Day one of clinical placements is when sh*t gets real. Torn from the comfortable bubble of university life, you are now thrown onto busy wards, into clinics, general practices and operating theatres. Gone are the days when you could roll out of bed hungover at 8.45, sling on some trackie bums and slump into the lecture theatre for 9 clutching a coffee. Now you need to be up early, dressed smart, fresh faced and starting to look just a little bit like you could actually be a doctor. I know, there must be some sort of mistake, right??!
You in first year ............................................................................ You on clinicalplacements
What’s more, clinical placements are when you first have to talk to real patients, make sense of their problems and understand what is being done to them and why. You’ll witness the best of humanity and the worst, encounter death and misery for perhaps the first time, and see and smell things you never imagined possible (and that’s just in your own pants). Placements can be a scary experience but they are also tremendously exciting. Personally, I enjoyed them much more than lectures and tutorials! Here are some of the pros and cons of your new learning environment:
To understand what a typical day looks like for a medical student on placement, check out this great blog from Argha Datta. I’ll also be writing separate posts about the specifics of medical and surgical placements, and how to get the most out of each of these.
In the meantime, here are my top tips which you can start following from day one of any clinical placement:
1. If you have any choice, aim for smaller hospitals and those with a strong teaching culture. It can be easy to get lost and ignored in big inner-city hospitals where everything is more crowded and everyone is busier. Speak to students in years above at your med school for advice on which hospitals to go for and which to avoid!
2. Carry a pocket-sized notebook to jot down all the conditions you encounter and topics to research later. Look these up as soon as you get the chance, while they're still fresh in your mind.
3. Be prepared to play dumb sometimes. I learned absolutely LOADS by using phrases like “I’m sorry but I don’t understand, would you mind explaining that again to me?” or “I haven’t learned about this condition yet – can we talk about it when we get the chance?
4. Try to get informal, off-the-cuff teaching from junior doctors, as well as the scheduled, formal teaching which is on your timetable. Informal teaching tends to happen later in the day on wards, when doctors are less busy. I often found the juniors were very enthusiastic to teach and would happily discuss particular patients or diseases in great detail, provided I caught them at the right time.
5. Perfect your poker face. Whether showing you their oozing scrotal wound or explaining a bizarre sexual practice, patients will often shock and surprise you when you least expect it. Try to remain calm and non-judgemental at all times!
6. Don’t limit yourself by profession or seniority. Medicine is very hierarchical and it can be tempting to assume you should be learning from those at the top, such as registrars and consultants. But you can learn from absolutely anyone at any time: I got amazing teaching from pharmacists, physios, FY1s, nurses, midwives and even other medical students. If someone is a good teacher and willing to spend time with you then grab that opportunity!
7. Create a good impression. Hospitals are extremely busy places and most people are just trying to get their job done to the best of their abilities. Teaching students is probably not a core part of that job, so to some extent you will have to ‘earn’ it. I found this much easier if you are polite and friendly, introduce yourself, smile and appear interested and enthusiastic. If people are happy to chat to you, they’ll be happy to teach you too.
8. OMG WTF with the TLAs? Medicine is absolutely awash with abbreviations and acronyms – to the point where it even has its own in-joke (TLA = three letter acronym). Whether it’s NAI or PCI, TOF or PPI, get yourself into the habit of noting them down and working out what they mean, and eventually you’ll start to understand what everyone is on about.
9. Develop a thick skin. Things won’t always go to plan on placements and sadly not everyone will be nice to you all the time, no matter how polite and friendly you are! Anything that crosses a line into unprofessional conduct or abuse should be reported to your medical school asap or discussed with a supervisor. But when it comes to low-level, day-to-day unpleasantness (which believe me you will encounter), don’t waste your valuable time and energy getting upset. Rude people are simply not worth damaging your studies and mental health for. Take a deep breath, count to ten, try to avoid them as best you can and channel your efforts into being a good person who can rise above it!
Remarxs is a powerful academic collaboration platform - to find out what we do, and join our network, click here