Mahjabin’s Email
Welcome to your longest year at med school. Lots of fear mongering around this year but I acc did enjoy it despite it being the roughest exam season I’ve ever experienced rip. The academic year ends up being ~11months so its key not to burn out before the finish line of exams. There’s a LOT I wish I knew tho esp closer to exams to split this email into placement advice, writtens, path and PACES.
Placement
Difficult to say anything general as placements reallyyyy are hit or miss. They change year on year based on who the TF is, if you have your boys with you, and how close to exams you have them. Don’t be disheartened if you got a supposedly peak placement. Just gotta work with what hand you’ve been dealt.
Psych
- Easy to bunk but I do think if you have a decent placement, the more you put in the more you get out. If you wanna skive, theres minimal DOPS and as long as you show face you should be calm.
- Psych has the least amount of conditions and I genuinely think I saw all of them in my time there. Get a list of the different clinics/specialist teams and drop an email to the ones you’re interested in at the start, and you can schedule them in across your 6 weeks. We ended up seeing all sorts like Eating Disorder clinics, Forensic psych units, Psychiatric ICU, Mum & Baby units, Substance misuse clinics and more.
- Psych ward rounds start late generally and are seated. If you’ve got a good consultant, you can get so much done before lunch. Additionally, a lot of what I saw really helped me for PACES; things like third party adjunct services, understanding the Mental Health Act, police and social involvement which is the stuff you kinda passively learn on placement.
- If you’re going to pattern anything on this placement, get to grips with psychiatric medications (anti-psychotics and mood stabilisers), how the biopsychosocial model is applied, and what services exist and how they link (GP, crisis teams, community mental health, CAMHS etc)
O&G
- Of the 3 specialities, I think O&G rotations usually have the best teaching. Schedules are usually quite loaded as a result (esp NWP and West Mid), but most of the year you’re fending for yourself so acc having something to attend is a nice change.
- This one has the most sign offs, a lot of which are practical and are a pain to hunt down. Get them done in your first few weeks so you split the rest of the time on what you want to do most.
- Lots of hands on experiences if you want them! I had never cared to scrub into any surgeries in med school but scrubbed into 15 just in O&G, where if you go when the nice regs/consultants are operating can let you take the lead a lot more. I got to assist in hysterectomies and diagnostic laparoscopies, stitched in C sections, and helped out in vaginal births. I also know some people got to take a much more lead role in non-complicated vaginal births. So chase the opportunities, and they weren’t hard to get you just need to ask (you’ll p much never get the chance again unless you go into OG in the future!)
- Triage or DAU (Day Assessment Unit) is great for acute scenrarios and stuff that comes up in questions a lot. Again, wait around time is annoying but you get good at histories and initial investigations. DAU being more chill means you might feel less initimated.
- Clinics are probably quite underrated although theyre boring if you don’t have an engaging reg. For obs it really helps you get used to what is monitored throughout the different trimesters and how, how to screen for red flags, how to safety net; for gynae its great for histories and learning how people present and directing them to further management (at least ONE station in PACES will be in a clinic/GP setting so its good practice.)
- If you’re really into OG you’ll have a good time. But there is a LOT of waiting around especially in obstetrics. I would have work to do with me (questions, reading over something so I don’t look thick in tutorials, taking histories) if I knew I’d be on labour ward waiting for a birth to happen. Sometimes you just have to cut your losses and go home,,,,
Paeds
- Lots of DOPS but unlike O&G theyre pretty much all mini CEXs. Paeds A&E is the best place to be for this (I did all of mine in 2 half days there).
- I also only found A&E to be useful. It covers the breadth of paeds quite well, and is great for consolidating a lot of what exam questions focus on. I had my paeds placement last though and hated my consultant so I admit I’m very biased.
- I enjoyed being with the kids as taking histories from them is way more fun and light hearted. Like it was a fun placement but didn’t appreciate it much cos I was crying over path. I know a lot of people adored their paeds placement and this was usually when consultants were more engaging and gave direction. I do think the bulk of the work with paeds however is learnt from the books or GP.
GP
- If you get a good GP, ask for all the psych, O&G and paeds appointments. You will get regular medicne cases (as getting patients for those 3 specialities just depends on whos asking for appts), but I got to practice the bulk of my paeds in GP. You also can get the most indepedance in GP; I would take histories, investigate, document AND counsel all my patients, and just needed to nip out to double check things with the GP I was assigned to.
- PACES heaven. Probably your best opportunity to get good at histories and practice all 3 specialties in one go. If you’re GP is quite chill, you can just bang out histories in the morning and leave midday and still get a lot out of the day.
- Bring work as the wait between morning afternoon clinics is usually 2-3h and some GPs will require/want you to stay. So bring work/get Qs done in dead time.
The other placements were just ops for me to cover Big3 content although I did hang around if I was actually interested. That being said, ID is a Godsend for path and GUM is OG relevant AND path relevant so I’d utilise those. SCP is either something you’re interested in, or your chance to go on holiday/create a half term for yourself/let your brain rot a little. Use it well x
Writtens
In terms of where to start, I would choose the specialty you start with or have earliest (I started on psych so filtered the Qs to psych only), and go in the order you have the placements (So I did psych then OG then paeds when learning conditions). Going into a specialty having already done a bulk of the Qs will really help you, although that’s not always feasible if you have a Big 3 placement first.
To cover the content, I would use question banks to then dictate what conditions I was going to cover/make notes on. It seems stupid to start with questions when you have no idea what’s going on, but with the brief explanation for the answers you can pick up very quickly buzzwords and clock what comes up more often. Your %score is gonna be horror but you learn to take the L. I kept track of conditions using a spreadsheet, but a bear in mind some things I made notes weren’t ‘conditions’ but still relevant like vaccination schedules, antenatal scans, Mental Health Act etc.
I used PassMed and NICE and RCOG guidelines to cover all the conditions, then used QuesMed then PasTest to consolidate and add to my notes. If you use the explanations from those Q banks in your notes, just be warned that some are a bit outdated in terms of management so just double check those. I’m not an Anki babe personally but honestly stick to what’s worked for you in the past! If you are someone who uses other people’s notes though, always check with the relevant guidelines and edit them cos things acc do change year on year and the exam will use the latest guidelines.
The exam is really specific and there is a LOT to cover. You’re likely going to revisit and add to your notes constantly, but each time does solidify it a bit more in your brain. I think we only clocked later exactly how much the exam focusses on management and niches in guidelines; the exam we sat the majority of the paper wasn’t “what’s the diagnosis” but instead was heavy on what to do next with some options being very similar. So try to rake through the guidelines for investigations and management more so! I ended up almost always adding to my notes when doing a new question bank, or when reviewing guidelines again cos I realised I hadn’t gone in depth enough on investigations/management
As a rough timeline, I finished Passmed and conditions for Psych and OG by Christmas (as this is when I had completed both those placements). I had Paeds last so finished Passmed and paeds conditions, and started/finished Quesmed for Psych and OG by end of Feb. I think then I did PasTest for all of them and finished end of March? Struggled to figure out what to do at this point. Reset to do the average/hard qs on pastest and finished the RevMed Q book and tried to go through conditions via presentation. Ramadan was in April so i just stopped revising for a month lowkey. Had a breakdown about Path in May so specialities was sidelined then, but got back into practice with Make A Medic mocks and doing pastpapers from like mid May until exams. At this point, anything I got wrong I would note down then would have a list of topics to go over the next day, which ended up being super niche like biological markers for Down syndrome screening or monitoring scan durations in gestational diabetes.
I do think this worked really well for me, and meant that the workload only slowly increased. By May time I think everyone starts to lose their minds a little. Exam season is absolutely brutal so don’t wear yourself out before then! Would highly recommend going through past papers with friends cos its too easy to get tunnel vision and not realise there’s a gap in your knowledge. I know a lot of things I only learnt the week or two before exam because my friends taught me.
Pathology
This is 100% the reason why 5th year starts to feel like A Lot. It’s annoying cos in hindsight I think it’s absolutely needed and the content preps you so well for Final year and filling in every gap of knowledge I’ve ever had in medicine. But it’s definitely the worst taught course in the world. I ended up ignoring it all year then cramming it all in the 6 weeks before exams but I do think I’ve permanently psychologically scarred myself by doing so. NB I did skip the bulk of my last placement in order to get the content done on time! There is also a LOT of difference in how people revised path, so I’ll only be telling you what I found worked but take it with a grain of salt.
Path has >100 lectures. If you’ve always been a lecture babe, attend them. If not, then don’t try. If you’re an Anki boss then do that but I do think it’s slyly satanic. I tried in the year to just use the MedEd Path guide and society lectures to cover content, but I do think both are more suited to revising then for inital learning.
People will have their 2 pence on what is “high yield” and “low yield” for path. I found that some lecs are very high yield because the majority of the content is stuff that comes up a lot in exams. A lot of other lectures may overall not be worth spending a whole hour on, BUT there is usually a small amount within it that is buzzwordy, comes up year on year and thus you need to know.
How I ended up going about things was taking a list of the lectures and grouping them into chunks. Then doing one “chunk” a day. I’d learn the content and end up writing a “summary page” of the lecture on my Ipad. Learning the content was sometimes just watching the lecture (I think I ended watching 50-60% of them), but it was often a mix of the lecture, society lecs, Osmosis videos, the pathguide, and a horrific amount of googling. This is definitely what I struggled most with because I was switching up how to learn the content constantly, but then once it was done I only really referred back and added to my own notes. I think it worked really well, and I wish I had just done it throughout the year and so then come May I had one resource to look back at, instead of synthesising the resource and learning it all in one go.
After that it was just doing past papers because path repeats absolutely everything. I would complete them then mark it myself then compare with a group around 2 weeks before exams. We would end up fighting most of the time cos we disagreed but honestly in that exam the amount of times I was doing a quick prayer for them cos something they mentioned came up!
Chempath lecs – all of Karims and Amirs ones are great. The others not so much I usually ended up reading the guide or learning it myself.
Haem lecs – I found it great for the cancers esp Donald McDonald’s ones. The others I just judged in the first 10 mins and if I found it rubbish then I used other resources
Immuno lecs – Margarets lecs are GREAT. She points out what is relevent. Peters are so bad the immuno deficiency one I highly rec you watch a meded lec instead and use the pathguide. The case lecs are good. Used the guide to cover allergy, HIV, and transplants.
Micro lecs – Generally I think the micro lecs are not good. LOVED the meded lecs for them use those they saved my life. I love Luke Moore’s lecs but he doesn’t do high yield lecs and the ones he does cover he talks around the conditions he likes more than whats in the exams. I liked the guy who did the hepatitis one and I watched the UTI, MYRO, RESP, and CNS ones. But I think of all the 5 topics this is the one best learnt elsehere.
Histo lecs – All of Robs lecs are GREAT. Thankfully he does a lot. Didn’t watch the rest cos I didn’t think they covered whats EXAMINABLE well. But again, v good other society sources to use. The pathguide I think is overkill cos it fully outlines the conditions and all the sx in a way thats more Y3 exams. I think using pathguide alongside soc lectures are the best.
MedGems – Imperial made bank of qs for path. Honestly I think some Qs are great but some honestly are just too niche, and definitely not things that would come up. But it did give you a Q&A format that you don’t really get anywhere else so I did end up doing them all and suffering
PACES
Get a group and a tutor as early as you can and keep it consistent! I think societies open up PACES tutoring schemes a bit later in the year, but if you can I’d get one earlier just because final years will end up dipping to focus on their exams around Christmas time and again around your exam time because of elective!
You end up “revising” for PACES through revising for writtens a lot of the time. You just need to be slick when taking histories, which comes with practice on placement as well as in groups. Closer to the exam, we would find previous PACES stations and recreate them because the faculty ones are acc quite rogue and nothing is ever simple lool.
One thing I didn’t do, but wish I did was create cases as I was doing conditions and then use them with my housemates later. Creating your own cases is defo a good way of revising cos it forces you to look up your notes, include risk factors and vaguer nicher symptoms, create VIVAS etc. This is lowkey what we ended up doing the week before PACES but ofc it was rushed and more last min.
Overall, this year IS intense when you deep the amount you end up learning, and the exam season is hell. But honestly, I didn’t mind it for most of the year. I found specialties much more interesting than general medicine, and a lot of the stuff you do this year you’ll never do again unless you choose it as a career! So honestly make the most of it and go with your interests when they crop up!
That being said, most of the year I was doing “post placement motives” and usually when I hadn’t even gone to placement that day or “study days” where we do one condition then decide to fuck around for the rest of the day. Plenty of time to engage in your hobbies, enjoy the summer properly, and do extra curriculars. You just need a trickle of work going on in the background just because of the sheer capacity and specificity that the exam demands. It really is one of those ‘slow and steady wins the race’ kinda years.
If you have any Qs or are losing your mind, pls feel free to drop me a message at any point. I firmly believe you have all got this tho <3
Lots of love,
Mahjabin