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Starting as a medical student 

Starting as a medical student
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Starting as a medical student
DOI:
10.1093/med/9780199681907.003.0001
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date: 26 October 2021

Congratulations!

Well done and congratulations on entering medical school! It has taken some blood, sweat, and possibly tears to get here, and you should feel proud of what you have achieved. You are about to enter a course of training from which you will emerge a highly skilled individual. You have tremendous potential to positively impact the lives of others, sometimes with compassionate words, other times with your intelligence or practical skills, and even through making new discoveries or forging new treatments. You are going to touch the lives of many people in a way that they will remember and be immensely grateful for. Remember this throughout your training, especially if at times things seem tough. You should expect that your time at medical school might sometimes be challenging for all sorts of reasons. But always remember the goal, what you said in your personal statement, and the immense privilege that lies in store during medical school, and after you qualify.

Medical school is a marathon instead of a sprint, so organization and time management are paramount to make the most of your course.

Before you start

Documentation

Prepare yourself for a plethora of paperwork in order to formally accept your position at medical school and begin your studies.

University acceptance package

Along with your acceptance letter, you will receive numerous important documents. Invest the time to read the contents, making a particular note of deadlines for submitting the necessary paperwork (often required many months prior to the course start date):

  • Course preparation material.

  • Fees and loan information.

  • Occupational health questionnaire and vaccination forms.

  • Disclosure and Barring Service (DBS) forms.

  • Halls of residence application forms.

Student loans

Applying for student loans is a long process and any delay in submitting your form can delay your loan approval. Students studying in England, Scotland, Wales, and Northern Ireland can apply online to the Student Loans Company. You may also need to send in evidence such as proof of identity, address, household income (in case of income-assessed category), and accounting reports. Your loan, depending on your financial circumstances, will be divided into the following:

  • Tuition fees (paid on your behalf to the university).

  • Maintenance loan (£4375–£7675 depending on your term address).

  • Maintenance grant (£50–£3354 depending on household income).

  • Special support grants (in certain circumstances only).

Some important notes

  • Graduate students are subject to different financial support.

  • Scottish students can apply to the Students Awards Agency for Scotland and are eligible for student loans (£940–£4500) and bursaries (Young Students’ Bursary, Independent Students’ Bursary, and Students Outside Scotland Bursary).

  • Welsh students are eligible for New Fee Grants and Assembly Learning Grants, in addition to the standard loans and grants.

  • Students in Northern Ireland will be charged a maximum of £3575 per year and may be eligible to the standard loans and grants.

Living arrangements

Living at home

Approximately 20% of students opt to live at home which can contribute to significant financial savings over the years. There is a common misconception that a consequence of living at home is social isolation, but this need not be the case. University offers the first real opportunity for many students to gain their first experience of genuine independence, and can represent a golden opportunity for your personal as well as professional development.

Halls of residence

These are usually guaranteed for first-year students. You will be given a tour of the halls on open days. Preference might be given to those coming from other cities. Important considerations when ranking your preferences include:

  • price per term

  • distance from main campus and hospitals

  • access links (e.g. walking, cycling, buses, trains, and driving)

  • catering services (some may be self-catering)

  • facilities (kitchen and bathroom-to-student ratio or en suite etc.)

  • neighbourhood (distance to city centre, and adjacent shops/services)

  • atmosphere and personality fit with current residents.

Private accommodation

(See Starting as a medical student Oxford Handbook for the Foundation Programme, second edition (OHFP2) p. 47).

Properties are listed in local newspapers, in shop windows, with estate agents, or on dedicated websites; but always see the accommodation before making your decision. If you decide to rent accommodation privately, ensure that the duration of your contract includes term time at least. All paperwork should be in order prior to starting the course including realistic estimates of water, gas, and electricity bills, and council tax. The websites listed in Box 1.1 specializing in university student accommodation may be useful.

Buying a property

Buying a property will require you to seek assistance from estate agents and mortgage advisers. Few students are in a position to consider buying a property in the region of their university, but willing parents/guardians looking for an investment opportunity might consider this option. Depending on your down-payment, mortgage loans and interest rates will vary according to your earnings and savings. Do not forget to account for associated costs including stamp duty, solicitor fees, and conveyancing fees. A fixed rate mortgage may provide some predictability regarding the repayment amount per month (versus tracker mortgages).

Occupational health clearance

Since you will be handling sharps and come into contact with bodily fluids, you will not be allowed to participate in clinical training until you have submitted the following appropriate health documentation.

Vaccinations

You need to provide evidence from your general practitioner (GP) or vaccination clinics on at least:

  • hepatitis B (including boosters)

  • measles, mumps, and rubella (MMR)

  • tuberculosis (bacillus Calmette–Guérin (BCG))

  • meningitis C.

You may also be required to show records for Haemophilus influenza type B (HiB), polio (inactivated polio vaccine (IPV)), pneumococcal meningitis, diphtheria, tetanus, and pertussis (DTaP), hepatitis C, and varicella.

Health questionnaire

You are required to give your personal contact details and declare any medical conditions (including those that do not require treatment), mental health disorders (e.g. addictions, depression, and psychoses), duration of previous sick leave (from school or work), current medications, use of recreational drugs, and any other information you think may be pertinent to your professional practice. You may also be asked to sign a consent form for the occupational health department to contact your GP for access to relevant parts of your notes.

Most health-related concerns which could influence your practice should have already been addressed before/at the application stage of applying to medical school. It is your responsibility as a future healthcare practitioner to provide any and all relevant information which may impact the care you can provide to patients. Withholding such information will invariably lead to professional disciplinary measures, and risk jeopardizing your place at medical school before it has even begun.

Criminal Record Bureau (CRB) check

You will be required to offer your personal contact details, national insurance number, addresses for the past 5 years, and any criminal offences that you have been prosecuted for.

Enjoy your holidays

Since you will become busy with medical school, new colleagues, and extracurricular activities, make the most of your holidays with your family and friends, travelling, and pursuing your hobbies.

Top 10 things to buy

You are starting a new chapter in your life, and you may benefit from buying a few new items to help get you off to a good start.

  1. 1. Clothes: everyone generally adopts two styles—casual and formal. You will need comfortable smart-casual wear for lectures, tutorials, and practicals (e.g. jeans, sweaters). When on hospital firms, you are expected to look professional with a shirt and formal trousers or a skirt; avoid wearing anything too revealing.

  2. 2. Books: most books will be available to borrow from the library. Yet, there may not be enough to lend out the more popular texts to every student in which case it may be worth buying them (even second-hand or from your seniors). You only tend to find this out once you begin your course and see what is available, so factor these costs into your balance sheet in the first month of medical school. There is no harm in waiting until the first few weeks of medical school have passed, during which time you can ask for advice from senior students, peers, or tutors and look at copies from the library to determine the most suitable books to buy if needed.

  3. 3. Laptop: essential, despite good computing facilities at every medical school, the luxury of answering online questions, writing up coursework, preparing presentations, and surfing for entertainment in the comfort of your own room means this is a necessary item for most students. Note that some companies, including Apple, offer educational discounts once you have a student card, so it may be worth delaying any new purchase until then. Software licences may also be bought at a reduced rate, or free, through the university, so do ask the IT department for advice on software you are considering buying.

  4. 4. Extra reading lights/extension cables.

  5. 5. Bed sheets and towels.

  6. 6. Stationery and rucksack.

  7. 7. Kitchen utensils: there will be some basic equipment already provided, but most students tend to bring their own as well.

  8. 8. Iron/ironing board.

  9. 9. Travel/railway card: cheaper than buying single tickets and you are likely to be eligible for more discount using your student ID card

  10. 10. White/lab coat: for use in certain laboratory/dissection classes (typically mentioned in the introductory documentation provided by the medical school either before you begin or in your first class).

Avoid rushing at the last minute to buy everything; it will take time to settle in, but having the right extension cables, cutlery, and stationery will make the transition a lot easier.

Buying a stethoscope

Invented by René Laennec at Necker-Enfants Malades Hospital in Paris (1816), the hallmark of medicine is the stethoscope. However, there are literally hundreds of choices available. Some are internationally renowned and some are disposable and for short-term use. It is worth investing in a quality stethoscope, which, if durable, will stay with you until the day you retire. You will require a stethoscope for most clinical examinations, in order to auscultate heart, breath, and bowel sounds, blood vessels, and measure blood pressure.

  • The diaphragm (larger circle in inset in Fig. 1.1) is designed for detecting high-pitched sounds with firm skin contact, while the bell (smaller circle) is intended for detecting low-pitched sounds with light skin contact.

  • Shorter tubing minimizes sound loss and transmits a better sound quality.

  • Pressing more firmly will enhance sound transmission.

  • You can switch from diaphragm to bell by twisting the chest piece.

  • The holes within the eartips should face you when inserted into your ears.

Fig. 1.1 Anatomy of a stethoscope.

Fig. 1.1 Anatomy of a stethoscope.

Reproduced from https://commons.wikimedia.org/wiki/File:Stethoscope.svg under Creative Commons Attribution-Share Alike 4.0 International license.

Uses

  • Auscultation : listening to breath, heart, blood vessel, and bowel sounds (including murmurs, abnormal breath sounds, bowel obstruction/ileus, and bruits).

  • Counting: heart and breathing rates.

  • Manually measuring blood pressure : listening for Korotkoff sounds using a manual sphygmomanometer.

  • Hearing aid: if you put the eartips in the patient’s ears and speak into the chest piece.

  • Measuring size of the liver: if you place the chest piece below the nipple and start scratching from the waist upwards until the sound becomes dull, this indicates the lower border of the liver.

The basics of stethoscopes

Brand

The most popular option is to buy a Littman stethoscope, but other brands include Welch Allyn, Tytan Merlin, and Reister, to name just a few.

Model

The commonest option is the ‘standard’ or ‘classic’ model. Stethoscopes can either be analogue, which is the standard choice, or digital, which are more expensive and usually reserved for specialists. By converting acoustic sounds into electrical signals, electronic stethoscopes (or stethophones) amplify volume, reduce ambient noise, differentiate between high- and low-frequency sounds, and are pressure sensitive. Many have Bluetooth compatibility to record, analyse, and store audiovisual data on your smartphone and laptop. While there are many stethoscopes available for clinical use, all that is required for your exams and clinical practice is the standard model of stethoscope with a bell and a diaphragm.

Specialist

There are dedicated stethoscopes for various medical specialities including cardiology, paediatrics, and respiratory medicine. Again, at this stage it is worth being aware of novel types of stethoscopes, to know what to avoid when purchasing your generic ‘standard’ model stethoscope.

Tips

  • Colour: almost every colour is available but many consider traditional colours (e.g. black) more appropriate than fluorescent pink.

  • Engraving: you may request an engraving when purchasing a stethoscope (e.g. name, email address/contact details if lost).

  • Offers: you may receive a good quality stethoscope or a substantial discount when signing up to the freshers’ fair. Also, look out for special offers from your medical school shop and professional bodies.

  • Price: there is no need to buy a very expensive stethoscope that is designed for specialities (e.g. cardiology) this early on in medical school. Most doctors use the standard model for their entire careers.

  • Infection control: it is good practice to sterilize your stethoscope after every use with alcohol wipes to prevent cross-infection between patients. Also clean the eartips regularly and avoid sharing them to prevent infection between users.

Paying for medical school

As one of the longest university courses, studying medicine requires effective financial planning to avoid spiralling debts. The longer course means that you will spend more by continuing to pay rent and living costs while missing out on 3 years of paid employment. You should therefore think carefully about your budget from the first day of medical school, and tally your monthly and yearly incomings and outgoings. You do not need be an accountant to make these simple estimates and avoid spending beyond your means.

Budget

It often helps to divide your outgoings into the following categories:

Rent

Depends on halls of residence versus private accommodation, catering facilities, size of place, en suite, suburb, and city. This is generally a fixed cost and therefore is easy to include in your estimates of monthly expenditure.

Utility bills

May vary again depending if you live in halls of residence (usually included in fees) or private accommodation (usually excluded), number of room/flat/housemates, but on average will come to £50–£75/month. Other bills such as a TV licence, Internet connection, and landline/mobile costs also need to be taken into account. As a full-time student, you may apply for council tax exemption through your university or GOV.UK (Starting as a medical student www.gov.uk). Again, this represents a fixed sum which can be accurately included in your estimates of monthly expenditure.

Food

You can still eat and drink well as a student as long as you spend sensibly. If your halls of residence have catering, you will receive breakfast and dinner included in the fees. You might consider bringing packed lunches to save money. A reasonable budget would be £30–£50/week which includes treating yourself to the odd takeaway or restaurant meal. Do not forget to find out which food outlets/restaurants offer a student discount, and be sure to register with an online voucher company for two-for-one and 50% discounts on meals (e.g. Starting as a medical student www.vouchercodes.co.uk, Starting as a medical student www.moneysavingexpert.com/deals/cheap-restaurant-deals).

Travel

Halls of residence are normally close to campus but you may need to make travel arrangements to hospitals. Universities near city centres have excellent public transport access so research your local amenities, and consider all the discounted options available, especially for regular predictable commutes e.g. travel pass, student rail card. Many students save money by choosing to cycle between sites. Occasionally, universities may offer some funding towards travel costs, particularly if you are required to travel a significant distance away from campus. For those with cars, applications for parking permits may be required for hospital sites or residential parking.

Textbooks and stationery

Most textbooks can be borrowed from the university library but popular textbooks on the recommended reading list may be worth buying. Set aside around £100 for books and stationery per year. Big savings can be made by buying used books from students in the years above or online. Universities may have online access to journals, textbooks, and databases. Be cautious about buying any scientific text that is more than a few editions old, as the material can be quite dated. Some useful websites include:

Entertainment

Work hard but also play hard. It is important to remember that while you have many years of important work ahead of you, relaxation and socializing are as fundamental to your success as learning medicine. A great deal of this should come without a price tag, as friends often make the best (and cheapest) distraction from studying. Be sure to broaden your horizons beyond the nightlife, explore the new city you have moved into, join clubs and societies at your student union, or just socialize with your new friends. You do not have to spend large sums of money to relax or enjoy yourself, and a sensible budget would be £40–£80/week depending on your location and financial circumstances.

  • The National Union of Students (NUS) offer the NUS card which entitles students to a wide range of discounts from restaurants, cinemas, high street shops, electronics, and travel.

  • Student Beans (Starting as a medical student www.studentbean.com) advertise the top 20 offers of the month as well as the offer of the week, saving you money on entertainment, food, clothes, and more. Surveys that pay you for participating are also advertised.

Sources of funding

Many students are financially independent and there are numerous resources available to fund your living expenses:

Student loan and maintenance grant

All students will be entitled to a student loan (to pay for tuition) as well as maintenance loans and possibly grants. Grants are subject to a means-tested assessment (of the household income) and do not have to be paid back. If you live at home during term time then you are likely to qualify for a smaller maintenance loan. Living and studying in capital cities may also yield higher loans. International students will have different criteria since tuition fees vary.

Organizations

Bank loans

High street banks and building societies offer professional development loans and graduate loans specifically to university students, such as the following organizations (subject to change):

The usual repayment period is up to 5 years and there is an option to start paying after graduating and working for a few months. Make sure that you take time to read the terms and conditions and consider the outcomes of fixed versus flexible interest rates. You should think very carefully about taking on additional unnecessary debts, and never take on instant payday loans; these can be offered as ‘fast cash’ with ludicrous (but often very well hidden) interest rates of >1000%.

It is very rare, but not unheard of, for medical students to be declared bankrupt, often precipitated by a series of these short-term loans, with serious personal and professional ramifications. Be cautious, and seek independent financial advice wherever necessary.

Overdrafts

These are also very helpful, especially if within a student account. You may also be offered lower interest rates and other incentives such as vouchers and discounts. Again, you should think very carefully about taking on additional unnecessary debts for short-term benefits, realizing that any expenditure will need to be returned (and often with significant additional cost to yourself).

Employment

You might be able to earn a little extra with part-time employment. Consider positions in the student union, local shops, gyms, telephone centres, or tutoring. Temporary employment during long summer holidays is also a popular option. You must be careful not to stretch yourself too thinly, as medicine is a demanding course and should remain your priority.

Allowance from parents or guardians

Offers a safety net in case you need funds in an emergency. If they have agreed to provide you with some financial support, it is probably sensible to receive the money by regular standing orders or direct debits rather than infrequent lump sums, which will also help you to budget.

Access to Learning Fund (ALF)/hardship funds

These are interchangeable terms in which the finance department of your university may be able to lend you small amounts (usually a couple of hundred pounds) in an emergency or due to unseen circumstances. This help is typically reserved for students from low-income families who need financial support to remain on the course. These are usually loans (repayable) and may become grants (non-repayable) at their discretion. Applications are assessed on an individual basis. You might be asked to provide evidence of parental income and your bank statements for the past few months to see if you are eligible for fiscal support. ALF is referred to as the Financial Contingency Fund (FCF) in Wales, Support Funds in Northern Ireland, and Discretionary Funds in Scotland.

State benefits

These are available on a means-tested or non-means-tested basis to select groups including students with dependents, disabilities, or long-term illness, for instance. The following websites may be helpful:

Prize money

A huge arena of open competition exists for medical students to win prize money. Obviously this forms a less reliable source of regular income, but can nicely supplement your income and boost your curriculum vitae (CV).

Scholarships

These are awarded on your academic merit:

  • Internal are offered by your medical school on the basis of your interview or exam performances by assessors. You may not be permitted to apply for specific ones. Ask the undergraduate medical school office for more information and to check your eligibility. Further information can also be found on your university website.

  • External are offered by other organizations and are usually based on applications. You may be asked to demonstrate academic merit by sending in your CV or an essay to the board members. Ask at your undergraduate medical school office or the Medical Student Union office for more details on external scholarships. The Royal Colleges, Royal Society of Medicine, and specialty associations offer a variety of prizes specifically for medical students.

Medical school prizes

Are usually reserved for those who score the highest marks in written and clinical exams at the end of the year. Hence, no one will be able to apply for these prizes. There may be other prizes you can apply for which may be awarded for undertaking an elective abroad, contributing to the student union, or volunteering. These prizes are still competitive but less so than national contents since these are reserved for your medical school only. This information can be found on your university website as well as on the Royal College websites that run medical student competitions (e.g. elective).

Charities

May offer scholarships or educational grants to students who may have a connection with the organization, their work, location, or background. Use a search engine to find these opportunities, and consider the following publications (published annually):

For more general and useful information for funding undergraduate and graduate medical students, visit the following websites:

Your first week

This will be a busy but exciting week, and you can expect to do the following:

Moving in

This will take considerable time. If you live in the city, it would be helpful to bring your car and some (ideally willing) parents and siblings to help you. You might choose to visit beforehand to establish what amenities will be available at your accommodation, before bringing the kitchen sink!

Freshers’ meeting day

This is the first time you will have a chance to meet with your year and interact with other students. This might take the form of a meet-and-greet in a large hall or over a barbeque. Use this opportunity to meet as many new faces as you can.

Freshers’ night/roadshow

This is the first evening of activities for medical students where you will mingle with your classmates and your seniors, and often be adopted by a ‘family’. Use this valuable resource to ask about anything that’s on your mind about medical school, the course, and halls of residence—they remember what it was like to be in your shoes and you’ll find everyone is eager to help and welcome you.

Freshers’ week

This consists of orientation and activities planned every day for you to familiarize yourself with your surroundings and mingle with your peers. Relax, meet new people, and enjoy the festivities. You will be spending 4–6 years with your year group and will find it easier to get through the course with supportive friends and classmates.

Introductory lectures

These will be given by a group of medical students, tutors, lecturers, and possibly an influential veteran or living legend of your university. You will listen to talks given by the dean, consultants, and professors about what to expect at medical school. They will give you some advice on how to make the most of your course, juggling extracurricular activities, professional conduct on firms, and tips on scoring highly in exams. Feel free to ask anything at the end of the lecture, either in front of your colleagues or in private.

Freshers’ fair

This is when every club and society that make up the student union set up a stall and recruit new members to sign up. There may also be incentives for joining for a very small fee per year (on average £5 per annum) depending on the activities offered.

There is usually a frenzy to sign up to everything that catches your eye but be realistic and ask yourself which society you will most likely end up committing the most to. Some clubs may also offer taster courses before requesting membership fees (e.g. fencing) so that you have time to make an informed decision after trying them out.

Look out for the following professional organizations and indemnity or insurance companies which can represent you for your entire career:

  • British Medical Association (BMA; Starting as a medical student www.bma.org.uk): the political representation of doctors; offers medical students national representation, online education resources, free library loans, discounts on medical supplies, advice on electives, and monthly Student British Medical Journal—the first year is free.

  • Royal Society of Medicine (RSM; Starting as a medical student www.rsm.ac.uk): an apolitical organization with national representation hosting a multitude of educational events, lectures, career advice, and competitions all year round. Other facilities include use of a bar, library, access to the Journal of Royal Society of Medicine (JRSM), and discounted accommodation in the heart of London—membership from £33.33 in your first year.

  • Medical Defence Union (MDU; Starting as a medical student www.themdu.com): a mutual not-for-profit organization offering its members guidance, support, and defence in addressing medicolegal issues, complaints, and claims. Student membership is free and benefits include a quarterly digital journal, revision resources and situational judgement test (SJT) support, indemnity for your elective, exclusive access to The Electives Network, events sponsorship, local liaison managers, and confidential medicolegal advice.

  • Medical Protection Society (MPS; Starting as a medical student www.medicalprotection.org/uk): offers medicolegal advice and assistance throughout the medical career. Other benefits include discounts on Oxford Handbooks and other series, regional representation, elective and career advice, event sponsorship, and free mock paper on SJTs—membership free for students.

  • Wesleyan (Starting as a medical student www.wesleyan.co.uk): provides free income protection for medical students. Offers contact with dedicated Student Liaison Manager to assist with financial planning and sponsoring various events. Also provide Elsevier book and medical equipment discounts, free career guides on writing CVs and job interview skills, advice on electives, free RSM Student Lite membership, and tips on safeguarding financial welfare—membership free for students.

  • Medical Doctors and Dentists Defence Union of Scotland (MDDUS; Starting as a medical student www.mddus.com): an independent mutual organization offering expert medicolegal advice and professional indemnity for doctors. Membership benefits consist of book discount, quarterly ‘Summons’ journal, access to online resource library, and a chance to apply for elective travel scholarship—membership free for students.

Work–life balance

It is your sole responsibility to look after yourself the best you can. As a medical student, your primary aim is to learn the theory and practice of medicine. You must also learn how to cope with a physically and emotionally demanding vocation and develop mechanisms to deal with its challenges: at times you may feel fed up, exhausted, demoralized, upset, stressed, and pushed to the limit. As a medical student, you must establish a sustainable lifestyle in which all aspects of your life can be fulfilled, in unison. By doing so, your chances of sustaining a career as a doctor—which may last 40 years or more—are greatly improved. It is very important that you register with a local GP in your first few weeks as a medical student, so that you can get help if necessary. Universities have clear lines of pastoral support which you should seek if needed.

Burnout

This is the term often given to the state of being exhausted and/or demoralized about work (lack of enjoyment, stress, physical exhaustion); it is a form of work-related depression that entails negative self-concepts, negative job attitudes, and a loss of concern about patients. Its estimated prevalence is 25–76% in doctors. Factors contributing to burnout include excessive workloads, patient pressures, lack of control, interference from managers, insecurity, reorganization, poor support, perceived threats of complaints or violence, and dysfunctional workplaces (BMA website). It is important to recognize the signs of burnout in yourself, and even in colleagues so that you can seek to address any potentially reversible causes of burnout, and identify strategies to deal with it. This applies equally to your medical student years. If you feel you may be suffering burnout, or be at risk, you may find burnout questionnaires helpful in screening for it (see Starting as a medical student ‘Resources’, p. [link]).

Mechanisms to avoid burnout

Sleep

Requirements for sleep vary between individuals. If you are tired at the start of the working day, you are at risk of burnout. Ensure you are well rested; 7–8 hours of sleep is suggested. Consider limiting caffeine intake if you have sleep disturbance.

Friends and family

These may be among your greatest allies, and are likely to form a support network that you can access at any time. Non-medics may provide useful emotional support, and those with a medical background may provide practical advice.

Colleagues

These may face similar challenges and provide meaningful advice to challenges (peer groups or mentoring relationships). Your tutors should be the first port of call, as they may have training in helping you to deal with stressors related to your work and life outside of it. Contact them early before a problem becomes entrenched and less easily addressed.

Diet

An enjoyable meal can help in alleviating stress. It is essential you establish a balanced diet, and find times to eat and drink during the working day. This can sometimes be challenging: consider taking a flask for an accessible drink and a packed lunch.

Exercise

Aim to undertake at least four to five sessions of exercise, lasting at least 30 min, every week if possible. Indulge in forms of exercise that are accessible to you, and that you tend to enjoy. Playing a sport that you enjoy with others will provide escapism and potentially valuable sources of support. Enjoying the outdoors is important.

Hobbies

Indulge in the hobbies you enjoy: music, drawing, painting, photography, etc. Creative hobbies offer a powerful escapism from medicine, perhaps because medicine is, for the most part, minimally creative, and doctors tend to enjoy creativity.

Counselling

This is both understated and underestimated and is associated with a falsely negative stigma, especially among the younger generations. In fact, it is common practice to have a ‘shrink’ for successful professionals in the US, who use this sacred personal time to reflect, plan, and work through personal issues in a safe environment, without judgement and criticism, governed by a trained expert. In this way, you can feel heard and maintain firm control over your decisions and reactions without having to act out, make mistakes, and then waste time and energy performing damage control due to destructive consequences.

Ten responsibilities of medical students

  1. 1. Correct declaration of occupational health questionnaire: you will be penalized if any necessary information is withheld or falsified. You must also report to occupational health in case of needle-stick injuries when on firms for further testing.

  2. 2. Budgeting: stick to it and save some funds for a rainy day!

  3. 3. Law: you are now an adult and the law applies to you like it applies to everyone else. Any crime will question your professionalism and affect your right to work in healthcare.

  4. 4. Meet assignment deadlines: you must submit assessments on time since extensions are only granted in extreme, unforeseen circumstances at the discretion of the examining board. If you think you have grounds for an extension, then make an application as early as possible to allow time for deliberation.

  5. 5. Communal chores: you and your roommates should all chip in to complete chores out of courtesy to one another.

  6. 6. Seek counselling when required: recognize your limitations since there is no shame in admitting when you need additional support and guidance. Besides your university student counselling services, counselling can be provided by your friends and family, your personal tutor, and the welfare officer. You will not be a safe doctor especially if you have unresolved emotional inner conflict.

  7. 7. Attendance: you are expected to attend (and sign in when required) lectures, seminars, practicals, and tutorials on campus as well as your clinical firms and associated teaching sessions with doctors.

  8. 8. Meet with personal tutor: you must make an effort to keep in touch with your personal tutor. In the worst-case scenario, if you need your tutor to represent and defend you to the medical school, your personal tutor can only support you after having known you for a considerable amount of time.

  9. 9. Keep up with bookwork: amid all the joy of being a medical student, living in halls, socializing with your new friends, and pursuing your extracurricular activities, it is easy to begin to lag behind with work. If possible, try to keep chipping away at your workload, and ensure you finish off your bookwork, revision, and assignments in good time to minimize stress and so that you can enjoy the other aspects of university life.

  10. 10. Balance: strive to achieve a balance between keeping up with your work (studies, revision, and assignments) and play (relaxing, socializing, and hobbies). Look after yourself, eat well, and exercise. Healthy mind, healthy body. Try not to commit to too many activities (work or play) as this will spread you too thinly and reduce the quality of your contributions.

Ten tips on being a successful student doctor

  1. 1. Bring in Oxford Handbook titles: if you are waiting around, then prepare beforehand by reading your Oxford Handbooks. Read in advance to prepare for predictable clinical encounters (if you are going to a respiratory clinic, perhaps refresh your memory on chest examination and common respiratory disorders). This will impress your trainers.

  2. 2. Clerking and presenting patients: each rotation will allow practising of focused histories and detailed examinations. Aim to clerk with focused histories and thoroughly examine many patients in clinics and on the ward before presenting to your doctors. You may also be expected to present patients at ward rounds which is good practice for when you become a junior doctor.

  3. 3. Supervision: to ensure that you are clerking, examining, and interacting with the patient or performing a procedure competently, ask one of your seniors to supervise a consultation. This will be excellent practice for exams (see Starting as a medical student Chapter 50).

  4. 4. Constructive feedback: be able to handle criticism well. Any advice given to you is for your own benefit. Conversely, do not take it to heart. Learn from your mistakes; better as a student than as a doctor.

  5. 5. Read patient notes: it is good practice to clerk patients and then compare your findings with their notes. With time and experience, your clerking will be closer to the written notes.

  6. 6. Observe and reflect: see how your doctors interact with patients with respect to communication, examining for signs, and implementing the management plan. Take a step back and reflect on what you have observed. Reflection is a very important skill because it will provide you with insight to grow as a doctor. Ask yourself what you learnt, what you liked about a consultation, and what you would do differently next time.

  7. 7. Taking initiative: there will be long pauses during your day where you find yourself waiting. If time permits, aim to clerk and present a patient, read patient notes, or prepare for the next teaching session. With more time on your hands as a medical student, get involved with clinical research and departmental audits (see Starting as a medical studentpp. [link][link]). Your seniors will appreciate you more if they see you managing your time effectively, which will have a positive impact on your evaluation.

  8. 8. Punctuality: better to be 5 min early so that you do not miss out on precious teaching time or letting others wait around for you. This will also be commented on during your sign off and evaluation.

  9. 9. Shadow multidisciplinary team (MDT) members: holistic patient care is provided through a MDT approach. Spend time shadowing and learning about the functions of ward nurses, physiotherapists, occupational therapists, social workers, dietitians, and clinical psychologists at MDT meetings (at least weekly).

  10. 10. Infection control: reduce the risk of cross-infection between patients by wearing gloves/aprons and washing hands/stethoscopes.