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Medical Students Handbook

Introduction

Medical Education in Cambridge Welcome 2015-16

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 2015 and covers mainly the first two years.

Dr David Good

Director of Education (Biological Sciences)

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.

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.

Duties

Duties as a Student Doctor

The behaviour and performance of all medical professionals, including student doctors, is regulated by the General Medical Council (GMC). During your first year you will be sent a copy of the General Medical Council’s “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 the document you will sign is included at the back of 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 for Student Doctors

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 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 practise” (November 2009), paragraphs 15 – 38;  http://www.gmc-uk.org/education/undergraduate/professional_behaviour.asp

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.

Students whose health or conduct give rise to concerns that they may be a risk to patients will not be allowed to have contact with them and will be subject to Fitness for Practice Procedures.  This can lead to students being removed from the Medical Student Register and 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.

All members of the University and College staff have a duty, in the public interest, to report matters that may affect a student’s fitness to practice, to the Director of Medical Education in the Clinical School.  Matters may be referred if they concern poor academic progression, serious conduct issues, or low-level conduct issues that continue over a long period. Health concerns will not normally require referral unless there are serious concerns over fitness to practice, but will be referred under other circumstances, where students have agreed to disclosure. Students are strongly encouraged to disclose health concerns both to their Director of Studies and to the Director of Medical Education.

Details of the Fitness for Practice procedures can be found on the web at: http://intranet.medschl.cam.ac.uk/students/az/MedicalPractice.htm

And on page 222-230 of the University’s regulations: http://www.admin.cam.ac.uk/univ/so/2014/chapter02-section27.html

Medical Students Code of Conduct and Guidance

Reproduced here is the University’s formal Code of Conduct for student doctors. You are expected to have read this and the GMC guidance before you come up to Cambridge.  Make sure you understand these and if you have any concerns consult your tutor. 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. 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.

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 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 email, social networking sites, ‘Blogs’, ‘Twitter’. ‘Facebook’ etc to share information about patients.

See British Medical Association (BMA) guidance booklet on using social media: http://bma.org.uk/media/Files/PDFs/Practical%20advice%20at%20work/Ethics/socialmediaguidance.pdf

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), Director of Medical Education (Clinical School), 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 Director of Medical Education (Clinical School) 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 Director of Medical Education (Clinical School) 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 Support Section P22 – P25) 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.

Students' Legal Standing

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.

You should:

  • Always wear a badge identifying you as a student doctor, and introduce yourself as such
  • Always obtain a patient's permission to see/examine him/her

You may not: -

  • initiate X-ray or other diagnostic investigations; request blood for transfusion
  • make a formal diagnosis of death
  • perform any practical procedure nor give any medication (intravenous or oral) without authorisation and supervision by a medical practitioner
  • 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)

In regard to patient care, students report to junior doctors (F1 trainees) who report to the clinical team which reports to the consultant. 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. The degree of supervision is determined by the practitioner and so will vary from firm to firm; consequently students may find that in some firms they are allowed to carry out duties which are forbidden in others.

If you undertake a task which you know - or ought to know - that you are not qualified or sufficiently experienced to perform, you may be guilty of negligence. If a patient were to suffer harm as a result of your exercising less than reasonable care, you might be held personally liable/legally responsible. You could in theory be sued, but in practice the patient would sue the supervising practitioner or the Hospital Trust 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. The level of responsibility which had been delegated to the student by the supervisor must be held to be reasonable in regard to the student's experience and level of attainment. 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.

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).    

Carry out only those tasks authorised by a consultant or named deputy and perform the task on the basis of a standard procedure and you will not incur legal liability.

The Course

Course Outline

Year of Study

What you will study

Subjects and Courses

Qualifications Obtained

Year 1 – MVST 1A

 

Scientific knowledge

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

2nd MB, Tripos IA

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 based at Addenbrooke's Hospital

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

Final MB, leading to MB BChir

At the end of the undergraduate course you will receive your MB ChB (or equivalent) degree, which is a Primary Medical Qualification (PMQ). Holding a PMQ entitles you to provisional registration with the General Medical Council (GMC), subject only to its acceptance that there are no Fitness to Practise concerns that need consideration.  Provisional registration is time limited to a maximum of three years and 30 days (1125 days in total). After this time period your provisional registration will normally expire.

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 GMC. You need full registration with a licence to practise for unsupervised medical practice in the NHS or private practice in the UK.

For further details, see: http://www.foundationprogramme.nhs.uk/pages/home

Although this information is currently correct, students need to be aware that regulations in this area may change from time to time.

There is some discussion about whether to remove provisional registration for newly qualified doctors. If this happens then UK graduates will receive full registration as soon as they have successfully completed an MB ChB (or equivalent) degree. It should be noted that it is very likely that UK graduates will still need to apply for a training programme similar to the current Foundation Programme and that places on this programme may not be guaranteed for every UK graduate.

In addition the GMC is currently considering whether to introduce a formal assessment that all doctors would need to pass in order to be granted full registration. Although no firm decision has been taken as to whether or when such an exam will be introduced applicants should be aware that the GMC envisages that future cohorts of medical students will need to pass parts of a new UK Medical Licensing Assessment before the GMC will grant them Registration with a Licence to Practise.

The Course in Detail

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. You must pass all modules to progress onto the clinical part of the course.

1st Year

Core Science Modules:

  • Functional Architecture of the Body (FAB) –layout and function of the body’s structures
  • Molecules in Medical Science (MIMS) – chemical and molecular mechanisms underlying the functions of the body
  • Histology and Homeostasis (HOM) –mechanisms underlying communication/maintenance of a stable internal environment within the body

Clinical Strand Modules:

  • Introduction to the Scientific Basis of Medicine (ISBM) – epidemiology and application to medicine
  • The Social Context of Health and Illness (SCHI) – cultural aspects of health care
  • Preparing for Patients (PfP) – experience in meeting patients at, for instance, GP surgeries

2nd Year

Core Science modules:

  • Mechanisms of Drug Action (MODA) –mechanisms of drug action upon the body
  • Biology of Disease (BOD) –processes underlying disease
  • Human Reproduction (HR) –structure and function of the reproductive system
  • Neurobiology and Human Behaviour (NHB) –structure and function of the sense organs and central nervous system and their role in determining behavior. Also the study of psychology
  • Head and Neck Anatomy (HNA) –overall structure of the head and  neck

Clinical Strand modules:

  • Preparing for Patients (PfP) – experience in meeting patients in hospitals

3rd Year – Part II

An advantage of Cambridge is this year of specialist study choosing one of a wide range of subjects outside the typical medicine curriculum. Options vary from more science-related subjects - zoology or history of medicine, to less-science related subjects - philosophy or management studies. The Preparing for Patients module (PfPD) continues throughout the year to maintain patient contact. At the end of this year, you receive a BA. The Director of Studies and the "Subjects Fair" in March 2016 will help you make the decision about what to study. If you are an affiliated student, you skip this year.

4th, 5th, 6th Years - The Clinical Years

Your Clinical Studies (years 4, 5 and 6 of the course) will be based at Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust. As well as being a tertiary hospital with an international reputation for medical excellence, Addenbrooke's is the site of several major biomedical research institutions. You will also spend time in other regional NHS hospitals throughout East Anglia, and in general practices in Cambridge and the surrounding region.

Throughout your Clinical Studies, you will build on your biomedical science education, developing the knowledge, skills and attitudes required to practise clinical medicine. You will be exposed to general medical practice, both in the community and in hospital and to the specialist care provided  in hospital settings. The emphasis for teaching and learning will be patient-centred, such that you will be encouraged to think of medical care from the patients’ perspective, with implications for patient choice within a national healthcare delivery service. The clinical curriculum is based around a common set of themes which allow integration of a wide range of medical subjects around core principles of healthcare for the individual and for communities. These themes include:

  • Core Science and Pathology
  • Clinical Communication Skills
  • Practical Procedures
  • Diagnostic Reasoning and Patient Investigation
  • Therapeutics and Patient Management
  • Professionalism, comprising:
    • Professional Behaviour
    • Medical Ethics and Law
    • Multiprofessional Teamworking
    • Reflection, Learning and Teaching
    • Management and Leadership
    • Patient Safety
    • Public and Population Health
    • Palliative Care
    • Research and the INSPIRE programme

During your Clinical Studies, you will have weekly small-group 'clinical supervisions' with junior doctors to develop and monitor your clinical skills. You will also receive teaching on the wards and at the bedside, in clinics, in facilitated small group seminars and sometimes in lectures. The Clinical School Virtual Learning Environment (VLE), contains a wealth of resources and material to support your learning, and you will be expected to plan your time carefully to take advantage of these resources and to pursue self directed learning, in addition to taking full advantage of the clinical experiences available to you.

More information on the clinical course can be found on the Clinical School website at: http://www.medschl.cam.ac.uk/education/courses/standard/

Study Skills

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; you are also expected to read further material on the subject matter.  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 catalogues, past examination papers, databases of scientific literature - and much, much more. The departments that provide your teaching are providing an increasing amount of supplementary information on their web sites, and the Faculty of Biology website (http://www.biology.cam.ac.uk/undergrads/mvst ) also provides a lot of basic information. You need to be aware that the University takes plagiarism very seriously. You can read more about this on the Faculty website (http://www.biology.cam.ac.uk/exams/plagiarism).  

Attendance

Diligent attendance is a requirement of the Faculty Board of Biology as you will need a certificate of diligent attendance to permit you to take the 2nd 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 will be in jeopardy.

If there is a good reason 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 will 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 will be on the University’s Downing site.  If you haven't time to go to your 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.

Time out of the course

If you believe you may need to intermit and take time out of the pre-clinical course, for health or other reasons, please discuss this as soon as possible with your Director of Studies or Senior Tutor. If, following further discussion (including, where relevant, with Occupational Health) you feel that a period of intermission would be appropriate, a request will need to be made by your College and formally approved through the University’s Applications Committee.

Please note that there is a maximum time period (including periods of intermission) over which the entire medical course can be taken. This is eight years for standard course students; six years for graduate course students; and seven years for affiliated students. Extensions to this period can be made under exceptional circumstances, and an application for additional time in which to complete the course would need to be made to the Faculty Board of Clinical Medicine.

Assessment and Exams

Courses have been designed to allow students, wherever possible, to learn for themselves rather than being passive recipients of instruction. 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 throughout the first three years:

Formative assessment is an informal, continuous review of progress. Meetings are organised by your College Supervisor and Director of Studies on a weekly or termly basis to review your progress.

Summative assessment is your formal end of year exams. The 2nd MB determines whether you are able to proceed onto the clinical part of the course and the Tripos determine your class of BA qualification.  

There are three sections to the summative assessment. Section I involves one-hour theory exams based on the lecture material and consists of short notes or Multiple Choice Questions (MCQs). Section II involves one or two-hour practical exams based on practical material covered. Because these 2nd 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. 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.

Section III involves two or three-hour exams consisting of essay questions from a wide range of topics. This last section only contributes (along with Section I and II marks) toward your Tripos qualification, not your professional MB. To do well in the Tripos, you will need to show a deeper understanding of the material, and to be able to mould facts into coherent arguments.

You should be aware that details of your academic performance in all aspects of the course currently count 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 GMC’s ‘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 2nd 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 end of this section and on the MVST website:   http://www.biology.cam.ac.uk/undergrads/mvst/course-details

Examination resits and mitigating circumstances

If you do not pass the 2nd MB sections of your examinations, you are allowed one further attempt at a separate 2nd MB examination in September. Students are permitted only two attempts at 2nd MB examinations unless there are mitigating circumstances, such as illness or other good cause. If you wish to apply for a third attempt, please discuss this with the Director of Pre-Clinical Studies or the Senior Tutor in your College. Applications for an exceptional third attempt are made to the Faculty Board of Clinical Medicine and are considered on a case by case basis. Those which are approved are almost always based on the presence of mitigating circumstances, and have the support of the College. Following discussion with your College, if you wish to apply for a third attempt, your College has to do this on your behalf and has to provide a letter to show whether or not they support the application, and why.

 Please note that unless exceptional circumstances apply, Faculty Board will not approve requests for third attempts at examinations, on more than two separate occasions throughout the entire medical course. For example, if Faculty Board approved requests in your first and second pre-clinical year, they would not normally consider further requests in subsequent years (including the clinical years of the course).

Please also note that mitigating circumstances MUST be declared in advance of the examination. Applications for exceptional third attempts based on a declaration of mitigating circumstances after the fact, will normally not be approved, particularly if those circumstances were known and could have been declared in advance.

You may be hesitant to discuss difficult circumstances such as depression or a family problem – however, if these difficulties are affecting your ability to study for your examinations and you are concerned that they will affect your examination performance, you are very strongly encouraged to discuss these with your Director of Pre-Clinical Studies or Senior Tutor before your examinations. Your tutors can then discuss possible sources of support and help, and can advise you on whether they believe your difficulties could potentially constitute mitigating circumstances. If so, they can make a declaration of such circumstances on your behalf. If you experience severe difficulties immediately prior to your examinations, and are not in a position to discuss these with your College first, please declare these difficulties to the examiners, to your College and to the Clinical Dean as soon as possible after the examination, and certainly by noon on the Monday following the last examination.

Being aware of and reflecting on, your own health and personal circumstances, and seeking support if you feel that your wellbeing and performance are suffering, is part of the professional attitude that you will be expected to demonstrate as a doctor in training, and subsequently as a fully licensed professional. Adopting this attitude towards your professional examinations will stand you in good stead for making similar assessments and decisions when it is your working environment and your contact with patients that may be affected.

Year One Examination Summary

Course

Exam paper structure

Material examined

Assessment

Exam format

Notes

Homeostasis (HOM)

Section I

1 hour

Lecture material

2nd MB

2nd Vet MB

Tripos

MCQs or Short Notes

Sections I & III taken   as a single 3 hour paper

Section II

2 hours

Practical material

2nd MB

2nd Vet MB

Tripos

Practical questions (by MCQs)

Section III

2 hours

Whole course

 

Tripos

Essay questions

Molecules in Medical Science (MIMS)

Section I

1 hour

Lecture material

2nd MB

2nd Vet MB

Tripos

MCQs

Sections I & II taken   as a single 3 hour paper

Section II

2 hours

Practical material

2nd MB

2nd Vet MB

Tripos

Practical questions

Section III

2 hours

Whole course

 

Tripos

Essay questions

Functional Architecture of the Body (FAB)

Section I

45 minutes

Lecture material

 2nd MB

Tripos

MCQs

Sections I & III taken   as a single 2 hour 45 minutes paper

Section II

75 minutes

Practical material

 2nd MB

Tripos

Practical questions

Section III

2 hours

Whole course

 

Tripos

Essay questions

Introduction to the Scientific Basis of Medicine (ISBM)

One paper

45 minutes

 

2nd MB

2nd Vet MB

 

MCQs

 

Social Context of Health and Social Care (SCHI)

One paper

1.5 hours

 

2nd MB

 

 

Essay questions

 

Preparing for Patients A (PfPA) Course work

 

 

 2nd MB

 

 

 

 

Note 1 Histology will be examined as part of the Homeostasis practical.
Note 2 The regulations for MVST IA stipulate that each subject of the IA examination should carry the same marks. Form and conduct notices http://www.biology.cam.ac.uk/exams/form-conduct have been published in the Reporter, which describe in detail the format of each examination.

Year Two Examination Summary

Course

Exam Structure

Material examined

Assessment

Exam format

Notes

Biology of Disease (BOD)

Section I

1 hour

Lecture material

2nd MB

2nd Vet MB

Tripos

MCQs

Sections I & III taken   as a single 3 hour paper

Section II

2 hours

Practical material

2nd MB 

2nd Vet MB

Tripos

Practical questions

Section III

2 hours

Whole course

 

Tripos

Essay questions

Mechanisms of Drug Action (MODA)

Section I

1 hour

Lecture material

2nd MB

2nd Vet MB

Tripos

MCQs

Sections I & III taken   as a single 3 hour paper

Section II

2 hours

Practical material

2nd MB

2nd Vet MB

Tripos

Practical questions

Section III

2 hours

Whole course

 

Tripos

Essay questions

Neurobiology and Human Behaviour (NHB)

Section I

1 hour

Lecture material

 2nd MB

 

Tripos

Short Answer Questions

Each section taken as a separate paper

Section II

1 hour

Practical material

 2nd MB

 

Tripos

Practical questions

Section III

3 hours

Neurobiology

Psychology of medicine

 

Tripos

Tripos

Essay questions

Essay questions

Human Reproduction (HR)

Section I

1 hour

Lecture material

 2nd MB

Tripos

MCQs

Sections I and III taken as a single 2½ hour paper

Section II

1 hour

Practical material

 2nd MB

Tripos

Practical questions

Section III

1½ hrs

Whole course

 

Tripos

Essay questions

Head and Neck Anatomy (HNA)

Whole Course

lecture and practical material

2nd MB

     Tripos

Short answer questions

Single 1½ hour paper

Preparing for Patients B (PfPB)

Course work

 2nd MB

 

 

Note: The regulations for MVST IB stipulate that the maximum marks allocated to each subject at IB should be in the following proportions:

Biology of Disease 10                                            
Mechanisms of Drug Action 10
Neurobiology and Human Behaviour 14
Human Reproduction 8
Head and Neck Anatomy 4

 Form and conduct notices http://www.biology.cam.ac.uk/exams/form-conduct have been published in the Reporter, which describe in detail the format of each examination.

Costs for Years One and Two

In addition to the standard living costs, preclinical medics should expect to have to meet the following costs (estimated on last year’s actual costs):

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

Less than £50 

Two Lab coats (see notes below table)

~£10.00 each

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

*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 ~£50.00 will be payable by cash or cheque only at the first Introductory Functional Architecture of the Body (FAB) session.

 Lab Coats

 You will be expected to have two lab coats. These can be purchased before arrival from external suppliers or from the University during your scheduled Molecules in Medical Science (MIMS) lab coat session for approximately £10.00 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.

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 needs improving.  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 learning.

The Faculty Board has student representatives, and we hope that some of you will wish to contribute through this means of discussion.  The student elected to sit on the Faculty Board from the medical and veterinary courses also sits on the Medical Education Committee, which maintains an overview of Cambridge medical education from admission to qualification. There is also a Faculty Committee, the MVST Part I Committee, which oversees MVST IA and IB, and includes student representatives.  Please feel free to take any thoughts you have about the course to any of your student representatives.

Concerns about other students/members of 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 from the College Tutor or Director of Studies if they think another medical student has behaved in such a way that suggests he or she is not fit to practise. 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 about the course

If you have problems with the organisation of a particular course, you should communicate this with the Course Organiser.  You can also tell student representatives who sit on the management committee for the course to raise the problem on your behalf.  Please don’t hesitate to raise an issue, especially since the problem may be general. If all else fails, raise problems with the Head of Department.

Problems with the teaching provided for you by your College should be raised with your Director of Education and, that failing, with your Tutor or Senior Tutor.  

Complaints about exams

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

Cambridge Culture

The complementary roles of the University and the Colleges

Cambridge is a collegiate University, and responsibility for your education is shared between the University and your College. 

Within the University, the Faculty of Biology is responsible for organising your teaching for the first three years. You will undergo practicals and lectures from staff of six departments: Biochemistry; Genetics; Pathology; Pharmacology; Physiology, Development and Neuroscience (PDN) and Psychology.

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:

http://www.biology.cam.ac.uk

This teaching will be augmented and enhanced by small-group teaching (supervisions) organised by your College.  These help with academic work, but also communication and writing skills. 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 provided by Departments. Your College Supervisors, Director of Studies and Tutor provide a unique pastoral network designed to support your studies at Cambridge.

Student Soceities

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 Waterstones.   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.srcf.ucam.org/~medsin/ to find out more.

Support

Academic Support

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

Begin by asking your College Supervisor in the appropriate subject. 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.

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. But 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.

The Medical and Veterinary Student Progress Panel

The College tutorial and pastoral system is backed up by the Medical and Veterinary Student Progress Panel. The Panel maintains a general overview of medical student progression throughout both the preclinical and clinical course at Cambridge and monitors the cases of students who, for one reason or another, may be having problems with the course. 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. The committee is not a disciplinary body but is set up to provide support for students and Colleges. Its basic remit is to ensure that students have a timely and trouble-free progress through the course. See more at:

http://www.bio.cam.ac.uk/sbs/facbiol/mvst/monitoring_student_progress.pdf

Protecting Your Health

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 a 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. Therefore, attendance at the Occupational Health vaccination sessions is an absolute must! 

Although you may already have begun the vaccine course (and even had a result confirming that you have responded), the Clinical School’s policy is for all students to have their immunity verified by the local laboratory. 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, staff responsible work to tight deadlines under a great deal of stress. Ensure you do not add to this stress by missing appointments or being late.  If you are required to complete a course of Hepatitis B vaccinations, Occupational Health 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.

Occupational Health Service

Tel: 01223 (3)36594

occhealth@admin.cam.ac.uk   

16 Mill Lane, Cambridge CB2 1SB

Non-Academic Support

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:

Chaplains

Director of Studies

Nurse

Supervisors

Student Mentors

Tutors

 

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

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

 

Counselling Service:
http://www.counselling.cam.ac.uk/
Tel. (01223) (3)32865
Email: counsellingreception@admin.cam.ac.uk

Disability Resource Centre:
http://www.disability.admin.cam.ac.uk/ 
Tel. (01223) (3)32301
Email: disability@admin.cam.ac.uk

Occupational Health Service:
http://www.oh.admin.cam.ac.uk/
Tel. (01223) (3)36594
Email: occhealth@admin.cam.ac.uk

Cambridge Student Linkline:
http://linkline.org.uk/ 
Tel. (01223) 744444
Email: email@linkline.org.uk

University Church Chaplain:
http://www.gsm.cam.ac.uk/chaplaincy/chaplaincies/
Tel: (01223) (7)41720
Email: office@gsm.cam.ac.uk

Alcohol - Drinksense
http://www.drinksense.org
Tel. (01223) 350599

Bullying - Bullying UK / Family Lives 
http://www.bullying.co.uk
Tel. 0808 800 2222

Bereavement - Cruse Bereavement
http://www.cruse.org.uk
Tel. (01223) 633536

Counselling - Centre 33
http://www.centre33.org.uk
Tel. (01223) 316488

Disability - Disability Rights UK
http://disabilityrightsuk.org
Tel. 0800 328 5050
Email: students@disabilityrightsuk.org

Domestic Violence - Abacus Counsellors
http://www.abusecounselling.co.uk/Counselling.html
Tel. (01223) 511551 / 07988 803620

Drugs - Inclusion
http://www.inclusion-cambridgeshire.org.uk
Tel. 0300 555 0101

Eating Disorder - BEAT
http://www.b-eat.co.uk
Tel. 0845 634 1414

Forced Marriage / Honour Killings - Foreign office Forced marriage Unit
https://www.gov.uk/stop-forced-marriage
Tel. 0207 008 0151
Email: fmu@fco.gov.uk

Housing Advice and Information (Cambridge City Council)
https://www.cambridge.gov.uk/get-advice-about-housing
Tel. (01223) 457918

Mental Health / Emotional Distress - Samaritans
http://www.samaritans.org
Tel. 0845 790 9090
Email: jo@samaritans.org

Racism - Cambridge Ethnic Community Forum
http://www.cecf.co.uk
Tel. (01223) 655241

Rape - Cambridge Rape Crisis
http://www.cambridgerapecrisis.co.uk
Tel. (01223) 245888
Email: support@cambridgerapecrisis.co.uk

Sexuality - SexYOUality
http://www.syacambs.org.uk
Tel. (01223) 369508
Text: 2byou to 07808 189158
Email: info@syacambs.org

Sexual Health - iCASH
http://www.icash.nhs.uk
Tel. 0300 300 3030

Medical Student Register Agreement 2015 

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[1];
  • The Clinical School’s notes on the Legal Position of Clinical Students[2];

2   I have also read the following information:

  • The University’s Confidential Sources of Help and Advice[3].

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 understand that all members of the University and College staff have a duty, in the public interest, to report matters that may affect my fitness to practise to the Director of Medical Education. 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, in the public interest, share information about my registration with external bodies and has the authority to remove my name, either temporarily or permanently, from the Medical Student Register 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:

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

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: ............................................       

Please complete this form at your Clinical School introductory session.