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Life as a medical student: Clinical placements

vicky hargest medical pre-medical studentMedical student Vicky Hargest has finally reached the clinical years of her degree. Here she talks about performing examinations, taking histories and how to deal with intimidating doctors.

Pre-clinical training

The aim of the first six months of clinical training was to become competent in clinical techniques without having to concentrate too much on diagnosis. Before starting my first hospital placement, I was taught how to examine patients and spent time practising on my peers. I learnt how to inspect the hands and face for any clinical signs that would indicate disease and also learned how to percuss (tap), palpate (feel) and auscultate (listen to) the heart, chest and abdomen to recognise what is normal and what is abnormal.

Musculoskeletal and neurological examinations were slightly more challenging but got a lot easier with practice. I was also reminded of how to take a focused history and learned some useful clinical skills such as venepuncture, cannulation, hospital life support and acquiring ECGs.

The wards

Armed with all these new skills I felt ready to face the wards. My first eight-week placement was in a small hospital that had a general medicine ward of 40 patients with a sub speciality of rheumatology. As the only medical student attached to my consultant I was instantly made to feel like one of the team.

As well as examining patients with classical cardio-respiratory signs, I saw those with rheumatoid arthritis and other interesting inflammatory conditions such as scleroderma and systemic lupus erythematosus. Although the doctors were busy they were extremely keen to teach so I asked plenty of questions and was as helpful as possible. Once I had proved that I was competent I was able to help out by taking bloods, placing cannulas and writing in the patients’ notes during ward rounds.

Taking histories

As well as learning how the ward operated and attending outpatient clinics and radiology meetings, I also found plenty of time to practice taking histories from patients and present them to the doctors. Some of my examinations were also observed by the doctors so that I could get feedback and improve my technique. It was also beneficial to find another medical student in the hospital and watch each other take histories and perform examinations.

Confidence

I have learnt a great deal from my first placement and have gained a huge amount of confidence. I now know not to be intimidated by the doctors or the busy environment. It can be quite daunting entering a ward and not knowing what to do or who to speak to, but being polite and confident usually helps.

Fears

I had two main fears before starting this placement, firstly that the doctors would ask difficult questions that I wouldn’t know the answers to and secondly that I would be apprehensive about physical contact with patients. These fears were unfounded as patients are more than happy to let you examine them, although maintaining their dignity is paramount, and the doctors couldn’t have been nicer. They did ask questions that I did not always know the answers to, but this would often be followed by a helpful one-to-one teaching session. This was a thoroughly enjoyable experience and I am already eager to start my next placement.

About Vicky

Vicky Hargest is a medical student at the University of Sheffield. Although she has an arts degree (health studies) she has taken the pre-med route (six year course) in order to learn foundation sciences.
She is the first in her family to enter higher education - proving that medicine is for people of all ages and backgrounds.
Having worked in medical education for the last six years she is now seeing things from the other side of the fence.