Thoughts on my course! PART TWO.

Hello! I've just come off of a two week celebration after the end of exams and I'm finally back home and relaxing, so what better time to carry on this post! I hope you're all excited about starting your courses if you've accepted offers!

In the last post I talked about MCBoM (Molecular and Cellular Basis of Medicine), so now I'll go into HBoM (Human Basis of Medicine), which focuses very much on the patient experience and the societal impact rather than the science of medicine.

HBoM is split into SHM, Ethics and WPC:

• SHM (Society, Health and Medicine).
  This is covered in the first half of the first term for approximately 10 weeks (my memory's rusty!). It is taught in one session every week comprising a lecture followed by a tutorial. You'll be given a paper to read every week, which you must do some set work on before the next week's tutorial. SHM was good, our group worked really well together and we got on with our tutors so it was really nice - the content varied and always sparked debate! Topics that I can remember were the reasons behind declining chlamydia testing, reasons why people choose to seek or not seek help for health problems, the societal view of disability etc.
• Ethics.
  This was covered quickly at the end of the first term just before Christmas, and examined just after Christmas with SHM. It was very much what I expected - it covered the different ethical perspectives and applied them to different situations, encouraging us to debate amongst ourselves as before.
• WPC (Whole Person Care).
  WPC gets a bad rap sometimes for being too 'flowery' or pointless after SHM - it focuses on the more holistic side of medicine, taking into account the 'whole person' in the clinical context rather than just the disease itself. I enjoyed parts of WPC more than others but to be honest that's the same with everything in life - I think I got quite a lot out of it; topics included Mindfulness, Emotional Factors in Health and Resilient Systems. WPC was assessed by an assignment rather than an exam, in which we had to complete a personal activity which could be anything from volunteer work to structured interviews to an art piece, followed by an essay which included reflection on the art piece and analysis of the relevant literature.

So although MCBoM and HBoM were the main components of this year's teaching, we also had Epidemiology and Primary Care, and Systems teaching towards the end of the year.

• Epidemiology
  Okay so disclaimer: I try not to be biased when I'm talking about different aspects of the course, because different people enjoy different things, but I hated Epi! I hated it so so much haha, it's just everything I dislike and urgh...but I understand that not everyone will share my opinion haha, so here's a fairly objective description. Epi was basically evidence-based medicine and medical statistics. Every week we had a group session with tutors who were all epidemiologists (they were so lovely bless them and they had such a passion for their subject - but even they couldn't sway it for me haha) and each week we'd go through a different topic after which there would be set work. Topics included ways of presenting data (histograms, bar charts etc), different types of studies (cohort, cross-sectional, RCTs etc), how to interpret P values and confidence intervals, regression lines and that sort of stuff. Basically, it was fairly simple if you'd done Statistics before, and I'm sure it'll come in handy in the future if I ever want to go into or interpret research.
• Primary Care (GP Placement)
  This was brilliant - as my first placement at medical school I got a lot out of having the chance to talk to the GP I was assigned to and seeing first hand the way he interacted with patients - however I'm sure most people will have already done a GP placement in some form before medical school, even if it was just with a nurse. The quality of teaching varies between GPs as you would expect but in general it was a really positive experience. The best part about Primary Care, though, was the home visits. During the term we'd do a mixture of sitting in on consultations and going in twos to patients' houses to interview them about their experiences with illness. This time was honestly invaluable to me - it brings medicine down to a personal level, and often the patients feel more comfortable with you as students than they do the doctors themselves. The things you find out about people and their resilience or their vulnerability in the context of their illness move you and affect you more than any textbook or lecture ever could, and the things I heard and learnt have stayed with me and, I hope, will affect the way I relate to my own patients in the future. Primary Care was assessed in the form of two assignments, which were my favourite assessments throughout the entire course, as it was easy to be inspired to write having heard these patients stories first hand. The Applied Case was an essay based on one of the topics covered within SHM, applied to cases that we had seen during observed consultations, and the Reflective Assignment was a creative piece that could be art, poetry, prose, dance, or music (I know a girl who wrote music inspired by a patient) backed up by a reflective essay, based on a patient seen on a home visit. Of course, across the assignments all patient information was kept strictly anonymous, and consent obtained from all parties. Your GP tutor can nominate your assignments for prizes if they wish (I was nominated for my applied case, but some GPs tend to nominate people much more readily than others - it's often the luck of the draw, I know groups whose GP nominated them all, and groups where the GP didn't nominate any, regardless of how good they were, haha!) and often the tutors will say goodbye to you with a meal or a drink (ours took us to Pizza Express - they were lovely). 
• Systems (In 1st year, you study CVS and MSK).
  This was hands down my favourite part of 1st year - it felt good to apply the scientific knowledge we had to the body as a whole with a more clinical slant. In Systems, as the name implies, we looked at different systems of the body (we continue with all of the others next year). Each System is primarily taught by one person, with many other guest lecturers who are often high-ranking consultants, who come with videos of surgeries (particularly in MSK - lots of hip replacements and fracture repairs) and real anonymised clinical data, which can be really interesting, especially if you are thinking about pursuing a career in that particular system (I was not one of those people, but it was still interesting). Alongside lectures there are pharmacology and physiology practicals (which are often electronic simulations, especially in CVS, for good reason), clinical lecture sessions which involve real patients, and more anatomy. Anatomy is changed slightly for Systems (it was so nice to have it back!) in that rather than being a completely topographical cadaveric examination session it was split into 4 parts; topographical anatomy (specimens), applied anatomy (learning how anatomy can shape clinical skills - this was my favourite bit, we learnt the basic of how to auscultate heart sounds, place an ecg, do musculoskeletal examinations etc), clinical cases (where we were given an unidentified disease specimen in a pot, eg an abdominal aortic aneurysm, or a photo of a condition, eg Dupuytren's contracture, and asked to identify it and asked questions about potential differential diagnoses and risk factors), and radiology (where we were given various unidentified x-rays, eg a Smith's fracture/heart valve replacement, and asked the same kind of questions as in clinical cases but with the added task of identifying all of the features of the x-ray, for example on a chest x-ray we might have had to identify dextrocardia or situs inversus). Overall I found the Systems exams challenging, but easier to deal with as I really enjoyed all of the content - even though the sheer volume of drugs we had to learn for CVS was challenging, haha!

Overall, my first year has been incredibly rewarding and challenging, but I've loved every moment of the course (minus Epi, haha). If you have any questions, feel free to ask as always, but do bear in mind that Bristol tweaks the course year to year based on student feedback, so it is always getting better and better - they really do listen to your opinion; based on feedback about MCBoM and HBoM I think the powers that be are changing the structure of those elements, so watch this space!

Until next time,

Tash x