There are five Heads of Year. Each is responsible for the curriculum and assessment within their specific year and is Chair of their respective Exam Boards. They meet students for initial management of professional problems (eg with attendance). Dr Dominique Hubble is a GP and leads year 1. She also has involvement in admissions. Dr Veena Rodrigues is a Public Health doctor and leads year 3. Dr Pauline Bryant is a GP and leads year 2. She is also responsible for PBL across all five years. Dr Paul Strickland is a GP and leads year 4. Dr Lawson Baxter leads year 5. 47 MB BS Student Support Team Maggie Bunting Katie Dyble Senior Advisor Disability Lead Dr Christina Mason Deputy Senior Advisor Dr Charlotte Salter Dr Nilesh Patel Dr Silke Schelenz Deputy Senior Advisor Deputy Senior Advisor International Student Advisor Please see page 56 for further details of their roles. 48 Other Leads Dr Mary Jane Platt is a public health doctor and is Head of Teaching and Learning for the Medical School. She is also our Admissions’ tutor and chairs the Extenuating Circumstances Panel. Dr Lesley Bowker is the Clinical Skills Director overseeing clinical skills training and assessment with particular responsibility for hospital placements and OSCE assessments. Dr Bowker runs the Clinical Skills Resource Area at the Norfolk and Norwich University Hospital (NNUH). Professor Amanda Howe is Professor of Primary Care, and is Patient Safety Lead. Dr Dickie Young is Lead Practice Development Tutor. He is responsible for the selection and training of the GP practices providing placements in Primary Care for the MB BS. He is a practising GP who has taught many students in his own practice. Dr David Barton is the Practice Development Tutor for year 1, with responsibility for overseeing teaching in Primary Care for year 1. Dr Gill Price is the Plagiarism Officer for Norwich Medical School. Each School has a plagiarism officer who hears all the cases of suspected plagiarism and/or collusion. Dr Mary Jane Platt Dr Lesley Bowker Professor Amanda Dr Dickie Young Howe TBC Dr Gill Price Dr David Barton Professionalism Lead Academic staff: Each module you undertake has an academic lead, and a number of clinicians also associated with the module. In year 1 the module leads are: Module 1 (the Human Lifecycle): Dr Laura Bowater Module 2 (Locomotion): Dr Tarnya Marshall Theme leads: Our course is divided into modules that you study one by one. Within these modules you will learn about medicine, and all its component parts – these are our themes/domains, from anatomy to psychology. In addition, each year you will undertake a Student Selected Study (see above) allowing you to study one of these themes in more depth. Each theme/domain has a lead. 49 Administrative staff: The administrative staff that support the MB BS are based in the Learning & Teaching Hub West (UG) on the ground floor of the Elizabeth Fry Building (opposite the MED building). They are there to help if you have any questions. Your year support should be your first point of contact and s/he will try to answer your question or refer you to someone who can. WHO Sarah Wright MAIN AREA Learning and Teaching Coordinator, Secretary to the MED Exam Boards EMAIL PHONE S.Wright@uea.ac.uk 01603 591531 Year 1 tl_medug.hub@uea.ac.uk 01603 593234 Lisa Clarke Year 2 Timetabling Years 1 & 2 PBL tutors med_ug.hub@uea.ac.uk 01603 591862 TBC Year 3 Timetabling for Year 3 med_ug.hub@uea.ac.uk 01603 591684 Emma Grant Year 4 Timetabling for Year 4 Electives Studies Allied with Medicine (SAM, previously Studies Outside Medicine) med_ug.hub@uea.ac.uk 01603 591233 Matt Clark Year 5 Consultation Skills Timetabling Year 5 Clinical Audit med_ug.hub@uea.ac.uk 01603 591231 Year 5 Consultation Skills Timetabling Year 5 Clinical Audit med_ug.hub@uea.ac.uk Team Leader for MED Years 1 -5 tl_medug.hub@uea.ac.uk Team Leader for MED Years 1 -5 Sarah Browne Sarah Reynolds Patricia Knights Sarah Browne Sarah Reynolds (Wednesday, Thursday & Friday) (Monday, Tuesday & Wednesday) (Mon – Wed am) tl_medug.hub@uea.ac.uk (Wed pm – Fri) 01603 591719 01603 593234 01603 593234 50 School Management: within the Medical School itself, our administrative team is led by Carrie White, Faculty Manager. Carrie manages the administrative staff within the Medical School, working closely with Professor Norris (Acting Head of School) in the management of the Medical School, and assists with some academic related committee work. Carrie is supported by Catherine Butcher, School Manager. Catherine ensures support for the delivery of teaching activity by the School and assists with the Staff Student Liaison Committee. Some students successfully submit abstracts for national or international conferences, or attend other national events for the school (eg as a student representative). Those students can apply for funding to the school for travel / conference expenses. Details of their activity are the promoted on our Student Achievement Blackboard site. Hospital administrative teams: Each hospital also has administrative staff responsible for putting together your timetable. The overall Secondary Care Co-ordinator is Jane Nicholls jane.nicholls@nnuh.nhs.uk Tel 01603 286620, who can be contacted about general queries to do with Secondary Care placements. Site specific queries can be answered by the site administrators. Who Title Email Phone no Jane Nicholls Secondary Care Jane.Nicholls@nnuh.nhs.uk 01603 Coordinator NNUH Rebecca Ogden Louise 286620 Administrative Team Leader Rebecca.ogden@nnuh.nhs.uk 01603 Administrator Louise.terrington@nnuh.nhs.uk 286619 01603 Terrington 286622 JPUH Carol Beamish Linda Turner Administrator Administrator Carol.Beamish@jpaget.nhs.uk 01493 Linda.Turner@jpaget.nhs.uk 453635 01493 453743 QEH Helen Bensley Administrator Helen.Bensley@qehkl.nhs.uk 01553 613136 Julie White Administrator Julie.White@qehkl.nhs.uk 01553 613128 /613921 IPSWICH Sue Holroyd Administrator Suzanne.holroyd@ipswichhospital.nhs.uk 01473 702525 Katie Haystead Administrator Module 9 Katie.haystead@ipswichhospital.nhs.uk 01473 703090 51 What the School expects from you The UEA MB BS is a professional qualification, and all our students need to develop themselves as professionals whilst undertaking the course. In general, we find our students to be excellent: you are hardworking, reliable, friendly, appreciative and supportive of others, try to improve things that could be better, and learn fast from any problems. We reward good progress in professionalism on an annual basis by a recognised ‘pass’ in this area, which can be declared in a CV, and exceptional achievement may also be recognised over time. It is impossible to specify all the ways in which a professional code of conduct can be violated: you must interpret the principles and make your own judgements, as will staff. The following examples indicate areas where medical schools have encountered problems and which students should be careful about. (Please read both our full professionalism guidance and our attendance policy which are available on Blackboard—MB BS General Information All Years →UEA & MB BS Regulations, Polices and Forms). As a student on the UEA MB BS course you are expected to: Comply with the spirit and principles set out by the accrediting body, the General Medical Council—particularly those in, ‘Duties of a Doctor and ‘Medical Students: professional values and fitness to practise’. “A student’s fitness to practise is called into question when their behaviour or health raises a serious or persistent cause for concern about their ability to continue on a medical course, or to practise as a doctor after graduation. This includes, but is not limited to, the possibility that they could put patients or the public at risk, and the need to maintain trust in the profession” Medical Students: professional values and fitness to practise (GMC, 2009) Ensure patient safety and wellbeing in every way you can eg Be on time for sessions booked with patients, ensure the patient is still willing to see you, check if there is anything you can help them with (eg pass on relevant information to staff) Be safe for practice – clean hands and clothes, healthy, not under influence of drugs/alcohol, preventive immunisations in place, follow occupational health advice. Do not exceed the limits of your competence. Do not develop personal relationships with patients – do not arrange to see them out of the NHS setting or without tutor knowledge and do not exchange personal details. Maintain confidentiality, while sharing essential information for patient safety. Be honest and truthful in all areas of your interaction with staff, students and patients eg Declare any special needs or health problems that need to be known to staff to ensure student and/or patient safety (eg an infectious illness, occupational hazard, addiction, mental health). Do not plagiarise or cite other people’s work without due attribution to them (brief notes about referencing and plagiarism are provided earlier in this handbook). Never falsify others’ signatures or ask others to sign for you. Ensure staff and patients know that you are a medical student and not a doctor, and declare any limit to your competence. 52 Be responsible about all formal requirements of the University eg Submit assessments and other compulsory paperwork by the deadline given. Attend all teaching OR complete the absence record by 10am on a day you are unwell using the online system AND notify any relevant tutor (PBL/GP etc.) as well. For Secondary Care, always sign the register. Those who arrive too late to sign MUST notify Jane Nicholls, or it will be marked as an absence. Complete the annual declaration and student-held record promptly and fully. Abide by and comply with the University regulations. This includes checking your email and pigeon holes at least every 48 hours. All email correspondence with the University and medical school should be using your UEA email address. Be respectful of the needs and efforts of others eg Support peers and any staff members involved in your teaching and learning. Be polite and appreciative when staff and patients have put aside time and effort to arrange learning and assessment. Should criticism be necessary, do this with due consideration and focus on how to resolve the problem, rather than being rude or aggressive to the person. Ensure that patients are given due time and attention, that you make their comfort and safety your first priority, and thank them for their involvement with your learning. Avoid late arrival, chatting, telephone and social networking use during teaching and assessment sessions. Always consider the safety of other clinical staff (eg safe sharp disposal, ensuring you leave clinical areas and teaching areas clean and tidy etc.) Seek help when needed – it is your responsibility to be proactive about issues which may undermine your performance eg Declare extenuating circumstances BEFORE formal assessments. Meet with your Personal Adviser regularly (the minimum number of meetings expected for MB BS students is twice per year), including consulting on progress. Consider your own reputation and that of the School and University when you are outside the campus or NHS setting eg Dress appropriately when working as a medical student. Breaking confidentiality, drinking to excess, voicing unjustifiable criticisms of others not present to defend themselves, having major rows in public settings with other students, criminal acts such as stealing or illegal drug use or illegal drug dealing are all examples which can bring both you and the School into disrepute. We would recommend that you refer to teaching staff, particularly on placement, by their title and second name, until you are invited to use their first name. For students undertaking paid work, it must not occur in timetabled sessions. You must limit this so that it does not detract from the private study required to support course work, or from time you also need to relax. You should judge how much is manageable according to your progress on the course, but we anticipate that it would be very unusual to manage more than 4-8 hours of paid work per week. Similarly, participation in extra-curricular activities should be guided by your course progress. NB: an absolute minimum of 10-15 hours private study per week is expected by the course. 53 Attendance Good attendance is closely related to good performance. The majority of our students attend well; all teaching sessions on the MB BS are considered to be core and attendance is expected. Absence vs. performance at rotation 1 OSCE 92 142 90 OSCE score year 2-4 140 88 OSCE score year 1 144 138 86 year 2 year 3 136 year 4 84 year 1 134 82 132 130 80 0 1 2 >2 Number of days of clinical absence Students with poor attendance are reviewed by their Head of Year (Dr Dominique Hubble, for year 1). Students with particular attendance issues may then be referred to the Head of School. Poor attendance can lead to the issuing of a ‘Warning’. These may be noted as a ‘GMC reportable warning’. GMC reportable warnings must be reported by you to the GMC and your future employer when you qualify. (Registration with the GMC is necessary to practise as a Foundation doctor, see page 15). Very occasionally, attendance patterns are such that students have been withdrawn from the course. Please refer to the MB BS document on attendance on Blackboard—MB BS General Information All Years →UEA & MB BS Regulations, Polices and Forms. 54 MB BS student support Personal Advisers Every student at the University of East Anglia has a Personal Adviser who is there to provide academic, career and pastoral advice. You have the same Adviser throughout the 5 years. Your Adviser will offer you support and guidance as you need it and may help with practical things like providing references. They will encourage you to adopt attitudes and approaches which will help you to become a good doctor. Regular meetings with them are crucial. You should meet your personal Adviser within the first 2 weeks of the first term of each new academic year, and then subsequently once each term to discuss feedback on your assessments and how things are going. The responsibility to make contact and organise the meeting is with you. For the first meeting of the academic year from years 2-5, please complete and take along your student held record to discuss. This student held record includes information on your exam results, career ideas and areas to develop. At all meetings it is important to bring a copy of all your assessment results and tutor reports. Each Adviser has approximately five students. Further details of the Advisers role are given on Blackboard. Senior Advisers The Senior Advisers can provide information on School’s procedures and advice on areas that may be impacting on your studying. They will have up to date information regarding university regulations and/or options available to students, and are experienced in supporting students in difficulty. Maggie Bunting leads our student support department and is the lead senior adviser and disability liaison officer. The student support system also consists of Dr Christina Mason, Dr Charlotte Salter, and Dr Nilesh Patel who also are senior advisers. Maggie and her team are happy to see any student who is experiencing particular difficulties who need support beyond what can be provided by their personal adviser (med.senioradviser@uea.ac.uk). Academic Adviser Katie Pak is our named adviser within the MB BS programme for academic advice. Your first line for academic advice should be your personal tutor. However, sometimes students need tailored support and advice on study skills. The MB BS programme requires different study skills to those that you adopted for your A levels and there is a high volume of studying. Therefore balancing learning that is efficient but still leads to a deep level of understanding is a skill that needs to be developed. If you believe you would benefit from additional support then contact Katie Pak. med.senioradviser@uea.ac.uk Supporting students with disability Maggie Bunting is our lead for MB BS students with any health-related or physical disability and Katie Dyble supports students with any form of specific learning disability including dyslexia. Maggie and Katie are there to support you and can help to ensure reasonable adjustments are in place for those who require them for the course, or our assessments. Both work closely with the Dean of Students office. Declaring a disability is strongly encouraged. This is a demanding course and you need to ensure you have support in place to ensure that you fulfil your potential while at UEA. Initially, discussions can remain confidential and Maggie can advise you and support you regarding any subsequent steps you may need to take. Maggie can be contacted at any time during your course via email med.senioradviser@uea.ac.uk or M.Bunting1@uea.ac.uk Dyslexia Adviser If you have dyslexia or believe that you have a specific learning difficulty you can contact Katie Dyble. She can support you and if you wish to get tested, she will refer you, in the first instance, to Dean of Students office. med.senioradviser@uea.ac.uk or K.Dyble@uea.ac.uk Pregnancy If you are pregnant please contact Maggie Bunting as soon as possible in order for the School to conduct risk assessments. All information is strictly confidential but for your safety the School needs to be aware at an early stage. med.senioradviser@uea.ac.uk or M.Bunting1@uea.ac.uk 55 International student adviser Dr Silke Schelenz sees her role first and foremost as a student adviser like any other student adviser except with special responsibilities to international students. This means that whilst you have your own personal adviser, just like other students, you are also very welcome to seek advice from her if you are an international student. We envisage that as an international student, you may have particular needs that may be different from home students such as English language problems, living very far away from home which may involve travelling across international or continental boundaries. You may experience cultural or social issues that are totally different from what you are used to. The financial issues you face may be very different for example; for some, you may have been sponsored by your national governments and as such have huge pressure on you to succeed as failure might lead to some penalty. Your educational background may be different in some ways and you may have very different learning styles and techniques as well as other particular personal issues. s.schelenz@uea.ac.uk or med.senioradviser@uea.ac.uk Dean of Student’s Office: www.uea.ac.uk/services/students/International INTO Centre: http://intohigher.com/universities/united-kingdom/university-of-east-anglia.aspx International adviser within the Medical School: Silke Schelenz, Clinical Senior Lecturer s.schelenz@uea.ac.uk Dean of Students’ Office The Dean of students is a valuable resource if you have any concerns of difficulties. They offer a Counselling service, accommodation and finance offices. The DoS also runs a learning enhancement service which offers advice on several areas including giving presentations, exam technique, organisation and time management. More information on this can be found at http://www.uea.ac.uk/dos or you can visit the Dean of Students it is located on the Upper Street close to the Library, between Waterstones Bookshop and the University Counselling Service. Intercalation Students may request to intercalate from the course (ie take time out from the course) for a number of reasons – health, personal issues, pregnancy, and intercalated degrees. Time out from the course is often a full academic year but each case is considered on an individual basis. All initial queries regarding intercalation should be directed to the EFB Hub med_ug.hub@uea.ac.uk. You can also find information here: http://www.uea.ac.uk/learningandteaching/students/studying/concessions This link also provides other information such as how to transfer to another course. General Practitioner You are required to have a local GP whilst at UEA and it is recommended that you register with the University Medical Centre so that if you have any health difficulties you have someone to turn to. The University Medical Centre offers free confidential sexual health and travel clinics. You can contact the medical centre by email on umsuea@nhs.net, by phone (01603) 592172 or in the case of emergencies (01603) 251600. Student Union Advice Centre The Union Advice Centre provides an independent, free and confidential service open to all UEA students. You can pick up leaflets and information about a range of subjects and the friendly staff can offer face-to-face advice on just about anything. If they can’t help you, they will send you to someone who can. The Advice Centre is located on the walkway of Union House, next to the Travel Shop and the entrance to the Hive overlooking the Square. They are open weekdays 9am-5pm (Wednesdays 11am5pm). You can drop in during the day to pick up a leaflet or book an appointment with one of their Advice Workers. We are also available by phone on 01603 593463 and by email at advicecentre@uea.ac.uk. 56 The Union of UEA Students DEMOCRACY & REPRESENTATION: Representing students on university committees is the core function of the Union; your course reps will speak for you to those who can change your course for the better. We are also a democratic organisation, so vote, stand for election, and be a council rep! ACTIVITIES: We have over 200 clubs and societies, but if you can't find the one for you we can help you start your own! We also accredit volunteers, so if you're volunteering come and pick up a log book. ENTERTAINMENTS: We run the bars, the LCR, the Hive and the Waterfront. Come along to our gigs and club nights, or just have a coffee in the Hive! All of the profit made through entertainment funds our charitable activities. ADVICE CENTRE & HOME RUN: Our Advice Centre provides free, independent advice on academic, housing and welfare issues. Home Run is our housing bureau; we have over 1500 houses on our housing list which all have to meet high standards of compliance. SHOPS: We make sure that our shops offer great value and our products are ethically sourced. All of the profit made in our shops funds our charitable activities. YOUR UNION: All UEA students are automatically members of the Union. We listen to our members, and we want to know what you think! So let us know on Facebook (Union of UEA Students), Twitter (@unionuea) and the website (www.ueastudent.com), or just pop into the office in Union House. How to avoid burn-out “Self-love, my liege, is not so vile a sin, as self-neglecting. “ Henry V, William Shakespeare (1564-1616). Caring for others can take its toll, both mentally and physically. Doctors are far from immune, in fact they are especially vulnerable to burnout, and the sense of losing control is one of the most important predictors. Doctors are also more prone to certain diseases, some of which are related to alcohol consumption. Diseases relating to smoking are less common as we all know the dangers of this habit. Are medical students any different? I doubt it, especially as many of you are living away from home for the first time, or juggling with being a parent, coping with financial pressures, and relationships. How can you avoid getting into the trap of emotional burnout or physical illness? Here are some tips: If you are a smoker, then make a plan to stop. There are lots of people willing to help (eg practice nurses, pharmacists). Eat regularly and sensibly. If you are overweight get some help and advice. You can achieve a lot in five years. If you lose half a kilogram a month, that’s 6kg a year, 12kg in two years. Don’t forget about group support (eg Weight Watchers). If you drink alcohol, have some alcohol free days and avoid binge drinking. That does not mean you cannot enjoy yourself, but learn to recognise your limits. Some students have come to our attention because of drunken behaviour. Don’t take or be involved with drugs. If caught, you will be expelled and no other medical school will take you. Harold Shipman started taking pethidine early in his career. If you are unfit start taking some exercise. You don’t have to be a fitness fanatic. Try walking for 15 minutes a day and build it up to 30 minutes. Cycling, swimming, running or other sports are alternatives. There are plenty of opportunities for team sports at UEA but these are more difficult to continue after you qualify (Olympic athletes excepted!). Organise your work so that you have breaks and time for leisure. Some people work best in the early morning (larks) and some late at night (owls). Either way, working for an hour or two every day is more efficient than working for 12 hours to catch up. If you start getting behind with your work, ask yourself why. The internet can waste a huge amount of time and good textbooks are almost always a better bet. If you run into trouble emotionally or physically, ask for help. UEA has an excellent system of student support and a first rate medical centre. 57 Index Administrative staff ................................ 50 Analytical review ................................... 34 Attendance ............................................ 54 Banding ................................................. 43 Books – student recommended ............... 6 Clinical Audit ................................... 18, 35 Clinical concerns ................................... 26 Clinical Skills ......................................... 26 Consultation Skills ................................. 21 Course Progression............................... 40 Dean ..................................................... 47 Dean of Students Office ........................ 56 Disability adviser ................................... 55 Dress code ............................................ 29 Dyslexia adviser .................................... 55 Elective ................................................. 13 End of Year Written Exam – Student suggestions .......................................................... 40 Peer assessment................................... 35 Personal advisors .................................. 55 Portfolio Reports.................................... 34 Pregnancy ............................................. 55 Primary Care ......................................... 23 Primary care tutor reports ...................... 35 Problem Based Learning ....................... 16 Reassessment....................................... 48 Research Methods .......................... 18, 34 Research Project ................................... 34 Results .................................................. 43 Secondary Care .................................... 25 Seminars ............................................... 17 Staff student liaison committee .............. 45 Student Evaluation ................................ 45 Student representation .......................... 46 Student Selected Studies (SSS)……19,33 Student Union Advice Centre................. 56 Evaluation ............................................. 46 Studies Outside Medicine ...................... 30 Feedback .............................................. 42 Term dates ............................................ 14 General practitioner ............................... 56 Union Advice Centre .............................. 56 Intercalation .......................................... 37 Who’s who ............................................. 47 International student adviser ................. 56 Lectures ................................................ 17 Logbooks .............................................. 32 Module 1 ................................................. 8 Module teams........................................ 46 Objectively structured clinical exam ....... 31 OSCE .................................................... 31 OSCE – student suggestions ................ 39 58
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