Fourth year

 We could finally see what it’s like to work as a doctor in a teaching hospital. Unlike the previous years full of lectures, labs and tutorials based on basic sciences, this year is spent almost entirely in the hospital environment on medical and surgical wards. We have to regularly clerk patients with various medical problems (cardiovascular, pulmonary, GI, neurological etc.), take their history and perform physical examinations. There are also regular bed-side teachings from specialist doctors and consultants and we need to regularly partake in a number of clinical skills, such as venepuncture, arterial blood gases, NG tube insertion and cannulation. Compared to the previous years, the fourth year is almost entirely clinical with the exception of three weeks of pathophysiology, microbiology and clinical biochemistry lectures. At the moment, I am placed in the Bristol Royal Infirmary, but will be moving to Taunton at the end of January where I will be focusing on pathology, ethics, musculoskeletal diseases, emergency medicine and ophthalmology.

As mentioned above, I spent this summer working on my research project at the laboratory of cardiac electrophysiology. My work focused on the structural relationship between microtubule cytoskeleton and transverse tubules in cardiac rabbit ventricular myocytes. For further details, see my previous article. Although we did not manage to get our hands on failing rabbit myocytes in the end, I managed to significantly improve and broaden my analysis. I ended up receiving an invitation to a research conference for doctors and students at the end of the summer and winning a prize for the best medical dissertation.

Even though I loved the preclinical years and especially the last year focused on cardiovascular science and research, I am very happy to have started clinical medicine. I can finally see how useful the previous years full of lectures and labs were. Furthermore, we finally interact with patients on a daily basis and can really see what it will be like to be a doctor in a teaching hospital. After all, there are only two years remaining before we qualify so it’s about time we got our hands dirty.