Year 4 by Alastair Wright

Alastair Wright
4th year MBBS
Comments taken from Year 4 feedback for terms
1 and 2 of 2012-13 academic year.
A number that allows a good teaching/learning
environment (only commented on when a problem)
“There were too many students for a practice with
only 1 GP”
“Other medical schools' students had clinics reserved,
so it was very difficult to sit in with some doctors, as
it was over-crowded.”
“As there were 4 students, only 2 students could sit in
with the GP and see patients at a time, and the other
2 would sit and wait.”
Gaps in the middle of the day may be a problem –
perhaps fill with some teaching? No need to keep
students there all day – we always have other work
to do, SSC’s etc.
“Leaving the surgery at 2:30 or 3pm is not such a
terrible thing if we have been working consistently
since 9 or 9:30am, especially as we need time to
digest all the information and go through it
“Would like to be able to leave earlier in the
evenings! Days were 9-6”
Students appreciated good organisation and a clear
timetable of what they will do, and what’s expected of
them e.g. presentations.
“We liked that we had timetables but that we were able
to swap clinics if necessary”
“The placement was well organised with a set timetable
with time specifically dedicated to us”
“We were all given timetables on the first day, outlining
our morning and afternoon activities. This was really
Students often know what they don’t know, and
appreciate having the choice of what they learn:
“we get to choose what we want to do”
“the [GP] was very flexible, teaching us what we felt we
“The teaching was logical and we were able to choose
the main topics we would like to cover”
Find a balance between clinical experience / community
medicine e.g. home visits, and separate teaching
Generally students like patient contact, but also find
separate teaching useful.
“I enjoyed the fact that we had a balance of GP
consultation, teaching and then home visits. Each day
was different and the variation kept me interested
- Again, ask students what’s the right balance for them.
Varied responses – find the right balance
“More patient contact, please! Less teaching (felt like a
repeat of our lecture week that we had just
“Very high level of commitment to teaching - each
morning given over entirely to tutorial and afternoon
patients specifically chosen to match studied areas”
“Separate teaching sessions that were module
appropriate were organised which I found very useful.”
Rare to get small group teaching at medical school.
“I liked the tutorials feeling more like a discussion
than a lecture.”
“Separate teaching sessions that were module
appropriate were organised which I found very
“Small group. Opportunity to all lots of questions”
As they’re small they can be interactive – make them
“Excellent interactive teaching from GPSI in derm”
“The teaching was not engaging. Instead of asking us
questions and waiting to answer, he answered the
questions immediately after asking. It made
concentrating for 2-2½ hours of slides in a row very
“Interactive, friendly atmosphere, felt able to ask
Highly valued by students:
“Lots of patient contact- I learnt more in my
paediatric week at the GP practise than I did in a
month at a hospital which had no teaching for
“Fantastic. Great amount of patient contact”
“Less classroom-style teaching. It almost felt like we
were doing nothing else but being taught. Only a few
goldfish bowl consultations and apart from that no
patient contact, which was a bit of a shame.
Students very much appreciate being able to see
patients relevant to the module they’re studying.
Some GP’s plan ahead and bring in relevant
patients for students to see.
“He invited in relevant patients who gave good
histories and knew exactly why they were there”
“Saw neurological and psychiatric conditions relevant
to the module.”
“Having module specific patients booked in was
A great (and rare) opportunity to be observed taking a
“Got to sit in on a clinic and was allowed to ask patient
questions which I never had before (it was really good)”
“let us lead the occasional consultation, which was
“Dr had a session where she observed us taking histories,
which was a very good learning experience.”
“Dr was really good at allowing us to try to take a history
during her appointments with patients. She then added
points which also helped us as we found out what we
Also can be an opportunity to let students speak
with patients before they see the GP (may depend
on space available)
“Although daunting at first, we were left with patients
to take their histories and start the examination (e.g.
for 6-8 week postnatal checks). It was a fantastic way
to learn and Dr was always nearby if we needed
“The 'Student Clinics' were both challenging (since
cases could involve any organ system, not just the ones
we have studied recently) and engaging, an idea more
GP placements should pick up.”
Again, a relatively rare opportunity to have clinical
skills observed.
“Very interactive clinic sessions. It was very helpful
being able to participate in the clinics, such as taking
a history, examining a patient. Other GP placements
should take note as they often lack this”
“Gave me a chance to run a surgery and practice my
clinical skills.”
“observing students history taking and examination
skills is useful and rarely happens in hospital
Some students find it helpful to give small
presentations to their groups.
“He encouraged us to learn in different ways: His
teaching, group discussions, seeing patients, private
study, presenting your own work, watching others'
presentations. Because he treated us like adults we
could ask questions and lead discussions”
“The presentations and extra homework, although
daunting at first, were very helpful for our learning”
Time available may depend on time of year – perhaps not
in the week before exams…
Mentioned by a significant number of students as a
positive. Perhaps reflects a contrast to the way we
are sometimes treated in hospitals and by the
medical school.
“G.P. treated us as (near) equals.”
“This was an exceptional placement. Without doubt
the best I have been on. The GP treated us like
“Treating us with respect and as the adults that we
are, rather than patronising us, treating us like
children, and not listening to us (as I have experienced
in numerous GP surgeries before now!)”
Exams are never far away, and students never get
that much OSCE practice. They liked:
“Tutorials and OSCE practice on bimanual examination
and speculum”
“A formal mock-type OSCE session might be useful at
the end of the placement, to ensure we've learnt the
necessary skills.”
“Being taken through OSCE examples with the correct
practice explained.”
“Dr was extremely inviting making a point to get to know
each of the four students, asking and giving advice about
our future careers”
“Dr was friendly and approachable, felt like he was
genuinely interested in our learning”
“Very friendly practice staff and doctors. Excellent teaching
facilities with dedicated room, wide screen for viewing
images etc. Organisation of the teaching was impressive.”
“Dr is an amazing teacher, and very devoted to the
“Useful for the more than just exams, good career advice
* If you give students responsibility they will respond to
it and act in a responsible manner.
* Students appreciate connecting with GP’s who
generally seem genuinely interested in them.
* Interactivity and engagement are key.
* Imagine the best student and create a programme for
them rather than imagining the worst student and
trying to create a programme that remediates them.
* Final thought – feedback overwhelmingly positive – we
love GP!

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