For medical students

2nd years – Coordinator – Dr Fitch

• Welcome to the Respiratory Unit. We hope you enjoy your time with us.
• 2^nd year teaching is on Thursdays from 10am to midday, meeting promptly in Ward 107 teaching room.
• Check the white board for the list of patients to see, from 10-11am. There will also be a rota of doctors to teach you, which occurs from 11-12.
• You can leave bags etc in the teaching room, which will be locked if we leave to do bedside teaching. Feel free to carry anything particularly valuable in your pockets, although mobile phones should be switched off.
• Please ensure you have your stethoscopes, pen and paper with you, although you should leave your notebooks behind during bedside teaching.
• You must always wear a visible ID.
• **You must sign attendance sheets when you arrive each day **. Please do NOT remove these sheets from the notice board in the teaching room. If these are not up when you arrive, speak to Lyn Flores (the Ward Receptionist). If she’s away, please print, sign and date your names on a piece of paper and stick it to the whiteboard in the teaching room.
• Ensure “2nd year” is written at the top to avoid confusion with the 3rd years. These attendance lists are collected by Lyn and sent back to the undergraduate office.
• Please go in pairs to take histories. Ask the patient’s permission first. Take a history and examine the relevant system(s).
• If you need extra patients because someone is away or doesn’t wish to be seen, please ask an FY1 or 5th year student.
• Your tutor will arrive around 11 unless otherwise instructed by them.
• Please note: teaching may include 5^th year peer teaching (which you are expected to attend). The University have introduced 5^th year peer teaching in the last couple of years for occasional sessions to cope with rota reorganisation. This is mostly history based.
• You should adhere to your dress code. Some examples of patient complaints include long hair (moulting and brushing them during examination) so hair should be tied up, strong odours (good and bad), high heels, exposed skin, inappropriate clothing, and untidiness so we would ask that you are considerate in your appearance. You already have guidance about jewellery, watches, ties etc from the medical school.
• With the best of intentions, occasionally in the Winter, the ward can be extremely busy and your tutor is required elsewhere. They have been asked to let you know if this is going to happen at 10am. However there will be some occasions when they are unable to leave what they are doing. If this happens and no-one comes to speak to you by 1015 , please find a junior doctor or 5^th year medical student on the ward, to obtain patient names, takes histories/ do relevant examinations and present to each other.

Below is the information we give tutors which is also worth reading

Notes for Tutor ie clinic rota person (FY2, CMT, GPST), 5^th year, ward reg or FY1

Dr Srivastava should have emailed you all with timetables and instructions before each block starts. Please read this in conjunction with the guidance above for the students which has some additional information.

• 3^rd year teaching runs Sep-Feb inclusive (3 blocks with a break Nov/Dec). It’s usually the clinic person (GPST/CMT/FY2) who does it but in order to fill rota gaps, the university is encouraging us to utilise our 5th years in teaching so they have been given some sessions to coordinate and teach. 5^th years are now being taught how to do peer teaching and the feedback from them has been very good. Registrars may do the occasional session.
• The programme is now about presenting histories succinctly, being able to do a normal examination, formulating diagnoses, management plans and bedside teaching on signs. When choosing patients/signs, diversify into all systems, not just respiratory.
  • • • • Each tutor takes responsibility for coordinating their session (and arranging cover if needed).
        • Please ensure you write 5 patient names on paper (if your session includes histories) and stick it to the whiteboard in the ward teaching room on 107 before 10am on Mondays and Wednesdays. Ask the patients first before doing this. Make sure your sheet is dated and marked for the 3^rd years (to avoid confusion with Dr Fitch’s 2^nd years on Thursdays).
        • Meet the 3^rd years at 10am. If scheduled for histories, ask them to go in pairs and come back at 1100 for bedside teaching till 1145/12. Tell them to ask the patient’s permission again. Avoid lunchtime.

• For 5^th years – you will be allocated history sessions only unless notified otherwise – once the students return, please ask them to present histories and discuss. This can be in the teaching room or at the bedside (feedback suggests they enjoy bedside more)
  • • • • Note the start times and duration of each session can vary. Not all sessions include histories.
        • Attendance sheets/copy of timetable are on the whiteboard in the seminar room, ward 107. Check students have signed this at the start of each session. Do not remove sheets from the whiteboard. Lyn Flores (ward receptionist) puts up an individual one for each day and collects them – see her if it’s not there. If Lyn is off put up a blank bit of paper marked “3^rd year attendance” for them to date/sign and print their names and she can collect this instead.
        • For those sessions marked as “written paper”, can the 5th years come and get these from me a few days beforehand please? Allow the 3^rd years an hour to do the paper. My office is in Clinic C or I can email you this. Would you mind leaving the completed papers in my tray in the secretaries office at the back of clinic C please? Note – not all blocks have a written paper or assessment.
        • Feel free to use your initiative eg Any good signs (there will be a respiratory bias with bedside teaching but please diversify into any system where possible), discussion of Oxygen and masks, Inhalers, Spirometry/Respiratory Physiology, peak flow meters, BP measurement, organomegaly, jaundice, Rheumatoid Arthritis, abnormal bloods, CXRs, ECGs, investigations etc etc, but make sure it’s not all respiratory.
        • Note I don’t work Wednesdays – if there are unanticipated problems on a Wednesday (or Monday), feel free to use your initiative. If you can’t manage your sessions, please delegate. Also we know that sometimes over the winter, it can be chaos. If in an emergency you can’t teach or get anyone to cover, keep the students informed and at the very least send them to see patients and write up their clerkings for you to look at later.

Many thanks for your help. Happy to sign off any teaching assessments. Contact me via my secretary.

Dr Srivastava

5th years – Coordinator – Dr Graeme Currie

• Welcome to the Respiratory Unit.
• Please contact Dr Currie via his secretary in your first week so he can meet you.
• You should be ready on Ward 107 just before 9am Monday -Friday, and leave between 4 and 5pm.
• Please introduce yourself to the medical and nursing team on the ward.
• Have your name badge clearly visible at all times.
• Please let Dr Currie know if you are ill and are unable to attend the ward.

Learning

• You should revise the Respiratory system chapter in MacLeods textbook of clinical examination, in addition to the Respiratory chapter in which textbook you use.
• You should make yourself aware of the clinical features, investigations and management of all the common respiratory disorders (such as asthma, COPD, lung cancer, pulmonary embolism, pleural disorders, interstitial lung disease, bronchiectasis, cystic fibrosis etc).
• Familiarise yourself with arterial blood gas analysis.
• Familiarise yourself with chest X-ray interpretation (consider borrowing the book “Chest x-rays made easy” from the library).
• Make sure you can examine the respiratory system correctly.

Daily routine

• You should be part of the Consultant ward round most mornings (which start at 9am); try to take an active role.
• In the afternoons, you should help the FY1 and other medical staff with ward work (including clerking in patients).
• You should practice completing drug Kardexes and writing up fluid administration charts.
• Please note you may be scheduled to do peer teaching ( 2nd or 3rd years)
• When you arrive, please contact Dr Srivastava and Dr Fitch via their secretaries to see if there are any sessions allocated to you.
• Your apprenticeship week can be staggered across several weeks.

Practical procedures

• There should be plenty opportunity to take bloods, insert venflons and take arterial blood gases.

Meetings

You should attend the following:

• Wednesday Grand Round (1pm in the Suttie Centre, generally during term time)
• Wednesday Interstital Lung Disease MDT, some Wednesdays.
• Thursday Unit Educational Meeting
• Some Thursday Lung Cancer MDTs

Assessment

• Please ask ward doctors to complete your various log book assessments.
• Dr Currie may take you for a tutorial during your attachment and he will meet you in you last week to sign off your log book – ask him about both of these.