5 tips for medical students starting their first clinical placement from a teaching fellow

About to embark on clinical placement? Tom is a Clinical Teaching Fellow in Severn Deanery, with an interest in medical education. Life as a medical student is just as overwhelming as it is exciting. Tom shares his advice about how to succeed on placement at medical school.

What will we cover?

Introduction

Whether you are a bright-eyed first-year student fresh into the realm of clinical medicine, or a final year student who is an expert at blending in with the furniture, there are some simple things that everyone can do to really maximise opportunities and learning whilst on the wards. 

Clerking patients, getting into theatres, attending clinics, and presenting to ward doctors are all excellent ways to learn but a few easy changes to how you approach each clinical placement can help you get an even fuller experience from your time in hospital.

Here are a few of my top tips to help you get the most out of each medical school placement to best prepare yourselves for exams but also life as a newly qualified doctor. 

One: Know your requirements and get signed off early!

It sounds simple but always takes longer than you expect. It really is worth taking an evening or two at the start of each placement to work out exactly what needs to be done so that you can more easily plan each week and make sure you’re on track to finish all your signs offs by the end.

Another one that may seem simple but can very easily get away from us is getting those sign-offs early. It can be easy to think “I won’t ask for a signature this time” or “I’ll come back tomorrow”, but it’s always worth asking there and then. Why make things harder for yourself and double up your time? If you’ve completed a task, you’re better off getting it signed off so you can focus on other areas that might need a bit more work.

Remember that junior doctors are more than happy to sign off competencies – unfortunately, the need for sign-offs continues at every level of medical training, so we are all in the same boat.

Two: Have a plan

Each day when you go into placement, have an agenda of what you want to achieve. Make a list of things that you want to get done or learn about (make sure it is achievable!) and have that purpose for your day. This will help to keep the sign off sheet ticking over and ensure that you are covering your curriculum. Not to say that if a great learning opportunity presents itself that you should turn it down because you never know when a practical skill or impromptu teaching session may present itself, but having a plan gives structure to your day and makes sure that you cover everything you need in an organised manner (or as close as is possible at medical school).

Three: Think about the end goal

Remember – what you are aiming for at the end of medical school is to become an F1. Being organised (and as I’ve mentioned getting sign offs done and dusted early) gives you more time to focus on the core skills needed for life as a doctor. Fully immerse yourself into ward life and get stuck in. Act up, work on your time management, and learn how to make a jobs list! You’ll get more out of it this way and the juniors on the ward will really appreciate you helping, no matter how small the job you can take off their workload. 

It’s also worth noting that you aren’t aiming to be a consultant straight after medical school, so it really is worth spending time with the junior doctors on the wards to prepare for your transition once qualified and avoid that “rabbit in the headlights” feeling.

Four: Pharmacology *sigh*

Pharmacology, marmite of the medical world, you either love it or hate it. But either way crucial for those finals, PSA and working life. Learning pharmacology however needn’t be the laborious task it is perceived to be. 

Get to know the online BNF – download it now if it isn’t already on your phone! Half of the PSA exam is knowing how to navigate the BNF. If you start early on in your career, you’ll be a whiz by the time you get to F1.

A really simple way to almost learn pharmacology passively is, every time you clerk a patient or see one on ward round, to simply look through their drug chart. Go through each drug, how they work and what they are used for. Some you will already know, great! But the learning comes from those that you don’t recognise and checking them on the BNF. You will come across the more commonly used drugs multiple times and on the second, third, fourth etc time of looking them up, you’ll begin to recall those times you read about them and why they were used.

Five: Patients aren’t doctors (usually)

My last top tip is more of a notion or a mindset to take with you onto the wards. We can very easily worry about not knowing everything or getting things wrong in front of patients when practising histories or examinations, but one realisation that helped me gain some confidence when seeing patients as a student was that patients don’t know medicine. They might have a bit of experience from previous hospital admissions but they don’t know all the subtle steps involved in an OSCE standard respiratory examination or what you are looking for when you ask them to “put your two index fingers together…copy me like this….yes that’s the one…okay now you can put your hands down again”. If you miss steps or get a bit muddled the patients aren’t aware of this so really just give everything a go (safely).

Remember, patients on the ward are usually very happy to help train up the future doctors of the NHS (plus they are usually quite bored so enjoy the distraction whilst they are inevitably waiting for their lift home or TTOs). It is a privilege to talk to these people, who are often in very vulnerable situations. Having a chat with them will really brighten their day!

Final words

Hopefully you’ll find these tips useful. Everyone learns differently but these are my tried and tested suggestions that I used at medical school. Remember you can always learn helpful tips from each other too so ask around and share ideas amongst your peers. Good luck!

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