Thursday 4 August 2016

ADVICE FOR FINAL YEAR MEDICAL STUDENT UCC

Assalamualaikum, 


It’s been 2 months since I left Ireland for good and it’s August now. Before I forgot, let me just give some tips and tricks for final years UCC. Although, I’m not the best person to give advice, but just take it as a sharing experience for those who like to benefit.

Study hard, pray harder. First and foremost, congrats for making until this far. Just a few more months to go, keep striving hard to improve yourself. So, this post is dedicated for ye guys, hopefully it will benefit ye. Plan early and try to stick to it or at least improvise the plan.

Before going to each module, let me give a brief overview how final year gonna be like. Quoting from one of the senior, “In final year, you are learning the same thing from fourth year but a lot more stressful”. It’s because everyone is having high expectations on you including yourself. You have to start thinking like an intern now. Learn how to prioritise the differentials, management plans etc. Ask and you will get the answer. Don’t be afraid making of mistakes, because you will learn better from that. Be afraid of being complacent! Always challenge yourself.
"And the Hereafter is better for you than the first [life]." Surah A-Dhuha:4
During the rotations, be friendly and try make yourself useful to the team. Aim to present cases to consultants, registrar or interns every week so that you will get a hang of how to present cases concisely and from that you will know how to tackle the history and examinations better next time. Yes, you need to polish your examination skills thoroughly! Open up your heart and mind to critics, I know it’s hard. But, just take it positively for your own personal growth.

1.       Medicine:

It’s a huge module with the biggest credit, meaning you have to pay extra attention to it without neglecting others. There are General Practice, Geriatrics and Clinical Practice. Follow ward rounds and get involve in the team. I used OHCM, Pockets of General Practice(Prof. Bradley) and ABC Geri. Being a textbook person, I try to complement the big topics by reading Kumar and Clarks/Davidson and make some notes because I learn better when I make my own notes. But, it depends on your style of learning. (tp, kne speed reading ckt sbb panjang kn). Assesment is mostly from your consultants so, be proactive and impress them.

Further info psl assessment, please refer to the ucc module websites. In brief for finals, practise a lot for short case, long case, MCQs, and data interpretation. Find a partner to correct you and vice versa. Better if you make friends with the interns, and ask any patient with good findings. Mse nk final tu, survey from previous years what kind of cases yg usually came out. Usually lebih kurang je.

Mine, I got Mallow University Hospital for short case. Dpt A.fib, aortic stenosis, consolidation and MS. Doa byk2 consultant lembut hati and dpt case yg bole jwb.

2.       Research:

Try settlekn data collection and analysis as soon as possible especially gang yg away tu. So that, bole focus on the hosp rotations. Ble da siap sume, aim utk siapkan slides for presentation and REHEARSE EVERYDAY at least for those like me yg tak suke public speaking ni. Mintk advice kwn2 utk komen stle presentation and hntr kt supervisor utk cek slides for improvement. Then, you can focus on the write up which has 70% weightage. So, wt leklok ye? Lit review kalau sama dgn tajuk FYP, copy paste je xpe.. jgn wt last minit, nt cuak plk.

3.       Obstetrics and gynaecology:

The content is exactly the same dgn 4th year except that you will have to focus more on the favourite topics and read the guidelines. Read from RCPIàRCOGàNICE. The MCQs after rotation quite specific because they expect us to know the details. So, bce guidelines. Kalau xsume page pn, bce summary da ckp n hafal. Siapkn logbook n present case kt consultants every week. In the finals, jwb essay and ade long case. Again, practise makes perfect. I like to spot question based on the trends from previous years. Tp, risky ckt. So, ikt instinct msg2 la.. I used Impey for 0&G, pocket O&G and guidelines.

4.       Paediatrics:

Challenging because the content is very wide, just like adult medicine but in kids. So, plan carefully or else nt xsmpt bce ble msk finals. I used Sunflower (Illustrated Paediatrics) and pockets paeds mse ward rounds. Very handy to refer. For osce, practise and practise with your friends. Make sure to cover the history and master examinations thoroughly. Look at previous years and practise them. Make sure to master all the common conditions but not neglecting the serious ones like child abuse, neglect etc. During the finals, practise all the past years or at least read the feedback that Prof gave because it will gives you an overview of how Prof want the students to answer the questions.  One page of answer per question, so no room to ‘goreng2’if you know what I mean. Memorise the differentials for common topics and the investigation and management plan. All and all, they just want to know how safe are you handling kids as an intern.

5.       Surgery
Surgery in finals focused more on abdominal and vascular as well as other topics. So, read all of them because the MCQs are very specific. Follow all the ward rounds and ask questions. I used Alisdairscott notes, OHCM, and other books too(xigt plk). It’s better if you practise answering data interpretation questions too. The most important topics that there want you to master is how to resuscitate patients, especially scenario like post-op patients etc. In the finals, make sure practise a lot of potential short cases. For me, I got CUH, and the cases are paraumbilical hernia, mastectomy male patient, ascites and incisional hernia. Brush up your examination skills. For long case, kne make sure cover the history in sequence, mention all relavant positive and negatives. Mcm patient presented with abdominal pain, list of the differentials git, urology-uti, gynae etc. Last but not least, know the first line investigation.

Quoted from kak zay:

Favourite questions for short case surgery:
A) ulcers: every type B) drains, tubes, lines C) stoma - diseases yg ended up dgn stoma whether temporary or permanent, ileostomy vs colostomy, loop vs end D) types of incisions/ scar Ulcers n stoma very common. X-rays n ct Abd pun kena biasakan describe. Akak dulu dpt 2 stoma, 1 ulcer, 3 pics with ortho n ent cases, thyroid exam. Ada station yg examiner suruh describe je cthnya stoma

Medicine can be varied. Tp for each sub specialties tu mmg ada at least satu disease yg almost every year keluar..tp depend dpt hospital mana gak. Summer: av fistula + history, neuro exam for stroke pt, Parkinson's, ECG for MI Winter: AS (cardio exam), CCF (respi exam on pt with pacemaker/defib), neuro exam on pt with hemiparesis, gi exam on jaundiced pt with ascites
buku short cases yg ramachandran n xpress tu hafal n practice. Short cases ni mmg kena biasakan exam pt dgn cepat n bg spot diagnosis. What is common in Irish people kena tau. Prof tony obrien suka tanya "if u can ask one question to this pt, what would u ask"..so kena terus ckp yg relevant cth for case of ascites due to liver disease, most common cause for Irish population is heavy alcohol intake. Most of the time mmg xsempat nk fikir jawapan pun..mmg kena bg jwpn terus bila examiner habis je bg soalan


Some extra tips from legend Bopek:
Spend time wisely kt hosp. bopek kata 2 minggu b4 finals, dia g hosp cari positive findings from patients..eg: renal transplant post-op pt. dtg kt pt, introduce sume, n tros inspect scar n palpate..krenye wt focused examination. so, dia advise start awl. study group from awl. final year mmg kne wt study group..2x sebulan.. doa3x..doa dpt examiner yg baik, dpt jwb dgn baik etc


Most importantly, betulkn niat selalu.. Begin with the end in mind bak kata Steven Covey.