Since I have survived the first year of graduate entry
medicine I thought it would be appropriate to give prospective GEM/GEC
(graduate entry medicine/course) students an idea of what an average week is
like.
The first thing to mention is that different medical
schools all have a slightly different structure to their graduate entry courses
so this might not fully apply to some prospective GEM students, however I am
sure that some aspects will overlap.
The GEM1 course that I was on was very PBL (problem based
learning) orientated, not all GEC/GEM courses are like this and some
universities prefer graduate students to primarily attend lectures rather than
undertake group based work.
It is important to emphasise that the PBL structure of my
course only applies to the first year of GEM because years 3-5 are the clinical
years that are primarily based in hospital.
This is in contrast to the standard 5-year undergraduate
course at my medical school, which is very lecture based. We never really got to meet the undergrad 1st
and 2nd years, because they attend lectures as the main bulk of their
pre-clinical years, therefore GEC/GEM students often get to know each other
very well and form a tight knit group.
PBL revolves around being put into groups of around 8-10;
and every week as a group you work on a problem based study with a tutor
overseeing discussions.
The problem based studies often incorporate key topics
involved in the biological sciences for a certain module as well as
incorporating the relevant anatomy, ethics and medical sociology for that week. Each member of the group covers all aspects
of the case studies and the problems are grouped into 4 week themed
blocks. This will cover the basic
science, anatomy, ethics and sociology; with all of these topics being
integrated into the problem based scenarios.
For example, in the 4-week neurology block one weekly
scenario might talk about a patient who has a movement disorder, who is on
certain drugs and who might also have other issues going on in his/her
life. As a group it is then discussed
what key topics need to be covered from the scenario e.g. how movement is
normally initiated in a person and then what can go wrong to produce disease,
what are the drugs that the patient is taking and how do they work, what
ethical problems crop up in the scenario etc.
Therefore, each PBL problem has many different aspects
and learning triggers to it and therefore each week involves having to cover a
great number of topics and learning outcomes.
After the PBL group discussion has finished, each member of the group
then goes away and studies and makes notes on the discussed learning
points/outcomes.
However, PBL does not encompass the whole of the GEM
course, far from it, there are also weekly anatomy lectures and group based
anatomy teaching with demonstrators.
Every week there is anatomy reading that has to be done in order for
students to get the most out of the group based teaching. Other lectures are also dotted about every
week and these might be lectures in ethics, statistics, sociology as well as
the key scientific principles that underpin the weekly PBL scenarios.
Every month or so there are also anatomy prosection sessions
in the medical school prosectorium.
Prosection is a pre-prepared dissection of a cadaver (the dead body of a
person) by professional anatomists; this enables the medical students to
observe carefully dissected human bodies that are extremely well preserved
(i.e. so you can see all the relevant structures). This is in contrast to dissection whereby
students learn by physically making incisions into the cadaver. As a general rule, some medical schools
prefer prosection and others prefer dissection.
All cadavers are individuals who have voluntarily donated their bodies
for medical school teaching and therefore it is a session that is treated with
great respect and most students feel very privileged to have such a learning
opportunity.
Weekly GP visits were often the highlight of the week and
every student is registered with a GP practice that they attend weekly, often
in small groups of 4-6 and are run by GP tutors. These GP sessions often involve sitting in on
GP consultations, conducting patient interviews and medical histories as well
as practicing clinical skills. Clinical
skills are great fun and really provide an insight into what life will be like
as a clinical medical student and as a doctor further down the line.
For example, clinical skills covered will often involve
learning how to take a patient’s blood pressure (the traditional way, using a
stethoscope and mercury sphygmomanometer) to more physical clinical exams such
as upper and lower limb examinations and neurological exams. My GP group were lucky enough to practice
venepuncture (IV access into a vein to gather a venous blood sample) on each
other and other groups gave flu vaccinations to patients. Other clinical skills might involve testing
cranial nerves, testing patient reflexes (using a tendon hammer), MMSE (mini
mental state exam) etc.
Communication skills are also exciting but a real challenge,
as certain points throughout the year the GP practice invites an ‘actor’ to act
out a certain scenario that we as medical students might have to deal with in
the future e.g. the angry patient, the upset patient, the difficult patient etc.
Learning the clinical skills really well is a good skill
to acquire early on in the course as it does prepare you well for the end of
year OSCE, which can be quite nerve wracking.
Every week a key theme in GP practice was to elicit a
patient medical history through interviewing a patient individually; these
patients often had medical conditions that related to the PBL scenarios of that
week. For example, when covering the 4
week cardiac and respiratory module I spoke to one patient who had COPD and
another who had suffered from a heart attack.
This is useful as it means you can apply what you learn to real life
situations and to see how such conditions affect a person directly.
In the first term of my course, 4 weekday evening medical
school sessions (7-10pm) are dedicated to what is known as BLS (Basic Life
Support). Everyone has to train to
provide BLS and it involves learning how to respond to certain emergency
situations, for example, how to deal with a patient who has a burn, someone who
is bleeding, choking or in shock etc.
Learning the recovery position and knowing how to correctly perform CPR
(which is practiced on plastic dummies); learning about chest compressions,
rescue breaths and how to use an AED (automated external defibrillator). At the end of the 4 weeks BLS there is an
exam that every student has to pass.
During the first year we also have a hospital induction
day whereby we shadow on of the 5th year medical students, which
gives a real taster of what is to come in year 3 (clinical years).
Overall, GEC/GEM1 is jam packed, non-stop year, but it’s very
interesting and you learn so much.
Anyway, enough of the essay. Any questions about GEM year 1? Feel free to write a comment!
