Huz Khojani

Starting 4th year

You would imagine that starting fourth year of medical school would be a daunting experience, knowing that your final university exams would be at the end of it. But as it turns out, that isn’t the case. There is a tremendous amount of confidence that comes from passing exams at the end of a medical school year, and so by the time that you’ve done it three times, you feel unstoppable. “Bring it on!” you declare to the challenge that lies ahead.

The first day of fourth year starts very similarly to how every other clinical year does; an entire day dedicated to talks that reinforce the principles of that we have been taught from the beginning, such as how to keep patients safe as well as ourselves. Then, during the final segment of the planned day, we are given the information that is most important to us; how fourth year is organised and which groups we are placed in.

In a nutshell, fourth year consists of a whistle-stop tour of the entire hospital (excluding the Accident and Emergency department). Four weeks are spent on each specialty except Medicine and Surgery, which get double the time. This makes sense, as these can be argued to be the “meaty subjects”. Because there are so many specialties to see, the year group is divided into groups that would rotate between the specialties. The concept of having “rotations” has been persistent since second year, however this year the groups are as small as five students. This means that a majority of the academic year will be spent with the same four people.

The first big change of the year that is quickly noticeable is the higher level of respect given on wards by doctors and more junior students. Along with the respect comes an expectation that we are able to perform more and better clinical skills on the wards. This means that we are given more responsibility in clinical practice, which I very much welcome. So far, the year has had me and my clinical partner running our very own GP clinic, as well as clerking patients in on a paediatric ward. Clerking a patient means that you are the first person that a patient talks to once they are admitted to the hospital. This can seem incredibly challenging as there are no patient notes and you are left with nothing but a stethoscope and your own clinical knowledge to determine what might be wrong with a patient. However, having a hands-on experience to this degree does make you more emotionally invested into the patient’s condition, resulting in remembering the features of the patient’s diagnosis for a long time in the future.

Not all clinical experiences have been rewarding however. The most frustrating time that I have had this year was when trying to examine a child who refused to let me go anywhere near them, but managed to pull at my ID badge and undo the lanyard that is attached to it from around my neck. Being particularly fond of my picture, the patient decides to put my badge into their mouth and starts chewing on it. The next half-hour is spent trying to get it back, which was a lot harder than expected.

As eventful as fourth year has been so far, I look forward to the challenges that it will definitely bring in the future. By this point in medical school, instead of seeing these challenges as problems you see them as opportunities to continue growing