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26. February 2019 Le Thu Tran

My first clinical exams

I always find it hard to explain to my family and friends back home what studying medicine in England is like. It is not just the terminology, it is also the format or the whole curriculum. I had my first clinical exam last week and when I told everyone I passed it on the first trial; I received many congratulations followed by “Sorry, what is actually a clinical exam?” Thus, I am dedicating this post to anyone who is equally confused by this term and hopefully, by the end of this post, you will have a clearer idea about studying medicine in England.

One component of our curriculum is called “clinical skills”. This consists of several teachings of basic examinations and procedures, such as obtaining blood samples, ECG readings or catheterisation. We practised all skills (there are fourteen of them in total) on fake models, apart from taking vital signs and an ECG. The biggest focus was on the patients’ safety; therefore, we were taught how to explain the procedures clearly, identify any risks/ contra-indications and gain consent to proceed.

In my first clinical exam, I was examined on six skills – handwashing, taking vital signs, drawing blood, inserting a cannula, administering IV drugs and setting up IV infusions. We had exactly 48 minutes to perform all these so as you can imagine, there was a lot of time pressure, too. Each station had the necessities prepared, a patient (whom we consented), and an examiner present. As soon as I introduced myself to the patient, I went on full-on autopilot mode – check this, confirm that, sign this etc. The hardest task for me in this examination was cannulation where the steps happen very fast after one another.

At the end of the exam, I received feedback immediately and a pass or fail result. I passed all the skills, which I was extremely happy about. As I was talking to a senior later that day, half of my year had failed at least one task so far. Therefore, passing on the first trial was a big confidence boost for me. The patient and examiner told me I explained everything very well, however, they advised me to use less medical terms as that might scare the patients off! (For example, instead of saying: “I will find the pulse on your wrist”, I medicalised the phrase and said: “I will measure your heart rate on your radial artery.”)

The first time we will be able to practice these skills on patients is during our upcoming summer placements. Medical students often practice obtaining blood samples on each other before going to hospitals. Thus, if you see me this June with bruises on my forearm, you will know what I have been up to (one of the risks of drawing blood is the formation of bruises.) But that is still quite a while away. In the meantime, I have two more clinical exams in March and my end-of-year-exams in May. So wish me luck!

For illustration, here is a photo of my friend and I measuring our blood pressures on the ground of our hospital’s corridor (everywhere else was too loud…).

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