What Is It Like to Be a Medical Student at Birmingham

College of Medical & Dental Sciences

Student Development and Support Office

What is it like to be a medical student at Birmingham?

We are delighted that you have chosen to study at the University of Birmingham Medical School. When students start here they often say that they really had no idea what to expect of medical school. This may sound strange, but most people who apply know that they want to be a doctor and are so focused on their application that they don’t necessarily think through all the issues involved in achieving that goal. Our older students have said that there are certain things they wish they’d known before they came. This document aims to tell you some of those things.

So, what’s different about being a medical student?

Some people feel when they get to University to study Medicine that they are a cut above everyone else. This is not so! The main way in which medical students are different is that straight away they have to take on some professional responsibilities. Of course this also makes it exciting. At Birmingham you will meet your first patients very early in the first term. This means that straight away you are in the privileged position of learning details about those patients that maybe even their own families don’t know, it also means that you are no longer just an interested young person – you’re a professional. When you came for interview you will have read the Code of Conduct which you will have to sign when you start here. The reason that we have a document like this is so that it is absolutely clear what is expected of our students in their lives as professional medical students.

The course

BirminghamMedicalSchool has two courses for Medicine, a five year course for people with A levels or equivalent, and a four year course for graduates. This information relates to the five year course.

For the first two years, the majority of the course takes place in the Medical School. The exception to this is the attachment to a general practice which happens for each student once a fortnight for a total of 8 days in year 1 and 8 days in year 2 (see also Travel). This attachment starts very soon after the start of term. Half the year goes one week and the other half of the year the next, and so on, alternating through the term, so you get to meet patients almost straight away.

The teaching in the Medical School is a mix of lectures, small group teaching (the year of about 400 students is divided into 22 groups, each with 16-18 students), directed self study – this normally involves working through tutorials on a computer,and is your own work reading round the lectures and small groups, and the student selected component (SSC), and generally keeping up.

SSC has two parts, student selected activities(SSA): where students can pursue interests they have developed in the core teaching and special study modules, where a range of professional skills needed to be a doctor e.g. presenting work to colleagues, teaching other students, doing some research, are learnt. The SSC strand runs through all five years.

Students at Birmingham do not undertake dissection. Rather, they engage in prosection, where a demonstrator carries out the dissection and students are then able to observe all relevant anatomical details.

From year 3 students attend hospitals in the West Midlands (see also Travel). After an introductory course held in theMedicalSchool, students attend one Trust from September to Christmas and a second from January to April. In years 4 and 5 students rotate through a series of specialties at different Trusts throughout theWest Midlands.

The Medical School day normally starts at 9am and often does not finish until 5 or 6pm. You will not be in formal sessions for all that time, but will have breaks and periods of individual study during the day too. In year 1 students study Basic Life Support on Monday evenings between 6 and 9pm. In Years 3-5 students normally start the day between 8 and 9am, having had to travel to get to the Trust they are placed at. In order to get the experience needed to be a Foundation doctor they sometimes have to work in the evenings and at weekends.

Attendance and absence

Medical Schools (all of them, not just Birmingham) have to put the safety of the public first, before even the student’s needs. This is why we have to be strict about attendance. While the patient may be very sorry that a student had appendicitis and therefore missed their attachment in orthopaedics, they want a doctor who can deal with their broken leg as well as other aspects of their care. This can seem quite harsh until you stop and think about it. None of us wants a member of our family cared for by someone with a great big gap in their knowledge. Of course, we treat our students as individuals and if we can accommodate a situation we do so, but sometimes we have to ask students to repeat a period of study to ensure the student is not inadequately prepared to be a doctor. Our experience of such situations is extensive. We always work from the position of making the student’s education as a future doctor the priority, even though at the time students often want to forge ahead, looking back they can see the sense of repeating a year or a “block” of study and learning the subjects properly.

At Birmingham we expect students to ask permission when they need time off from the course. The request is considered by one of the year tutors responsible for welfare and authorised when appropriate. Short periods of absence are permitted for a variety of reasons, but not for holidays. We expect holidays to be taken during the University vacations. After year 2 the medical course does not adhere to University term times. In years 4 and 5 students study a series of specialities in blocks of five or six weeks. This makes it very difficult to make up learning if more than a few days is missed.

Fitness to Practise

If a student is not attending because they can’t be bothered to get out of bed, and we’re sure that isn’t a sign of illness, we are not so accommodating as we try to be if they are ill. In the case of laziness, or where a student is cautioned or convicted in connection with a criminal offence, their fitness to practise is questioned. The General Medical Council requires all medical schools to have a system for ensuring that students are fit to practise.

How long are the terms?

In years 1 and 2 there are three terms: ten weeks from late September to December, ten weeks from January to March and then after the Easter break an exam period followed by a two week SSA for year 1, or hospital attachment in year 2, in June.

Universities do not have half terms. It is not possible for students to take holiday during term time.

Year 3 runs from the end of August to Christmas, when there is a two week break, then January until May, with a week off at Easter. At the end of the year students have a five week holiday.

Year 4 starts in the third week in June and goes through to Christmas with a one week holiday in September and two weeks at Christmas. The year continues from January until April with a one week holiday at Easter. From April to June students have an eight week elective period where most travel abroad. There is holiday built into this period.

Year 5 starts in the last week of June and runs through to the following June for 50 weeks. Students currently have 5 weeks holiday, spread through the year.

Travel

We are very fortunate to have 15 NHS Trusts and over 100 general practices for students to attend. This means that during their time on the course students see an enormous variety of illness and disease in an extremely diverse population. We believe that this is one of the enormous strengths of our course. During the five years of the course students will be attached to 6 general practices, again spread throughout the West Midlands which is a large region.

In order to experience such diversity students need to travel. Right from year 1 this can mean getting up very early in order to go to a general practice in places like Worcester, Lichfield, Kidderminster or Wolverhampton, as well as in Birmingham itself. Later in the course students go as far afield as Hereford.All these journeys, and even those to practices and Trusts in the Birmingham area, involve travel. If using public transport, it often involves changing bus or train two or three times. In years 1 and 2 such journeys will be for 8 days a year only, but there is currently no financial subsidy available for students. In years 3, 4 and 5, when students will be going to hospitals almost every day, and to different general practices (for between 8 and 11 days) the NHS provides students with a contribution towards their travel costs, but this does not fully cover the costs incurred.

Over five years we try to ensure that the distance travelled by each student is roughly equivalent, so no-one always gets a distant placement and no-one always gets a near one.

Past student representatives devised the system of allocation by distance and the distribution of the subsidy to try to be as equitable as possible. All distances are measured from the MedicalSchool, as being the fairest central point. This is something to note if you are planning to live at home in, for example, Coventry. You don’t have to come to the MedicalSchool every day in years 3-5, but neither will we measure your travel from Coventry.

Religion and culture

The student population of the Medical School is very diverse. We benefit from having students from all over the world and who follow all the major religions. The University and the MedicalSchool are secular organisations. We respect everyone’s beliefs but there are certain times when the duties of a doctor, and therefore of a doctor in training, might conflict with an individual’s beliefs. For example, individuals are free to believe that terminating a pregnancy (abortion) is wrong. However, a doctor, and therefore a medical student, has a duty to treat a patient requesting a termination with respect and not to impose his/her own beliefs on the patient. Doctors must ensure that the patient is referred to another doctor for treatment. Students are also expected, for example, to examine both men and women; people whose lifestyles may conflict with their views of what is right or healthy (e.g. drug and alcohol abusers) and to “scrub up” when going into an operating theatre. This latter procedure involves washing the hands and arms very thoroughly right up to the elbow. You will understand that in order to minimise the risk of infection students need undertake this procedure in front of nurses and surgeons to ensure that it is done properly.

These examples illustrate the fact that even in the most personal matters of belief a doctor has to always put the patient’s interests first – and this applies to medical students too. To learn more about what the duties of a doctor are we suggest you look at the General Medical Council website (

Living at home

Some students live at home during their time at Medical School. This has obvious financial benefits and means that you can have your meals cooked and your washing done! Sometimes families make a lot of demands on students living at home, expecting them to look after younger siblings, do the shopping, cooking and cleaning as well as help in a family business. Medicine is a very intensive course. It is full time and, as explained above, we expect students to attend. In our experience it is worth talking through with your family what the course entails, and perhaps showing them this document. Many students have to work in the holidays to earn money. Some have to do part time work in term time too, but these jobs have to be for a small number of hours a week due to the intensity of study medical students have to undertake. Our experience tells us that it is sometimes difficult to be a successful medical student whilst keeping your family’s business afloat or being the primary carer for a sick family member. While some students fit in running a family home with their studies, others find that they struggle to accommodate their family’s expectations. You may need to negotiate this to avoid becoming stretched in too many competing directions.

Being an International Student

Our International students add considerably to the cosmopolitan nature of our student population and their different life experiences enhance everyone’s learning. Being an International student can be a real culture shock though. For some the British educational system where teachers expect to be challenged by their students takes some getting used to! The University International Student Unit offers all sorts of practical help, especially when students first arrive. We recommend that you make contact with them before you come to Birmingham.

The fees for International students are very high (in 2012-13they are £15,150 per year for years 1 and 2 and £27,510 per year for years 3,4 and 5). Sometimes during the course something happens and a student’s source of income (their government or family usually) cannot pay. The University is a business and it will expect the student to pay for the tuition they are receiving. While some help can be given in terms of staged payments neither the University nor the Medical School has funds that it can use to pay students’ fees. We can help by directing students to charitable sources, but they are usually only able to give small amounts of money e.g. up to £500.

The University uses the Home Office rules to determine whether a student is classified as a Home or International student. This classification remains the same throughout the student’s period of study, even if the student gains residency during this time. Therefore if you embark on the course as an International student you can expect to remain classified as such throughout your studies.

This all sounds very serious, should I carry on?

Before deciding how you are going to spend the next 5 years of your life (and potentially the next 40 years of a career!) you need to think very carefully. Being a doctor is a very interesting job, but one which bears a lot of responsibility for other people. Our students have a lot of fun and enjoy their studies a great deal, but you need to come to MedicalSchool with your eyes open!

This document was written by staff involved in student welfare. August 2007 and updated June 2012.

Disclaimer

The information included in this document is correct at the time of writing, but all aspects of the course: educational, organisational and financial are subject to constant revision and improvement. Applicants should therefore anticipate that the detail of the course will change.