Clinical Placements as a First Year

As a First Year Medic, I didn't - and still don't really - feel like I know anything at all! Fresh from A-levels suddenly being thrown into the deep end in a GP surgery on my SECOND week as a Medical Student was scary. But I was so excited to jump straight in, being reminded immediately of every reason why I chose this path.

The First Day

The night before my first day I was giddy with excitement, yet filled with so many nerves about the day ahead. What if the train gets delayed? How about if I can't find my way there? I don't know anyone else going. I hope my outfit is ok. Ahh I don't know anything, what if I can't answer any questions?

It was so hard to get off to sleep that night with my mind racing, yet it was so easy to get up in the morning raring to go. I had my overnight oats, put on my favourite 'professional-looking' outfit, slapped on a bit of makeup and headed out the door.

When I got off the train good old Apple Maps wasn't telling me if it was left or right I needed to go. I saw 3 others with the oh-so recognisable UoB clinical student badges, so I started heading in their direction. Completely the wrong way. It turned out that they were final year Pharmacy Students going to a completely different practice!

I finally got on the right route and arrived to my first day as a Medical Student out in the clinical world! My feet were bleeding (I still have scars to this day haha), so I put on some plasters and the day began.

I had an amazing day and felt as though I had learnt so much already. Although none of my fears came true, I know that they were totally valid, and I empathise with anyone about to go on their first ever clinical placement!

Be worried, be excited, but just know that you are where you are for a reason!

Preparation...

I knew when I applied to the University of Birmingham that there would be clinical placements really early on, yet I did not quite know what the days would look like.

All students were assigned to a GP practice in the local area (some further than others) in groups of between 4 and 6 students. It was up to us to find our way there and back and contact the practice as to what time we should arrive.

What surprised me was how structured the days were. Each placement day (every other Thursday) was named and designated a theme. We were given the exact timetable of the day and preparatory tasks that would help us in advance. These included reading articles, watching videos of clinical examinations (OSCE style) and printing off resources.

I found that when I thoroughly prepared I had more confidence. I felt that I could contribute my ideas more authoritatively and could absorb more from my experiences with patients.

Did I get to interact with patients?

Yes!

On my first day (only 2 weeks into my degree at this point!) I had to interview a patient with another student for 30 minutes. Patients were invited in to the practice to speak to us, and we were tasked with discovering as much psycho-social information about that patient as possible. This was such a daunting task, and 30 minutes seemed impossibly long to talk for, but we did it and learnt so much from it!

Over the next few weeks we interviewed many more patients about various topics and conditions. Often we began with general histories (social, past medical, family etc.) then homed in on particular conditions the patient had. For example, one week was centred around digestive conditions, so patients with colostomy bags were invited in to talk with us about their experiences.

As well as patient interviews, we were also able to examine patients under the supervision of our GP tutor. We learnt the basics of Abdominal, Respiratory and Joint exams, and I even got to use my stethoscope for the first time!

What I learnt from the patients I encountered...

I cannot tell you how valuable patient interactions are, not just for learning in an academic way, but developing bedside manner and adaptable communication skills - both being absolutely vital to becoming not only a competent, but compassionate Medic.

I am so grateful that I have been able to develop and start to refine my bedside manner from such an early stage in my Medicine journey. I have really felt my confidence grow throughout this academic year, especially in more uncomfortable situations.

On placement days I have had to discuss with patients why they don't want to stop smoking despite the risks, hardships in their lives contributing to their conditions and their bereavements and many other topics of conversation. None of these conversations for me were comfortable, but as a Medical Student you begin to recognise that what is uncomfortable for you is 10x more unnerving and uncomfortable for the patient.

Examining Patients...

This skill is one that takes years to master, and as a first year you are certainly not expected to be perfect by any means!

We began super simply with the basics of examination: Inspection, Palpation, Percussion and Auscultation. Patients were invited in to let us practise our examination skills.

We encountered patients of all shapes and sizes, reflecting the general public we will be examining in the future. I was often reminded how important it is to be able to examine patients of all different body types, and not to shy away from those who do not resemble 'textbook examples'. This (hopefully) will help when it comes to OSCEs!

During any kind of examination I talked through exactly what I would be doing next with the patient. This ensured there would be no surprises, and the patient felt more comfortable. There was a female patient who I carried out a Respiratory examination on who told me how thankful she was that I had communicated throughout the whole examination, and how knowing exactly what is happening is so comforting.

Another thing that is super important (and I often forgot to do) is use layman's terms! A patient may not necessarily know what a 'clavicle' or 'scapula' is, but would understand if you said 'collar bone' or 'shoulder blade'. The less jargon the better!

RESOURCE RECOMMENDATION: Geeky Medics

What did I wear?

The all important first impression outfit! I do overthink every outfit I put on, and this scenario was no exception!

I don't think you can go wrong with a smart pair of trousers (I had a variety of 'paperbag waist' options) and a blouse or smart-looking T-shirt. Boys on my placement tended to wear a pair of smart trousers and a shirt without a tie.

When it comes to shoes, I had a pair of buckled black patent shoes (the Bain of my life and the cause of the worst blisters I have ever had) so they are being changed for next year! On the second week I started to wear my Air Force 1's to get there and change when I arrived. Comfort for the win!

Advice for your first day...

- Know exactly where you are going and at what time you need to leave to be on time

- If you need to contact the placement and make arrangements do so in advance

- Lay everything out you may need the night before - ID badge, money, food, hand gel,

paper...

- Do not forgot a pen and paper!

- Take your stethoscope - you never know when you might need it!

- Have your student ID card in your bag or out somewhere so that you won't forget it

- Please wear in your new shoes - I have the scars on my heels to convince you to haha!

- SMILE - it goes a long way with both staff, fellow students and patients!

When approaching your first clinical placement I really think donning a big SMILE and being polite is the best thing that you can do to make the best first impression you can!

Ask questions, be inquisitive and take every opportunity you can. Every patient you encounter will teach you a lesson - big or small - that will influence the kind of Medic you will become, so appreciate every moment and try your best!

But remember, being nervous is so natural and you are not expected to have all of the answers now (or even when you are fully qualified). So, just try to enjoy being a clinical student!

I hope you enjoyed reading this, and that it can help you out in some way!

Francesca 🖤