So November is drawing to an end, and in medical school, this means it’s time for exams.
Since my last blog, I have completed the cardiovascular block of the course, covering hypertension, valvular heart disease, arrhythmias, and heart failure, as well as the medical and surgical management of these conditions. We’ve looked at a range of diagnostic tests and learned how to carry out cardiovascular examinations: how to take a detailed medical history, what peripheral signs to look out for on hands, skin and the face and what sounds to listen for when you place the stethoscope on the patient’s chest.
Following on from this intense four weeks, I really felt like I could have used a reading week to consolidate everything we had learned, but instead was thrown straight into the gastrointestinal block. This made me realise just how much extra reading and practice of clinical skills needs to be done outside of class. There’s a reason why physician associate studies is advertised as a full-time course!
After sitting the first exam of my postgraduate career last week, I thought I would take this opportunity to explain how the first year of physician associate studies is assessed at Swansea.
Foundations in Clinical Medicine for Physician Associates – 1/3 of the mark
This module is what takes up the majority of our teaching time. It forms the underlying knowledge required to understand the anatomy, physiology and pathophysiology of each body system covered throughout the course.
This module is tested with a “single best answer” exam where we are given a clinical problem e.g. a 57-year-old man walks into Accident and Emergency experiencing chest pain and shortness of breath. His BMI is 35 and he has type two diabetes. He currently takes Simvastatin and Omeprazole and he smokes 20 cigarettes per day. We then have to answer a question such as: what is the most likely diagnosis? What investigations would you do next? Which medication from this list could be causing his symptoms? What would be the best management plan for this patient? The questions are followed by five possible answers and we have to choose the single best one.
That means, it’s not as simple as a multiple-choice question whereby there is only one correct answer. It’s possible that multiple answers are logically correct, but we must choose the most correct; so for example, if two investigations would be helpful in finding the cause of a patient’s symptoms, both of those answers might be right, but you would have to pick the one that would typically be carried out in practice. You would therefore have to think about the NICE guidelines, the pros and cons of both investigations and any factors about the patient which may mean one particular investigation isn’t appropriate.
Clinical Skills for Physician Associates – 1/3 of the mark
The next module, clinical skills, is exactly what it says on the tin. In this module we are taught how to take a thorough medical history, how to examine a patient, how to carry out investigations, interpret test results and perform procedures such as injections, cannulation and stitching wounds. This module is assessed through exams called OSCEs (Objective Structured Clinical Examination) and we also get skills ticked off by our placement supervisors once we are deemed competent.
Human and Health Sciences Modules – 1/3 of the mark
We also have smaller modules taught by the college of human and health sciences which covers sociology, psychology, health care law, ethics, research, evidence-based practise and reflection. These modules are assessed with essays and presentations and some of the legal and ethical factors can also pop up in the foundations of clinical medicine exam, where they could be relevant to choosing the answer that is medically, legally and ethically correct.
I sat my first foundations in clinical medicine paper last week and this week I have my OSCE which I will talk about in more depth next time.
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