Subject Code/Name: MD4:
MEDS90025: Transition to Practice and
MD Research Project 2Workload: Varies.
Assessment:MDRP2Progress Reports (3 short reports, submitted at 6 week intervals, accompanied by supervisor reports), throughout semester (10%) Note: 10% if all 3 submitted, 0% if < 3 submitted.
Literature review, 5000 words, due mid-semester (week 11 of 22 week subject) (30%)
Journal-style monograph describing the research (suitable for peer review, with author instructions), 4000 words, due at end of semester (40%) [Hurdle requirement]
Poster presentation at Student Conference 4, 1500 word equivalent, end of semester (10%)
Supervisor evaluation, end of semester (10%)
Satisfactory standard in professional behaviour, as demonstrated by observed Professional Behaviour Assessment [Hurdle requirement]
TTPSituational Judgement Tests, written, 2 x 80 minutes, during term [Pass/Fail]
Satisfactory performance in simulation exercises (basic life support), during term [Pass/Fail]
Vocational SelectiveSafety and Quality Improvement Project Plan, 1000 words (eg. patient safety, infection control, clinical audit), during term [Pass/Fail]
Supervisor report (using structured report form), end of term [Pass/Fail]
Case Based Discussion, 2 x 30 minutes each, during term [Pass/Fail]
Trainee InternCase Based Discussion, 2 x 30 minutes each, during term [Pass/Fail]
Multisource feedback (coordinated by supervising intern) using structured feedback form, x 2 (one at the end of each term) [Pass/Fail]
Log Book - satisfactory completion of clinical tasks as specified in each rotation
Applied Clinical Knowledge Test, 2 x 2 hr MCQ exam, end of term [Pass/Fail]
Year & Semester of completion: 2019
Comments: MDRP2Depending on the project as well as your supervisor, this can either be extremely relaxed or intensive. The main aim of the project is to give you an opportunity to conduct your own research project that you can potentially present and publish. While some students do have the opportunity to go to conferences, sometimes you simply won't be able to due to the nature of your project. Many people continue on with it as junior doctors, so don't be too discouraged if you don't get those chances yet.
Every person will have their own unique experience with this subject, but the most general advice I can give is to be familiar with your topic, regularly communicate with your supervisor (or your team), actively maintain your curiosity and ask questions, and try to be as independent as you can. Since this does take up the first six months of the year, I would encourage you to still go onto the wards and get some clinical exposure - otherwise you will be severely deskilled by the time interviews and TTP come about. Some clinical schools run several clinical skill tutorials throughout the term, but not all do.
PMCV Internship MatchThis will be quite a stressful part of the year for you, so it's best to get started early. The Postgraduate Medical Council of Victoria (PMCV) is responsible for matching you with health services that you've preferenced. There is an excellent explanation into the process
here.
Unlike other states, the Victorian match is merit-based. Different health services will have their own requirements and weighting, which can include:
- Z score
- Cover letter
- Standardised CV
- Interview (video vs. panel vs. MMI)
- Clinical reference
- Non-clinical reference
My advice would be to get started on your cover letters early (late March-early April) and definitely do not forget your interview preparation. Most interviews are conducted in early-mid June, and the match results are out in July. Most people try to use their research supervisor as a reference, but be careful about who you pick as you cannot de-nominate them. You should pick someone who you are pretty confident will give a good reference, and they must have clinically supervised you. The more recent the reference, the better. There is also no "gaming" the match as it runs similar to the GEMSAS and VCAT matches. Go to the information sessions of all the health services, and then draw up a list of what hospitals you want to go to, but do not fill up your preferences with hospitals you're not likely to get into as you'll run the risk of being unmatched.
Always put in more applications than you need to avoid being unmatched - 8-10 at minimum. I found that "Marshall & Ruedy's On Call" was an extremely helpful book in giving you a structure on how you'd approach clinical scenarios that you're likely to encounter. It's also a great book for internship as well.
Transition to PracticeFor the last half of the year, you'll finally be back on the wards. There will be a couple of weeks of lectures at the beginning where you revise everything that you've probably forgotten over the years. You'll be allocated a medical term, a surgical term, and then an elective that you can do wherever you'd like.
I would emphasise that unlike MD2/3, this is not a time when learning clinical medicine is your biggest priority. You are not just a medical student observing in the background anymore - you are the trainee intern. Try to stick around the intern as much as possible, because you are going to be doing their job next year and it's worth picking up skills that'll be helpful when you start working. Learn how to document properly, actively seek out opportunities to put in drips or catheters, practice referrals and handovers, help out with admissions and write discharge summaries - try be an
active team-player. Develop good work etiquette (AKA being aware of behaviours that piss people off or make life for other people harder) and communicate often with your team. Observe how your intern manages the constant interruptions to their workload. See how they update friends and family of an unwell patient. Ask practical questions as this is probably the last chance you have before you're thrown into the deep end as a junior doctor. Be aware of what guidelines and resources you can refer to. You don't have to know everything (and you won't), but try read up on common things that'll pop up on your ward so you 1) can understand what's happening and 2) are able to somewhat come up with a plan (rather than always needing to defer questions from patients and nurses to your intern).
The team will involve you more as you're a final year medical student, so you will be allocated some jobs to do, but also remember to always liaise with the team on things you're not sure about. You are also not a slave - you're not being paid to do all of the intern's boring paperwork, so it's a fine balance to strike. The more enthusiastic and proactive you are, the more opportunities you'll be handed, and the team is usually way more accepting if you'd like to take a few days off. Do not be
that guy who only shows up once in the middle of ward rounds, doesn't come in for the rest of the term apart from when they need to get something signed off, and as a result has no idea how to function properly as a junior doctor. I would usually try to let the team know what I wanted to do early in the term so that when an opportunity came, they'd let me know. Make sure that you're being supervised appropriately and counter-sign all documentation with the intern
I was usually off by lunchtime everyday. You
do not have to go overboard and stay back to ridiculous hours though - as a general rule, once the other doctors tell you to leave, there's probably not much for you to do (and you're not being paid for the mundane jobs either). That being said, I think it's better to be on a busier ward. Gen Med would be a great medical term for learning how to do bread-and-butter referrals and discharge planning of complex patients, while clearing out jobs in the middle of a 6 hour ward round. In surgical terms, you should probably stay and help out the ward intern rather than always going into theatre (especially if there will be too many people scrubbed up in theatre already). Try and attend pre-admission clinic (where patients are assessed for any perioperative issue) - it's a bonus if you can do the history, examination and fire off some investigations to chase too. That being said, if you do go to theatre, definitely practice putting in some urinary catheters, and if you are scrubbed in, ask the fellow/registrars how to close the wound.
You'll realise that many of the jobs that an intern does can get quite stale and menial after a while during the day - until you go on a cover shift. Arrive in the afternoon for a cover shift once a week, and chances are you'll probably hold the pager and you can practice prioritising, assessing patients and answering any questions from the rest of the covering nurses. You'll feel more like a doctor, and it's a nice break from all the discharge summaries you'll begin to hate doing. I'd highly recommend doing covers as much as you can.
While there is an accreditation examination at the end of the year, most people pass without needing to study quite intensively. As long as you're familiar with MD2/3 knowledge, you don't need to be constantly studying throughout this year. Teaching MD2/3 students both on the ward and in class is a great way of refreshing content you should probably know. After your day has finished, go and relax (as your interns will probably tell you!)
(As a side note, it's a great idea to be actively involved in teaching more junior medical students, because you'll have to learn how to juggle/prioritise both work and teaching responsibilities as a doctor anyway. Remember how common it is as a medical student to feel discouraged when the team forgets your presence and doesn't teach you? Or that you always feel like you're in the way? By being involved in their education, it's a good opportunity for you to practice being a mentor and role-model, as it'll be expected of you as you climb up the medical ladder)
Final commentsFinishing medical school is the first step in a very long pathway. Of course, you don't need to know the ins-and-outs of recognising and managing every Zebra condition you've been taught, but it is expected that you know how to manage basic, common conditions and that you are
safe by ruling out life-threatening causes and recognising when you need to escalate for more help. This is the time to try step up from "just the medical student" to being a trained medical professional who is allowed to have a voice and opinion on what is in the patient's best interest. Next year, you will become a doctor that your patient and team has to trust, so this is an important time to try gain some more responsibility before it becomes expected of you.
That being said, this is also your last chance to really relax before you begin full-time work, so make the most of it after you've developed a good relationship with your team. And finally, congratulations on attaining your medical degree!
