4th year at Cardiff University is a big deal. To get to this point, you’ve survived Platform to Clinical Sciences (also known as PCS), the very first term studying medicine at Cardiff which can be found quite intensive by some – this is due to the full timetable of anatomy, physiology, pharmacology teaching to “get everyone on a level playing field”. You’ve also finished case-based learning, which starts after Christmas in your first year and extends throughout second year. You’ve had one year of clinical placements and this will be your second full year of placement. And not just any placement – specialities, something a lot of people enjoy as they haven’t had much exposure to them in younger years.
The reason it is a big deal is that at Cardiff is because the dreaded ‘finals’ are sat in this year. These are clinical exams called ISCEs (Integrated Structured Clinical Examinations) and they test all your medical, surgical, scientific and clinical knowledge over three challenging days.
My experience may be different from others, but I hope it will gives you a sense of the structure of the placements in 4th year at Cardiff.
Placements are split into three 8 week blocks:
- Psychiatry, Clinical Neurosciences and Ophthalmology (PCNO)
- Obstetrics and Gynaecology/Paediatrics
- Chronic Disease 2 (CD2)
My PCNO block kicked off with an intensive week of ophthalmology, mainly tutorials with one day of placement and a simulated ‘clinic’ with patients for us to examine. This was followed by three weeks of neurology, which I enjoyed as there were lots of interesting cases on the wards in Cardiff, and then 4 weeks of psychiatry, which I found very different to medicine – it also has a very different, almost slow pace that I wasn’t used too. All three subjects were very interesting and I learnt about lots of new conditions.
I really enjoyed my paediatric block, which I spent at the children’s hospital in Cardiff. The lead facilitator is a very enthusiastic man so ensured there was lots of bedside teaching and online e-learning. In fact, I enjoyed the placement so much, this is now a field I am thinking about for my career in future. I like the versatility – you can remain a true generalist as a paediatrician.
Obstetrics and Gynaecology was a specialty I expected to love, but my experience fell a little flat. I don’t know whether it was because of the hospital I was in or the people I was with, but I didn’t enjoy it as much as my previous blocks, and I didn’t get to see enough natural deliveries for my liking. However, highlights definitely included assisting C-section deliveries on multiple afternoons – I got to retract the bladder and assist with suturing, and most importantly help bring a baby into the world.
CD2 was a mishmash of rheumatology (joint problems), musculoskeletal medicine, dermatology (skin problems) and care of the elderly medicine. Depending on where you are on placement will determine how much of each of these subspecialty placements you will get. For instance, I only got one dermatology clinic whereas friends at different hospitals got a whole week of clinics. Thankfully, Cardiff University are good at organising teaching and case based discussions so you can rest assured you will have covered all the learning objectives relevant to your exams and GMC requirements. And luckily, a lot of older patients have many dermatology/musculoskeletal complaints, so you can learn a lot without officially doing that specific bit of placement. This was a strange block for me, as it was when Covid-19 decided to strike. I managed to complete half of this block, and unfortunately missed out of my care of the elderly weeks. Luckily, we have covered the teaching over Zoom and I feel I will be able to make up for this placement easily in my 5th year blocks.
After the third block, ISCES were meant to take place. We’d had mocks earlier in the year and staff in the university and on placement had really invested in preparing us for these. They are now rescheduled for February next year which I am disappointed about, as one of the reasons I chose to come to Cardiff was the fact you get your finals out the way in 4th year. However, this is understandable and I look forward to the challenge next year instead.
After the ISCEs have been sat, there is usually a 7-week Student Selected Component (SSC) block, where students can undertake a project in any area of their choosing. Some students go on to present their projects at conferences and submit them for prizes. As it was deemed unfair for clinical tutors to have to look after medical students and their projects in the current climate, plus we couldn’t go on the wards, the decision was made for us all to write a literature review based on the topic, or something similar, to what our project would have been. We were then tasked to create some e-learning modules in groups, remotely of course, to help students who had missed content because of coronavirus.
All in all, it had been a great year, despite the unusual end. Although starting the year with the mind-set that it was a big year, I still managed to fit in all my extracurricular activities, including being President of two societies and continuing my scholarship with Medic Mentor. I feel I managed all of this by starting revision early – that would be my advice to anyone starting their year with finals. Little and often is much better than cramming, and also helps develop muscle memory in terms of examination technique. My other advice is to make the most of every opportunity – my time at university is quickly coming closer to an end and I wish I had more of it. Despite this, I look forward to my fifth and final year and the challenges that it’ll bring.
By Dion-Emily Manning