Top 5 tips for approaching your final year at medical school

Congratulations on getting through to your final year of medical school!

After many years of studying medicine, the thought of starting your first job as a doctor can be quite daunting. Add to that your day-to-day clinical attachment, UKMLA AKT and CPSA exams, and additional exams such as the Prescribing Safety Assessment (PSA) and Situational Judgment Test (SJT); it can get a bit too much to think about!

That's why we've set out the top 5 tips to help you get through your final year and take you one step closer to being a doctor!

Tip 1: You are only expected to know the basics by the time you graduate

In the past few years, you have come across a lot of medical knowledge through seeing patients, reading and attending lectures. However, one of the main issues of 'drinking from the fire hose' of medical knowledge is that you're never quite sure which information is important to remember for your day-to-day life as a doctor.

Do you need to know that a common cause of osteomyelitis in sickle cell disease is Salmonella?

Or that neuromyelitis optica is associated with aquaporin-4 antibodies?

The truth is that the more niche material you'll come across is essentially just 'good to know' rather than 'need to know'. This sort of information sometimes comes up in your written exams, but you will not need to know about it during your time as a foundation doctor.

At a professional level, your seniors will expect you to do the basics: be on time, bring up results, order and review investigations and generally ensure that any concerns are fed back in a timely manner.

In terms of knowledge, you will be expected to know and practice the core aspects of medicine that relate to commonly encountered scenarios and emergencies:

Principles of emergencies (the first steps to do prior to involving your seniors, like taking bloods, or performing an ECG)
Principles of advanced life support (including administering good CPR)
Interpreting blood tests, ECGs and chest x-rays
Understanding the rationale of requesting investigations and prescribing treatments for your patients
Procedural skills like bloods, cannulas and catheters
Communicating effectively with patients, families, and colleagues.

That's it.

You're not expected to make a diagnosis of acute intermittent porphyria at 3am on a night shift (although that would be quite cool to see!)

All you need to do is engage with the curriculum to understand the above key principles, and you will be more than fine to start as an effective, useful member of the clinical team!

Tip 2 Remember that where you do your foundation training doesn't matter in the long term

Applying for foundation jobs can generate a lot of anxiety for medical students in their final year. There is just so much uncertainty about where you will be placed and whether this will impact your career in the long term.

The truth is that it really doesn't matter where you go for foundation training.

All foundation programs in the UK are regulated by the GMC and provide similar clinical experiences.

In all programs, you will have six different rotations in various medical or surgical specialties (including a community placement in F2).

The main focus is to develop competence in basic clinical and non-clinical skills such as communication and teamwork.

At the end of the two years, all doctors will be expected to achieve the same competencies.

Sometimes you might like to choose specialties that you might like to pursue as a career. If you don't manage to do those specialties during your foundation years, don't worry! You can always do them during an 'F3 year' (a commonly-taken "year out" after F2) and during your core training.

In summary, it doesn't matter where you end up for foundation training.

Clinical training is very long (!), and there will be many opportunities to pursue your interests during and after your foundation training, wherever you end up for the next two years!

Tip 3 Be aware of key deadlines for the year

There is much to keep up with in final year, let alone the extra assessments you must pass!

Make sure to familiarise yourself with the key deadlines on the UKFPO website so you can prepare in advance for the application forms you need to fill in and the exams you need to sit.

Generally speaking, you can sit the Situational Judgement Test either in December or January.

Delivery of the Prescribing Safety Assessment exam is usually decided by your individual medical school, so it's worth checking in beforehand to see when you'll be sitting it.

Tip 4: Focus on active learning for your written/OSCE exams

At this point in your medical school career, you've likely come across a study method that works for you!

Final year is about bringing together all the information you've learnt throughout your years at medical school and focusing on any gaps in your knowledge so that you can graduate as a competent foundation doctor!

That said, there's a lot to do in final year, so it's important to use your time wisely.

Active learning is the most efficient way to revise and review lots of information in a shorter period of time. Many studies have shown that 'active learning', where you engage deeply with the material, is the quickest (and most long-term) form of learning in many different fields.

The most well-established way to test yourself is through a question bank, for example, Quesmed's QBank, which allows you to work through relevant clinical scenarios to understand which differentials, investigations and management plans are appropriate for a wide variety of presentations.

Another powerful way to revise is by going through spaced repetition flashcards, which help you drill down the key facts you need to remember to aid your problem-solving.

For CPSA/OSCEs, practice is absolutely key. We recommend investing time in finding a reliable study partner or group to practice scenarios, examine patients and gain feedback on your performance.

You can also use our dedicated OSCE/CPSA platform as a source of interactive mark sheets, progress tracking and videos to familiarise yourself with tricky OSCE stations!

Tip 5: Enjoy your last year as a student!

Becoming a doctor is a long journey with many hours spent revising or working unsociable hours.

It's worth remembering that this is your final year as a student, where you are very much in control of your own schedule. Therefore, it's important to focus on your mental health by taking regular breaks, seeing friends, going on holiday or doing whatever helps you relax. Additionally, if you have any particular medical (or non-medical) interests, now is the time to explore that interest!

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