I remember my first day of clinical placement in fourth year like it was yesterday. The combination of being lost in the hospital, with my fresh, out-of-the box stethoscope and not knowing what was expected is something that doesn’t leave you quickly!
It was also the first time I was trying to learn outside of the formal teaching setting. How would I make the most of this? Now, nearly eight years on from that first-day experience, I’ve compiled some hints and tips on how you can make the most out of your placement.
Why are clinical placements so important?
Clinical placements provide a vital part of a holistic medical education.
Medicine is a patient-focused, practical vocation that requires a dynamic learning process. Not only do we need to have our underpinning scientific knowledge but we also need to learn how to communicate with patients and colleagues, as well as take histories, examine patients to recognise important clinical signs and practise those key clinical skills.
While it’s important to have that textbook knowledge of medicine, patients are not textbooks, and they can present vastly different to those ‘classic’ presentations we read about.
This is where clinical placements come in. They help teach you about the breadth and variety of patients we see on a day-to-day basis, alongside the challenges associated with that.
How has COVID-19 impacted placements?
The COVID-19 pandemic disrupted clinical placements significantly, particularly as many patients being admitted to hospitals were COVID positive. While COVID wards are becoming fewer in number, there are some things that are set to stay in a post-COVID era.
The main change we’ve seen across the NHS (both in hospital and general practice) is in the out-patient setting, with a large number of telephone clinics now taking place. Learning in this scenario can often feel more challenging – however, telephone consultations are an excellent example of communication: something you’ll be tested on throughout your OSCEs.
Patients are not textbooks, and can present vastly different to those 'classic' presentations we read about.
Tips for getting the most out of placements
- Be prepared. If you’re going to a specialist clinic or ward, it’s worth doing a small amount of reading around that topic. Not only does this show your interest to learn but having some basic background knowledge can really help in these fast-paced settings.
- Be organised. At the start of each week, write out a timetable and ‘block’ your time. This is not only important for knowing when your clinical placements are, but it will also allow you to block in time for reviewing the content you’ve learnt and scheduling in that all-important downtime.
- Ask questions and be interested. Ever heard the phrase, “if you don’t ask, you don’t get”? Junior doctors have been in your position only a short while ago and the majority are very approachable: ask questions, ask why they’re making decisions, ask to tag along to see unwell patients and learn first-hand what it’s like to be an NHS junior doctor!
- Observe. While on placement I encourage you to observe what happens in each setting you go to. This is particularly key for learning how we communicate as a profession, but also how we communicate with families and the multi-disciplinary team.
- Reflect. When you’ve seen a patient with a particular medical condition, aim to consolidate knowledge on that condition in the next 24-48 hours. I found writing an anonymous summary of a patient at the top of an A4 page and then writing a brief summary (brief pathophysiology, important diagnostics, signs/symptoms and evidence-based treatment) of the condition on a single side of A4 helped me consolidate and retain the knowledge for that subject.
- Seek opportunities. Wards, GP surgeries and out-patient settings are all excellent places to seek out projects and research in areas you might be interested in. Saying ‘yes’ to some opportunities can really benefit you in your later career.
- Keep a good work-life balance. Being well rested is also important to getting the most out of your placements. Ensure you schedule in time to do things you enjoy – whether that’s sport, music, art or anything at all. This is an important skill to learn as a clinical student so you can take this forward into your working junior doctor life.
Clinical placements are going to form the basis of your learning for the rest of your career, so it’s important to find what works for you and, most importantly, try to enjoy them – this is the first time you’re seeing a glimpse of what your future career as a doctor entails.