Year One, Trimester 1
So, the end of first year is nigh. Only two more weeks left before I sit my OSCEs (Objective Structured Clinical Examination), which tests our ability as practitioners to clinically examine a patient. But I’ll talk more about exams later on in another post. What you probably want to know right now is what has it been like for the last year on possibly one of the most demanding postgraduate courses around.
Trimester 1 (Sept – Jan)
We hit the ground running as we kick started Trimester 1 of 3. Day 1 wasn’t filled with awkward team building exercises or get to know each other hugs – there isn’t any time for that soppy stuff! I sat down at 08:55 with 29 or so other people and Dr Rahman began. Introduction to Cardiac Anatomy and Physiology. Good, I thought, something I already know. Boy was I wrong. What I learned from my previous degree (and job) was nothing compared to what I was expected to know as a PA (Physician Associate). Clinical medicine is not to be underestimated, regardless of your background. You need to know everything. From how many vessels supply each myocardial cell to the gross location of the heart. No minute detail is not worthwhile knowing. We spent roughly three to four weeks covering anatomy, physiology, pathology, pathophysiology, epidemiology, clinical presentation, clinical examination, investigations and imaging studies before we then we got down to the management and treatment of each clinical presentation. Oh, and that was just for cardiology. We then moved on to respiratory and repeated the same process. Each three to four weeks is dedicated to one body system: cardiology, respiratory, gastrointestinal, endocrine etc.
Alongside the Clinical Medicine module above, we also had the Family Welfare and Child Healthcare (FWCH) module as well as the Clinical Pharmacology module running. The FWCH module taught us the basics in diagnosing and managing conditions that fall into family medicine, incl. OBGYN, as well as assessing, diagnosing and managing paediatrics. Clinical Pharmacology taught us the basic pharmacological principles as well as covering the drug groups, including their chemical effects, indications, side effects and interactions. We covered, for example, common drugs used in cardiology, respiratory, endocrine, neurology, mental health, antibiotics and so on. At this stage we were not expected to know how to prescribe these medications or their exact doses (due to PAs currently not being able to prescribe due to legal constraints), but we were expected to have a good understanding of the indications for the drugs. The module primarily focuses on the biochemical interactions of drugs and their pharmacological actions within the body. This was a little overwhelming for me – the non-biomedic. But with the support of the biomedics on the course I quickly got up to speed. Utilising the skills of others on the course is a real bonus. One of the nice things about PA training is that the biomedics have excellent knowledge of the biochemistry and chemical aspects of the course, so healthcare professionals buddy up with them! The healthcare professionals however have the upper hand when it comes to the clinical aspects such as procedural skills, clinical examination and their experience with sick patients. Biomedics, buddy up with the health professional if you want to survive your first week on the ward in Year 2.
As you can probably tell, it’s ridiculously intense. You’re juggling three modules, all of which have a lot of content to cover, as well as trying to live a life. We often had Monday night Nando’s after work (you get an Anglia Ruskin student discount on Monday’s, make use of it!). It’s important to have fun and socialise with the people on your course. We set up the Physician Associate Society (PASOC) to help us with social activities. Most of my days though did consist of waking up at 6:30am to a day of lectures, home by about 05:30pm, dinner and then up until about 10:30-11:00pm studying and making notes. It’s hardcore. But to be honest, looking back, it was worth it. I feel relatively confident coming to the end of Trimester 3. But if there’s one thing you need to take away from this it’s this:
TRUST IN THE STRUCTURE. At the end of Trimester 1 you’ll be thinking there’s no way that I’ll ever be able to learn all of this in just one year of academic learning. But you’d be surprised. And just remember, you’re only learning the theory. The real learning will come in Year 2 when you see things for yourselves. But putting in the effort now will pay off when you’re grilled by your consultant on your first ward round in your second year.
Tips to Survive Trimester 1
- Make notes early on. Don’t leave it until the end of the Trimester. You need to get your brain in gear from day 1.
- The lectures are a good place to start, but don’t expect the lecturers to be able to cover every nook and cranny of that field of medicine. Medicine is rapidly advancing and its scope is too wide to be covered in three weeks’ worth of lectures. The idea of PA training is for the lecturers to give you the basic understanding and for you to go home and learn it in-depth. Read around, PubMed search and read journal articles. You have to be up to date.
- Don’t expect the knowledge to be gained purely through osmosis. You need to put the time and effort in to learn things. Don’t cram before your exams and smash them with high grades only for that knowledge to be lost three months on. Find a way of learning for the long haul rather than for the short term.
- Write out neat notes that follow the same pattern and layout for every disease. This really helps organise your brain and forces you to learn for the long term.
- Pick a condition a night. Don’t try and cram three or four different conditions into one night. You’ll never learn it properly and will confuse treatments between diseases.
My Recommended Reading for Trimester 1
The library has lots of books available and e-Books. Make use of this. Money is scarce as a postgrad. Don’t waste it.
Books to buy for yourself:
- Oxford Handbook of Clinical Medicine (9th Edition)
- The Top 100 Drugs: Clinical Pharmacology and Practical Prescribing
Get from the Library:
- Oxford Handbook of Clinical Specialities
- Davidson’s Principles & Practice of Medicine
- Essential Clinical Anatomy
- Harrison’s Principles of Internal Medicine
- Robbin’s & Cotran Pathologic Basis of Disease
- Crash Course: Pharmacology
- Crash Course: Cardiology
- Crash Course: Respiratory System
- Crash Course: Gastrointestinal System
- Crash Course: Endocrinology
- Macleod’s Clinical Examination
TIP: Don’t waste money buying the BNF.
You can access it for free through www.medicinescomplete.com/ by using your ARU Library account. It’s current, up to date and the book costs about £40.00 and is only valid for three to four months at a time. Then they release a new one and your copy is no longer legally binding.
That’s all for now folks. I’ll let you know how I found Trimester 2 soon.