Clinical Medicine: Year 5 (Specialty rotations)
Building on the clinical skills learnt in year four, you will spend year five (year 2 of the clinical course) studying the major clinical specialties. This is a particularly intensive year, the main focus of which is on developing core skills and knowledge in specialist clinical areas. There may be opportunities during this year to study abroad. The year consists normally of seven week blocks: brain and behaviour (a combined 14 week neurosciences/psychiatry block); community based medicine; orthopaedics, rheumatology and emergency medicine; paediatrics and women's health. It is particularly important for students to develop their time management skills during this year, to make the most of the opportunities that arise eg between lectures, clinics etc, to undertake self-directed study in order to consolidate their learning from clinical and formal teaching environments.
Please note that the course structure below relates to the current curriculum and may be subject to change, in line with the GMCs 'Outcomes for Graduates' standards guidance. Click here to go to GMC website and view 'Outcomes for Graduates'.
BRAIN AND BEHAVIOUR
OVERVIEW
The Brain and Behaviour rotation incorporates core elements of the Psychiatry and Clinical Neurosciences modules, reflecting the clear complementarity between the respective specialties and meeting the expectations outlined in the GMC Outcomes for Graduates document. This neuro-psychiatry experience features alongside a humanities thread focusing on key aspects of medical professionalism and is based on the report entitled ‘Advancing Medical Professionalism’ published by the Royal College of Physicians.
CLINICAL NEUROSCIENCES
At the start of each course, all students will be exposed to key neurological concepts in the form of seminars and small group teaching (which will include expert patient tutor sessions). Students will then rotate through three-week clinical experiences in Clinical Neurosciences and Psychiatry. During the clinical rotation weeks, Fridays will be reserved for subspecialty teaching/experiences (mornings) and interactive humanities sessions focusing on various aspects of medical professionalism (afternoons). Clinical tutorials will be provided throughout the rotation.
OPHTHALMOLOGY
The Ophthalmology placement is located in the Oxford Eye Hospital. Students will see patients in the outpatients clinics with common conditions such as glaucoma, age related macular degeneration, diabetic retinopathy and cataract, as well as a wide range of other conditions including urgent aspects of eye disease in the eye casualty. There are weekly tutorials to enable clinical skills and case based discussions with access to model heads for fundoscopy practice.
PSYCHIATRY
The Psychiatry course addresses the common and important mental disorders, such as depression, anxiety, schizophrenia, bipolar disorder, delirium, dementia, and alcohol problems. It comprises a comprehensive programme of lectures and seminars; weekly clinical skills tutorials, in groups of 2-3 students; weekly academic tutorials, in groups of 3-5 students; and clinical attachments throughout the 8 weeks of the course, in which one or two students are attached to a mental health team. Clinical attachments are available in general adult psychiatry, old age psychiatry, child and adolescent psychiatry, forensic (criminal) psychiatry, and addictions psychiatry, and every student will spend at least 4 weeks in a general adult team.
Community medicine Block: Clinical Geratology, Dermatology, Palliative Care, Primary Health Care, Population Health 2: Public Health
Clinical Geratology
With the population rapidly aging, geratology presents some of the most difficult and intriguing challenges in medicine. Indeed, it may now be the widest medical specialty (ranging from acutely ill patients to those who need longer-term care). The course in clinical geratology is spread over years 4, 5 and 6 in short bursts, with the main attachment in year 5. Lectures and seminars are based mainly on interactive, case-based problem solving, while bedside teaching is organised at various clinical settings: the geriatric Day hospital, Community hospitals with rehabilitation wards, Acute geratology and medical wards, Stroke unit (thrombolysis, acute stroke), Outpatient clinics and Trauma wards (orthogeriatrics). During the attachment students also observe patients’ contacts with therapists (e.g. occupational therapist, physiotherapist) and participate in a multidisciplinary team meeting as appropriate. They are taught how to perform comprehensive geriatric assessment and participate actively in assessing and managing older patients.
Dermatology
Dermatology is an important specialty. At least a quarter of the population have skin disease. The dermatology course is based at the Outpatient Department at the Churchill. This is a busy department with 8 consultants. Clinics include general dermatology, daily skin tumour/skin surgery clinics and many specialist areas of interest including skin allergy, chronic eczema, psoriasis, acne, paediatric and blister. The course aims to introduce you to important concepts in dermatology, and by contact with patients, to provide you with tools for diagnosis and insight into the impact that a chronic skin disease may have on quality of life.
Palliative Care
We pack a lot into the Palliative Medicine Course weeks in the Community Medicine Block. Patients from the hospice are invited to talk to the students about their experiences, we have interactive small group lectures on symptom management, and actor-led sessions on communication skills and ethics. Students are divided into small groups and asked to research how they would treat real cases of patients who have recently been admitted to the hospice and these are then discussed by the whole group. Every student has the opportunity to do a placement either in a local hospice or with the Community Macmillan Nurses. The course receives good feedback and aims to give students a ‘toolkit’ to be able to look after terminally ill patients.
Primary Health Care
The core primary care attachment is in year 5. During the course weeks, students are attached to individual practices, seeing patients themselves with the support of a general practitioner clinical tutor. They learn to communicate, manage their consultation time and make shared decisions with patients presenting with a wide range of clinical and social problems (many of which are seldom seen in hospital). In addition to time in practice, students also have departmental seminars and tutorials on a weekly basis. This part of the course is integrated with Palliative Care, Geratology, Public Health and Dermatology.
Population Health 2: Public Health
The clinical course in public health introduces the principles of population health and the specialist practice of public health in the UK. Teaching in the Department of Public Health includes a grounding in some of the population health disciplines that guide public health research and practice, including epidemiology, medical statistics, health promotion, health protection, occupational and environmental medicine, as well as offering opportunities to explore how health policy, health services and clinical medical practice in the UK relate to the needs of society.
Orthopaedics, Rheumatology & Emergency Medicine
Orthopaedics and Rheumatology are based at the Nuffield Orthopaedic Centre, whilst Emergency Medicine is based at the John Radcliffe Hospital. The first course week involves an intensive skills-lab based compulsory attendance course aimed at providing students with the necessary skills, competence and confidence to deal safely with real patients later in the course. These sessions are run as small groups and are highly interactive, intensive and enjoyed by students. Students attend a number of compulsory teaching sessions and sign up for a variety of orthopaedic and rheumatology outpatient clinics and A+E shifts. Attendance in the operating theatres is positively encouraged and students also take part in Ambulance Paramedic shifts.
WOMEN's HEALTH
The aims of the course are to learn about the presentation, pathophysiology, diagnosis and management of common or important conditions specific to women’s health or affecting pregnant women. A vital part of the course is to practice communicating about sensitive topics such as menstrual problems or sexual intercourse. Students will also gain an understanding of the impact of pregnancy and gynaecological symptoms on women both physiologically and socially, and have the opportunity to explore their own reactions and feelings regarding topics such as stillbirth, termination of pregnancy, and sexuality.
Paediatrics
The Department of Paediatrics delivers the specialty rotation training in Paediatrics for Year 5 students studying medicine through the University of Oxford Medical School.
Paediatrics is the only medical discipline concerned with all aspects of the well-being of infants, children and adolescents - including their health, and their physical, mental and psychological growth and development. It is one of the most diverse and varied medical specialties studied at medical school - covering everything from babies born more than three months early, to young adults, and from children in hospital for only a few hours to those who spend their whole life navigating the health care system.
It is one of the few areas of hospital medicine where you can still be a true generalist but there is also a full range of sub-specialties and interests. We are limited only by the age of our patients. The different areas of paediatrics – acute general paediatrics, community, neonatology, and the various specialties – often require different skills and strengths so there is often something in paediatrics for everyone, whatever your interests and skills.
The principal aim of the undergraduate course is to equip students with the necessary tools to be able to take a good history from the parent and/or the child, and perform a competent clinical examination; to know about common conditions of childhood as well as rarer but still important conditions; and to understand growth and development, and the impact illness may have on these. We also aim to teach our students to place the child and their clinical problems within the context of the family and society in which they live – paediatricians need to be concerned not just with organ systems and disease, but also with environmental and social influences which have a major impact on children and their well-being. A good paediatrician needs to know about health as well as disease, and also must be advocates for the child, irrespective of culture, religion, race, gender, ethnicity or social status.
From 2021 onwards the course is 7 weeks in length, comprising an initial 2 week block in Oxford of lectures and taught modules, as well as other teaching. This is followed by a central 4-week block during which the students have attachments at hospitals across the region in order to maximise paediatric clinical experience. The course ends with a one week consolidation block in Oxford.