Transitioning to placement

The move from pre-clinical to clinical years can be one of the biggest transitions in medical school. We know that stepping onto the wards for the first time brings a whole new set of challenges, from navigating hospital corridors to figuring out how to learn in a completely different environment.

That’s why we’ve asked recent graduate, Dr Charlie Pearson, to reflect on his experience of starting placement, offering practical advice for those about to make the leap. If you're feeling unsure about what to expect, you're not alone - and this blog is here to help.

One of the most challenging moments I found at medical school was the change from second year to third year. Or to be more precise, the shift from lecture theatres and tutorials to placement.

I feel like it probably took me more time than it should have to adjust. Understanding what is about to change and recognising what might have to adapt in your approach to work and learning is something that helps massively.

Lectures and tutorials vs. placement

I’m particularly receptive to lectures and tutorials, which give context and structure to the curriculum. For me, it helps my understanding of the bigger picture and allows me to give more time and attention to specific topics.

Placement, by contrast, isn’t based on singular topics. You become exposed to a patient who may have three to four co-morbidities, and some or all may be new to you. Then you continue the seemingly endless ward round and suddenly you have over 20 of those situations.

It’s a vast array of pathologies, both known and unknown. Of course, this is the reason we go there – to learn. But it can be overwhelming, and I remember frequently coming home and not knowing where to start when it came to reinforcing what I’d seen.

Learning for exams

Having to learn for exams that cover every speciality was very difficult in the early days when you hadn’t been exposed to more than a few. Do you stick to revising what you’ve seen? In an ideal world, yes.

Being introduced to an illness or condition in context helps anchor it in the memory. But we’re medical students, and paranoia lingers with the knowledge that failure is determined by the success of others in your year. You end up diving into question banks and trying to consume as much information as you can to gain those extra marks. But consuming the information with no reference and no patient to link to was deeply unsatisfying and harder to remember.

I admit this is just based off my own experience, but I hope that it is a generally accurate account of what a good proportion of medical students experience.

Some top tips

• Have a general idea of how you are going to establish the foundations in your approach to learning.
• Go steady, do a bit every day based on what you’ve seen and explore a bit around the topics. Don’t go too far down rabbit holes at the start.
• Get the balance right. Use your time effectively and give yourself nights off where you go out or do something different.
• Know what’s expected of you. You are there to learn, there will be plenty of times you get it wrong.

Your confidence is subject to bruising in those early stages of placement. You might find yourself grilled by a consultant, or face-to-face with an emotionally challenging situation that you’re not quite sure how to handle.

Often you will be trying to assimilate all the new information you’re picking up without knowing what most of it means. This is common and I certainly remember feeling like this myself, but all things must pass.