Fifth and Final Year

The blog's rather quiet. I think everyone is still euphoric, the aftershock of passing the professional exam.
With the new grouping of final year students released, many of us had been asked "Is starting with this posting good? What to do? etc etc"
The only thing I can tell you is no matter what posting you kick off with, there's nothing you can do to change it. So just go and do it. ^^

But of course, there are some tips that can make end-of-the-world year more enjoyable. Here are some tips, which is fully my personal opinion. May vary according to individuals.

1) Does the initial and end posting matter?
Theoretically, yes. Imagine you ending the year with things like O&G and Paeds instead of Family Medicine. Sounds scary huh? But in reality, no. Whatever posting you are in, you need to be on your toes. Just work hard. If you end your year by being complacent, you are doomed to misery during your study month. Of course, some posting are more tedious than others, but if you are not on your toes, easy things becomes hell.

2) Is it stressful?
You are in medical school and you expect it not to be stressful in your final year? Of course its stressful! And tiring in some postings where you have to rush againts time to "cover bed" and study! The key is how you manage your stress. Take Saturdays when you're not on call to do what you like. Forget about can think about wards and studies any other day.

3) Is there a lot to read?
Well.... gone were the times when reading is the main thing in your life. You need to practice, especially the long cases. Of course you must read, but don't imprison yourself in the room 24 hours a day. Spend the day time practicing, spend the night time studying. Its time for targeted reading, meaning reading only the important stuff. Things like syringomyelia and dystrophia myotonica can be forgotten, but not Cerebrovascular accident.

4)How to practice?
Get a fully committed partner. Sounds gay but yes, do it. Do 1 long case every other day. The days in between, just do short cases. Make sure you know your subject before going into it. Don't trust your partner's knowledge, after your discussion u need to countercheck and re-read to reinforce your knowledge, and correct misconceptions.

5) I could not remember what I read. How?
Nobody can say that they remember everything they read, unless they try expressing it out. Try to express out what you read. Most of the time, remembering is not the problem. Its how you apply it. Thus, ask yourself, how will I be asked about this stuff in the long case?

6) Should I start reading now?
Except if reading is your enjoynment, I suggest you to treasure your free time now. :P

7)What are we expected to do?
You are a final year, you are expected to know everything, at least in principle. Do not be disheartened when you are humiliated in front of juniors, its part and parcel. Patch up your mistakes and do better.

8) So many stuffs, how to remember??
Personally, for those who know me, I remember my stuff because I tried to make other people understand it through teaching. Once people understand what I'm saying, it means I understood it too. The knowledge will stick to you like jejunum to ileum. But that does not mean I don't need to revise, it just makes my revision faster, and I know which part that I am unclear with and clarify it.

9) I am not you, I don't know how to teach.
Absolute nonsense. You are final year, if you don't know, who knows? -_-" If you don't want to teach, refuse study group, than there's only one way for you, isn't it? Study and talk alone. It will be extremely depressing.

10) What is Long Case, short case?
Long case format is: 45 minutes for you to clerk and examine and do simple bedside test, with the patient.
After that, you are not allowed to talk or examine the patient anymore. You have 15 minutes on your own to reorganize your thought and plan management.
After that, 30 minutes with 2 lecturers. They may bring you to see the patient, ask you to perform examination.
Cases are from Major postings: Internal Medicine, O&G, Paediatrics,Surgery. (the chief complain)
Psychiatry and Orthopaedics are NOT major postings.
Although the Chief complain is from the major postings, the patient might have some other problems in ENT, Psychiatry, etc.
Do not expect that your patient have only 1 problem. Its normally a cocktail of problems.
Don't worry about uncooperative or blur patients. The patients are extremely "well trained"

Short case: virtually anything under the sun can be tested, from Urinary catheter insertion to performing ERPOC. One station even asked you to call the consultant to report a case. -_-"
4 stations : 1 Internal Medicine, 1 Surgery or 0rthopaedics in ratio of 1:3, 1 O&G(the most creative department) and 1 Miscellaneous( includes Psychiatry, Paediatrics, ENT, Opthalmology)
10 minutes each station.

I summarise in the following
At the end of final year, students should be able to
1) have a thick face
2) Dare to ask, dare to answer, dare to do wrong, dare to correct self.
3) perform Hx taking, PE and give outline of Mx confidently and more importantly, correctly.
4) Manage emergencies
5) Pass professional exam in March.

Good luck and enjoy your fifth year in medical school!^^ Its definitely not final, yet.

Related articles: 
Back to Introduction toYear 5 clinical postings.

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