What to Expect: Clinical Years

What firm are you on? How’s placement? Where are you at? The medics I know keep asking all these questions and leaving the house really early dressed smartly, but what actually are clinical attachments?

Year 3 is clinical, with attachments (‘firms’) in hospitals across West London. They are called ‘firms’ from back in the old days when you would be with the same medical team for a while and became like a little family. Firm means the group you are with, and the name seems to have stuck (we like using technical terms to confuse non-medics).

Hospital placements at Imperial covered a lot wider area than I expected- from Paddington (St. Marys Hospital), Chelsea (Chelsea and Westminster Hospital), Hammersmith (Charing Cross Hospital), White City (Hammersmith Hospital) across to Twickenham (West Middlesex Hospital), Harrow (Northwick Park Hospital), Southall (Ealing hospital), Harlesden (Central Middlesex Hospital), right out to Uxbridge (Hillingdon Hospital) and Chertsey in Surrey (St. Peter’s Hospital). In third year each 10 week attachment covered a different speciality at a different hospital, and within a 10 week surgical block we rotated through anaesthetics and different types of surgery- which kept things varied and interesting! Most students who visit Hillingdon or St. Peters end up living out in the hospital accommodation (if they are lucky enough to get a room!) which provides a unique experience (we organised pizza deliveries and film nights) but can be quite isolating from the rest of the medical school, never mind the rest of Imperial! Exams are both written and practical (you see 12 different patients and examine them or perform a practical procedure e.g. take bloods/suture a wound, or talk to them to find out what is wrong (‘take their history’ in medical speak!)).

St Peters- way off the map
St Peters- way off the map

Looking cool on the wards with the stethoscopes around the neck!

Year 5 is a very long year (for me I worked out it was something ridiculous like a 54 week year!). This starts with a pathology lecture course, after a 1 month summer holiday, before moving onto continual clinical placements across a range of hospital sites. Rotations include Orthopaedics, Dermatology, GP (in London), Rheumatology, HIV/sexual health (I got to visit a very interesting clinic in Soho!), Psychiatry (most placements mix community services and psychiatric hospital inpatient care), Obstetrics and Gynaecology (yes I delivered some babies by myself!) and Paediatrics. Exams again are both written and practical (this year you have a viva after each patient and have to manage them, not just find out what’s wrong!).

Yes, I actually bought a baby into the world!

Everyone seems to get broody after paediatrics (“ahh, that child is sooo cute! Look what it just did! Coochy, coochy cooo!”), but that often changes during obs and gynae (“What is going on? All of those complications are from childbirth? Count me out!”)

Year 6 starts after a 2 week holiday from 5th year exams, so is a bit of a shock to the system! This year is basically preparing for the first year of work, so rotations include medicine and surgery, GP (outside of London), A&E, Neurology, Cardiology and a special choice module. Again, it’s a tiring year, running in continual clinical placements from mid-July to Christmas without a break! However, this does free up time for later in the year, when, after exams in March, we depart on a medical elective of our choice- anywhere in the world, any medical work, for at least 7 weeks- so I cannot complain!

Very nearly a doctor now….

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