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 of six eight week blocks: community block (comprising clinical geratology, dermatology, palliative care, primary health care and public health); neurology and neurosurgery (including otolaryngology and ophthalmology); orthopaedics, rheumatology and emergency medicine; psychiatry; obstetrics and gynaecology; and paediatrics. It is particularly important for students to develop their time management skills during this year, to make the most of the oppportunities that arise e.g. between lectures, clinics etc., to undertake self-directed study in order to consolidate their learning from clinical and formal teaching environments.
Community Block: Clinical Geratology, Dermatology, Palliative Care, Primary Health Care, Population Health 2: Public Health
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 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.
We pack a lot into the 2 week Palliative Medicine Course. 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 these six 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 now 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.
Clinical Neurosciences, Ophthalmology and Otolaryngology Block
Neurology & Neurosurgery
The clinical method, as it pertains to disease of the nervous system, is taught through attachment to a clinical neurology and neurosurgery firm in the John Radcliffe Hospital, a regional neurosciences centre. Students will encounter patients with very diverse conditions which present a range of challenges to the clinician: common conditions such as epilepsy, stroke and Parkinson's Disease sit alongside conditions which will be met infrequently during most careers. Allied specialities such as neurosurgery, neurophysiology and neuropsychology contribute to the course.
During the Ear, Nose and Throat attachment students get involved in all the activities of the busy unit. ENT surgeon treats many conditions including patients with ear disease and cochlear implants, children with tonsillitis and glue ear, adults with sinus and nose conditions and patients with head and neck cancer. The students spend time in theatre, clinic and on the ward, as well as special attachments to audiology, speech therapy and deaf awareness.
The Ophthalmology course is conducted wholly in the Oxford Eye Hospital in conjunction with the Neurosciences and ENT module. The timetable includes sessions in the out-patient department, attendance at the eye casualty department, treatment sessions (either theatre or laser), and sessions in the orthoptic and optometry departments.
Orthopaedics, Rheumatology & Emergency Medicine
The course runs over 8 weeks in Year 5. Orthopaedics and Rheumatology are based at the Nuffield Orthopaedic Centre, whilst Emergency Medicine is based at the John Radcliffe Hospital. Week 1 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. During Weeks 2 – 7, 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. The course then draws to a close in "Exam Week" (Week 8).
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.
Obstetrics & Gynaecology
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.
This course covers the vast spectrum of children born as premature neonates weighing a few hundred grams up to adolescence. The majority of children who are admitted to hospital are 2 years old or younger. The principal aim of the paediatrics course is to equip students with the necessary tools to be able to take a history from the parent(s) and/or child, and perform a competent clinical examination; to know about common conditions of childhood as well as less common but important conditions; and finally to understand growth and development, and the impact illness may have on growth and development. The 8-week course comprises two 2-week blocks in Oxford of lectures, modules, problem-based learning, tutorials and a variety of small group clinical teaching, flanking a central 4- weeks during which the majority of students have attachments at peripheral hospitals or hospitals overseas in order to maximise paediatric clinical experience.