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What can I expect when I begin my clinical years?

Transitioning from preclinical to clinical years of medical school can be very unnerving for a lot of students, but ultimately, it is just like any change you go through in life. The fear of the unknown is more frightening than the actual experience itself, and once you get settled in, life will proceed as normal.

Every medical school does things slightly differently but essentially, their goal is to produce safe and competent doctors while giving you the experiences you need to become a good doctor. Some medical schools start their clinical training in year 3 while others begin in year 4.

So what can you expect from your clinical year experience? Firstly, in clinical years, you usually do rotations in various departments which means you actually get to spend the majority of your time in the hospital instead of a lecture hall. This way, you get a lot more hands-on experience and are able to see real patients, procedures and surgeries. In this article, we will go through several things you can expect from clinical year training.

One of the first things you will notice about being in your clinical years is that the focus of your learning shifts from the basic sciences to more clinically relevant knowledge. This will include things like disease presentations, examination findings, investigations and management strategies. Some may find that the clinical years are more interesting as you are able to integrate your pre-clinical knowledge into clinical practice whilst immersing yourself in the hospital or clinic setting. This will be your opportunity to really understand what a doctor does and the responsibilities attached to the title.

As you adjust from pre-clinical to clinical teaching, you realise that your learning becomes much more self-directed. Often, you are scheduled to go into clinics, wards or theatres and are given little direction about what you’re supposed to do. The amount you learn depends on what type of clinic, surgery or ward you go to, the doctors you shadow and the amount of activities you are allowed to do or observe. It is important to take advantage of your opportunities in the clinical setting as this allows you to understand and grasp the important things you should focus on when studying. In addition, you are also able to interact with real patients with actual signs and symptoms. It will help you recognise your areas of weakness which can be very helpful for revision purposes.

It is important to take advantage of your opportunities in the clinical setting as this allows you to understand and grasp the important things you should focus on when studying. Don't be afraid to ask questions!

Being in your clinical years also allows you the opportunities to travel as you are sometimes posted outside of your teaching hospital. This could mean being smaller hospitals, GP clinics or even a large tertiary centre where they are dedicated to a specific subspecialty (i.e paediatric cardiology).

There are pros and cons of being in a large, busy hospital versus a small, rural hospital. In smaller hospitals, there are more opportunities to be more hands-on as there are less staff and students around, meaning you may be able to carry out procedures (within your remit and under supervision, of course!), speak to and examine more patients. Smaller hospitals are good for teaching too, as there are less students around and doctors can give you more personalised teaching. There is also more flexibility in smaller hospitals which allows you to have more control over what you want to do and sometimes even, you are allowed to decide your own hospital shifts. On the other hand, larger hospitals are great in that you may be able to see a larger variety of patients and observe more complex procedures or surgeries. Larger hospitals are also more accustomed to having students around, and therefore tend to have more structured teaching.

In terms of clinical skills, you will be able to apply the practical knowledge you have learned in your pre-clinical years and practice these skills on real patients. It is good to try practicing simple procedures when you have the opportunity to do so as there will be supervising doctors to help you if you need guidance. You may also be able to examine patients who have relevant clinical signs which is a great learning experience and helps consolidate knowledge even better. Being in hospital also allows you to meet more people and build connections with senior doctors. This will be helpful especially if you want to do things like research or other projects which can help boost your CV.

All in all, the change from preclinical to the clinical phase can be a steep learning curve as there is much more expected of you. However, with guidance from your tutors and your own commitment, you will learn to adapt to this new environment. Additionally, don't forget the value of supportive colleagues and friends around you - they will bolster and encourage you when you become tired, and in turn, you can do the same for them. Make full use of the opportunities that emerge while you’re in the hospital or clinic as this is the best chance for you to learn from your surroundings and the experienced clinicians around you!

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