Clinical

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Entering the clinical phase is when it starts to get serious! You will be used to going to lectures and being lectured all you need to know. Clinical medicine is VERY different. The emphasis is on you to identify what you need to learn. There are very few lectures, and those you receive are only giving you the basics. You will soon come to realise that you are being taught, for the first time, by institutions where education is not the priority. To learn clinical medicine you need to see as many patients as you can. Spending time on the wards, seeing what goes on, following patients to their investigations - that's how you learn (with plenty of reading!) Clinical courses vary, but in the end, the same product is created!

Below I will give an overview of the main clinical examinations, and give a list of text books that I used to get me through the clinical years!

Clinical examinations

You will soon hear many times, how >80% of diagnosis comes from the patients history. This is true, but examination of the patient plays an important part in confirmation or challenging the diagnosis suggested. And perhaps more importantly, examination of systems forms the basis for a proportion of finals, and post graduate exams. Therefore, it is very important to get into the habit of examining patients regularly. Some suggest that you should aim to examine at least one patient a day, and this may sound a simple task, but when lectures, assignments and other specialty activities distract, it is surprisingly hard to achieve this goal. However, I would strongly recommend making it a priority to examine as many patients as possible during your early clinical years. This will make revising for finals much simpler!

The main examinations to master are as follows:

- Cardiovascular examination - examination scheme

- Respiratory examination - examination scheme

- Gastrointestinal examination - examination scheme; Link to useful sBMJ article on stomas

- Peripheral nervous system - examination scheme

- Cranial nerve examination - examination scheme

 

These examinations form the basis for much that is required in every day practice, and will certainly be examined in finals. There are many different opinions on how exactly to approach the examinations, and a suggested routine can be found by clicking on the links above.

 

Other examinations that should be mastered for finals include:

- Endocrinology: acromegaly, cushings - examination scheme

- Peripheral vascular disease - examination scheme

- Varicose veins - examination scheme; link to student BMJ article on varicose vein examination

- Hernia examination - examination scheme; powerpoint presentation on hernia examination

- Neck lump examination - examination scheme

- Orthopaedic knee examination - examination scheme

- Orthopaedic hip examination - examination scheme

- Orthopaedic Shoulder examination - examination scheme

- Rheumatological hand examination - examination scheme

- Dermatological examination - examination scheme

 

These too should be practised throughout the course - on patients, colleagues and cuddly toys!

 

The best sources to assist with learning the examination schemes includes:

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Past university mark schemes - shows you exactly what will be expected!

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Macleods Clinical examination - Douglas, Nicol, Robertson

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Clincial examination: a systematic guide to physical diagnosis - Talley and O'Connor

      

Writing in Medical notes

This is a skill that needs to be developed during the clinical years. I have attached a document which offers some advice on writing clerkings in medical notes. There are many ways to structure these, and this is just one.

Writing in medical notes

 

Recommended Text Books

This is a list of the text books that I used during the clinical part of the course, and which were very helpful during finals revision!

 

General medicine

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Clinical Medicine - Kumar and Clark

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Medicine at a glance - Davey

General surgery

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Essential Surgery - Burkitt, Quick, Reed

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Surgical talk - Goldberg and Stansby

Paediatrics

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Paediatrics and Child Health - Rudolf and Levine

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Illustrated textbook of paediatrics - Lissauer and Clayden

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Core clinical cases in paediatrics - Ewer, Barrett and Diwakur

Obstetrics and Gynaecology

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Gynaecology by ten teachers - Clayton and Monga

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Obstetrics by ten teachers - Baker

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Obstetrics and gynaecology - Impey

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Core clinical cases in obstetrics and gynaecology - Khan, Gupta and Mires

Psychiatry

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Psychiatry: An Oxford core text - Gelder, Mayou and Geddes

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Psychiatry at a glance - Katona and Robertson

Oncology

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Clinical Medicine - Kumar and Clark

Infectious diseases

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Clinical Medicine - Kumar and Clark

Genitourinary medicine

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ABC of sexually transmitted infections - Alder, Cowan, French and Mitchell

Orthopaedics

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Apleys concise orthopaedics and trauma - Solomon, Warwick and Nayagam

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Surgical Talk - Goldberg and Stansby

Neurology

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Neurology: and illustrated colour text - Fuller and Manford

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Clinical Medicine - Kumar and Clark

Rheumatology

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Crash course rheumatology and orthopaedics - Coote and Haslam

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Clinical Medicine - Kumar and Clark

Dermatology

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Dermatology: an Illustrated text - Gawkrodger

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ABC of dermatology - Buxton

ENT

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Ear, nose and throat, and head and neck surgery: an illustrated text - Dhillon and East

Ophthalmology

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Ophthalmology: an illustrated colour text - Batterbury and Bowling

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ABC of eyes - Khaw, Shah and Kanski

Anaesthetics

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Lecture notes in clinical anaesthesia - Gwinnutt

 

Pathology

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Lecture notes in medical microbiology and infection - Elliott, Osman, Gill and Worthington

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Clinical biochemistry: an illustrated colour text - Gaw, Murphy, Cowan and O'Reilly

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Clinical chemistry - Marshall, Bangert

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Haematology: an illustrated colour text - Howard and Hamilton

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Crash course immunology and haematology - Kitchen and Horton-Szar

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General and systematic pathology - Underwood

Ethics, Law and public health

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Lecture notes on epidemiology and public health medicine - Farmer and Lawrenson

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Essential public health - Gillam, Yates and Badrinath

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Lecture notes on medical law and ethics - Howard and Bogle

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Medical ethics and law: the core curriculum - Hope, Savulescu and Hendrick

 

Finals revision

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250 cases in clinical medicine - Baliga

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Finals in surgery: a guide to success in clinical surgery - Thompson and Park

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EMQ's and MCQ's for finals - Bath, Morgan and Patel

 

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On Examination - resource for medical students with a selection of >3500 MCQ/EMQ's  Highly recommended website Discount available with MDU membership

Finals revision

Attached is a document that I wrote after exams as a summary of how I prepared myself for finals throughout the final year of the course. Hopefully these notes may be useful

Finals revision notes

Elective

For my elective, I went to Vanuatu, a group of Islands in the South Pacific. I had an amazing time, and attached is a copy of my elective report for anyone who is interested. If anyone is going, or thinking of going to Vanuatu for elective, don't hesitate to contact me if you have any questions.

Vanuatu Elective Report

For your information, 'The Electives Network' is a very useful website to use to assist with finding a location for your elective. It is free to use with your MDU membership number, and I would recommend you search this site if you are unsure of where to go on your elective!

 

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