UCL MEDICAL SCHOOL
Year 5 Student Guide
2018-2019
The UCL Doctor
A highly competent and scientifically literate clinician,
equipped to practice person-centered medicine in a
constantly changing modern world, with a foundation in
the basic medical and social sciences. This vision is
underpinned by the values of scholarship, rigor and
professionalism. The focus is on the development of the
student as a scientifically informed, socially responsible
professional who, in turn, can serve the health needs of
individuals and communities
The information contained in this guide was correct at the time of going to press, but no guarantees
can be given that it will be amended before the commencement of, or during, the degree programme
to which it refers. Please refer to the Year 5 Moodle pages regularly throughout the year
Year 5
The Life Cycle
CONTENTS
Section 1:
Welcome to Year 5
Introduction to the year
Aims for the year
How to do well in year 5
Clinical Reasoning Discussions ( CReDs)
Clinical Method
Performed & Observed procedures
Prescribing skills
Multisupervisor Reports ( MSRs)
Learning logs & Summary of absence
Assessments Attendance and Engagement
Summary of required formative assessments by module
Record of Procedures Cards
Formative assessments & Portfolio
Exam practice
Student selected Team Projects & Leadership Training
Case of the Module
Professionalism
Attendance & Engagement
Summative Assessment
Timetable for the year
Section 2:
Module 5A
CFHD: Child and Family Health with Dermatology
Child health
Core GP
Child and adolescent mental health
Dermatology
Section 3:
Module 5B
WHMH: Women’s Health and Men’s Health
Obstetrics and Gynaecology
Breast diseases
Genitourinary and HIV Medicine
Urology
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Section 4:
Module 5C
HOPE
Health care of the older person
Ophthalmology
Oncology/Palliative Care
Psychiatry
ENT
Section 5 Core Conditions and Common Presentations
Section 6
Staff Contact Details
Section 1: Introduction to Year 5
The theme of Year 5 of the MBBS curriculum is “the life cycle” - you will encounter patients
with medical conditions from across the “seven ages” of man. A large part of the year is
dedicated to beginnings of life, through women’s and men’s health, sexual health and child
health. In addition you will learn about family and adult health and behaviour through
general practice, breast services, urology, psychiatry, dermatology, ophthalmology and
ENT. The latter parts of the life cycle will be explored in health of the older person, oncology
and palliative care. This handbook is a guide for your learning through the year, including
details of progression requirements. It should be read along with the more detailed module
information on Moodle.
The year begins with a two day Introduction and Orientation Module (IOM) where you will be
introduced to important details of the year, some core lectures covering key concepts for
the year. As Year 5 is also an important year with regards to your Foundation School
application and planning your elective, within the IOM you will also receive advice about
career planning, Foundation School application and arranging your elective.
The rest of the year consists of an Anchor week, and three modules; each module comprising
a core introductory teaching week, and then 12 weeks of clinical placement.
The three Year 5 modules are:
Module A - CFHD: Child and Family Health with Dermatology (Paediatrics, General
Practice, Dermatology, Child & Adolescent mental health)
Module B - WHMH: Women’s Health and Men’s Health (Obstetrics, Gynaecology,
Breast disease, Urology, Genito-urinary medicine, Contraception & HIV medicine)
Module C - HOPE: Health of the older person, Ophthalmology, Oncology/Palliative
Care, Psychiatry and ENT
The Anchor week occurs at the end of the spring term and is classroom and lecture theatre-
based.
Clinical & Professional Practice teaching occurs at different points through year 5:
i)
integrated and embedded within the clinical teaching weeks of each module
ii)
specific CPP teaching sessions on some specific Fridays during the year
iii)
the person-centred pathway
iv)
during the IOM week
v)
during the Anchor week
The specific CPP teaching sessions are deliberately coordinated with the modules so that
learning is integrated with the particular module you are studying. The specific dates for this
CPP teaching are detailed on both the module and CPP Moodle sites. You can access the
site at
http://moodle.ucl.ac.uk. In Modules A and B all students are expected to return for these Friday specific CPP
teaching sessions, regardless of whether they are at a central placement, DGH or GP
attachments. In Module C students will not be expected to attend these CPP sessions during
the three very short placements of Oncology/Palliative Care, Ophthalmology or ENT.
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The Person Centred Pathway
The Person-Centred Pathway is a strand of learning which runs through the course of the
year, and is designed to support students in enhancing effective communication with
patients, especially those with long-term conditions. The ‘pathway’ is a pathway of learning
and skills training - you will learn about supporting self-management and consultation
techniques, to enable you to demonstrate a more person-centered approach. Learning is
supported with highly interactive tutorials through the year. In these you will learn about
different approaches to communicating with patients, to share decision making, support
behaviour change, and support management of their own health conditions. Between
tutorials you will be asked to practice these skills, observe whether and how experienced
clinicians adopt them, and complete short reflections upon their impact upon the patient and
the consultation.
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Aims for the year
The aims of Year 5 are explained in detail under each module section. You are advised to
go through the aims and objectives of each module at an early stage so that you are aware of
what will happen during the year, the portfolio and summative assessment requirements
and to assess your learning needs. The core conditions and presentations list for the whole
MBBS programme is provided in this handbook in Section 5, but we have also identified
those that are of particular relevance to each module.
As an additional guide, core conditions and presentations that you are particularly likely to
encounter in Year 5 have been highlighted in
bold, however, since the year includes
general practice and health of older persons, the conditions and presentations you learnt
about in Year 4 will still be relevant.
How much of year 4 do you need to know to pass year 5?
Students approaching the end of year exams, often ask the extent to which they might be
tested on medicine they learnt in year 4. Given that year 5 includes general practice, care of
the older person, and surgical sub-specialties, it is advised that you revise year 4 content
too, which will also help in your preparation for finals (about 6 months after the year 5
exams).
How to do well in year 5.
It is a cliché because it is true, that seeing as many patients as possible, and getting
involved in clinical activity is the key to learning medicine.
Year 5 builds on the abilities you have gained from year 4. We expect you to be able to
take histories from patients and know how to examine them, but within each module we
will be teaching you new types of content for history taking – such as obstetric or
psychiatric histories, and new examination skills – such as examining a child, or genital
examination.
Year 5 introduces you to more vulnerable patient groups, where you may need to be more
sensitive and careful about the way you communicate and gather information. We
encourage you to be observed in these situations and to gather feedback that will help you
improve, pass the exams, and be better clinicians in the future.
We want you to develop your diagnostic skills in year 5, and to help you do so, have
suggested you complete both Clinical Reasoning Discussions for each module, and
preferably go through these exercises as self-directed learning for additional core
presentations.
Year 5 moves rapidly through very different types of clinical attachments, and a strong
recommendation is to read ahead of each attachment. If you rely upon teaching within the
attachment, or reading prompted by seeing a specific patient, you may feel like you are
constantly behind and trying to catch up.
There is limited crossover between the teaching and types of patient in one module
compared to another, although the General Practice attachment may offer opportunities to
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catch up with missed competencies from a previous module, or gain skills for a future one.
If at the end of a module you or the faculty feel there are key skills that you have been
unable to gain, we may look at specific catch up sessions being provided for you.
Your end of module grading is compiled on the basis of your Record of Procedures Card
completion. We ask you to gather feedback and grades from across each module, and to
demonstrate to us that you are achieving the required diagnostic, clinical examination and
procedural skills. You will be asked to link these to SLEs, and also to obtain Multi-
Supervisor Reports from across the module that help us determine your grade.
The strategic student will ask for SLEs early in the module (these ask for formative
feedback and don’t include grades), and for MSRs throughout the module from clinicians
who have seen them “in action”. Students who end up in difficulty, often appear to leave
these workplace based assessments until the last week, and then fail to complete the
required number.
The rapid change from one location and specialty to another can leave students feeling a
bit lost and alone, so you are encouraged to make use of your peers, your personal tutor
and student support.
Clinical Reasoning Discussions (CReDs)
Working out the diagnoses to consider and prioritise for a patient presenting with a new
problem, is a key aspect of medical practice. For each module, we have highlighted Core
Presentations you are likely to encounter.
We ask you to link complete two CReDs per module linked to of patients you have seen. These
involve you documenting your reasoning and gaining feedback from a clinician through
discussing where they think you may be on the right lines, and where you may have missed
something.
In addition, we recommend that you to practise the first stages of this process (from
presentation to potential diagnoses) in a more abstract way for more core presentations as self
directed learning.
From presentation to differential diagnoses
Starting with the core presentation, think about the different systems (CVS, gastro, psychiatric
etc.) or iatrogenic issues that could be linked to the presentation. This helps you to think
broadly to begin with, rather than narrowing your focus too early.
Then list diagnoses/conditions that could be linked to that presentation. Think about each
diagnosis, think about the features that would make that diagnosis more likely – consider
the demographics and risk behaviours of the patient,
their past medical history
their presenting symptom onset, and exacerbating factors, and associated symptoms
signs to look for on examination
bed-side tests – e.g. urinalysis, peak flow rate, O2 saturations.
Linking to a patient and considering a management plan
When you come to request a Clinical Reasoning Discussion, we would like you to link specific
patients you have seen with a Core presentation for the module.
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We would want you to select the diagnosis you feel is the likeliest, but also identify others you
feel should still be ruled out.
Then, consider initial management – the investigations you feel would be indicated to help
confirm the diagnosis and whether any empirical treatment is indicated while the diagnosis is
being established. For some cases you may feel that the diagnosis is clear and that a definitive
treatment is indicated.
The clinician you talk to for the CReD, will give you feedback about how you have weighed the
different diagnostic options, and you may find it helpful to note this feedback. They will also
think about whether your initial management aligns to what they would do, and give you
feedback about this.
Clinical Method (history taking, communication, and physical examination)
Within each module, there are specific history taking frameworks, examination techniques and
practical procedures you will need to master. These have been included in your Record of
Procedures Cards – for some asking you to obtain feedback after observation and link this to
an SLE, and for others asking the supervising clinician to sign if they feel you are competent in
the skill, to the level expected of an FY1 doctor starting their job. To align this feedback to your
clinical communication teaching, please ask the clinician to consider giving feedback against
the Calgary Cambridge criteria. It may be helpful to show this to them.
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How will your clinical method and communication be assessed in the
exams?
Clear Pass
Pass
Borderline
Fail
Clear Fail
DOMAIN A
Correct
Majority of clinical
Clinical method
Clinical method
Clinical method poor
CLINICAL
comprehensive
method correct.
incomplete.
inadequate,
and disorganised, with
METHOD
clinical method.
Systematic and
Systematic but with
unsystematic and
major omissions
(History and/or
Structured,
thorough with
important omissions
with important
physical
thorough and fluent minimal important
omissions
examination)
omissions
DOMAIN B
Identifies the
Identifies the majority Misses significant
Misses important or Misses or invents the
IDENTIFICATION correct history or
of physical signs/
physical signs/
obvious physical
majority of physical
OF SIGNS/
physical signs/
symptoms
symptoms
signs/ symptoms
signs/ symptoms
SYMPTOMS
symptoms
DOMAIN C
Able to interpret
Able to interpret
Interprets signs or
Poor ability to
Unable to interpret signs
INTERPRETATI
signs/ symptoms to signs/ symptoms to
symptoms to offer
interpret signs or
or symptoms. Not able
ON OF CLINCAL reach a sensible
reach a reasonable
incomplete
symptoms. Offers
to offer a sensible
INFORMATION
differential
differential diagnosis differential diagnosis confused/ incorrect differential diagnosis
diagnosis and/or
and/or management
and/or management
differential
and/or management
management plan
plan. Some ability to
plan. Poor ability to
diagnosis and/or
plan
and can defend
defend conclusions
defend conclusions
poor management
conclusions
plan. Unable to
defend conclusions
DOMAIN D
Clear flexible
Structured
Some structure, lack Insensitivity to
Severe insensitivity,
COMMUNICATIO communication
communication but
of awareness of
patients’ feelings,
muddled messages,
N
using intelligible
lacks some clarity.
patients’ feelings or
unclear messages, poor listening
language &
Reasonable listening emotions.
uses jargon. Little
avoiding jargon,
Inconsistent listening evidence of active
good listening
listening
DOMAIN E
Treats the patient
Treats the patient
Treats the patient
Treats the patient
Treats the patient
PATIENT
respectfully and
respectfully and
respectfully and
respectfully and
roughly or insensitively
WELFARE
sensitively in a
sensitively in a
sensitively in a
sensitively in a
to cause physical or
manner that
manner that ensures manner that ensures manner that
emotional discomfort
ensures their
their comfort, safety
their comfort, safety
ensures their
comfort, safety and and dignity.
and dignity.
comfort, safety and
dignity. Addresses
Addresses most of
Addresses some of
dignity.
concerns in an
the concerns in an
the concerns in a
Unable to address
appropriate manner appropriate manner
reasonable manner
the patients
concerns
adequately
Performed and Observed procedures
In each module there will be some specific procedures or examination techniques to learn and
be signed off as competent to perform. In addition there may be procedures we want you to
observe, but where we don’t expect you to be able to perform the procedure. Here your
objective is to be able to understand what is involved, and to be able to describe this to a
patient.
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Prescribing skills It is really important for you to be a competent prescriber. In year 5 you will encounter specific
patient groups – e.g. children, pregnant women, older people, the terminally ill – where there
are specific factors to consider when prescribing. We want to assess, and give you feedback
on your competence in these situations within the study guide in preparation for the end of year
exams, and your future as qualified doctors.
MSR Multi-supervisor reports
These enable the clinician conducting your end of module grading, to see the views of a range
of clinicians, about your abilities.
The clinician who is completing each MSR should be someone who has seen you with
patients, who can give feedback about your communication skills, clinical skills and/or your
knowledge. They are also asked to comment on your professionalism and give you an overall
grade.
Each MSR should be completed by a DIFFERENT clinician.
At the end of the module, the grade you are assigned is based upon reviewing these MSRs,
and is typically the median value grade from the 5 you complete.
Learning Log. The idea of the learning log is for you to note key tips and topics you have learnt about in the
week and also to identify personal learning you recognise you need to do as a result of
experiences in the week.
Students who have engaged with this meaningfully in the past have documented activity and
learning needs, in a way that would be useful for them to review as part of their revision and
preparation for exams. It is not intended to be a summary of what you attended, but a way to
record specific items you have learnt (or realise you need to learn about).
Summary of absence
If you are unable to attend for any reason, you should inform the clinical teacher and the
medical school by submitting the online Absence Reporting and Leave Request form on
Moodle or the following hyperlink;
https://www.cognitoforms.com/UCLMedicalSchool1/AbsenceReportAndLeaveRequestForm
We ask you to complete a running tally of absence to be reviewed at the end of the module,
and so that you can also keep track. If you are absent for more than 12 days per module, we
ask you to liaise with student support, as this falls below the required attendance threshold for
completion of the module. Repeated absence that is not reported in advance, may lead to a
Concerns over Attendance & Engagement (CoAE) form.
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Assessments, Attendance & Engagement
Summary of required formative assessment documentation:
All formative assessment evidence gathered during the year will be via the
e-Portfolio or Record of Procedures card. It is recommended that you scan any paper based
forms into the personal library section of your e-Portfolio in case of loss or if you need to
produce a record of competency later in your career.
Module A: CFHD
Module B: WHMH
Module C: HOPE
Supervised Learning
4
4
4
Events (SLE):
Multi-supervisor reports
5
5
5
Clinical Reasoning
2
2
2
Discussions
Team Project with
PowerPoint presentation &
No
Yes
No
Leadership day MSR
Case of the Module online
Yes
Yes
Yes
Person Centred Pathway
reflections on consultations
Yes
Yes
Yes
(2 during the year)
Written assignment
Chronic care essay
No
Polypharmacy project
Online SBA paper OSCE Online SBA paper & mock
Online SBA & mock
Mock exams
revision
OSCE
OSCE
Summary of absence &
Yes
Yes
Yes
learning log
The Record of Procedures Cards
Your completion of each module’s Record of Procedures card and learning log evidences your
achievements and your engagement throughout each module, and will be used to inform your
End of Module Grading alongside the completion of SLEs on your e-portfolio.
Please make sure you consider how you will
“back it up” at regular intervals by scanning/
photographing.
An absence of evidence may lead to an end of module grade of “Wel below the level
expected”
Formative Assessment & Portfolio:
Clinical teachers will provide you with feedback on your performance and progress, either
formally through on-line supervised learning events (SLEs) or the Multi Supervisor Reports
(MSRs) which are in the Study guide or informally as part of everyday practice. If you
would like specific feedback, it is sensible to ask for this as part of the discussion of an
SLE, or MSR, and we would
strongly recommend that you ask the supervising
clinician at the start of the relevant clinical session about completing one of these
workplace-based assessments – rather than at the end. This allows the clinician to think
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about your performance during the session, and provide more meaningful feedback.
In each module you are required to obtain feedback in the form of 5 MSRs. These form
the basis for calculating your grade for the module. In each module you will need to
obtain MSR feedback from 2-3 stipulated clinical supervisors (e.g. the consultant
paediatrician tutor at your DGH placement), but the remaining MSRs may be completed
by any HCW (except an FY1) who has observed your practice, for a clinical session or
longer.
On the whole, students tend to find it easier to compile MSRs than SLEs, probably because of
the issue of asking clinicians to complete tickets, which can be frustrating, but will be part of
your e-portfolio gathering requirements from now on into postgraduate training. Ask early, and
resend the request if you don’t receive a reply. If the assessor has still not replied, you would
be wise to ask for someone else to complete an SLE with you to ensure your portfolio is
complete.
Remember the request for feedback must be made before the end of the clinical encounter
to be assessed.
It is not acceptable to send an e-ticket at a later date to a clinician who
was not expecting to formatively assess you. Busy clinicians may not notice your ticket
requests, and some students have had difficulty obtaining SLEs by this route. It is YOUR
responsibility to produce a completed portfolio, so you should anticipate this sort of problem
and not rely upon tickets being responded to at the last minute.
In addition, you can make the most of these events by reflecting on your own performance,
identifying aspects you are pleased with, and those you would feel could improve. Asking
the supervising clinician for specific guidance on areas you need to improve, will help to
personalise the feedback you receive and make it more informative.
Engaging with the process of obtaining evidence of feedback is important and, throughout
your medical careers, you will be required to do so via e-Portfolios and other mechanisms.
Producing evidence of participation in formative assessment is a key progression
requirement for each module in Year 5, and for the year as a whole.
Exam practice
Each module provides you with the opportunity to practice for your summative assessments.
In Module A, online SBAs are available and DGH sites have been asked to provide OSCE
practice; in Module B the final day of the module includes a mock OSCE and discussion of
mock SBAs available on line. In Module C, the final day of the module includes a mock
OSCE.
Student selected Team Projects & Leadership Training
In Module B, you will be expected to work with a team of peers on a project of your choice and
for each team to give a power point presentation of their project to a panel of judges and
fellow students at the end of the module. Participation in a project is compulsory; it needs to
be undertaken as a joint venture with other students. Involvement with these projects is
again used as evidence of engagement with the course and of taking responsibility for your
own learning. As such, project work will be taken into account when considering
progression. There are prizes associated with the project work.
Also within the module there is a “Leadership Day” within CPP Friday activities, which will
involve you gathering feedback about your behaviour within a team, and we would like you to
then document how your involvement in the Team Project was informed by the feedback
received on the Leadership day.
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Case of the Module
As part of the required coursework for each module, you will be expected to complete the
relevant online Case of the Module. More details will be available on Moodle.
Written Projects
Within individual modules there are written projects you are required to complete.
Professional Behaviours
An assessment of professionalism and fitness to practice underlies all parts of the MBBS
course and assessments. Mark schemes and progression criteria include provision for
teachers and examiners to submit reports of Concerns over Professional Behaviour(s) (CoPB)
if any aspect of a candidate’s performance during the course or assessments gives cause for
concern about engagement, attendance, behaviour, attitude or fitness to practice. CoPBs are
reviewed at pre-examination boards before presentation at examination boards and can lead to
a student failing to progress and to awards of merit and distinction being rescinded. Further
information about CoPBs can be found at:
https://www.ucl.ac.uk/medical-school/current-mbbs-students/general-information/policies-
and-regulations#copb
Attendance & Engagement
Attendance
Good attendance & engagement with study is part of your professional responsibility and there
is a minimum number of hours of attendance that you must achieve in clinical placements in
order to qualify as a doctor. In order to satisfy EU requirements for a specified number of days
of clinical learning, you need to be able to provide evidence of attendance & engagement with
the course.
In each module you will be asked to keep a running summary of absence within the Record of
Procedures Card.
Please report all absences ( Authorised & Sick Leave) using the Online Absence Reporting
and Leave Request form on Moodle or via the link below;
https://www.cognitoforms.com/UCLMedicalSchool1/AbsenceReportAndLeaveRequestForm
If Clinical supervisors notice a pattern of repeated absence without explanation, they may
submit a Concerns over Attendance and Engagement form, which will then require discussion
with senior faculty.
If you realise you will be absent from scheduled teaching then please;
i)
Record this in your summary of absence.
ii)
Inform the clinical teacher– preferably prior to the start of the session
iii)
Inform the medical school
if the period of absence is greater than 24 hours via
Moodle or the link above.
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Summative Assessment You will be assessed at the end of the academic year through a combination of written
papers and clinical examinations. The written examinations will use single best answer
questions. The clinical examinations will consist of an OSCE. Both exams will require you to
demonstrate knowledge and skills from across the year, including Clinical & Professional
Practice learning. The proportion of questions contributing to the exams from each subject
area reflects the time spent studying each subject during Year 5.
Timetable for the year
The following is an overall timetable for the academic year 2018-2019. You are advised to
check the UCL Medical School website for the most up to date information.
Dates
Schedule
Introduction and Orientation Module
Thursday 6 September - Friday 7
September 2018
Monday 10 September - Friday 14
Block 1 Core Teaching
September 2018
Monday 17 September – Friday 7
Block 1 Clinical Placements
December 2018
Monday 10 December – Friday 14
Block 2 Core Teaching
December 2018
Monday 17 December 2016 – Friday 22
March 2018
Block 2 Clinical Placements
Holiday Mon 24 December 2018 – Friday 4
January 2019
Monday 25 March
- Friday 29 March 2019
Anchor Week
Monday 1 April – Friday 5 April 2019
Block 3 Core Teaching
Monday 8 April – Friday 5 July 2019
Block 3 Clinical Placements
Easter Holiday 17, 18, 19, 22, 23 April
Bank Holiday May 6 & May 27
Monday 8 July - Friday 12 July 2019
Taught revision
Wednesday 17 and Friday 19 July 2019
Clinical assessments
Monday 22 July 2019 – 26 July 2019
Personal revision
Fri 26 July 2019
Written assessments
Monday 5 August - Friday 9 August 2019
Introduction and Orientation to Final Year
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Section 2: Module 5A: Child and Family Health with
Dermatology
Introduction and orientation
During this module you will spend most of your time learning about the clinical specialties of
Paediatrics, General Practice and Dermatology and, in addition, cover related aspects of
Child and Adolescent Mental Health (CAMH). As with all modules, there will be Clinical and
Professional Practice (CPP) related teaching (see separate CPP guide on Moodle for details).
A module specific study guide is available online which gives more depth and detail.
The overall aims of the module are:
To learn the knowledge, clinical skills and attitudes needed to manage children
and their families as patients in hospital and community settings.
To gain experience and understanding of the care of individuals and families in
primary care and awareness of the holistic nature, scope and limitations of the
discipline of general practice.
To develop knowledge of common and important skin disorders in both children
and adults with emphasis on diagnosis and management
To understand the principles of child and family mental health and the relationship
between physical, psychological and social factors in health and illness
To experience working with multidisciplinary teams in child and family health care
To have the opportunity to integrate knowledge of basic sciences and pathology
with clinical practice
To have the opportunity to continue learning related to all elements of the Clinical &
Professional Practices
The module is organized as follows:
Teaching and learning takes place in a variety of settings including lectures,
seminars, hospital wards, outpatient clinics, general practice and other community
clinics/centres.
The module consists of one week of introduction followed by three four-week
attachments (Central Paediatrics, General Paediatrics and General Practice).
There is core and CPP teaching on the final Friday of each of the 4 week
attachments (i.e. weeks 4, 8 and 12). All students are expected to return from their
clinical attachments for this teaching. In addition some CPP teaching will place on
Friday of the second week only for the students who are on their General Paediatric
attachment.
Dermatology is taught throughout the module especially during the core paediatrics
and GP attachments.
Module requirements
To fulfil the portfolio requirements, you need to complete the following:
4 SLEs
5 MSRs (We would like you to ask for feedback from five people, specifically one from
Tutors of your central, general paediatric and core GP attachments. You should obtain one
MSR per 4 week block plus two additional “wild cards” from any part of the module).
Procedures detailed in the Module Study Guide
Case of the month CFHD module
GP chronic care essay
13
Formative assessment
At the end of the module, you will have a formative online assessment consisting of SBAs.
Details will be given to you in due course. During your DGH Paediatric attachment, a
formative OSCE may be provided.
Further information
The module has a Moodle site which provides the following information:
Core and general timetables, including appropriate maps
Lecture timetable
Study guide and course handbooks
Course resources: Image Bank, Podcasts (iPaediatrics), Narrated Presentations
Assessment details
Module 5A: Child and Family Health with Dermatology : core
presentations
Try to complete a Core Presentation Differential Diagnosis Exercise for the
presentations below. Aim for a minimum of six. Where possible, link these to patients
you see, and discuss your reasoning as part of Case Based Discussion
Dermatology:
General Practice - emergencies
Urinary symptoms
Rash
Chest pain
Joint pain
Skin lesion
Breathlessness
Confusion
Blistering disorder
Acute abdominal pain
Febrile infant
Skin ulcer(s)
Acute psychiatric illness
Hair loss
Cough
Tired all the time
Pigment disorders
Ear ache
Diarrhoea & vomiting
Child health
Ear ache
Abdominal pain
Sticky /red eyes
Breathing difficulty Fits/Faints/Funny Haematuria
Short stature
Noisy breathing
turns
Proteinuria
Faltering growth
Short of breath
Squint
Jaundice ( neonatal)
Developmental delay
Sore throat
Diarrhoea
Hepatomegaly
Precocious puberty
Cough
Constipation
Lymphadenopathy
Delayed puberty
Chest pain
Rectal bleeding
Limb/joint pain
Abnormal head
Cyanosis
Abdominal mass Urinary
size/shape
Fever
Vomiting
frequency/dysuria
Crying baby
Headache
Purpura
MBBS core conditions and topics related to Dermatology
Acne
Burns
Dermatological
Eczema
Benign & malignant
Cutaneous
emergencies
Psoriasis
lesions of the skin (
infections
Lichen planus
BCC, SCC, melanoma,
Cutaneous
Pressure sores
naevus)
manifestations of
Blistering disorders
systemic disease
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MBBS core conditions and topics related to Child health
Asthma
Cystic fibrosis
Infantile hypertrophic
Rickets
Autism/ Aspergers
Diabetes
pyloric stenosis
Separation anxiety
ADHD
Dysplasia of the
Inherited disorders of
Testicular mal-descent
Birth asphyxia
hip
metabolism
Transient synovitis
Bronchiolitis
Down syndrome
Intussusception
Turner syndrome
Cerebral palsy
Febrile
Kawasaki disease
Wilms tumour
Coeliac disease
convulsions
Neuroblastoma
Congenital heart
Female genital
Problems of
Child abuse,
defects (VSD/
mutilation GORD
prematurity
Safeguarding and child
patent ductus)
Henoch-Schonlein
Respiratory distress
protection
Croup
purpura
syndrome
Infantile Colic
Child Health
During the child health component of this module, you will receive teaching and experience
in paediatrics and child health as follows:
Lectures and seminars on paediatric topics
4 weeks: Central Paediatrics attachment (Bloomsbury, Royal Free or Whittington)
4 weeks: General Paediatrics attachment at one of the hospitals affiliated with UCL
2 days of paediatrics based in General Practice (Child Health in Primary Care) during
the General Practice attachment. You will spend two separate days with a GP tutor in
their practice learning about child health in primary care.
Aims and objectives of the child health component:
Paediatrics is the study of health and diseases of children. Child health encompasses the
strategies for promoting health and preventing disease during childhood. As always,
prevention is better than cure. Your aims for the child health experience during the module
are described under the domains of knowledge and understanding, skills and attitudes.
1. Knowledge and understanding
The normal child
Knowledge of the normal child and child rearing is an essential prerequisite to the study
of disease. This encompasses:
Changes at birth and the normal newborn infant
Principles of infant feeding and nutrition
Growth and development: physical and emotional
Parenting and family dynamics
Health promotion and disease prevention in child health
Screening and surveillance including immunisation
Health education and promotion, accident prevention
Child protection
Ethics and law in child health
An understanding of:
Consent in children and young people: Gillick competence and Fraser guidelines
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Parental responsibility
Confidentiality
Common and important childhood diseases
The depth of knowledge expected for the many thousand diseases affecting infants and
children clearly varies.
A syllabus has been developed by UCL medical students and paediatric trainees and
consultants, with an interest in medical education, to guide your learning in paediatrics. The
syllabus starts with sections on the normal child and the child with complex needs, followed
by clinical information classified by system. Within each section, there is an alphabetised list
of important conditions with those that are included in the UCL MBBS core conditions
highlighted in bold. This is followed by guidance on what you need to know and be able to
do and a list of useful electronic/on-line resources. An example is shown below. At the end
is a table showing some of the most common or important diagnoses in infants, children and
young people for the UCL MBBS core presentations. This syllabus forms part of the module
specific electronic study guide which is available on the module Moodle site.
Example from Syllabus:
Child Maltreatment and Safeguarding
Emotional abuse
Fabricated Induced
Illness
Neglect
Physical abuse
Sexual abuse
Child Maltreatment
Know the different categories of child abuse
Be aware of the potential presenting features of child abuse
Be aware of key factors in the history and examination that may raise concerns of child
abuse, for example history inconsistent with injury, changing stories, particular injuries
Be aware of some of the presentations that can be associated with child maltreatment
including burns and fractures, bruising, head injury (especially in very young babies,)
faltering growth, vaginal bleeding or discharge, soiling and wetting, apnoeic episodes in
very young babies and self-harm
Appreciate the importance of a thorough assessment (taking a full history and performing
a thorough examination, including documenting any marks seen on a body map,) when
child maltreatment is suspected
Know the appropriate investigations when child abuse is a possibility
Know the local procedure for who to contact if you have concerns about a child, and
recognise the importance of calling for senior help early
Be aware of the other professionals that may be involved when there are concerns
regarding child maltreatment (including social worker, police, school, health visitor and
GP
Resource:
Child Maltreatment – Student BMJ article on child abuse – what you need to know.
http://student.bmj.com/student/view-article.html?id=sbmj.d2145
NICE guideline on recognising child maltreatment -
http://www.nice.org.uk/CG89fullguideline
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2. Skills – these are itemized within the Study guide
Management by initiation of investigation and treatment
Investigations
Blood tests
Haematology: full blood count; blood film
Biochemistry: U&Es, LFTs, bone
Microbiology: culture, serology, immunoglobulins
Urine tests
Dipstick; Microscopy and culture
CSF analysis: Biochemistry, microbiology, immunology
Imaging: Radiology; ultrasound, MRI, CT
Treatment
You should know about the management and treatment of common and serious
conditions. It is particularly important to know the immediate management of the following
emergencies:
Cardiorespiratory arrest (basic life support).
Shock (circulatory failure) due to:
meningococcal septicaemia/anaphylaxis/diabetic keto-acidosis.
Acute asthma.
Upper airways obstruction, e.g. stridor and choking.
Birth asphyxia.
Acute seizure.
In addition, you are expected to understand the principles of managing an infant or
child's:
Nutrition including use of nutritional supplements e.g. vitamins, iron.
Fluid and electrolyte balance.
Therapeutics and how to write a drug chart.
Principles of paediatric prescribing including the use of common medications.
Communication skills
Verbal and written communication skills including:
Talking to children of different ages and anxious parents.
Explaining common childhood illnesses and discussing treatment.
Breaking bad news and responding to emotional distress.
Case presentations.
Satisfactory written medical record keeping.
Safe and accurate paediatric prescribing.
3. Attitudes
Develop appropriate and satisfactory attitudes towards children, families and colleagues:
Children: Taking account of their special needs and vulnerability. Minimising
pain and discomfort. Accepting uncooperative behaviour.
Parents: Inspiring confidence and demonstrating friendliness, whilst showing
respect for parental opinion.
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Colleagues: Ability to give and take instructions professionally. Work efficiently in a
team. Support colleagues and seek help when appropriate.
Personal professional development.
Community paediatrics
Community paediatrics (care of children at home and in the community) is a sub-specialty
within child health. Care of children in the community places a great emphasis on health as
opposed to illness which is often the focus in the hospital. The teaching may involve small
group seminars, presentations and attending community clinics (e.g. children with complex
disabilities). By the end you will know about community paediatrics including child health
promotion, the multidisciplinary team, and complex disability. Every child discharged from
hospital goes home to their family, community and school. Whatever their illness they need
to achieve the 5 outcomes set by the government in “Every Child Matters, Change for
Children”.
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Child Health in Primary Care
During your Core General Practice attachment you will spend two days with a GP tutor in
their practice learning about child health in primary care. Teaching will usually be in groups of
4 students. The overall aims are to provide you with opportunities to learn about common
paediatric problems in primary care, to practice your basic clinical skills in paediatrics and to
help you to understand the role of the community in children’s health care.
Child and adolescent mental health: This is a branch of psychiatry that specialises in
the assessment, diagnosis, treatment and prevention of psychiatric disorders and mental
health problems in children, adolescents and their families. Adolescence represents the
period of development when emotional and psychiatric disorders most commonly emerge.
Mental health disorders are common, with a population prevalence in children and
adolescents of about 10-20%. This can increase significantly in certain at-risk groups, those
attending paediatric clinics (about 30%).
Core conditions in child and adolescent psychiatry and their treatments
During your attachment you may not encounter every core condition; however they will be
covered in the lectures. You do not have to know all about every part of every condition but
it is very important that you understand how to assess and manage the common diagnoses
and how to recognise a child in difficulty.
There is some overlap between child and adolescent psychiatry and general adult
psychiatry, as well as with paediatrics and GP. In order to get the most out of your child and
adolescent psychiatry experience, it is a good idea to consider bio/psycho/social aspects of
all the young people and their families you encounter. You should try to assess and present
as many new patients as you can, and formulate a differential diagnosis and management
plan for each which takes into account their bio/psycho/social needs.
The following conditions are suggested as the basis for a study guide:
Hyperkinetic disorders (ADHD)
Neuro-developmental disorders (Autism Spectrum Disorders, Learning Disability)
Behavioural disorders(Conduct Disorder and Oppositional Defiant Disorder)
Mood disorders specific to children and adolescents
Anxiety disorders specific to children and adolescents
You will receive lectures and seminars on these topics during the Introductory week and
weeks 1, 5 and 9. You will then spend a day with a Child & Adolescent Psychiatry team
during your Core placement to gain clinical experience. You will also have chances whilst
on all your clinical placements to see patients with either direct mental health disorders or
mental health difficulties relating to their medical condition, family or social situation. There
are additional opportunities to experience a range of generic and specialist services offered
and conditions managed by CAMH teams in your Core placements, if you are interested in
this area. You should discuss this whilst on your placements.
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Core General Practice
During the CFHD module one of your four -week clinical attachments is based in a general
practice in or around London. This “Core GP” attachment is in addition to the two days you
spend learning specifically about paediatrics and child health in general practice during your
DGH paediatrics four weeks. When you are in the practice you will be supervised on a one -
to one basis by one of the GP tutors associated with the Medical School. Unlike the
placements which you have taken in general practice during specialist firms in other years,
this attachment is designed to help you learn about the whole range of problems presenting
to GPs and the variety of services provided in primary health care. Please note that the
London GP attachment also incorporates some elements of your dermatology teaching
programme and one seminar on occupational medicine.
The four core GP weeks are made up as follows:
One day introduction to primary care in the NHS (at Royal Free Campus).
The equivalent of 12 days core GP experience in your allocated practice.
One seminar on chronic disease management.
One seminar on occupational medicine.
Two mornings in GP based dermatology teaching sessions (may be your own or,
more often, a different practice).
Please note that ALL of these components are compulsory and your attendance will be
monitored and taken into account in your end of course assessment.
No teaching is scheduled for Wednesday afternoons. These are free for sport or self-
directed learning. You may however negotiate a different half day with your practice if it
suits you and the practice to do so.
Most of your time in the practice will be spent with a GP tutor in the surgery or
accompanying them on home visits. If your tutor does not suggest that you see patients
alone within the first week then please make the suggestion yourself. In some practices you
may have a gap in the middle of the day when there is no formal learning activity arranged.
This will give you time to meet other members of the primary health care team and
understand their roles (e.g. receptionists, practice nurse, district nurse, health visitor,
midwife) to read up on conditions you have seen in the surgery or to visit patients
suggested by your tutor. You should also discuss with your tutor whether it is possible for
you to gain some experience of out of hours care in general practice. NB – please read
notes on “Staying Safe in the Community” provided.
In this placement we hope you will see community-based problems that do not need referral
to a hospital e.g. minor illnesses, chronic diseases, undifferentiated problems, multiple
pathologies and the early stages and less severe forms of diseases. You are also likely to
focus more on the impact of social and psychological factors on illness, the patient’s
perspective and how these affect medical management. It is important for all
undergraduates to have this experience as half will become GPs and those who do not
clearly still need to know the scope and limitations of this discipline and how it relates to
secondary care. Many of you will also spend three or four months working in General
Practice in year two of your Foundation Programme as newly qualified doctors.
20
Aims of the core general practice attachment:
To enable students to experience and understand the provision of care to individuals
and families in general practice and become aware of the nature, scope and
limitations of the discipline.
To provide an opportunity for students to practice and integrate their clinical skills
in terms of history taking, physical examination, and patient management.
To encourage students to reflect on their experiences in medical education
and develop an integrated and holistic approach to patient care.
Getting the most out of your GP attachment
Teaching in General Practice is one of the few occasions during your course where you will
benefit from one -to-one teaching. It also provides a chance to gain a lot of practice
assessing patients before they have been seen by the responsible doctor. All attachments
should start with a discussion of your learning needs. Although we provide you with a list of
learning objectives, please remember that this course presents a valuable opportunity for
you to learn about a whole range of aspects of medicine in the broadest sense. Try and
discuss any personal learning objectives with your tutor in the first two days. You are likely
to start off by sitting in with your tutor, observing and discussing consultations. This is an
important activity but should not be the sole theme of the placement. Students usually
report that the most valuable and enjoyable aspect of this course is the chance to see and
assess patients on their own. This is a golden opportunity to practice making initial
assessments and concisely presenting your findings.
Most of your important learning in this course will come not from textbooks but from
participating in the everyday work of your host practice and the discussions with your tutors
and in seminars at the medical school. We do however recognise the need for some
direction to your learning and so we include in your course materials a list of clinical areas
in which we do expect you to be able to demonstrate knowledge by the end of the course.
Dermatology
Dermatology is a specialty you will encounter in every field of medicine throughout your
career. Please note, that this is the
only formal dermatology teaching you will receive in
medical school, so we recommend that you capitalize on this. In order to help you learn,
teaching occurs in a number of formats: Large group lectures, seminars and hospital/
community outpatient clinics.
Core competencies
By the end of the course you should be able to do the following:
Take a dermatological history.
Examine skin, hair, nails and mucosae systematically.
Describe examination findings appropriately.
Suggest differential diagnoses.
Formulate a management plan for the common conditions
Recognise the specialist treatments are available to the dermatologist. For
example;
1.Topical therapies e.g. steroids, dithranol, tar, wet-wraps, compression
2.Phototherapy e.g. Psoralen + UVA and UVB
3.Photodynamic therapy
4.Systemic drugs e.g. retinoids, immunosuppressants, biological drugs
5.Specialised surgery e.g. Moh’s micrographic surgery
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By the end of the course you should also have an understanding of the following:
Investigations available in dermatology e.g. skin biopsy, patch testing etc.
Structure and function of the skin and its appendages.
The principles of the skin immune system in the pathogenesis of disease and
cancer.
The clinical features of common skin diseases.
The psychosocial impact of skin disease on patients’ lives.
During your attachment, please do not expect to encounter all the conditions listed but be
assured that they will be covered in the lectures. You do not have to know all about every
dermatological condition but it is very important that you learn to describe skin conditions
accurately and recognise important common diagnoses such as skin cancer etc.
There is considerable overlap between Dermatology and most other specialities, including
general medicine, paediatrics, general practice, rheumatology, oncology and surgery. You
will get the most out of your dermatology attachment if you try to put into context the
patients you see with us. Try to clerk and present as many new patients as you can, and
formulate a differential diagnosis and management plan.
The MBBS Core Conditions & Common Presentations list, details those skin conditions
you should learn about as a priority. More detail is available on Moodle.
Lecture Schedule
The lectures are broadly focused around the study guide above and occur in 2 blocks
during the introductory week and a final block in the week prior to the exam. This session
contains a revision lecture.
Clinical Teaching
You will be allocated 4 consultant-led (during Central Paediatrics attachment) and 2 GP
clinics (although this might vary).
Dermatology in Primary Care
During your Core GP attachment you will also spend a day in each of the second and fourth
weeks with a GP tutor in their practice learning about skin problems commonly seen in
general practice.
The aim of primary care based teaching in dermatology is to provide students with
opportunities to assess any skin complaint and to recognise and manage those
dermatological problems. The focus is on dermatological history, examination, and common
skin problems. Examples of topics taught include dermatological history and examination,
common skin problems e.g. eczema, psoriasis, acne, rosacea, skin infections, urticaria,
childhood rashes.
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Section 3: Module 5B Women’s Health & Men’s Health
Introduction and orientation
This module incorporates Obstetrics and Gynaecology (O&G), Breast disease,
Genitourinary (GU) and HIV Medicine, and Urology. You may have encountered patients with
conditions commonly treated by some of these specialties in Year 4 and this module will build
on this learning. Many of the areas you will learn about can be sensitive subjects to address,
both in terms of verbal discussion and clinical examination of patients and you will be taught
skills to help you navigate these areas during the module.
The overall aims of the module are:
To understand how the core conditions covered by this module present; to be able to
take a full history, including collateral and social history; to conduct a clinical
examination from a patient with any of these conditions.
To develop an understanding of the principles of assessment and management of
common and important disorders within these specialties.
To competently examine the female and male pelvis and reproductive tract organs.
To understand issues relating to public health medicine which affect the population
perspective of women’s and men’s health.
The module is organized as follows:
1 Core Teaching week
1 x four week attachment in Women’s Health in a DGH setting
1 x four week attachment in Women’s Health in a teaching hospital setting
1 x four week attachment in GU/HIV medicine and Urology
Teaching and learning takes place in a variety of settings including hospital wards,
outpatient departments, general practice, other community clinics/centres and patients’
homes. It includes related aspects of Clinical and Professional Practice such as social
determinants of health, epidemiology, ethics and law, anatomy and imaging, pathology,
use of evidence and use of medicines. Detailed timetables for the Core Teaching Week
and clinical attachments are on Moodle. Although the teaching and learning activities at each
site are slightly different, all attachments satisfy the aims and objectives of the module and
prepare you for the assessments. CPP teaching occurs on Fridays, either fortnightly or
monthly depending upon your rotation through the module, and all students are expected to
attend this teaching regardless of their current attachment. This includes a Leadership day
with the Clinical Skills Teams. On the final Friday of the module, there will be a formative
assessment consisting of a mock OSCE and face to face feedback session. You will also
prepare a project presentation during the module, details of which are on Moodle, and which
you will present on the final Friday. You will have access to an online mock SBA and other
learning resources on Moodle throughout the year.
Module requirements
To fulfil the portfolio requirements, you need to complete the following:
4 SLEs
5 MSRs (We would like you to ask for feedback from five people; you should obtain
one MSR per 4 week block plus one additional “wild card” from any part of the
module plus the leadership day MSR
Feedback from the Leadership Day
Procedures detailed in the Record of Procedures card
23
Student reflections on learning achieved as detailed in the Procedures card
Team project presentation
WHMH case of the month
24
Module 5B: Women’s Health & Men’s Health : core presentations
Try to complete a Core Presentation Differential Diagnosis Exercise for the
presentations below. Aim for a minimum of six. Where possible, link these
to patients you see, and discuss your reasoning as part of Case Based
Discussion
Breast lump
Early pregnancy
Vaginal discharge
Scrotal
Breast pain
bleeding
Male urethral
pain/swelling
Post-partum breast
Early pregnancy
discharge
Difficulty passing
pain
pelvic pain
Genital ulceration
urine
Pelvic pain
Hyperemesis
Genital lesions
Urinary frequency
Amenorrhoea
Antenatal
Genital rash
(male and female)
Dysmenorrhoea
assessment
Dysuria
Haematuria
Menorrhagia
“Small for dates”
Long term
Loin pain
Inter-menstrual
“Large for dates”
contraception
Urinary
bleeding
Reduced fetal
request
incontinence
Irregular menses
movements
Emergency
Erectile dysfunction
Post-coital bleeding
Itching in pregnancy
contraception
Post-menopausal
Headache in
request
bleeding
pregnancy
Difficulty
Menopausal
Abdominal pain in
conceiving (male
symptoms
pregnancy
and female)
Abdominal bloating
Breathlessness in
Termination of
Pelvic mass
pregnancy
pregnancy request
Diagnosis of labour
Ruptured membranes
Ante-partum
haemorrhage
Post-partum
haemorrhage
Post-partum low
mood Maternal
collapse
25
MBBS core conditions and topics related to WHMH
Breast cancer
Polyhydramnios
Pelvic inflammatory
Prostate cancer
Fibroadenoma
Placenta praevia
disease
Benign prostatic
Breast cyst
Placenta accreta
Chlamydia
hypertrophy
Breast abscess
Placental abruption
Gonorrhoea
Testicular cancer
Ovarian cancer
Preeclampsia/
Syphilis
Testicular torsion
Ovarian cyst
Eclampsia
Herpes
Epididymitis
Uterine cancer
Amniotic fluid
HPV
Urinary calculi
Fibroids
embolism
HIV
Phymosis/
Cervical cancer
Medical complications Infections in the
paraphymosis
Vulval cancer
of pregnancy
immunocompromised Balanitis
Menopause
- gestational diabetes; Hepatitis A, B & C
Bladder cancer
Endometriosis
- cholestasis
Vaginal candida
Urinary tract
Ectopic pregnancy
Bacterial vaginosis
infection
Threatened
Stress incontinence
miscarriage
Urge incontinence
Miscarriage
Women’s Health including Obstetrics & Gynaecology and Breast
Disease
You will have two Women’s Health attachments; one lasting four weeks which will be
at a DGH, and one lasting a total of four weeks, at either the Whittington, UCLH or the
Royal Free. The DGH attachment will comprise mainly O&G although some of the
placements will also have opportunities for breast clinics and theatres. The base
campus attachment will contain a mixture of O&G and Breast disease plus community
placements in midwifery and general practice settings. Teaching in the hospital
setting is primarily delivered in clinics, theatres and at the bedside, with additional
small group tutorial teaching at both DGH and base campus settings.
Obstetrics and Gynaecology
Core competencies
There are a number of core conditions that you should know about in O&G. These are
listed in the core conditions and presentations list in Section 5. Further details are
available on Moodle.
By the end of the module you should be able to:
communicate effectively and courteously within a women’s health setting
demonstrate the ability to take a systematic O&G history and to present it in
a clear manner
demonstrate the ability to examine the pregnant abdomen and undertake an
antenatal examination
demonstrate the ability to perform a female bimanual examination
demonstrate the ability to conduct a Cusco speculum examination and cervical
smear test
perform a urinary pregnancy test
demonstrate an understanding of risk assessment within obstetrics and
26
gynaecology
demonstrate an understanding of general and targeted screening
approaches within O&G
demonstrate an understanding of the law and of basic ethical concepts relevant to
O&G
understand the processes of normal and abnormal labour and delivery
understand the ways in which delivery can be expedited, including instrumental
delivery and Caesarean section
understand the ways in which fetal wellbeing is assessed during pregnancy
and in labour, and how the newborn infant is assessed at delivery
understand the role of different care settings within maternity care
recognize the common presenting signs and symptoms of obstetric
emergencies (severe pre-eclampsia, antepartum and postpartum
haemorrhage, fetal hypoxia, maternal collapse, sepsis) and describe the
initial steps in management
describe the differential diagnoses underlying common presenting problems
within gynaecology and how these might be investigated and managed
Recognize the common presenting signs and symptoms of gynaecological
emergencies (ectopic pregnancy, ovarian torsion, sepsis and haemorrhage related
to the reproductive tract) and describe the initial steps in management
respect and understand the professional contribution of other health care workers
understand how healthcare professionals can support women in making decisions
about their care
During your attachments, you should have:
attended gynaecological outpatient clinics
attended antenatal outpatient clinics
attended gynaecological theatre sessions
attended and supported women in labour
observed and participated in different types of delivery
attended community-based clinics (within general practice and with a
community midwife)
attended the Gynaecology Teaching Associate session
attended breast sessions as detailed in the breast disease section below
Women’s Health in General Practice
During your DGH O&G attachment you will spend 2 days with a GP tutor learning about
women’s health in the community. Sessions will in smal groups with the GP tutors at
base campus for two GP-led seminar days during the term. Placement details will be
available via Moodle. This is part of the medical school’s community-based teaching
programme. The overall aims of the of the community based teaching in women's health
are to provide you with opportunities to learn about common women's health problems,
to practice your core clinical skills in obstetrics & gynaecology and to help you to
understand the role of community-based healthcare services in relation to women's
healthcare.
Your learning objectives within these sessions are as follows:
to understand the role of community based services in women’s health care
to gain understanding of what are the common women’s health problems in
the community, how they present and how they are managed
to practice gynaecological history taking
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Breast Disease
Breast cancer is the commonest cancer affecting women, both around the world and
in the UK. In the UK 1 in 8 women will be affected at some point in their lifetime.
During your base campus Women’s Health attachment, you wil be timetabled to
attend sessions within the Breast Unit, including:
A “One-stop clinic” for patients who have been referred with new breast
symptoms. Patients have their history taken and are examined, and then
if necessary on the same day they can have breast imaging with
mammograms and / or ultrasound and needle biopsy, and receive their
results on the same day. As well as spending time with the Breast Surgery
Consultants seeing the patients, you should follow a patient as she goes
for a mammogram and ultrasound and then return to hear the
Consultant discussing the results. If the patient has a biopsy you should
watch the Consultant pathologist processing and analysing the slides.
A Treatment Planning Session
Operating theatre sessions. Most of the operations we do are for breast
cancer either with breast conservation or mastectomy often with immediate
breast reconstruction. Students would be expected to attend the pre-and
post-operative ward rounds where possible.
A Multidisciplinary Meeting (MDT) where cases are discussed by the whole
team in terms of determining ongoing management. Students are expected
to attend one MDT during their placement and to use this as an opportunity
to become familiar with the terminology and detailed discussion necessary
to decide upon optimal treatment. Students should aim to follow a case
through from the clinic to the MDT session and then to theatre, and use this
as an opportunity for case-based discussion with your tutors.
Please note that formal teaching takes place within clinic and theatre
sessions as well as in tutorial sessions.
Core competencies
There are a number of core conditions that you should know about in relation to
breast disease. These are listed in the core conditions and presentations list in
Section 5. Further details are available on Moodle.
By the end of the module you should be able to:
take a full history - including breast risk factors, from a patient complaining of a
breast abnormality
demonstrate the ability to conduct an examination of the breast and axilla
demonstrate an understanding of the investigation of breast disease: try and
learn about
‘triple assessment’ and how breast investigation results are scored
and take note of what the patients have to go through so you could explain it
to another patient in the future
understand the importance of communication skills - both for good and bad
news
understand the role of the Breast Clinical Nurse Specialist
understand the role of the multidisciplinary team relating to management of
breast disease
understand the principles of screening in general and with specific
reference to screening for breast cancer
understand the role of imaging and pathology within the management of
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breast disease
recognise major abnormalities on mammography
stage carcinoma of the breast
understand what treatment modalities are available for breast cancer including
early and advanced disease
understand the consent process for a patient requiring intervention for breast
disease
understand the different types of breast surgery
understand the anatomy of the breast
understand the role of team working to ensure patient safety in the operating
theatre
demonstrate an understanding of theatre scrubbing and sterile techniques
be able to present a case
During your attachment, you should have:
attended a one stop clinic
attended a Treatment Planning Session
attended Breast Theatre
attended an MDT meeting
undertaken Breast examination
seen Fine needle aspiration being performed for cytology
seen Breast ultrasonography
seen Mammography
You may also have opportunities to attend Breast clinics and theatre during your DGH
attachment.
GU/HIV medicine & Urology
This is a 4 week attachment during which there is weekly classroom based teaching in
both GU/HIV medicine and urology for all students. For the first 2 weeks half the
group are assigned to clinical sessions related to GU/HIV and the other half are
assigned to clinical sessions in urology. The groups swap for the second 2 weeks.
There is fairly limited potential for students who miss essential clinical sessions in
one half of the attachment, to catch up on this during the other half of the attachment.
Students who are aware that they will be unable to attend specific clinical
sessions should alert the module administrator as soon as possible. (for
GUM contact Lydia Clinton
x.xxxxxxx@xxx.xx.xx; for Urology contact Zoe Lau
xxx.xxx@xxx.xx.xx) Students work across the three home campuses throughout the 4 weeks. Most
GU/HIV sessions occur at the Mortimer Market Centre (Bloomsbury site); Archway
Centre (Archway site); UCH and the Royal Free Hospital, but contraception clinics
occur at other sites. For urology individual students are based at one of the main
sites (Royal Free, UCH or Whittington) for most of their clinical sessions, plus
specific sessions at the other sites.
Core competencies GU/HIV medicine
Core conditions and presentations you are likely to encounter during this attachment
are highlighted in the MBBS list in Section 5. Further details are available on
Moodle.
By the end of the module you should be able to:
demonstrate a non-judgemental approach to discussing sexual issues with
patients
29
take a sexual & contraceptive history to establish risk of STIs & pregnancy
and recognize symptoms suggestive of STIs
perform a genital examination, (offering a chaperone) & differentiate normal
findings from those indicative of an STI; perform a speculum examination &
be able to describe proctoscopy
advise & test a patient for HIV in any setting, know when HIV testing
should be offered routinely, and “red flag” conditions for targeted HIV
testing.
advise a new HIV+ patient about its likely impact upon lifestyle & future
health & health-care
identify when an HIV+ patient needs antiretroviral therapy (ART); the factors that
determine which treatment, & the importance of adherence & drug-drug
interactions for patients on ART
recognise signs & symptoms suggestive of HIV immuno-suppression, and of
opportunistic infections (OIs), (particularly PCP & CMV retinitis) and how OI
risk is linked to CD4 count
recognise that STIs are often asymptomatic & those for which patients should be
screened
give advice on STI transmission routes & risks; safer sex & vaccination against
viral hepatitis
follow legal & ethical guidelines when managing patients reporting under -age sex
know when & how to treat an STI in a non-specialist setting & when to refer
take correct action after needle-stick & know how & how rapidly to access PEP
request & interpret appropriate diagnostic tests for STIs, viral hepatitis & HIV
and describe initial management of the patient & their partner(s)
be able to differentiate STI from non STI causes of genital symptoms
know how emergency contraception can be accessed & what form to
recommend when
explain use of the combined oral contraceptive and advise if missed pills
recognise symptoms of sexual dysfunction, initial investigations, where to refer
& first line treatment
explain what a GUM consultation involves & how to access GUM or
Contraception services
Core competencies relating to urology
Core conditions and presentations you are likely to encounter during this attachment
are highlighted in the MBBS list in Section 5. Further details are available on
Moodle.
By the end of this module you should be able to:
take a history to identify symptoms of urological conditions including
haematuria, renal colic, bladder outflow problems, incontinence and
urological malignancies
examine the urinary tract (including genitals & prostate) and be able to
identify
a palpable bladder
a renal mass
features of benign prostatic enlargement vs prostate cancer
be able to examine the scrotal contents & distinguish between
a hernia
testicular tumour
hydrocoele
30
epididymal cyst
formulate a differential diagnosis & plan for investigation of the above
symptoms & findings
recognise the presenting features of common urological emergencies (torsion,
retention, upper & lower urinary tract trauma; haematuria; uro-sepsis; priapism,
paraphimosis and renal colic) and describe the initial steps of management
understand the indications for the following investigations: CT K-U-B,
urinary flow rate study, urinary tract ultrasound and flexible cystoscopy
pass a urinary catheter in a male or female patient & describe basic catheter care
describe risk factors & screening recommended for carcinoma of the prostate
and testis
describe the routes of spread, staging & treatment options for carcinoma of
the prostate, bladder, kidney and testis
• describe investigation and treatment of urinary incontinence, urinary calculi,
urinary tract obstruction and urinary tract infection
explain the types of trauma that may cause injury to the kidney or lower urinary
tract, how these present and their initial management
describe the common indications for and complications of renal transplant
31
Section 3: Module 5C: Health of older people, ophthalmology,
oncology, psychiatry, palliative care and ENT (HOPE)
Introduction and orientation
This module includes Care of Older People (COOP), adult psychiatry, General practice,
ENT, ophthalmology, cancer and palliative care.
You will have had exposure to patients with the illnesses commonly treated by most of
these specialties in year 4, and this module will build on this learning. The overall aims of
the module are:
To understand how the core conditions covered by this module present and to take a
full history, including collateral and social history and relevant physical examination
To be able to perform a mental state examination
To develop an understanding of the principles of assessment and management in
cancer medicine and palliative care.
To competently examine the eye and the ear.
The module is organized as follows:
1 introductory teaching week
1 x four-week attachment in Care of the older person
1 x four-week attachment in psychiatry
1 x two-week attachment in cancer incorporating palliative care
2 x 1 week attachments in ophthalmology and ENT
Teaching and learning takes place in a variety of settings including hospital ward s,
outpatient departments, general practice, other community clinics/centres and patients’
homes. It includes related aspects of other disciplines such as public health, epidemiology,
ethics, pathology and use of medicines. Detailed timetables for the introductory teaching
week and clinical attachments are on Moodle. Although the teaching and learning
activities at each site are slightly different, all attachments satisfy the aims and objectives
of the module and prepare you for the assessments.
On the final Friday of the module, there will be a formative assessment consisting of
mock OSCEs, online SBAs and review of SBAs.
Module requirements
To fulfil the portfolio requirements, you need to complete the following:
4 SLEs
5 MSRs (We would like you to ask for feedback from five people, specifically one from your
psychiatry and COOP placement tutors, plus three from any other health care professional.
You should obtain 2 MSRs per 4 week block plus 1 additional “wild card” from any part of
the module).
Procedures detailed in the Study guide
Case of the month HOPE module
Polypharmacy project
32
Practical prescribing project – during the COOP, cancer, palliative care or psychiatry
attachments, you will need to complete a prescribing project focusing on
polypharmacy. More details are available on the Moodle site.
Module 5C: core presentations
Try to complete a Core Presentation Differential Diagnosis Exercise for the
presentations below. Aim for a minimum of six. Where possible, link these
to patients you see, and discuss your reasoning as part of Case Based
Discussion
Health of older
Psychiatry
Ophthalmology
ENT
people Falls and
Low mood/depression
Acute visual loss
Epistaxis
immobility
Anxiety disorders
Gradual visual loss
Hearing loss
Frailty
Psychotic disorder
Red eye
Hoarseness
Polypharmacy
Deliberate self harm
Diplopia
Dizziness
Confusion
Drug and alcohol misuse Seeing Flashing
Ear ache
Cognitive/memory
lights
Neck lump
problems
Rhinitis
Incontinence
Sore throat
MBBS core conditions and topics related to Module 5C: HOPE
Breast cancer
Generalised
Alzheimer’s
Acoustic neuroma
Head and neck
anxiety disorder
Lewy body
Vertigo
cancer
Phobias
dementia
Meniere’s disease
Laryngeal cancer
PTSD
Vascular dementia
Cholesteatoma
Ovarian cancer
OCD
Cerebrovascular
Obstructive sleep
Uterine cancer
Anorexia
disease
apnoea
Cervical cancer
Bulimia
Multiple-co-
Otitis media
Vulval cancer
Mental health
morbidities in the
Otitis externa
Prostate cancer
problems in people elderly
Otosclerosis
Testicular cancer
with learning
Pleomorphic salivary
Lung cancer
disability
Deprivation of
adenoma
Colon cancer
Depression
liberty
Presbyacusis
Stomach cancer
Bipolar disorder
Mental health act
Perforated ear drum
Oesophageal
Personality
Salivary gland
cancer
disorders
Cataracts
disorder
Hepatocellular
Post-partum
Diabetic eye
carcinoma
mental health
disease
Pain and analgesics
Pancreatic cancer
disorder
Glaucoma
Palliative care
Metastatic cancer
Psychosis
The eye in systemic
(bone, liver, brain;
Schizophrenia
Disease
spinal cord)
Somatoform
Neuro-
disorders including ophthalmology –
somatisation &
diplopia, ptosis, visual
hypochondriasis
field defects and
pupillary defects
33
Care of the Older Person (COOP)
You will be primarily based at the Whittington, UCLH or the Royal Free Hospitals. You will
have seen very many elderly patients during year 4. The COOP attachment aims to help
you to understand how illnesses present in older people, how to undertake a full history,
including a collateral history, and examination in an older person and the management of
common conditions. The attachment offers a mixture of structured seminars, ward based
teaching, teaching within the general practice setting (one session each week) and facilitated
bedside teaching.
Core competencies
There are a number of core conditions that you should know about in COOP. These are
listed in the core conditions and presentations list on page 32.
By the end of the module you should be able to:
Communicate effectively and courteously with older people
Demonstrate the ability to take a full history including social and functional history
(past and present) from an older person and third party history (from relative, carer, GP)
and present it in a clear manner both verbally and in writing
Demonstrate the ability to examine and elicit physical signs in an older person
Demonstrate an understanding of the functional assessment of an older person
Demonstrate an understanding of assessment within the home environment
Recognise the patterns of presentation of illness in older people
Understand the common problems of old age seen in the community
Understand that a precise diagnosis may not be possible in all older patients and
learn to tolerate such diagnostic uncertainty
Have a basic understanding of the principles of rehabilitation
Demonstrate an understanding of the law and of basic ethical concepts relevant to older
patients
Demonstrate an understanding of frailty, impairment, disability and handicap
Formulate a problem/diagnostic list and management plan for individual patients
Differentiate acute medical, rehabilitation and discharge or placement agendas
Respect and understand the professional contribution of other health care workers
Outline the different care settings in the community
Psychiatry
You will have seen patients with psychiatric illness throughout your training and had some
psychiatry teaching in year 4. The aim of the year 5 attachment is to develop an
understanding of how severe mental illnesses present and are managed, how to take a
full psychiatric history and carry out a mental state examination.
Most of the psychiatry attachments are based within Camden and Islington NHS
Foundation Trust but Barnet, Enfield and Haringey NHS Trust, North and South London
Priory Hospitals also host attachments. You will also receive teaching in a GP setting for
two half days as well as a Primary Care mental health teaching session during the Friday
CPP session. The GP attachments have been organised so that you have an opportunity to
interview and assess patients independently, and see patients with the core psychiatric
conditions of depression and psychosis.
There are a number of core conditions that you should know about in psychiatry. These are
listed in the core conditions and presentations in Section 5.
34
Core competencies
By the end of the module (and from learning in year 4) you should be able to:
take a structured psychiatric history
take a collateral history
assess the mental state of a patient
carry out a cognitive examination, assessing orientation, attention and concentration,
memory, visuospatial skills (e.g. by copying intersecting pentagons), expressive and
receptive dysphasia and executive functioning
assess risk, including suicidal intent
assess appropriate investigations and make a treatment plan
recognise psychiatric morbidity in non-psychiatric settings
know how the Mental Health Act and Deprivation of Liberty safeguards are used
know the main psychotropic drugs used, including the most common and serious
potential side effects
Cancer medicine and palliative care
One person in three in the Western world will experience malignant disease at some
stage of their lives. You will have seen patients with cancer throughout your training and
had teaching and patient-based experience during the cancer patient pathway. This
module builds on this learning and the aims of this attachment are to develop an
understanding of the principles of assessment and management in cancer medicine
and palliative care.
For your cancer medicine attachment, you will be based at UCLH or the Royal Free
Hospital. You will also spend two half days learning about palliative care: one as a clinical
attachment and the other as interactive seminar based teaching.
There are a number of core conditions that you should know about in cancer and
palliative care. These are listed in the core conditions and presentations in Section 5
Core competencies
By the end of the module (and from the patient based learning in year 4) you should
have improved your ability to communicate with cancer patients
have improved your technique in history-taking and physical examination in cancer
patients
be developing a facility for elucidating cancer related problems
be familiar with some of the emergencies that can befall cancer patients and
have a knowledge of how they can be ameliorated. These include spinal cord
compression, superior vena cava obstruction, sepsis in the presence of
neutropenia, acute uraemia
hypercalcaemia, intestinal obstruction, tense ascites, acute shortness of
breath, and confusional state.
have some knowledge of the role of radiotherapy and chemotherapy in the
management of cancer, the different approaches for radical and palliative therapy,
and the types of toxicity they produce.
Understand the basic principles of palliative care (definition, brief historical context,
how it works in practice, type of conditions and the range of patients where palliative care
applies
35
Understand the relevance of thorough history and examination in pain assessment
Be aware of WHO pain ladder and use of opioid and non-opioid medications
Recognise the value of acknowledging that some of your patients do die, and know
how to use this to improve patient care
Demonstrate an understanding of common symptoms at the end of life and their
treatment
Outline how different health care professionals and teams can contribute to patient
care in cancer medicine during treatment and at the end of life.
Outline the ethical principles of withdrawing treatment at the end of life and ceilings
of care.
Palliative Care Objectives
These objectives should be met through direct interaction with a patient and/or family
member in palliative care service in addition to time spent with healthcare professionals
discussing cases and the different elements of palliative care. It is really important that
students get the opportunity to meet patients – including those that are dying when possible
and with patient consent.
By the end of the placement students should be able to
Apply knowledge gained about palliative care to appropriate patients (e.g. during the
rest of year 5). This will be tested and reinforced during the palliative care seminar
which follows the placements during the oncology block.
Give examples of physical, psychological, social and spiritual problems and how
these can be addressed
Describe how the multidisciplinary palliative care team can improve a patient’s
quality of life
Explain how different services interact with each other to provide palliative care to
patients and facilitate someone to die at home, the range of palliative care services
available and when specialist palliative care services should be involved
Ophthalmology
A structured introductory teaching day in Ophthalmology is at Moorfield’s Eye Hospital on the
Monday with clinical teaching at The Royal Free Hospital, Whittington, UCLH, Barnet and
Edgware hospitals from Tuesday to Friday. Students are offered a comprehensive mix of
clinics and theatre allowing them to gain an understanding of the various facets of the
specialty, for example, Oculoplastics, Vitreoretinal Surgery, Glaucoma, Neuro-
Ophthalmology, Medical Retina, Accident & Emergency (A&E), and the External Eye.
Teaching is continuous and extends throughout all operating sessions. Some topics may not
be presented in the clinic or at core teaching, but are specifically taught within the theatre
environment. Students therefore are strongly encouraged to attend theatre. They are not
expected to stay throughout all day lists but their attendance will enhance their level of
knowledge on each and every occasion that they attend.
There are a number of core conditions that you should know about in ophthalmology. These
are listed in the core conditions and presentations in Section 5
The aim is to ensure that students:
Recognise the different patterns of presentation of eye disease
Understand the following conditions:
36
The Red Eye - differential diagnosis
Causes of Acute Visual Loss
Causes of Gradual Visual Loss
Understand why the eye is relevant to systemic diseases
Understand the risk factors, signs and treatment of Ophthalmic Malignancy
Understand the common conditions of Paediatric Ophthalmology
Are able to take a full history including present ophthalmic complaint and past ocular
history
Understand the principles of a screening program and to be aware of the screening
process
Understand how to assess an eye that has lost vision and the urgency with which it
needs to be referred
Understand which cases should be referred to the Ophthalmologist
During your week long attachment you should ensure that you have practiced the following
procedures:
Take a red eye history and formulate differential diagnosis
Take a history of acute painless visual loss and formulate a differential diagnosis
Take a history of gradual vision loss and formulate a differential diagnosis
Assess visual acuity including pin hole, assess pupillary responses – direct, consensual
and relative afferent papillary defects
Assess visual fields on confrontation
Assess extraocular eye movements including saccades and accommodation
Assess colour vision as an assessment of optic nerve function
To be able to assess the disc and posterior pole with use of a direct ophthalmoscope
You should have seen:
Cataract Operation
Refraction
LASER treatment
Tonometry
Optical Coherence Tomography
Diagnostic tests: Fundus fluorescein angiography and Humphrey Visual Field
Applanation Tonometry
37
ENT
ENT teaching and learning is organised and delivered mainly at the Royal Throat Nose and
Ear Hospital in Grays Inn Road. The aim of the attachment is to show medical students the
wide variety of work which exists within the disciplines of ENT surgery and audiological
medicine. As a major postgraduate ENT hospital and Institute we treat both common and
rare diseases. Students are expected to be present at ALL tutorials and it is a rare event for
one of these to be cancelled. Senior staff are assigned to students and asked to give them
absolute priority. As this requires considerable commitment from the staff, we do expect the
students to attend. Likewise, attendance is expected at outpatient sessions where students
will find a surprising amount of medicine, paediatrics and immunology, etc., in the general
ENT surgical clinics. It is usually possible to have no more than two students with any given
doctor and all staff are expected to teach the students with enthusiasm and commitment.
Any members of staff failing to do this should be reported directly to the firm lead.
Teaching is continuous throughout all operating sessions and many of the topics in theatre
will not be presented during tutorials or outpatient sessions, but are specifically taught
within the theatre environment. Examples of tracheostomy, the basics of sutures and
needles, laser surgery, endoscopy etc., are all taught within the theatre environment.
Students are encouraged to come along with enthusiasm for periods of 90 minutes to 2 hours.
They are not expected to stay throughout all day lists but they will receive good tuition on
each and every occasion that they attend.
There are a number of core conditions that you should know about in ENT. These are listed
in the core conditions and presentations in Section 5.
Core competencies
During your week long attachment you should ensure that you have practiced the following
procedures
Performing a hearing test
Examinations of the pharynx and larynx
Using an auroscope to examine the ear
38
Section 5: Core Conditions and Common Presentations
The field of medical knowledge is vast and increases exponentially: you cannot learn the
whole of medicine in an undergraduate programme, or even in a whole professional life as
a doctor. The MBBS programme at UCL aims to provide you with a foundation to
continually learn as a health professional. Part of this is to develop a good understanding of
a core group of conditions.
Below is the list of core conditions and presentations that underpin the learning in the
MBBS programme. Some presentations are very common in primary care and hospital
settings. Some are less so, but are important to understand and to know how to diagnose
and manage. Some conditions have long been health challenges, some are increasingly
important as we move into the 21st century.
These common presentations should form
the basis of your learning but remember that they are not exhaustive. You should
pay particular attention to a detailed list of conditions given in each module.
Common presentations
Abdominal pain
Low back pain
Acute confusion and coma
Nausea / Vomiting
Blackouts / loss of
Obesity
consciousness
Palpitations
Bloating
Polysymptomatic
Change in bowel habit
Rectal or other GI bleeding
Chest pain
Shortness of breath
Cough
Sleep problems
Dizziness
Swollen Legs
Falls
Tired all the time
Fever
Urinary symptoms
Headache
Weight loss
Itching / pruritis
Wheeze
Cancers (if not included elsewhere)
Breast
Head and neck
Larynx
Metastatic cancer - bone, liver, brain
Prostate
Testes
39
Circulation and breathing
Arrythmias - atrial fibrillation, flutter, nodal tachycardia, ventricular ectopics,
tachycardia, fibrillation first, second & third degree (complete) heart block
Asthma
Blood vessel disorders (aneursyms, varicose veins, peripheral arterial
disease, atherosclerosis)
Chronic obstructive pulmonary disease including bronchiectasis
Heart failure and its consequences
Hypertension
Interstitial lung disease
Ischaemic heart disease
Pericarditis & tamponade
Pleural effusion
Pneumothorax
Respiratory cancers
Respiratory failure: type 1 and 2
SVC obstruction
Thromboembolism - arterial and venous
Upper and lower respiratory tract infections including infections in
immune-compromised patients
Valvular heart disease including infective endocarditis
Endocrine system regulation and Reproduction and Genetics
Adrenocortical insufficiency and excess
Diabetes mellitus type 1 and type 2
Diabetic emergencies: ketoacidosis, hypo and hyper glycaemia, hyperosmolar
non-ketotic coma
Disorders of calcium metabolism
Endocrine emergencies: Addisonian crisis, thyrotoxicosis,
myxoedema, phaeochromocytoma, pituitary failure
Gonadal dysgenesis
Lipid metabolism disorders
Metabolic syndrome
Pituitary and adrenal tumours
SIADH and diabetes insipidus
Thyroid cancer
Thyroid dysfunction: hyperthyroidism, hypothyroidism, goitre
Ear nose and throat
Acoustic neuroma
Acute vertigo/ Meniere's disease
Cholesteoma
Epistaxis
Facial palsy
Hearing loss
Obstructive sleep apnoea
Otitis media and externa
40
Otosclerosis
Pleomorphic salivary adenoma
Presbyacusis
Rhinitis
Safe perforations
Salivary gland disorders
Gastroenterology
Alcoholic liver disease
Anal conditions –abscess, haemorrhoids, fistula, fissure
Cancers of the bowel, stomach, oesophagus, liver and pancreas
Diverticular disease
Enteropathies and malabsorbtion,
Functional disorders of the GI tract
Gallstone disease
GI bleeding
GORD / dysphagia
Hepatitis, cirrhosis, drug related liver injury and metabolic liver disease
Infection & infestations of the GI tract
Inflammatory bowel disease
Jaundice
Obstruction
Oesophagitis / Barrett’s oesophagus
Pancreatic disorders - pancreatitis, insufficiency
Ulcers –peptic and duodenal
Haematology
Anticoagulation
Bleeding disorders: thrombocytopenia; DIC; haemophilia
Blood transfusion
Haematological malignancies: lymphoma; leukaemia; myeloma
Haemolysis including haemoglobinopathies
Iron deficiency
Megaloblastic anaemia
Neutropaenic sepsis
Polycythaemia
Thrombophilia
Infection and Defence
Bone and joint infection: osteomyelitis, septic arthritis of joints, TB
CNS infections: meningitis; encephalitis; abscess;
infections in the immunocompromised
ENT infections
Genitourinary infections: syphilis; gonorrhoea, chlamydia
Hepatobiliary infections
HIV
Imported fevers including malaria
Septic shock
41
Tuberculosis
Urinary tract infection and pyelonephritis
Vaccination
Viral hepatitis
Kidneys & urinary tract
Acute kidney injury
Acute nephritic syndrome
Bladder and urothelium cancers
Chronic kidney disease
Diabetic nephropathy
Glomerulonephritis
Hypertension & the kidney
Kidney cancer
Microscopic haematuria
Nephrotic syndrome
Prostatic hypertrophy
Renal replacement therapy
Upper urinary tract obstruction, hydronephrosis
Vesicoureteric reflux and nephropathy
Movement and musculoskeletal biology
Bone cancers
Common disorders and injuries of the hip, knee, ankle, foot, neck, back,
shoulder, elbow, wrist and hand
Common fractures of upper and lower limbs including principles of treatment
Compartment syndrome
Connective tissue disorders (inc SLE)
Gout & pseudogout
Inflammatory arthropathies (inc RA)
Management of spinal injuries
Metabolic bone disease e.g. Paget's, osteoporosis and Vitamin D
Osteoarthritis
Rehabilitation after joint replacement, fractures or severe injuries, especially
spinal injuries
Seronegative arthritis
Mental health
Alcohol and substance misuse
Anxiety including generalised anxiety disorder, phobias, PTSD and
OCD
Deliberate self harm and assessment of suicide risk
Dementias (psychiatric aspects of)
Eating disorders : anorexia and bulimia
Mental health problems in people with learning disabilities
Mental health problems in older people
Mood (affective) disorders including depression and bipolar disorder
Personality disorders
42
Post-partum mental health disorders
Psychoses, and schizophrenia
Sexual dysfunction
Somatoform disorders including somatisation and hypochondriasis
Neuroscience
Cerebrovascular disease including TIAs, intracerebral thrombosis and
haemorrhage
Cranial nerve lesions
Delirium
Dementias - vascular, Alzheimer's, Lewy Body, Fronto-temporal
Functional neurological disorders
Guillain-Barre syndrome
Intracranial and spinal tumours
Migraine
Motor neurone disease
Multiple sclerosis
Myaesthenia gravis
Myopathies
Nerve root and cauda equina compression
Organic causes of psychiatric disorders
Parkinson's disease
Peripheral and autonomic neuropathy
Seizure disorders
Spinal cord compression
Ophthalmology
Acute and gradual visual loss - causes
Cataracts
Children and the eye
Diabetes and the eye
Eye in systemic disease
Glaucoma
Neurophthalmology – diplopia, ptosis, visual field defects, pupils
Red eye
Screening & public health in ophthalmology
43
Plastic surgery / skin
Acne
Benign & malignant lesions of skin and oral mucosa
Blistering disorders
Breast reconstruction & reduction
Burns
Cutaneous infections
Cutaneous manifestations of systemic disease
Dermatological emergencies
Papulosquamous disorders -eczema, psoriasis, lichen planus
Pigment disorders
Pressure sores
Surgical care and interventions
Acute abdomen
Benign breast disease: fibroadenoma and cyst
Benign enlargement of the prostate
Bowel obstruction
Causes of persistent fistulae
Diagnosis & management of shock
Diagnosis of postoperative pyrexia
Haemorrhoids
Hernias
Lipoma, cysts, ganglion, inclusion dermoid, warts & moles
Phimosis, paraphimosis, balanitis
Testicular problems including maldescent and torsion
Urinary calculi: renal, ureteric & vesical
Women's health
Abnormal menstruation including menorrhagia, dysmenorrhea,
intermenstrual bleeding, postcoital bleeding and postmenopausal bleeding
Benign gynaecological conditions including: pelvic pain, endometriosis and
polycystic ovarian disease
Genital tract cancers including ovary, uterus, cervix, vagina and vulva
Menopause and postmenopausal health
Urinary incontinence
Vaginal discharge
Congenital genital tract abnormalities
Contraception
Termination of pregnancy
Female genital mutilation
Infertility – causes, investigations and treatment
Complications of early pregnancy, including miscarriage and ectopic
pregnancy
Care of the pregnant woman
Drugs in pregnancy
Fetal development –normal and abnormal
44
Medical complications of pregnancy, including pre-eclampsia, gestational
diabetes, cholestasis
Labour and delivery of the baby and placenta – normal and abnormal
Obstetric emergencies – intrapartum hypoxia, antepartum and postpartum
haemorrhage, eclampsia, sepsis, delivery emergencies, amniotic fluid
embolism
Postnatal care and puerperal complications
Special situations
Anaphylaxis and allergy
Deprivation of liberty
Domestic violence
Drug reactions
Health promotion
Major trauma
Medically unexplained symptoms
Multiple co-morbidities, especially in the elderly
Pain and analgesics
Palliative care
Public health disasters
Safeguarding including child protection, female genital mutilation
45
Section 7: Medical Student Code of Conduct
UCLMS enjoys a reputation as a world class medical school and prides itself on creating Tomorrow’s UCL Doctors
-
highly competent and scientifically literate clinicians, equipped to practise person-centred medicine in a constantly
changing modern world, with a strong foundation in the basic medical and social sciences. As a medical student you will study for a degree which, in conjunction with the General Medical
Council’s Medical Licensing Assessment, allows you to work as a Foundation doctor. UCLMS has
a duty to ensure that its students can fulfil the requirements of the General Medical Council, both
for studying medicine and for working as a doctor, and it fulfils this duty by enabling students to
acquire the knowledge and to develop the skills and attitudes appropriate to their future role.
These include professional behaviour and fitness to practise right from the start of the programme.
UCL medical students are therefore required to abide by this medical student code of conduct
and MBBS policies set out at:
www.ucl.ac.uk/medicalschool/staff-students/general-information/a-z. With relation to fitness to practise, you are specifically required to declare any issues which
might affect your fitness to practise and to carry a student support card outlining any restrictions
to your practice or special requirements and to present the card to each educational supervisor
to whom you are attached so that they are aware of your circumstances.
This code of conduct sets out the School’s expectations of you as a UCL medical student and
must be read in conjunction with:
MBBS policies set out at:
http://www.ucl.ac.uk/medicalschool/staff-students/general-
information/a-z.
Policies specific to conduct include:
o Absence reporting
o Honesty and probity
o Additional placement-related
o Patient confidentiality
experience
o Patients in medical education
o Attendance and engagement
o Personal beliefs
o Communications
o Use of social media
o Concerns over Professional
o Student Support Card
Behaviour(s)
o Substance use and misuse
o Dress and Behaviour
o Disclosure and Barring Service
checks
o Duties of a doctor and student ethics
o Exceptional Leave
o Fitness to Practise proceedings
o Freedom of information
o Harassment and bullying
o Health clearance /Immunisations and
BBVs
46
General Medical Council policies set out at:
o http://www.gmc-
uk.org/guidance/good_medical_practice.asp
o http://www.gmc-
uk.org/guidance/good_medical_practice/duties_of_a_doct
or.asp
o http://www.gmc-
uk.org/education/undergraduate/professional_behaviour.
asp
If you anticipate any difficulty adhering to any element, please make an
appointment with a Student Support Tutor who will discuss with you how best
to reconcile it.
Students are advised to join either the MDU or the MPS, both of which
offer free student membership and provide advice in the event of
medical student negligence.
In the interests of public safety, in accordance with GMC and NHS
requirements, and in your own best interests, information pertinent to
your educational achievements and to your fitness to practise may be
shared by UCLMS with training providers, employers, regulatory
organisations as set out in the School’s privacy notice. Additionally,
details of students who are excluded from UCLMS on fitness to
practise grounds will be shared with the Medical Schools Council
(MSC) for inclusion in their database of excluded students, which is
accessible only to other schools with courses leading to entry to a
registered profession in the UK.
1. Attendance through the programme must fulfil the number of
theoretical and practical hours required for undergraduate medical
training. To achieve this level, you are expected to attend between
9am – 5pm on Monday, Tuesday, Thursday and Friday and 9am –
12.55pm on Wednesday and to attend some teaching events
starting at 8.00am or finishing at 6.00pm. During Years 4-6 there
may be occasions when you are also expected to attend in the
evening, early morning and at weekends. You are also expected to
spend a minimum of 10 hours per week in personal study outside
the programme.
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2. You are required to inform us of any absence from teaching
following the process set out in the School’s attendance and
engagement policy. Exceptional leave may only be taken with prior
permission after completing the process set out in the School’s
authorised leave policy.
3. You must listen to patients and respect their views, treat them
politely and considerately, respect patients' privacy and dignity and
respect their right to refuse to take part in teaching.
4. You must not allow personal views about a person’s age, disability,
lifestyle, culture, beliefs, ethnic or national origin, race, colour,
gender, sexual orientation, marital or parental status, social or
perceived economic status to prejudice your interaction with
patients, teachers, professional services staff or colleagues.
5. You must be honest. You must not abuse the trust of a patient or
other vulnerable person. You must not plagiarise material from
other sources and submit it as your own work. You must not
present false information or omit important information in your
dealings with the Medical School or in any application related to
your studies, including UCAS form and Foundation School
application. Dishonesty is a fitness to practise issue.
6. You must not enter into an improper personal relationship with
another person, for example, with a school pupil whom you are
mentoring or a member of staff who is teaching you.
7. You must always make clear to patients that you are a student and
not a qualified doctor. Introducing yourself as a “medical student” or
“training to be a doctor” is preferable to describing yourself as a
“student doctor”. You must always act within the direction of your
educational supervisor(s) and within the remit and competencies of
a medical student.
8. You are bound by the principle of confidentiality of patient records
and patient data. You must therefore take all reasonable
precautions to ensure that any personal data relating to patients
that you have learned by virtue of your position as a medical
student will be kept confidential. You must not discuss patients with
other students or professionals outside the clinical setting, except
anonymously. When recording data or discussing cases outside the
clinical setting you must endeavour to ensure that patients cannot
be identified by others. You must respect all hospital and practice
patient records.
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9. You must maintain appropriate standards of dress, appearance,
and personal hygiene so as not to cause offence to patients,
teachers, or colleagues. The appearance of a student must not be
such as to potentially affect a patient’s confidence in their
professional standing.
10. You must be aware of safe drinking guidelines for alcohol and to
adhere to these guidelines. Misuse of alcohol and any use of an
illegal drug is a fitness to practise issue.
11. To ensure appropriate communication, students are required not to
cover their faces in any part of the programme, including
assessments/examinations, except where clinically indicated.
12. You are required physically to examine patients of both sexes
(which includes touching and intimate examinations) in order to
establish a clinical diagnosis, irrespective of the gender, culture,
beliefs, disability, or disease of the patient. In order to qualify as a
doctor in the UK, it is required that the practitioner is willing to
examine any patient as fully and as intimately as is clinically
necessary.
13. You must attend Trust inductions before taking up placements and
adhere to local Trust policies and procedures.
14. You must keep your health clearance and immunisations up-to-date
and inform the Divisional Tutor of any changes which might affect
your ability to undertake Exposure Prone Procedures, e.g. exposure
to, or infection with, blood-borne viruses. Exposure Prone
Procedures (EPPs) are practical procedures which carry a risk of
transmission of blood-borne viruses. If you have not had HIV and
Hepatitis C testing prior to entry to UCLMS, then you will be
required to undergo testing as part of your OH clearance or you will
not be able to do EPPs. If you opt not to undergo testing and hence
are not cleared for EPPs, you must carry a student support card to
present to your clinical placement supervisor explaining that you are
not cleared for these procedures and you must not perform or assist
in surgical procedures such as episiotomy in Obstetrics, and much
of Orthopaedic surgery. This will not stop you qualifying but may
have a bearing on your future career.
15. You must adhere to the local NHS Trust policy on infection control
during your clinical placements which includes bare arms below the
elbow.
16. You must inform us if you are investigated, charged with, or
convicted of a criminal offence during your time as a medical
49
student at UCLMS. Although you are required to have a Disclosure
and Barring Service check upon entering the School, you must also
inform us if you receive a subsequent warning, reprimand, caution
or conviction.
17. You must inform us if there is any significant change to your health
that might affect your fitness to study medicine or to practise as a
doctor. It is a student’s responsibility to recognise when they are ill,
to seek medical advice, to accept appropriate treatment, and to
recognise when their fitness for clinical work is, or could be
impaired.
18. You must maintain a portfolio as set out on year Moodle sites and
present it as requested.
Professor Deborah Gill (Director of UCL Medical School)
Dr William Coppola (Divisional Tutor)
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Section 8: Staff Contact Details
Year 5 MB BS - General Contacts
Year 5 Manager (Curriculum & Assessment)
Paula Raftery
xxxxx.xxxxxxx@xxx.xx.xx
0207679 0858
Year 5 Student Administrator
Errol Lobo
xxxxxx.xxxxx@xxx.xx.xx
020 7679 0860
Academic Lead for Year 5
Jonathan Cartledge
xxxxxxxxxx@xxx.xxx
Deputy Academic Lead for Year 5
Melissa Whitten
xxxxxxxxxxxxxx@xxx.xxx
Student Support / Student Support Clinics
Student Support Team
xxxxxx.xxxxxxxxxx@xxx.xx.xx
020 7679 0859
NHS Bursaries
Errol Lobo
xxxxxx.xxxxx@xxx.xx.xx
020 7679 0860
Module A: Child and Family Health with Dermatology (CFHD)
Module Lead
Eddie Chung
xxxxx.xxxxx@xxx.xx.xx
Module Manager
Yusuf Ozkizil
x.xxxxxxx@xxx.xx.xx
020 7679 6101
Paediatrics
Academic Lead
Eddie Chung
xxxxx.xxxxx@xxx.xx.xx
Administrator (Bloomsbury)
Yusuf Ozkizil
x.xxxxxxx@xxx.xx.xx
020 7679 6101
Administrator (Bloomsbury)
Natalie Cassius
x.xxxxxxx@xxx.xx.xx
020 7679 6102
Administrator (Whittington)
Billie Josef
x.xxxxx@xxx.xx.xx
020 7288 5310
Administrator (Royal Free)
Nadine Mason-Bertrand
x.xxxxxxxxxxxxxx@xxx.xx.xx
020 3108 9875
DGH (Paediatrics)
Contact Yusuf Ozkizil or the local DGH Administrator
Child Psychiatry
Academic Lead
Michael Groszmann
xxxxxxx.xxxxxxxxx@xxx.xxx
Core GP (4 week block)
Academic lead
Sophie Park
xxxxxx.xxxx@xxx.xx.xx
Administrator
Hallie Cook
xxxxxx.xxxx@xxx.xx.xx
020 7794 0500 ext 31004
Dermatology
Academic Lead (Whittington)
Chris Duhovic
xxxxx.xxxxxxx@xxx.xxx
Contact Academic Staff
Academic Lead (UCLH)
Jennifer Crawley
xxxxxxxx.xxxxxxx@xxxx.xxx.xx
via Dermatology
Academic Lead (Royal Free)
Mark Griffiths
xxxx.xxxxxxxxxx@xxx.xxx
Administrators
GP Primary Care Placements (for Core GP, see above)
Academic Lead
William Coppola
x.xxxxxxx@xxx.xx.xx
Teaching Admin Lead
Kristina Narvet
x.xxxxxx@xxx.xx.xx
020 7794 0550 ext 31004
Administrator Child Health in PC
Hallie Cook
xxxxxx.xxxx@xxx.xx.xx
020 7794 0550 ext 31004
Administrator Women’s Health in PC
Besheer Abbaro
x.xxxxxx@xxx.xx.xx
020 7794 0550 ext 31004
Administrator Dermatology in PC
Besheer Abbaro
x.xxxxxx@xxx.xx.xx
020 7794 0550 ext 31004
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Module B: Women’s Health and Men’s Health (WHMH)
Module Lead
Melissa Whitten
xxxxxxxxxxxxxx@xxx.xxx
Deputy Module Lead
Jonathan Cartledge
xxxxxxxxxx@xxx.xxx
Module Manager
Jennifer Rattray
x.xxxxxxx@xxx.xx.xx
020 3108 9249 (M/Tu)
020 7679 0837 (W/F)
Obstetrics & Gynaecology
Academic Lead (Bloomsbury)
Ephia Yasmin
xxxxx.xxxxxx@xxxx.xxx.xx
Administrator (Bloomsbury)
Wendy Pereira
x.xxxxxxx@xxx.xx.xx
020 7679 0839 (M/W/F)
Joint Academic Lead (Whittington)
Amma Kyei-Mensah
Contact via Stephanie Woods
Joint Academic Lead (Whittington)
Amali Lokugamage
Contact via Stephanie Woods
Administrator (Whittington)
Stephanie Woods
x.xxxxx@xxx.xx.xx
020 7288 5433
Academic Lead (Royal Free)
Joanne Hockey
Contact via Jennifer Rattray
Administrator (Royal Free)
Jennifer Rattray
x.xxxxxxx@xxx.xx.xx
020 3108 9249 (M/Tu
020 7679 0837 (W/F)
GU/HIV Medicine
Academic Lead
Jonathan Cartledge
xxxxxxxxxx@xxx.xxx
Administrator
Lydia Clinton
x.xxxxxxx@xxx.xx.xx
020 3108 2084
Breast Surgery
Academic Lead (Bloomsbury)
Gloria Petralia
Contact via Laura Alfisi or
Administrator (Bloomsbury)
Wendy Pereira (from Nov 2017)
x.xxxxxxx@xxx.xx.xx
020 7679 0839 (M/W/F)
Academic Lead (Whittington)
Gloria Petralia
Contact via Stephanie Woods
Administrator (Whittington)
Stephanie Woods
x.xxxxx@xxx.xx.xx
020 7288 5433
Academic Lead (Royal Free)
Debashis Ghosh
Contact via Jennifer Rattray
Administrator (Royal Free)
Jennifer Rattray
x.xxxxxxx@xxx.xx.xx
020 7472 6220
Urology
Academic Lead (Bloomsbury)
John Hines
Contact via Zoe Lau
Academic Lead (Royal Free)
Vibhash Mishra
xxxxxxxxxxxxx@xxx.xxx
Academic Lead (Whittington)
Chitale Sudhanshu
xxxxxxxxx.xxxxxxx@xxx.xxx
Administrator
Zoe Lau
xxx.xxx@xxx.xx.xx
020 7472 6220
52
Module C: Health of the Older Person, Ophthalmology, Oncology, Psychiatry and ENT (HOPE)
Module Lead
Johnny Swart
xxxxxx.xxxxx@xxx.xxx
Module Manager
Deana D’Souza
d.d'xxxxx@xxx.xx.xx
020 7679 9460
Psychiatry
Academic Lead
Suzanne Reeves
xxxxxxx.xxxxxx@xxx.xx.xx
Administrator
Deana D’Souza
xxxxxxx@xxx.xx.xx@ucl.ac.uk
020 7679 9460
Administrator
Sandra Asante
x.xxxxxx@xxx.xx.xx
020 7679 9475
Health of the Older Person
Academic Lead (Bloomsbury)
Michael Yeung
xxxxxxx.xxxxx@xxxx.xxx.xx
Administrator (Bloomsbury)
Thameenah Hamid
x.xxxxx@xxx.xx.xx
020 7679 6276
Academic Lead (Royal Free)
Dean Noimark
xxxx.xxxxxxx@xxx.xxx
Administrator (Royal Free)
Tereze Bogdanova
x.xxxxxxxxx@xxx.xx.xx
020 3108 9226
Academic Lead (Whittington)
Johnny Swart
xxxxxx.xxxxx@xxx.xxx
Administrator (Whittington)
Billie Josef
x.xxxxx@xxx.xx.xx
020 7288 5310
Oncology & Palliative Care
Academic Lead (Oncology)
Ursula McGovern
xxxxxx.xxxxxxxx@xxxx.xxx.xx
Academic Lead (Palliative Care)
Sarah Yardley
xxxxxxxxxxxx@xxx.xxx
x.xxxxxx@xxx.xx.xx
Administrator (Oncology / Palliative Care)
Helena Ingram
xx.xxxxxxxxxxxxx@xxx.xx.xx
020 7679 6658
Ophthalmology
Academic Lead
Riaz Asaria
xxxxxxxxxx@xxx.xxx
Academic lead
Administrator
Anne-Marie Preston
xxxxxxxxxx.xxxxxxx@xxx.xxx
07867 780838
ENT
Shakeel Saeed
xxxxxxx.xxxxx@xxx.xx.xx
Academic Lead
Alam Hannan
xxxx.xxxxxx@xxx.xxx
x.xxxxxxxxxxx@xxx.xx.xx
Administrator
Margarita Bartholomew
xxx.xxxxxxxxx@xxx.xx.xx
020 7679 8966
CPP Academic Lead
Faye Gishen
x.xxxxxx@xxx.xx.xx
Head of MBBS Management for CPP and QA
Tor Wright
xxxxxx.xxx@xxx.xx.xx
020 7679 6127
Absence reporting
Please report all absences using the Online Absence Reporting and Leave Request form on Moodle.
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