1. What I Wish I Knew In 4th Year

2. 4 rotations
Paediatrics and Child Health
Women’s Health
Emergency Medicine and Critical Care
Long Term Conditions
Assessments (Progress Tests and OSCEs)
QIP

3. Ice berg –
What you see as an individual student is only the tip of the iceberg
Different students will have very different experiences, and you won’t see everything you need to know about
Therefore you need to read around a lot as you go along

4. Some general points Be prepared in advance
Bookwork, histories, examinations etc before you start
Introduce yourself and be proactive
Going in out of hours can be useful
Seek out extra learning
Be flexible

5. Paediatrics It’s normal to be apprehensive
Paediatric ED/short stay ward is a great place to gain confidence around children (and their parents!)
When on neonates, find out who the on-call delivery reg is and ask to shadow them
You will end up spending lots of time playing/drawing/making silly faces – embrace it!!
Step up to general paeds from ED/short stay
Clerking with juniors is really helpful – get stuck in with the ward rounds

6. Women’s Health Prepare to be frustrated on the delivery ward!
Early Pregnancy Assessment Units are a good place to practice obstetric histories and examinations
You will have to ask personal questions – find ways of asking that you are comfortable with
Intimate examinations
Surgery
Sexual Health clinics
On the ward
Babies choose when they come, and it’s often not 9-5!
Early morning can be a good time to see natural deliveries as apparently lots of inductions happen then.
The midwives are your friends – be proactive, say why you’re here and what you want to do
Sexual/other personal histories – only ask as much as you need to know, but make sure you don’t miss out on key info because it’s embarrassing to ask
GTA sessions are bizarre but helpful
Practice on models early
Everyone finds it easy to do in different places
Make sure to get consent (written forms for surgery)
Do it as a Mini-CEX

7. EMCC Know your ABCDE assessment
ED is a great place to learn, but you have to be smart
Buddy up with a Junior Dr in majors
Resus is a good place for practical skills
Don’t spend too long on ITU
Spend time with the Critical Care Outreach team if possible
Get hands on with the anaesthetists

8. Long Term Conditions
Covers A LOT of different specialties – be prepared
Learn and practice the rheumatology and orthopaedic examinations before your placements
Be proactive in seeing the cases you need to see
It may seem less exciting – take the time to consolidate your knowledge

9. Portfolio Learn how to use DEBRIEF Be proactive in seeking out SLE’s
Read the relevant Anchor Statements so you know what a good SLE should look like
Have the Anchor Statements to hand for the Dr to look over
Make sure to cover all discussion points
Learn how to use DEBRIEF
It will make reflections much easier

10. Progress Tests 3 throughout the year
Only the 3rd is summative, but all appear on your transcript!
3rd and 4th year content came up fairly equally for us
Don’t try and guess what might come up based on previous PT’s
Tortoise and hare

11. OSCEs Prepare based on what you’ve covered
Some common ones include moulage/ALS, difficult communication, obstetric history and examinations, collateral histories and orthopaedics/rheumatology examinations
Practice throughout the year
We had some curve balls this year, but knowing the basics will stand you in good stead

12. QIP Start early and make sure you have a plan in place Keep it simple!
Follow the guidance from Kings

13. Learning Resources Masterpass (Finals and Specialties)
A lot of Finals Courses are coming up in spring for people in the year above at other medical schools – go to them now as you won’t get another chance before finals
Masterpass (Finals and Specialties)
Online questions banks
Lots of courses (too many to name here)

14. Key take home points
Be prepared, be proactive and make the most of the time you have
Read up as you go along
Have fun!