Types of course
Your experience of medical school will depend largely on the kind of course your university offers. There are three main types:
- Traditional
- Problem based learning (PBL)
- Integrated
Traditional courses are offered by Oxbridge and tend to have a very science- based preclinical period, followed by clinical teaching from years three onwards. Some of the preclinical training often involves undertaking a BA degree in a particular subject.
Problem Based Learning
In problem based learning, the teaching is very student-led, based around clinical cases in small seminar groups of 8-10 students. Amongst other skills, problem based learning aims to develop team working skills and self-directed learning [1]. This style of course is offered at Manchester and Liverpool.
'The timetable in uni is not completely full; we are not meant to learn everything from the few lectures we have, most of our learning is meant to be 'self-directed' ie teach yourself! We then have a lot of tutorials where we discuss what we've found through the week in the presence of a tutor. This can present problems if you have a lazy group who hasn't done the work.' 2nd year medical student, Manchester University.
Integrated
The integrated approach is a mixture of lecture-based teaching of the key sciences, with clinical experience from day one. This approach is taken by most medical schools including Newcastle and Edinburgh.
'It's been good to have the science teaching based around patient cases during the first couple of years because it really prepares you for meeting the patients in the clinical years'Teaching styles
- Third year medical student, Newcastle
Lectures
Its 9 am, you're feeling quite sleepy and you're being made to sit in a huge room with 200 other people while an old looking guy with a beard talks about the joys of mucous - this is a lecture and you better get used to it! In traditional and integrated courses, lectures make up a large proportion of the first couple of years at medical school. Don't worry, though, they're not all quite as boring as mucous. The lectures vary, from ones where everyone gets involved to more formal ones which stick to the didactic approach. There's usually a presentation involved and if the lecturer's feeling especially kind (and technological) they often upload them onto the intranet; always useful, especially if you missed that vital bit whilst scoffing down the toast you meant to eat at home!
Seminars
Seminars are another thing you'll have a lot of in the first couple of years. They're often in much smaller groups (between 15 and 25 people) and a tutor leads the session, often complementing a previous lecture. These are really good opportunities to ask those questions you didn't dare ask in front of 200 other people, and the tutor often brings in patients to bring the subject to life.
Anatomy
Gone are the days where a group of students would be presented with a cadaver from day one. Now medical students are taught anatomy through prosections demonstrated by tutors or through computer-based tutorials. I initially dreaded dragging out my formaldehyde smelling lab coat for the weekly anatomy sessions; however, as the course progressed, the relevance of what we were learning really became apparent, and the budding surgeons really seemed to love it!
Clinical Skills
Stethoscope around your neck, tourniquet clipped on to belt and tendon hammer in hand - what else do you need to feel like a proper doctor? Clinical skills sessions will teach you the essentials of examining patients and the practical techniques needed for when you're let loose on the wards. You tend to have a morning of clinical skills every couple of weeks, each concentrating on a particular examination. There are lots of fake arms and plastic bodies with various heart murmurs to practise on and your fellow medical students often come in to good use! Be warned - you very soon start to irritate your non-medic housemates by pointing out that the doctors on TV have their stethoscopes on the wrong way round!
Clinical contact
The amount of clinical contact with patients you get depends on the type of course your university offers. With an integrated course, you tend to get a few afternoons over the first couple of years in the hospital talking to patients, then in third year you see patients galore. The first time you are faced with a real, live, talking patient is terrifying, but you'll soon get used to them chatting about their numerous cats and how you look like their grandchildren! The hospital-based work tends to be in small groups on the ward with a clinical tutor, generally re-visiting a concept you've been taught in a seminar. You take histories, examine patients in pairs, report back and also go on call with the doctors. Getting on the right side of the nurses is always a bonus.
Self-study
Although it seems particularly unfair in first year when all your non-medic friends spend their mornings watching television and popping into uni for the odd lecture while you're slaving away at 9 am, use your free time wisely! Most courses will build in 'white time' to the timetable, its so tempting to pop to the shops or go to the union for a couple of hours in between lectures, but it really is worth using the occasional free time to do a bit of reading up. Unlike in school where you are set homework and nagged if you don't do it, at uni there's no-one to chase you up about it and it's so easy to fall behind!
Summary
Teaching styles Lectures
- Seminars
- Clinical skills
- Anatomy sessions
- Patient based work
- Self study
- Traditional - quite science orientated. Very clearly split into preclinical and clinical years.
- Problem based learning - small group lead sessions based around a certain clinical topic. Good if you're motivated and work well in small groups.
- Integrated - a mixture of clinical teaching and basic sciences. An option for those out there who want some early clinical experience but with some lectures thrown in.
References
1. Wood D. ABC of learning and teaching in medicine: Problem based learning. BMJ 2003;326:328-330.