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