MBBS - Third Year: General Information and Rotations
General Information
Third year at UTAS is longer than first and second year by several weeks and is divided into clinical (3; Tues, Thurs, and Fri) and pre-clinical (2 Mon and Wed) days. Core pre-clinical content is delivered to the entire cohort together on the two pre-clinical days, while clinical content is rotation based and the cohort are divided into four groups for these and rotate throughout the year in 8 week intervals.
2020 was unusual for so, so many reasons that I likely don't need to explain. From mid-March onwards, all pre-clinical content was delivered via online teaching. Fortunately, the school was quite well set-up for this, and one lecturer in particular, who was responsible for delivering complex semester one content, was already very experienced in delivering lectures, workshops, and practicals online, so it was largely handled very well, imo, and I actually found the online nature more accessible than self-led pracs. It's difficult to say how much of the content will remain online given lectures have all now been nicely recorded. It could be 'easy' for the Uni to simply re-use these, but I have no idea what the plans are for 2021. I also found the online nature of much of the teaching (and the fact that lectures, even guest ones, were recorded) made scheduling life outside of university (especially work) much more straightforward.
Rotations
These were somewhat altered due to the nature of the difficulties experienced this year. It's likely this aspect of the timetable will revert to normal next year if there are no further COVID outbreaks in Hobart/Tasmania. Instead of 8 week rotations, they were reduced to 7 weeks, giving the School of Medicine a couple of weeks at the end of the year to schedule 'catch up' sessions for any clinical skills that were missed or for lectures/workshops that had to be rescheduled.
Clinical Specialties
Paediatrics: Lectures and workshops on taking a child health history, developmental history, unwell child assessment, newborn check, immunisations, feeding, general health. In a normal year, clinical skills would include a formative child health history taking OSCE with a child in the room, a newborn check in NICU, a visit to the paediatric area of DEM, Teddy Bear Hospital school program visit.
Obstetrics and Gynaecology: Lectures and workshops on all aspects normal pregnancy, complications in pregnancy, contraception, menstrual history taking and problems, pain relief in pregnancy, breast pathology and examination. Clinical skills and practical sessions included antenatal clinic sessions, colposcopy clinic attendance, pregnancy assessment centre visit, breast and vaginal examinations.
Psychiatry: Lectures and workshops on mental status examinations, important psychiatric presentations, mental health history taking, introduction to various therapies, and medications. I think there was meant to be a workshop involving patients, however this was cancelled for my rotation, so I'm not 100% sure.
Ophthalmology: A half-day placement in a clinic setting. All other teaching for this specialty was completed in the pre-clinical teaching block.
Clinical Teaching Associates: Well woman checks (including history taking, breast examination, vaginal examination (speculum and bimanual). Male check involved history taking, testicular examination, and digital rectal examination.
Assessment: Formative OSCEs, child development brief essay, summative OSCEs, summative written exam at the end of the year.
Primary Care
Lectures: Drug and alcohol, sports medicine, sexual health, oral health, lifestyle and behaviour modification, smoking cessation, skin cancer.
Consulting skills: Practical workshop sessions in small groups focussing on assessment and management of key primary health care presentations.
Tutorials: Common primary health care presentations.
Clinical skills: Venepuncture and immunisation sessions.
Community placements: Didn't run this year but usually cover Drug and Alcohol Services, Oral Health Tasmania, migrant and refugee health clinics, skin check centres, etc.
GP placement: Two week placement with a GP clinic in southern Tasmania.
Assessment: Research project in small, allocated groups, diabetes case history on GP placement, attendance, summative OSCEs, summative written exam at the end of the year.
Medicine
CBL: Small, allocated groups run each CBL session on common broad presentations in general medicine (jaundice, anaemia, pyrexia of unknown origin, palpitations, altered conscious state, acute dyspnoea).
Tutorials: Clinician-led sessions on topics such as acute and chronic kidney disease, neurological presentations, etc.
Pharmacology: Pharmacist-led sessions with pre-reading and quizzes embedded. There was meant to be a pharmacy placement, too, but this didn't happen.
OSCE preparation sessions: Practical sessions on how to approach OSCEs.
Clinical pathology: Lectures on various topics including haematology and endocrinology.
Placement: This operated differently for my group. I did a two week placement at the hospital with an allocated team. It was utterly fabulous. I am not 100% sure how it usually works, but I think it is a day a week usually, and for more weeks, rather than grouped together into a 2 week block like I did it. I think the way I did it was better and I hope they keep the new format.
Bedside tutorials: These would usually take place on the ward, but were relegated to online for me. Usually facilitated by a registrar in small groups of 5-6.
Assessment: Placement booklet full of tasks including researching a topic of interest, completing a signs log, clinic attendance, case presentations, drug chart reviews, etc. CBL presentation. Summative OSCEs and summative written exam at the end of the year.
Surgery
Disclaimer: My surg rotation coincided with the height of lock-down so I did nuthin...! This is a guide of what is supposed to happen!
Tutorials: From several surgeons covering topics such as general surgery, hernias, breast surgery, thyroid and other endocrine surgery.
Self-directed learning: Very, very introductory plastic surgery content especially centring on wound healing. I legit skipped this entire section and it didn't matter!
Surgical pathology: Case-based tutorials where you're divided into small groups and get allocated a specimen to discuss each week.
Placement: Allocation to various clinics (public and private) and theatre sessions. I didn't do any of this so don't know any details.
Ward-based tutorials: As with bedside tutorials in the med rotation, these were meant to occur at the hospital but were online instead. Registrar-led case-based sessions in small groups of 5-6.
Medical imaging: Pre-recorded, online tutorials.
Surgical skills: Suturing workshop, gloving and gowning/surgical scrubbing, cannulation workshop. These were all conducted in the catch-up period for me, so I did all these and they were great. Nothing like feeling completely incompetent while washing your hands!
Assessment: As this rotation fell apart around us, almost all in-rotation assessment was dropped. I only had to do a journal article review which I submitted 5 months ago and, as far as I can tell, still hasn't even been opened, let alone marked! This is atypical and there would usually be more involved. Summative OSCEs and summative written exam at the end of the year.