Register for MedSoc 2013

Future Students

Beginner’s Guide to the UNSW Medical Course

Original By Tom Hughes 2008/ Updated by Matthew Lam 2009 and Jacqueline Ho 2010

Introduction
Background
The Phases, the Teaching Periods and Graduate Capabilities
Phase 1
…..Foundations
…..Phase 1 Assessment
Phase 2
…..The Independent Learning Project (ILP)
…..Coursework
Phase 3
General Education/Extra-faculty Units
Medicine/Arts
Medicine/Science (Honours)
After Graduating

Introduction

The undergraduate Medicine course at UNSW has many aspects and quirks, which make it different to other courses at UNSW and even other medical degrees in Australia (although you’ll be equally qualified). Its’ structure also makes it more than a little confusing for its own students – this guide will give an overview of the course structure, its jargon and some of its variations such as the Combined Bachelor of Medicine/Bachelor of Arts program and the Bachelor of Medicine/Bachelor of Science (Honours) program.

The UNSW Medicine Faculty page discussing the course structure can be found here.

PLEASE NOTE- The information here is written by current students and not the faculty. While we try our best to keep the information here as accurate and up to date as possible, ALWAYS consult the faculty website for the latest information.

Background

Until 2004, the medical course at UNSW was split into two parts, pre-clinical and clinical: the first 3 years were on-campus, lecture/tutorial based learning with little or no clinical exposure, followed by 3 years of hospital-based teaching with a small number of university-based lecture blocks. This had both advantages and disadvantages; theoretically, students knew all the medical science they needed to know by the time they commenced in hospital – but with up to 3 years since they had learnt some material, there was a good chance they had forgotten parts of it. Additionally, it was left to the students to effectively integrate their earlier lecture-based learning with their later clinical-based learning. At the same time as the course was restructured, the entrance process was also changed include an interview. It was hoped that the interview would help to select more motivated students and students with better communication skills, with the hope of reducing dropout rates and producing graduates with better bedside manner. Whether or not this worked is still being debated, but it was felt that a single factor (the UAI) was not enough by itself to choose people who would make good doctors.

The New Course

In contrast to the old course, the new course which commenced in 2004 (Med V of 2008) is an integrated course where both lecture-based and clinical-based teaching are conducted throughout the program and scientific information in integrated with clinical material as it is taught. The rest of this page will describe the course and its structure.

The Phases, the Teaching Periods and Graduate Capabilities

The course is divided into 3 Phases, each with a different emphasis on the skills being taught. Each Phase is broken into a number of 8-week Teaching Periods, with a total of 27 in the entire course – 4 per year in the first 3 years, and 5 per year in the final 3 years (Med IV V VI students commence in Jan).

This structure is significantly different to the rest of UNSW- only a single course is studied per Teaching period in Medicine, whereas most UNSW students study 3-4 subjects per 13-week Session followed by a 2-3 week exam period. The following table illustrates this difference.

As a result, almost all your classes as a medical student will be with other medical students only, except for your General Education and extra-faculty courses.

Graduate capabilities are the Faculty’s way of describing its expectations of what students will learn from a given class, task or whole course. They are divided into 8 areas which represent different areas of good medical practice:

• Basic and Clinical Sciences
• Social and Cultural Aspects of Health
• Patient Assessment and Management
• Communication
• Teamwork
• Self-directed Learning
• Ethical and Legal Responsibilities
• Reflective thinking and writing

The various teaching activities are spread over these areas, and you will need to choose assignments and projects in your various courses so that by the end of each Phase you have completed assessments focusing on each area at least once or twice.

Phase 1

Phase 1 contains 8 Teaching Periods:

• Foundations [MFAC1501]

• Beginnings, Growth and Development A + B [MFAC1521 and 1522] – Conception, pregnancy and birth; childhood growth and development; puberty, adolescence, sexuality and relationships; nutrition, growth, and body image
• Health Maintenance A + B [MFAC1523 and 1524] – Homeostasis, sustenance, and equilibrium; education, health promotion, and disease prevention; host defence; lifestyle factors that risk health
• Ageing and Endings A + B [MFAC1525 and 1526] – Menopause; the ageing process; degenerative disease; death, dying and palliative care
• Society and Health [MFAC1527] - Society, culture and genes; socioeconomic determinants of health; health delivery systems; health and human rights

Students commencing on an odd year start with Cycle B courses and complete Cycle A courses in year 2, and vice versa.

The focus of Phase 1 is acquiring basic scientific knowledge in the key medical science disciplines – anatomy, histology, physiology, pathology, microbiology – and learning basic history-taking and examination skills. The emphasis is not on diagnosing or treating problems but on practicing the skills necessary to do so by recognising the normal and the abnormal. Hospital tutorials take place once per fortnight for 2 hours, with on-campus clinical and communication tutorials for 3 hours in the alternate week. A typical week in the first 7 weeks of each term would have 6-8 hours of lectures, 4-6 hours of practicals, 2-3 hours of clinical/communication tutorials, 4 hours of scenario group sessions and 1-2 hours of specialized tutorials (anything from ethics to pathology). The final week is usually the exam only, leaving 2-3 days for exam preparation.

Each 8-week term is based around 3-4 ‘scenarios’- each scenario examines one of the course themes and teases apart various aspects of it based on an introductory story which is developed in tutorial classes (scenario groups). For example, a scenario on heart disease might start with a skit about a middle-aged male smoker with chest pain and a suspected heart attack- to understand what has happened, you might be taught the anatomy, histology and physiology of the cardiovascular system, the prevalence of heart disease and its risk factors, how to examine the cardiovascular system including listening to heart sounds, the pathology of heart attacks and their clinical complications, some basic treatment and the ethical issues surrounding heart transplants. Each of these things is taught over a series of lectures, tutorials, clinical tutorials and science practical classes, and integrated with discussion, homework tasks and learning activities in the scenario group sessions which happen twice per week.

Foundations

Foundations is the first course in first year, which is designed to ease new students into the structure and assessment style of the medical program. Clinical tutorials commence in the first or second week to acclimatise you to the hospital environment, while the on-campus theory is focused on providing a broad introduction into each of the main medical and clinical science disciplines. Foundations represents a good opportunity for students who didn’t do chemistry or biology in the HSC to catch up the necessary information- this isn’t to say that you would be able to catch up everything, or that most of Foundations is a repetition of those subjects. Many students also find foundations as a good opportunity to meet fellow students who you’ll be spending the next 6 years with, and to generally settle into university life.
In addition, Foundations, whilst not formally assessed – the same kinds of tasks are completed but the marks will not be counted towards passing or failing Phase 1 (as opposed to the subsequent 7 courses) – it must still be satisfactorily completed to move onto the next course.

Assessment in Phase 1

Each term in Phase 1 is assessed in 3 parts: an individual assignment, a group project (with a few other members of the scenario group) and an end of course exam. The written tasks are usually due around Week 6 or 7, and the exam is usually on the Thursday of Week 8. Each of the written tasks assesses 2 focus capabilities from the list of 8, as well as 3 “generic” capabilities (communication, self-directed learning and reflection). Each capability is graded as either Fail, P- (roughly a pass conceded or low Pass), P (high Pass or a Credit) or a P+ (Distinction or High Distinction), plus an overall grade on the same scale.

Each end of course exam has 6 sections: 4 short answer questions and a multiple choice section. If you fail 2 or more exams in a year, you will need to repeat that year as well as sitting the usual supplementary exam for failing an exam.

By the end of Phase 1, you should have balanced your assignments so that each capability has at least 1, preferably 2 results. At the beginning of your 3^rd year, you will need to write a 3500 word reflective essay (the Phase 1 Portfolio) about your learning and development in each of the 8 capabilities over Phase 1. The Portfolio is a barrier exam; that is, you must get a grade of P- or higher to continue to Phase 2.

A progressive practical barrier exam consisting of 3 exams are held at the end of year 1, after TP2 in year 2 and at the end of year 2. This will examine the material provided in the practical classes across the disciplines of anatomy/embryology, microbiology/biochemistry/genetics, histology/histopathology, and physiology/pharmacology. An overall pass is required in each of the disciplines to move onto phase 2.

In addition, after the final Phase 1 course, there are 2 other barrier assessments: a clinical skills exam (OSCE – Objective Structured Clinical Examination) covering history taking and basic examination skills on actors, and a large multiple choice theory exam. All 2 exams cover material from all 8 courses; material from Foundations is not directly examined but most of it appears in the other courses, from where it could be examined.

Phase 2

Phase 2 is broken into 2 distinct parts: the coursework component and the Independent Learning Project (abbreviated ILP). They can be completed in either order; it is pretty much up to you whether you complete ILP or coursework first, although a few people may not get their preference if too many from their year choose one over the other.

The Independent Learning Project (ILP)

The ILP is a compulsory research project aimed at giving students some experience in the research process, including developing self-directed learning skills in choosing and completing a project. It is similar in many ways to a Science Honours project, the main difference being that it is slightly shorter and part-time rather than full-time for half of its length. The ILP consists of 4 Teaching Periods: the first term is for completing a literature review of the topic area (3000 words) and learning and skills necessary to complete the project (eg lab techniques); the middle 2 terms are given to collecting data and the final term is for writing the final report (up to 5000 words; written as a journal article). Of the final mark, 40% is awarded directly by the supervisor, and the other 60% is given by the report’s marker. You must pass the ILP to move into Phase 3.

It is advised that you negotiate the topic of your ILP, as this allows you to choose an area you are interested (and hopefully a supervisor who you can work well with). To negotiate a project, contact an academic associated with the Faculty in the area you are interested in, and ask if they have any projects that you could complete or if they would be interested in supervising a topic you are interested in. If you do not negotiate your own, the Faculty does prepare a list of projects for you to choose from. However, as some projects tend to be more popular than others, you may find you are allocated a project that was fairly low on your preference list.

The ILP is given a part-time loading (in the number of units in enrols you in) to allow you to complete your extra-faculty courses.

There are 2 cases in which you do not need to do an ILP: if you have already completed a research project as part of another course (you will need to provide detailed evidence) or if you choose to undertake the Honours program instead.

For more information on the ILP see the Faculty website .

Coursework

The coursework component of Phase 2 is an extension of each of the four course themes of Phase 1. However, the structure and content of the courses is quite different to Phase 1, as there is a much greater emphasis on clinical teaching. Three days per week are spent at clinical attachments while only 2 days are spent on campus for lectures and tutorials. In addition, the clinical teaching is quite self-directed compared to Phase 1, as your timetabled activities will provide a good introduction into each area but you will need to use the course syllabus and some of your own time to get the most out of each course.

The clinical allocations for Phase 2 are done via a preference system, as per Phase 1. You also get to place a preference for which kind of community health clinic you would like to be attached to in Society and Health 3. Most people are allocated to the Royal Womens’/Sydney Children’s campus for at least part of Beginnings, Growth and Development 3, although it is also possible to be allocated to other sites, eg St George or Campbelltown.

If you choose, you may complete Phase 2 coursework at one of the faculty’s rural clinical schools: Wagga Wagga, Albury, Port Macquarie or Coffs Harbour, however this is for students completing coursework in year 4.

There are 6 courses in coursework and you will be allocated into one of four sequences in which they are run:

• Adult Health 1 (6 weeks)
• Oncology and Palliative Care (4 weeks)
• Adult Health 2 (6 weeks)
• Aged Care and Rehabilitation (4 weeks)
• Beginnings, Growth and Development (6 weeks)
• Society and Health (6 weeks)

The assessment for Phase 2 coursework takes the form of a group project for Society and Health, and individual case report assignments for the other courses (please note: Beginnings, Growth and Development requires 2 case reports – one based on obstetrics/gynaecology and the other on paediatrics).

You must pass each of these assessments to move to Phase 3, and you must also balance the graduate capabilities you focus on as per Phase 1.

At the end of coursework rotations in Phase 2, there is another End of Phase barrier clinical exam. This exam consists of six 10 minute stations; each station has a 10 minute focused history or physical examination and students will be expected to provide differential diagnoses and answer questions based on the presenting condition.

In addition to the clinical exam, there is also another reflective Portfolio due at the end of 4^thyear, similar in most aspects to the Phase 1 Portfolio, except that it is a focused version. This means that it only requires a minimum of 2 capabilities, although more can be done as required or desired. In particular, students must address any capability where they received poor marks in the Phase 1 porfolio or in Phase 2 assessments.

Phase 3

Phase 3 covers the final 2 years of the course and consists of 10 Teaching periods:

• Internal medicine
• Surgery
• Critical care (emergency and intensive care)
• Selective term – students undertake a medical or surgical term of their choice, dependent on what is available at their hospital
• Psychiatry
• Obstetrics & gynaecology
• Paediatrics
• General practice
• Elective term – this term may be completed at any hospital in the world, subject to Faculty approval (for more information, see the Faculty website)
• Internship preparation (usually called PRINT)

Students are allocated to a teaching site for both years of Phase 3; however, a number of courses are allocated independently by the individual schools that run them. Local students must complete at least 4 weeks in one of these courses in a rural setting (hospitals include Grafton, Lismore, Kempsey, Orange and Broken Hill); however, the option also exists to do one or both years in a Rural Clinical School (Wagga Wagga, Albury, Port Macquarie or Coffs Harbour). Each Rural Clinical School takes around 14 students in each of year 5 and 6, meaning that roughly a quarter of local students will spend a significant amount of time in a Rural School. Preference is given to rural entry students; however rural entry students may also be co-opted to attend a Rural Clinical School if insufficient students preference Rural Schools. Please note that international students are generally unable to undertake either short or long attachments to rural hospitals or the Rural Clinical Schools due to the structure of the Federal funding arrangements.

Assessment

Assessment in Phase 3 varies from term to term, and each term has specific learning outcomes. More information about specific course assessments will be added later.

In addition, there is a Biomedical Sciences viva voce examination at the end of Year 5, which must be passed before you can leave for your elective term.

At the conclusion of Year 6, the Phase 3 portfolio is submitted, which is also a barrier examination. Other details for final Phase 3 assessments are still being finalised.

General Education/Extra-faculty Units

In order to promote broader education for its students, UNSW requires students to undertake studies in areas other than their field of specialisation. For medicine students, this means that students must complete 12 Units of Credit (UoC) in courses outside of the MBBS program. This can be done by studying-

• General Education courses (normally 3 UoC) and/or
• Extra Faculty courses (normally 6 UoC)

The courses available are very diverse – virtually every faculty has courses you may enrol in- from Arts to Law, Engineering to Built Environment, Science to Business and even the College of Fine Arts. The only restrictions are courses which are too similar to what is studied in the MBBS program; the Faculty maintains a list of courses which it will not credit on its website. For more complete information, see the Faculty website..

These GenEd/ExtraFac requirements are normally completed in Years 3-4, hence students commencing in Year 1 will receive plenty of information regarding them as they progress through the course.

Medicine/Arts

Students may opt to enrol in Medicine/Arts instead of a normal MBBS. This extends the degreefrom 6 to 7 years due to a year spent completing only Arts courses. Ideally, students need to decide before the beginning of their second year of medical study whether they wish to persue the combined degree, as they would be expected to enrol in Arts courses from their second year onwards. The Arts year can be taken after the second, third or fourth year of medical study. Upon completion of the 7 year course, a student will graduate with a Bachelor of Medicine/Bachelor of Surgery degree and Bachelor of Arts degree.

For more information, see the Faculty website.

Medicine/Science (Honours)

Instead of completing an ILP, students may apply to undertake the Science Honours program. Typically, this adds an extra 6 months to the length of the degree as extra-faculty units are not completed during the Honours year, although it is possible to complete within the normal 6 year length if you load your courses appropriately in 2nd and 3rd year. If this is done and you are not accepted into Honours, then you run the risk of having less than a full time load (18 or more UoC) in your ILP year and being ineligible for travel concessions and various Centrelink payments, which may or may not be a problem for you.

Acceptance into the Honours program is based on academic merit and the merit and design of the proposed thesis; students whose proposals are not accepted after modification and re-submission are required to undertake the ILP instead.

Completion of the program leads to the award of the Bachelor of Science (Medicine) Honours degree.

See the Faculty website for more information.

After graduating

Once you graduate, you will be entitled to the title Doctor and you will be able to work as a junior medical officer (commonly called an intern). Almost all JMOs complete their intern year in a new graduate training program to provide appropriate supervision and training while they gain experience. Places are allocated according to a preference system; currently, the supervising body in NSW is IMET (NSW Institute of Medical Education and Training, a division of NSW Health). Each state has a separate body, meaning a graduate can apply to multiple states and receive multiple offers (only one offer per state however). Each state gives slightly different preference to local and international graduates, and to graduates from within the state, from another state or from overseas.

After 2 years as a JMO (the 2^nd year is usually referred to as the resident year), you will be eligible to apply to one of the specialist Colleges to study a Fellowship (specialty) with them – trainee specialists are called registrars. Fellowship training can take anywhere from 3-6 years depending on the specialty, meaning a grand total of 11-14 years since you started your medical degree.

Once you have earned your Fellowship, you can go into private practice – you can continue to work in hospitals without a Fellowship but the Federal Government will not allocate you an unrestricted Medicare provider number, necessary for private practice, without a Fellowship. This is true even for General Practice, which is not the case in many other countries.