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Medical Students Handbook

Medicine at Cambridge: The first two years

Welcome to Cambridge, and congratulations on gaining a place to study medicine.  This is the beginning of an exciting and challenging time: going to University, perhaps leaving home for the first time, and embarking on a demanding course which will lead you to qualification in a highly respected profession.

This booklet provides a general introduction to the Cambridge medical course for students starting their course in October 2013 and covers mainly the first two years.

Dr David Good
Director of Education (Biological Sciences)

The Aims of the first two years of your Medical Education

Our ever-increasing knowledge of biology, physics and chemistry provides the fundamental underpinning to the practice of medicine.  The first two years of your medical course is designed not only to give you a thorough knowledge of that science base, but also to make you aware that because this knowledge base is continually changing, you will need to develop this knowledge and its application during your professional career.  

We will encourage you to adopt an approach to learning based on curiosity and the exploration of knowledge rather than on its passive acquisition, because we believe it is important for you to develop this ability to apply new knowledge, and to adapt to changing circumstances in your professional life.

We will also help you to develop your intellectual skills, such as the understanding and interpretation of scientific evidence, problem solving skills, and skills in oral and written communication; skills which can be transferred to later stages of your medical education.

However, being a doctor involves much more than just knowing about biomedical science and the effects of illness on people.  By the end of the first two years we aim to give you a sound grounding in the basic knowledge and skills necessary for working with patients in the clinical part of the course.  These include certain technical skills, and the skills of listening and talking to people, generically known as communication skills which are essential for a doctor.   

We expect you to practice and develop these skills, both in the Preparing for Patients programme, and also in the supervisions arranged by your College. Do participate in supervisions - they are not just teaching sessions, they are learning sessions, and learning requires self-expression. Also, ask questions in practical classes; the demonstrators are there to help.

Finally, we aim to introduce you to the fact that doctors have an obligation to practice medicine in the best interest of patients, and that this obligation requires not only knowledge and skills, but development of certain attitudes to your work and in your approach to it.

Section A - Your Duties as a Medical Student

The behaviour and performance of all medical professionals, including student doctors, is regulated by the General Medical Council. During your first year you will be sent a copy of the General Medical Council’s (GMC) “Duties of a Doctor.” This summarises the duties of a doctor registered with the GMC and you should familiarise yourself with these as they apply equally to your private and professional lives. However, from the very beginning of your course, you will be expected to behave in a manner appropriate to a medical professional.

At your first introductory session you will be admitted to the Medical Student Register, a copy of which is included in this handbook. Please read this carefully, because in signing this Register you are making a formal commitment to observe the standards of attitudes and behaviour appropriate to an entrant to the medical profession.

Standards of Behaviour

As a student of the University, you are subject to the disciplinary provisions set out in the University Statutes. As a student doctor, you are studying for a degree that will automatically allow you to register provisionally as a medical professional. During your studies you will be working within this professional environment and the General Medical Council (GMC) expects you to behave in a manner appropriate to your future role.

The standards of behaviour expected of you are set out in guidance published by the GMC and Medical Schools Council: "Medical students: professional values and fitness to practice” (November 2009), paragraphs 15 – 38;

The University has also agreed a Code of Conduct for student doctors to guide you during your studies. This is reproduced on page 5 of this booklet. You are expected to have read this and the GMC guidance before you come up toCambridge.  Make sure you understand these and if you have any concerns consult your tutor.

On the first day of term you will be asked to confirm that you are willing to adhere to these standards by signing the declaration which is copied at the end of this booklet.  Your name will then be entered in the Medical Student Register and this entitles you to have patient contact, which begins in the first year of medical studies.  Throughout your course you will receive reminders about the importance of the Register.

Students whose health or conduct give rise to concerns that they may be a risk to patients will be removed from the Medical Student Register and will be subject to Fitness for Practice procedures.  This can lead to students being prevented from entering the Final MB examinations for the award of the MB/BChir. Provisional registration with the GMC is subject to a declaration of fitness to practise.

Details of the - Fitness for Practice procedures

And on page 212 of the University’s regulations

Although most of the teaching which you receive during years one to three is under the supervision of the Faculty Board of Biology, it is the Faculty Board of Clinical Medicine, working through the Director of Medical Education in the Clinical School, which is formally responsible for the supervision of your contact with patients.

Reproduced here is the University’s formal Code of Conduct for student doctors. On the first day of your course you will be asked to sign a declaration (reproduced at the back of this handbook) stating that you have read these documents.

Medical Students Code of Conduct and Guidance

 

Respect others: patients, professionals, teachers and fellow students.

Treat patients politely and considerately, respect their views, their privacy and their dignity; respect the right of patients to refuse to participate in teaching.

Guidance note
In all your dealings with, or in relation to, patients, teachers and colleagues, act without any discrimination, whether on the grounds of age, colour, disability, gender, illness, marital status, national or ethnic origins, nationality, perceived economic worth, race, sexual orientation, social status, religious or other philosophical belief.

Be an effective and discreet communicator.

Always make clear that you are a student and not a qualified doctor; be aware of your limitations and do not exceed your ability when giving information to patients.  Understand, accept and agree to be bound by the principle of confidentiality of patient data and also of information concerning staff and students. 
Ensure that you can be easily contacted by University and NHS staff and always reply promptly to all communications.

Do not use mobile electronic devices – cameras, mobiles, discs, data-sticks etc to record and store patient images or any other patient information; never use E-mail, social networking sites, ‘Blogs’, ‘Twitter’. ‘Facebook’ etc to share information about patients.
See BMA guidance booklet on using social media.

Guidance note

Contribute to the review of teaching by completing feedback forms as requested by course organisers and reporting any difficulties as they arise through the appropriate channels.
Do not discuss patients with other students or professionals outside the clinical setting, except anonymously.  When recording data or discussing cases outside the clinical setting, ensure that patients cannot be identified by others.

Abide by rules and policies, follow procedures and guidelines.

You must be aware of and comply with the rules, policies (including Health and Safety), procedures and guidelines of the University, Colleges and NHS (Trusts and General Practices). Comply with the rules and procedures laid down by the Director of Education (Biological Sciences), Clinical Dean, supervising Consultant, General Practitioner, Ward Manager or their deputies.

Guidance note

Be in attendance for the hours as directed by any of those above and as required to gain experience of emergency situations.  As doctors, you will have to make decisions not to go to places at the times you would like to because of your clinical duties.  You have a responsibility to yourself, your financial sponsors and your future patients to complete your placements.

Comply with appropriate current and new health-testing requirements.  Be aware of the risks and implications of contracting a blood-borne virus (BBV); contact Occupational Health immediately if you believe that you may have been exposed to a BBV infection requiring further testing and refrain from exposure-prone procedures (EPPs) until cleared.

Be open and honest.

Do not break the law in any way, never threaten violence, act violently towards others or act dishonestly.

Guidance note

Just one criminal conviction could jeopardise your career prospects in medicine. 
Do not cheat in examinations: cheating, at any level, destroys trust and those who cheat may also lie and be unfit for medical practice.

Inform the Clinical Dean immediately if you are involved in any University or police investigation which may lead to charges being brought; concealment of involvement in a drunken brawl that may lead to prosecution may be viewed as an even greater offence than the incident itself.

Take care of your appearance.

Your appearance, personal hygiene and demeanour should always be modest and reasonably conventional.

Guidance note

The appearance of a student or medical practitioner should not be such as to potentially affect a patient’s trust in that person’s medical judgment or standing.

Always wear an identification badge and show your face so that you can be recognised by patients, teachers and staff. Head dress routinely worn for religious observance must not cover the face: facial expression is an important part of communication, showing your face also makes it easier for patients with a hearing impairment to hear you and/or lip-read.

When examining patients in any clinical setting, observe the clinical dress code: short-sleeved shirts or sleeves rolled up above the elbow; no wrist watches; only one plain band ring (without stones); no white coats; long ties only if securely pinned or tucked in.

Take action at an early stage when any problem arises.

Inform the Clinical Dean or a College Tutor immediately if you become aware of any personal problems arising which may put the health and well-being of patients at risk.

Guidance note
Medicine is a demanding profession and, at times, all medical students are subject to stress and anxiety; emotional problems and psychiatric conditions such as depression and eating disorders are not uncommon. Do not hesitate in seeking support (see Confidential Sources of Help & Advice) as the earlier a problem is addressed, the greater the likelihood of a successful outcome.
Seek advice if you think a doctor or colleague has behaved in a way that suggests that he or she is not fit to practise; examples of such behaviour include:

. making serious or repeated mistakes in diagnosing or treating a patient's condition;
. not examining patients properly or responding to reasonable requests for treatment;
. misusing information about patients;
. treating patients without properly obtaining their consent;
. behaving dishonestly in financial matters, or in dealing with patients, or research;
. making improper advances towards patients;
. misusing alcohol or drugs.

Do not abuse drugs and alcohol.

Guidance note

Abuse of alcohol and other mind-altering substances may lead to behaviour that puts patients at risk; problems associated with such abuse, e.g. violent and aggressive behaviour jeopardise your career.  Never obtain or seek to obtain drugs that have not been properly prescribed, prescription or non-prescription, for yourself or others by any means.

 

Student Support and Guidance

As a medical student and budding doctor you must now be prepared to take responsibility for your own actions and your own personal development.  This means thinking about what you do and in particular, facing up to and dealing with problems in the context of your work and relationships with others.  However, the University has many support systems in place. For a compendium of essential information for any student in the University see the on-line student gateway.

Motivational problems - Are you on the right course?

If you are having serious doubts, talk about them immediately with your Tutor and/or Director of Studies.  There are students who realise, having got to this stage, that it was all a big mistake. If you really do want to get out, then don’t hesitate to say so; it is never too late to change your mind. Cambridge offers exit routes from medicine into other Triposes, so you can still acquire a degree. Many students study subjects which contribute greatly to the practice of medicine, e.g. genetics or pathology, without becoming a medical practitioner.

Are you having difficulty coping with the demands of the course?

Again, talk to your supervisor and /or your Director of Studies.  If you have a serious problem they will help, or in some cases direct you to sources of professional help such as the Counselling Service, but the College Tutorial system should be your first port of call.
You can, however, seek support from the Counselling Service directly if you prefer:

Are you having Academic problems?

Begin by asking your College Supervisor in the appropriate subject, but University teachers can be approached if a problem remains unresolved and, in practical classes, demonstrators are on hand to deal with immediate queries.   Problems with lectures and practical sessions can be raised with those who are lecturing or running a particular class.

Complaints or concerns about other students or staff

The Student Code of Conduct requires students to 'take action at an early stage when any problem arises'. All medical students should seek advice if they think another medical student has behaved in a way that suggests that he or she is not fit to practice; examples of such behaviour include:

• misusing information about patients;

• treating patients without properly obtaining their consent;

• behaving dishonestly in financial matters, or in dealing with patients, or research;

• making sexual advances towards patients;

• misusing alcohol or drugs.

Complaints and concerns about your fellow students should be raised in the first instance with your College Tutor or Director of Studies. Complaints about academic staff should be raised with the relevant course organiser, or with the Director of Education (Biological Sciences). The University has a formal student complaints procedure.

Monitoring and mentoring student progress

The General Medical Council has certain expectations regarding the attitudes, behaviour and performance of medical students from the beginning of their course through to graduation and provisional registration and this guidance places the responsibility for monitoring this on the University.

In theUniversityofCambridge, much of the day-to-day responsibility for this rests with the college tutorial and pastoral care system.

This is backed up by the Medical and Veterinary Student Progress Panel, which will monitor the cases of students who for one reason or another may be having problems with the course.

The Medical and Veterinary Student Progress Panel

The College tutorial and pastoral system is backed up by the Medical and Veterinary Student Progress Panel, which maintains a general overview of medical student progression throughout both the preclinical and clinical course atCambridge. It will also monitor the cases of students who, for one reason or another may be having problems with the course. This may be because of illness, personal difficulties or due to repeated examination failures. The Medical and Veterinary Student Progress Panel consists of senior members of the School of Biological Sciences, the School of Clinical Medicine and Department of Veterinary Medicine together with College tutorial representatives.

In co-operation with Colleges, through the Senior Tutors and the College pastoral system, the Medical and Veterinary Student Progress Panel will review student cases with a view to offering advice about support for students who are encountering difficulties with the course. The committee is not a disciplinary body and is set up to provide support for students and Colleges. Its basic remit is to try to ensure that students have a timely and, as far as possible, trouble free progress through the course. A more detailed description of the Panel and its functions can be found here.

However, the Medical and Veterinary Progress Panel is aware of the GMC expectations of medical students and it will have the option of referring cases which raise serious concerns to the Fitness for Practice Committee. Details of the Fitness to Practice procedures can be found here.

And in the University’s regulations.

Patient Safety - Your Legal Position as a Student

Even as a trainee Doctor, the safety of patients must be your paramount concern.

These notes are taken from the Clinical Course Guide and set out broad principles and are intended to clarify the legal position for student doctors in regard to work undertaken with patients.  For these purposes, a student is one who is registered on the Clinical School’s Medical Student Register and who has access to patients as part of an agreed attachment under the supervision of a specified medical practitioner.

Specific Points for Students to Note

Identification: Always wear a badge, identifying you as a student doctor, and introduce yourself as such.

Permission: Always obtain a patient's permission to see/examine him/her.

Laboratory Investigations: Do not initiate X-ray or other diagnostic investigations; never request blood for transfusion.

Practical Procedures: Do not perform any practical procedure nor give any medication (intravenous or oral) without authorisation and supervision by a medical practitioner.

Certificates and Documentation:

You may not: -

• make a formal diagnosis of death;

• sign statutory certificates (e.g. death) or prescription sheets;

• obtain patient consent;

• witness a patient's signature on any official hospital document;

• sign hospital accident forms;

• 'identify' patients before operation;

• check blood bags for transfusion;

• authorise any patient to be discharged from hospital (particularly A&E)

Levels of responsibility and potential legally dangerous situations

• All patients in hospital are under the care of a clinical team led by a consultant whose most junior member is normally an F1 trainee doctor. Any student carrying out clinical duties does so as an assistant to this trainee doctor. When the trainee doctor is absent he/she is required to designate another qualified doctor to cover him/her and a student may be an assistant to the official deputy. Whenever doubt exists as to patient management, seek assistance from a qualified doctor or, in obstetrics, from a certified midwife.

• A student's legal safeguard depends upon the supervision exercised by a named medical practitioner. The degree of supervision will vary and is determined by the practitioner; consequently students may find that on some firms they are allowed to carry out duties which are forbidden on others.

• Provided that you carry out only those tasks authorised by a Consultant or named deputy and perform the task on the basis of a standard procedure, there is little prospect of incurring legal liability. If, however, a patient were to suffer harm as a result of your exercising less than reasonable care, you might be held personally liable. If you had been given a task to perform for which you were not sufficiently skilled, a court would probably conclude that you were not to blame for having performed it badly.

• You may be guilty of negligence if, of your own accord, you undertake a task which you know - or ought to know - that you are not qualified or sufficiently experienced to perform.

• If you did injure a patient through lack of care or skill, or are negligent, you could in theory be sued, but in practice the patient would sue the Hospital Trust and the student jointly and it is unlikely that the hospital authority would refuse to assist a student with any defence that might be necessary, or to meet damages if awarded.

Medical Defence Organisations

If a patient suffered injury as a result of a procedure carried out by a student, a Medical Defence Organisation would be expected to support the member responsible for the student at the time, provided that the student had been authorised to undertake the procedure in question.

  • Medical students must take advantage of the free cover provided by medical defence organisations before they meet any patients (i.e., at the start of Year 1). Students are not automatically indemnified against negligence but have nothing to fear provided they adhere to the general principles described above
  • In the unlikely event of a patient being harmed and action being taken against a student, legal responsibility for negligence could, in theory, rest with a student although, in practice, that responsibility is likely to be carried by the supervising practitioner, NHS Trust or other body concerned. The fundamental principle is to undertake clinical work only under the supervision of a registered medical practitioner.

The level of responsibility which had been delegated to the student by the member must be held to be reasonable in regard to the student's experience and level of attainment.

Vaccination against Hepatitis B

This is not, repeat, not an option. You must be vaccinated.

Vaccinate yourself against cancer

Hepatitis B is a small DNA virus transmitted by blood contact, by sexual contact and perinatally (around the time of birth) from mother to child.   It currently infects around 5% of the world’s population and once infected, it is possible that you will carry the virus for life.  Depending on the virus level in your body and the state of your immune system, you may be a highly infectious or low-level infectious carrier.  

Infectious carriers will require increased screening if admitted to medical school and their clinical practice will be restricted should they be considered a potential infection risk to patients.  Students or doctors who become infectious carriers will have problems in training and will not be permitted to specialise in disciplines in which they may put their patients at risk, e.g. surgery, obstetrics.  In addition, their ability to perform the full range of care in other disciplines may be limited.

If you are not vaccinated, you risk infection from a needle-stick injury during your clinical practice.  It is for this reason that Hepatitis B vaccination is compulsory.   Our immune system is not very good at recognising and making a protective response against the Hepatitis B vaccine (unlike some of the other vaccines you have had, e.g. measles, mumps, rubella).   Therefore, you must have three separate injections with the Hepatitis B vaccine.

It is vital to make sure that your Hepatitis B immune status is established while you are still a student and, therefore, among all the other things we demand of you, so is attendance at the vaccination sessions at Occupational Health.  This is an absolute must! 

Although you may already have begun to have the vaccine course and may even have a result confirming that you have responded, theClinicalSchoolpolicy is for all students to have their immunity verified by the local laboratory, so you will need a blood test.  You will also be screened for exposure to tuberculosis, hepatitis C and HIV.

Should you need any further convincing, remember that being a carrier of the Hepatitis B virus may lead to liver failure and also gives you a greater than 100-fold increased risk of developing primary liver cell cancer.   The reason that this cancer is still one of the 10 commonest in the world is almost entirely due to Hepatitis B.   There are few reliable ways of preventing cancer.  This is one, so take the opportunity.

 

Keeping appointments with Occupational Health

With around 300 new medical students to be processed through this time-consuming procedure in a short time, the staff responsible are working to tight deadlines under a great deal of stress; ensure you do not add to this by missing appointments or being late.  If you are required to complete a course of Hepatitis B vaccinations by Occupational Health, staff will do their best to provide you with appointment times, which minimise (but which cannot completely avoid) interference with your academic work.  Not all appointment times are totally convenient, and some may involve you having to get up rather early or missing part of a practical class.   Too bad!   You must not miss your appointment/s.  Failure to keep an appointment for a trivial reason will be treated as a very serious matter.

What to do if you have problems.

It is an unfortunate fact that with a large student body, some individuals will encounter problems in their private lives, and these can affect their progress on the course.  The table below gives a list of confidential sources of advice for many types of problem.

Confidential Sources of Advice 

Student’s College:

University:

External:

Tutors

Director of Studies

Chaplains

Supervisors

Nurse

Student Mentors

Dr David Good, Director of Education (Biological Sciences)
tel. (01223) (7)66899
Email: dg25@cam.ac.uk

Dr Diana Wood, Clinical Dean/DOMECs
tel. (01223) (3)36732 
Email: clinical.dean@medschl.cam.ac.uk

CUSU Welfare Officer:
tel. (01223) (3)33313
Email: welfare@cusu.cam.ac.uk
http://www.cusu.cam.ac.uk/welfare/

Counselling Service:
http://www.counselling.cam.ac.uk/
tel
. (01223) (3)32865
Email: reception@counselling.cam.ac.uk

Occupational Health Service:
tel. (01223) (3)36594
Email: occhealth@admin.cam.ac.uk

Disability Resource Centre:
tel. (01223) (3)32301;
textphone: (01223) (7)64085
http://www.admin.cam.ac.uk/univ/disability/
disability@admin.cam.ac.uk

Mental Health Support Group: www.srcf.ucam.org/mhsg

CUSU Eating Disorders Support (EDS)
tel. (01223) (7)40555 (Mon & Wed, 8-10pm)  
www.cusu.cam.ac.uk/campaigns/eds/ 

Cambridge Students night time Linkline:
http://linkline.org.uk/
tel
. (01223) 744444

University Church Chaplain: http://www.gsm.cam.ac.uk/chaplaincy/chaplaincies/

General Practitioner: University or Family

NHS Direct
24hr Helpline: 0845 4647
(will eventually be replaced by: 111)http://www.nhsdirect.nhs.uk

National University Counselling Services:
http://www.student.counselling.co.uk/index.htm

Samaritans
http://branches.samaritans.org/cambridge/
4 Emmanuel Road, Cambridge
tel. (01223) 364455 or (08457) 909090
Email: jo@samaritans.org

Centre 33 Information & Counselling Service:
33 Clarendon Street, Cambridge
tel. (01223) 316488  
Email:help@centre33.org.uk

Cambridge Racist Incidents Support Project
62-64 Victoria Road 
tel. (01223) 462615
Email: crisp@cecf.co.uk

Drinksense:
Dashwood House, 185 East Rd, Cambridge
tel. (01223) 350599
Email: centraloffice@drinksense.org
http://www.drinksense.org/

Alcohol Concern: www.alcoholconcern.org.uk

Rape Crisis:
http://www.rapecrisis.org.uk/

Down Your Drink NHS online alcohol reduction programme: http://www.downyourdrink.org.uk/

GMC- supporting students with mental health conditions (PDF flyer)

Section B Course and Assessment Information

Outline of the Medical Course

In the first two years of the course, you will study biological sciences relevant to medicine both as subjects in their own right, as well as means to solve medical problems.  The official title of the course reflects this: it is called “The Medical and Veterinary Sciences Tripos”, usually abbreviated to MVST (a Tripos is Cambridge–speak for a series of courses leading to a degree).  This is a traditional way of teaching medicine: learn the biomedical science first, and then study its application to medical practice.  Many students prefer to study this way, and by choosing theCambridge course you have declared your preference.  During these first two years these courses will give you instruction leading to both your professional medical qualifications (Second MB), and to yourCambridge degree (BA).  In order to proceed to a clinical school (where you take the Final part of your MB), you have to pass all subjects in the Second MB and gain your BA.

An advantage of theCambridgecourse is that all medical students have the opportunity in the third year either to specialise in a medically related subject such as pathology or psychology, or to widen their educational horizons by taking courses in, for example, social science, management or philosophy.
This freedom of choice gives a wide range of educational opportunities. 

You will also acquire experience of meeting patients from an early stage in your studies, in the "Preparing for Patients" component of the course, which forms a clinical strand through first, second and third years.

You will graduate with a BA after three years but the degree course also gives you the science grounding needed for professional education, which should result in your acquiring the degrees of Bachelor of Medicine and Bachelor of Surgery after your clinical study. The table below gives an outline of the course.

 

Year of Study

What you will study

Subjects and Courses

Qualifications Obtained

Year 1 – MVST 1A

 

Pre-clinical medical science

Medically relevant core scientific knowledge and skills, together with some optional specialisation.

2nd MB,
Tripos 1A

Year 2 – MVST 1B

2nd MB,
Tripos 1B

Year 3 - Part II

Part II course of specialised study

A wide range of courses and subjects (other Tripos courses are also available to medics).

BA

Years 4, 5 and 6

 

Clinical studies in Cambridge, Oxford or London Medical Schools

Clinical medicine leading to the development of clinical skills and knowledge in a range of specialties.

Final MB,
leading to
MB, BChir

 

Clinical Study

In the clinical part of the course, you will acquire further knowledge and clinical skills and apply your scientific knowledge to clinical problems.  On passing their Final MB examinations, students who have qualified in the United Kingdom are provisionally registered with the General Medical Council subject to demonstrating to the GMC that their fitness to practise is not impaired.  The initials you acquire vary: MB, BChir (if you stay in Cambridge), MB, BS (if you complete your course in London), BM, BCh (if you go to Oxford), or MB, ChB (if you go to various other places) but are known as primary medical qualifications (PMQ).

Provisionally registered doctors can only practise in approved Foundation Year 1 posts: the law does not allow provisionally registered doctors to undertake any other type of work.

To obtain a Foundation Year 1 post you will need to apply during the final year of your undergraduate course through the UK Foundation Programme Office selection scheme, which allocates these posts to graduates on a competitive basis. So far, all suitably qualified UK graduates have found a place on the Foundation Year 1 programme, but this cannot be guaranteed, for instance if there were to be an increased number of competitive applications from non-UK graduates.

Successful completion of the Foundation Year 1 programme is normally achieved within 12 months and is marked by the award of a Certificate of Experience. You will then be eligible to apply for full registration with the General Medical Council. You need full registration with a licence to practise for unsupervised medical practice in the NHS or private practice in the UK..  You need to be aware that regulations relating to medical registration may change from time to time.

For details, see national and local websites:

The Complementary Roles of the University and the Colleges

Cambridgeis a collegiate University, and responsibility for your education is shared between the University and your College.  You were admitted by a College and you will, I hope, soon make friends with other students in your College.  Your College Director of Studies will get to know you as an individual, and will organise the provision of supervisions to support and enhance the formal teaching given by Departments. Your College Supervisors, Director of Studies and Tutor provide a unique pastoral network designed to support your studies while at Cambridge.

Within the University, the Faculty of Biology is responsible for organising your teaching for the first three years.  The Faculty delegates responsibility for delivery of this formal teaching to Departments, or to course management committees: the majority of your formal teaching (lectures and practicals) is delivered by staff from six departments (Biochemistry; Genetics; Pathology; Pharmacology; Physiology, Development and Neuroscience and Psychology).  This teaching will be augmented and enhanced by small-group teaching (supervisions) organised by your College.  The supervision system can help with academic work, but also helps you to develop communication and writing skills.

Departments will provide course handbooks for each of the courses you take, and these will include details of the arrangements for lectures and practical classes in that subject, and detailed guidance about the form and conduct of examinations.  Much more information, especially on timetables, is available on the Faculty of Biology web site and you should become accustomed to consulting this:

Study Skills - how to survive the terms

University is not like school. There are significant differences between the way you were taught at school and the way you will learn at University, and sometimes you may feel bewildered by the transition.  In place of relatively small school classes, information at University is delivered by means of lectures, (essentially a 50-minute monologue) to groups of over 300 students.  Lecturers will issue hand-outs, but you will also need to develop your listening, concentration and note-taking skills to get the best out of this. The material will be delivered quickly, and it is then up to you to understand and assimilate it.  The information you are provided with in lectures will be developed and set in context in practical classes.  Although classes may be large you will work in small groups with demonstrators on hand to help and answer questions. These sessions are vital to your education and attendance is mandatory.

The supervision system is there to complement the formal teaching and the onus is very much on you to make use of it, and to develop study and time management skills to help you cope with, and master the material.  College supervisions will play a very important part in your education.  Make them interactive and take full advantage of them to ask questions about any parts of the course you need help with.

You will need to use the internet to consult library resources, past examination papers, databases of scientific literature, timetables - and much, much more.  The departments which provide your teaching are providing an increasing amount of supplementary information in the form of on-line course materials on their web sites, and the Faculty of Biology website also provides a lot of basic information.

You need to be aware that the University takes plagiarism very seriously. You can read more about it here.

 

Assessment and Exams 

Courses have been designed to allow students, wherever possible, to learn for themselves rather than being passive recipients of instruction, and you will get far more out of your course and are more likely to do well in your exams if you regard university as an opportunity to study what interests you, rather than just learning a syllabus to pass an exam.

You will encounter two kinds of assessment.

Formative assessment is designed to indicate to you how you are progressing, on a weekly or termly basis.  Your College supervisor and Director of Studies are the persons mainly responsible for providing this kind of feedback and continuous performance review.  Formative assessment, more or less informal, may also form part of some University-based teaching.

Summative assessment (end of year exams) determines your ability to proceed with the rest of the course. The main science courses in your first and second year will be examined in this way for two qualifications:

  • Second MB, which determines whether you are able to proceed to the clinical part of your medical course;
  • Tripos, on the basis of which you are classed and will receive your BA degree.  

Each of the exams for the major courses is divided into three sections, and the marks awarded to Sections I and II count for the Second MB qualification.  The general format is a 1-hour theory exam (Section I), which covers the lecture material and consists of MCQs or short notes, and a 1 or 2 hour practical exam (Section II) covering the practical material.  Because these Second MB exams constitute a professional qualification, you will be expected to pass them at a qualifying level, and to demonstrate a good knowledge and understanding of the whole of the subject material in the courses.   The marks obtained in these two sections will then be added to those of Section III, to give a final Tripos mark.

Students often ask, “How much do I need to know to pass the exams?”  The bottom line is that to pass your professional qualification (Second MB) you will be expected to show a good working knowledge of the subject material in all your courses.  Furthermore, you will be expected not merely to know this material but, more importantly, to understand it and apply that understanding to the solving of problems.

Courses will provide you with the scientific knowledge which doctors need to have in order to cope with today’s clinical practice, but we are also trying to show you that learning is a continuous process and that practitioners will have to continue to develop their knowledge and skills throughout their working careers.  To do well in the Tripos, you will need to show a deeper understanding of the material, and to be able to marshal facts into coherent arguments.

If you do not pass the Second MB sections, you are allowed one further attempt at a separate Second MB examination in September. Students are permitted only two attempts at Second MB examinations unless there are extenuating circumstances, such as illness or other good cause. If you require a third attempt, your College has to apply for this on your behalf to the Faculty Board of Clinical Medicine.

Section III consists of a 2 or 3 hour exam, during which you will be asked to write essays from a wide choice of topics; this section does not figure in your professional qualification, and the marks obtained count only towards your Tripos class.

In addition to the main science courses, there are other courses, for example the Social Context of Health and Illness, which are assessed only for the Second MB.

You should be aware that details of your academic performance in all aspects of the course currently counts as a major factor in your application for Foundation Year placements at the end of your undergraduate medical programme.

In the interests of public safety, in accordance with Tomorrow’s Doctors, and in your own best interests,  information pertinent to your educational achievements and to your fitness to practise may be shared by the Cambridge University School of Clinical Medicine with training providers, employers, regulatory organisations and other medical schools.
The consequence of this is that the best strategy is to aim to pass not just your Second MB exams, but also to secure a good performance in the Tripos, because this strengthens your application.

Further details of these exams and how they relate to the course can be found in the tables at the back of this booklet and on the MVST section of the website.

Complaints

(a) About courses

For each course that you take there is a Course Organiser (listed at the back of this booklet).  If you have problems with the organisation of a particular course, you should communicate with him/her.  You can also tell the student representatives who sit on the management committee for the course you are concerned about, and ask them to raise the problem on your behalf.   It may be a general problem, and this is one way of bringing it to the notice of the organisers.  A problem arising within a particular department may be raised, if all else fails, with the Head of the Department.

Problems with the teaching provided for you by your College should be raised with your Director of Studies or, if that fails, with your Tutor or with the Senior Tutor.  

(b) Queries or complaints about examinations

Any complaints about the conduct or the results of examinations must be raised in the first instance with your College Tutor, and not directly with the Examiners concerned.  It is your Tutor’s responsibility to advise on these matters.Cambridgeexam rules and regulations make provision for cases of illness or other misfortune; if you encounter any kind of illness or other impediment to exam preparation, the sooner you inform your College Tutor, the better.  All liaison between a student and the central administration, particularly in matters relating to examinations, must be conducted through your College Tutor.

Attendance at Teaching Sessions

Diligent attendance is a requirement and you need a certificate of diligent attendance to permit you to take the Second MB examinations.

Attendance at practical classes (but not lectures) is recorded, and if your attendance at the practical classes is unsatisfactory, the Head of the Department concerned will be unable to provide a certificate of diligent attendance, and your progression in the course and professional future may be put in jeopardy.

If there are good reasons why you are unable to attend a practical class then you should tell your Director of Studies and the appropriate Course Organiser.  It may be possible for you to do the practical at some other time.  Organisers of practical classes may notify students and their Colleges if a student’s attendance record is unsatisfactory.

As a student your timetable is likely to be very full. Most of the teaching in the first three years is carried out on the University’s Downing site.  If you haven’t time to return to College for lunch, undergraduates are welcome at the University Centre which is at the end of Mill Lane.

MIMS and HOM lectures will take place in Lady Mitchell Hall on the Sidgwick Site. The Sidgwick Buttery is open Monday-Friday 08:30 – 16:00

First Year Courses

Three courses are assessed for Second MB and Tripos. They cover the following topics:

- the overall layout of the structures of the body in Functional Architecture of the Body (FAB)
- the chemical and molecular mechanisms underlying the functions of the body and the mechanisms that govern inheritance in Molecules in Medical Science (MIMS)
- the mechanisms that underlie communication within the body, and the maintenance of the stability of the internal environment in Homeostasis (HOM) and Histology

Three other courses are assessed only for Second MB, and during these you will:

- be introduced to the broader cultural aspects of healthcare and the medical profession in the Social Context of Health and Illness (SCHI) and epidemiology and basic statistics in Introduction to the Scientific Basis of Medicine (ISBM).

- encounter patients in the community in Preparing for Patients A (PfPA). This is a patient contact strand, where you will begin to acquire the skills of listening and talking with patients, and it runs through the first three years of your course. Subsequent parts of this course will take place in second year (PfPB and PfPC) and in your third year (PfPD), and satisfactory completion of all four parts is required for Second MB qualification.

Second Year Courses

Four courses are assessed for Second MB and Tripos, and they cover:

- the structures of the head and neck in Head and Neck Anatomy (HNA)
- the mechanisms by which drugs act upon the body in Mechanisms of Drug Action (MODA)
- the biological processes underlying disease in Biology of Disease (BOD)
- the structure and function of the reproductive system in Human Reproduction (HR)
- the structure and function of the sense organs and the central nervous system and the study of mental processes in Neurobiology and Human Behaviour (NHB)

You will also have the opportunity to study aspects of these subjects in more detail in two Option courses, chosen from a range of subjects and also to continue to develop your experience in Preparing for Patients B and C (PfPB and C).

Summaries of the subject matter in these courses and detailed timetables will be provided in the individual course handbooks and on the MVST website.

The Third Year - Part II

After two years of preclinical study you do a further year’s study and take a final Tripos exam to complete the requirements for the BA degree. This year allows you to choose which course you want to study, and a big advantage of theCambridgesystem is that it offers an enormous range of courses in your third year.  You may choose to take in-depth courses in many of the subjects you studied in the first two years, or you may take courses in something completely different, such as Anthropology, Management Studies or Philosophy, or you may decide to combine different subjects via a course such as NST Part II Biological and Biomedical Sciences.

Your Director of Studies will be able to help you make a decision about what to take in your third year, and there will also be the opportunity to attend the "Subjects Fair" in March 2015, where the various course organisers will explain what they offer.  In April 2015, you will be asked to state preferences for which course(s) you want to take in your third year.

If you are an affiliated student, you will start the clinical part of your course inCambridgeor elsewhere after two years of undergraduate study.

The Preparing for Patients strand continues in your third year (PfPD).

The Clinical Years

Many of you will stay in Cambridge and go on to clinical study at Addenbrooke’s, but some may choose to go to the John Radcliffe in Oxford, or to one of the several London Clinical Schools.

Your College Director of Studies in Clinical Medicine should be able to advise you, and the various clinical schools run Open Days and are also represented at an annual meeting organised by the Medical Society at which the Deans of the variousLondonschools come toCambridgeto tell you about what they offer. In November 2015 (or November 2014 for affiliated students) you will have to complete an application form for your Clinical study and attend interviews.

Information about the Clinical School selection process is published on the Clinical School Intranet.

Student Feedback and Representation

Course organisers will actively solicit opinions from you about the teaching you receive.  We do change our teaching as a response to comments and suggestions made by previous students, and you owe it to those coming after you to respond to questionnaires, so that those responsible for organising the teaching know when something is right, and when something is wrong.  When you complete a teaching questionnaire try to be honest, informative, and, if possible, helpful.

Course liaison committees also have student representatives and it is at this level that most of the useful work is done in providing feedback to those who teach from those who are trying to learn.

The Faculty Board also has student representatives, and we hope that some of you will wish to contribute in this way to discussions about how the teaching is organised.  The student elected to the Faculty Board from the medical and veterinary students also sits on the Medical Education Committee, which maintains an overview ofCambridgemedical education from admission to qualification. There is also a Faculty Committee, the MVST Part I Committee, which overseesMVSTIAand IB, and includes student representatives.  Please feel free to take any thoughts you have about the course to any of your student representatives.

Student Societies

Within Cambridge there are various societies organised by and run for medical students. Here are “welcome” messages from two of them:

MEDSOC

The Cambridge University Medical Society warmly invites all undergraduate medics to join. Members will receive invitations to fantastic social functions and enthralling guest speakers at reduced prices. We organise trips to clinical schools in Oxford and London and members will also get a copy of Murmur, our very own publication, and receive book discounts at Waterstone's. For more information, visit us at

http://www.srcf.ucam.org/medsoc/

MEDSIN

Could you work abroad as a doctor one day? Or go into schools right now and teach first aid or sex education? Do you care about access to healthcare in the developing world, the AIDS crisis or refugees? And would you like to meet medics from all over the country, and go to conferences all over the world? The Medical Students International Network may be just what you’re looking for - opportunities to look at medicine in its widest sense, as well as some of the most original social events Cambridge has to offer. Take a look at http://www.societies.cam.ac.uk/medsin/ to find out more.

 

Estimated additional course costs 2013-14

In addition to the standard living costs, preclinical medics should expect to have to meet the following estimated costs):

  • 2 Lab coats (see notes below table)

£ 10.00 each

  • Dissection kit, gloves, safety glasses, manual*, loan of locker and key

£ 50.00

  • University approved calculator

£ 14.00

  • Preparing for Patients -
    • maximum for travel first year
    • 2nd year  College rent fees, up to
    • 3rd year travel up to

 
£  25.00
£130.00
£  25.00

  • Electron micrographs (optional)

£    2.00

*This manual is a dissection guide with additional notes to help you make the most of learning anatomy through cadaveric dissection.  It is specific to the Cambridge course and is not a substitute for a standard textbook.
The £50 will be payable by cash or cheque only at the first Introductory Functional Architecture of the Body (FAB) session on Wednesday 9 October 2013.

Lab Coats
You will be expected to have two lab coats. These can be purchased before arrival or during your scheduled Molecules in Medical Science (MIMS) lab coat session on Wednesday 9 October 2013 in the Hopkins Building in the Department of Biochemistry for approximately £10 each. This will be payable by cash or cheque only.
Lab coats purchased before arrival must be clean, full-length (down to your knees), high collar, closable, and white with pockets.

 

MEDICAL STUDENT REGISTER AGREEMENT

If you have a difficulty with any element of this declaration, please contact your college Senior Tutor to discuss how this might be resolved.  In exceptional circumstances, resolution may require GMC approval for special pre-registration experience.

1   I have read the following documents, and I agree to abide by the principles laid down in them:

  • The GMC and Medical Schools Council guidance “Medical students: professional values and fitness for practice” (November 2009), paragraphs 15 – 38;
  • The University’s Medical Student Code of Conduct and explanatory notes[i];
  • The ClinicalCourseClinicalSchool’s notes on the Legal Position of Clinical Students[ii];

2   I have also read the following information:

  • The University’s Confidential Sources of Help and Advice[iii].

3    I will comply with these and other  rules and procedures which may from time to time be laid down by the Faculty Boards of Biology and Clinical Medicine, the Director of Education (Biological Sciences), the Director of Medical Education, the supervising Consultant, General Practitioner, Ward Manager or their deputies;

4    I will inform the Director of Medical Education immediately if I am no longer able to meet the requirements of this agreement or if I become aware of any change to my physical or mental health which may put at risk the health and well-being of patients.

5   I understand that the Fitness for Medical Practice Committee may share information about my registration with other bodies in the public interest and has the authority to remove my name, either temporarily or permanently, for failing to observe the Medical Student Code of Conduct or failing to progress academically.

6   I understand that I will remain on the Cambridge Medical Student Register and observe the University’s Medical Student Code of Conduct until I have:

  • progressed to a clinical course elsewhere or withdrawn from the medical course;
  • sat any MB examination on two occasions without passing;
  • completed the requirements of the clinical course satisfactorily and been accepted onto the provisional GMC register;
  • been suspended by the Fitness for Practice Committee.

7    I understand that, if I fail to abide by this agreement and the Code of Conduct, I will be responsible for paying any reasonable costs arising from a review of my fitness for practice in the event that such review leads to me being found unfit to practise or fit to practise only on certain conditions.

8    I give my consent to the processing of my data by the University and understand that information on my educational progress and fitness to practise may be shared with other relevant organisations.

 

Student Name: ......................................   Witness Name:....................................      

Signature: ..............................................  Signature: .........................................

 
Date: ............................................       

 

Note that you will be reminded annually of the importance of these statements.

Please complete this form at your first Functional Architecture of the Body (FAB) introductory session on the morning of Wednesday, 9 October 2013, with Dr Cecilia Brassett.