Advice for a Clinical Medical Student

It’s the end of Phase 3 and with exam pressures looming and time increasingly being spent studying, moments of reflection creep in here and there.
What did I wish I did better?
What did I wish I knew earlier?
Some snippets of streams of thoughts for the taking.
You own your time and your degree. 
When you start clinical years, you’ve actually stepped foot onto the pathway to being a real-life doctor.
The passage through pre-clinicals may have been dark and blinded by lectures and timetables, but between then and now you’ve progressed around the bend and the real destination is in sight.
I know some guys and girls who are still missing their swaddled muslin inflatable eggshells.
Their reluctance to escape the womb may hold them back.
Start being proper, proper early. 
You’re in a position of responsibility. If you choose to be active on the wards, clerking patients, administering subcutaneous injections, installing venflons; you’re acting as part of the organism of the NHS.
These opportunities aren’t handed out to everyone.
Get up early, look smart, be punctual. The rule of ‘what you put in, you get out’ has never been more suitably applied than to your experience in clinics.
Work consistently through the year. 
You’re also in full responsibility of your own learning. Lecture capture is a thing of the past, the curriculum is mazed and wriggles from comprehension, and teaching sessions are not compulsory for teachers nor students.
Take it as it comes. Teaching happens when all the holes line up – and multiple factors are held in the balance. Probably the most important factor is whether your doctor-teacher is on call or not.
Don’t be afraid to ring ahead, get ahold of a bleep number, or have other plans as a back up.
Make life easier and learn on the job. On ward round, or with the F1s in the doctor’s office; ask about management for conditions. Each condition will have tiers of different medications and treatments, and it gets complicated. Start early and disperse the load.
My advice from a fifth year was to read up on one condition a day. He called me an ASSPIT.
A – Aetiology/ Epidemiology.
S – Symptoms
S – Signs
P – Pathogenesis
I  – Investigations
T – Treatment
Gaining exposure throughout the year is a sure-fire way to know the difference between the NYHA and the CHA2DS2VASC scores by exam time. You can’t out-caffeinate revision.
I have another friend who was mad enough to do the USMLE mid-year. It may have been a painful month, but she knows a lot of medicine now!
Get some books and do some reading. 
Kumar and Clark (Big and Little)
Oxford handbook of Clinical Medicine
Differential diagnosis.
Psychiatry PRN
The psychiatry handbook given to you by the Maudsley.
I survived on this. Add more. More helps.
For the exams – The opthalmology and haematology quizzes are really good.
I’m using for questions.
Use the NICE website to learn treatment guidelines.
(Update) – The NICE guidelines rock. Seriously.
Go to and choose Conditions.
Lo and behold, pops up the different systems in the body.
Click on Digestive Tract, for example, and up comes the conditions that YOU need to know about.
Click on a more specific condition and you have the option of seeing the NICE guidelines and the NICE Treatment pathway.
Loads of information, plus a handy visual aid to get things sorted in your head
If there is any one way to get zero favours or opportunities in hospital, it is to look like a rubyouupthewrongway and spoon fed toddler. Don’t throw your stethoscope out the pram if you don’t immediately get what you want.
Be nice, smile, and be present. If you spend time on the wards and get to know the doctors, they’ll get to know that you’re the one who wants to cannulate/ bleed/ catheterise / ABG a patient.
Spend time outside of hospital medicine. 
“Medicine – Spending my life trying to save yours” and other more emotional variations exist as memes on the internet.
It doesn’t have to be so. Yes, work hard. Yes, make opportunities and own your time. No, don’t die at 30 due to chronic stress, type A personality, with dearth of social networks and anhedonia.
I spent a lot of my year at The Yard Peckham and have met lots of non-medics (a must).
It’s a club where people go to sweat, wear expensive clothing and oosh oosh but they don’t fist-pump unless they’re lifting weights and exercising or have just finished.
I plan to cycle up and down some French mountains. I’ve also tried keeping in touch with people from Phase 2 (trust, can be hard), and people from secondary school (trust, can be even harder). I’ve failed at reading more books, but the to-read pile is growing expectantly.
I also learned Mandarin as an adjunct to medicine, inspired by spending time in Singapore last summer. 很好。
Lastly, I went to a few conferences, and helped out the Move Eat Treat team with their social media.
Move Eat Treat is Ace, and should be on the tip of your tongue before you say pharmacological intervention.
My year hasn’t been perfect (which is why I wish I knew a lot of these earlier, and there is still much to learn). I missed out on opportunities and I was a bit slow off the get-go. I didn’t give clinics my all in the first period of the year. However I’ll be satisfied when I pass my exams and I’m looking forward to MBBS4.
This has been a blast but I’m procrastinating, so I will head back to the ASSPIT that is heart failure, then learn all about Epilepsy drugs, their interactions and contraindications.


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