Core Medical Science
The Cambridge Graduate Course takes four academic years, with students starting in September/October of year one and taking the qualifying Final MB examination in June of year four (i.e. 3 ¾ actual years).
There are at least four weeks of holiday each year as shown on the diagram below.
The course is divided into three levels with 14 integrated themes.
The course content is monitored by the pre-clinical, Medical and Veterinary Sciences Tripos Committee and the Clinical School’s Curriculum Committee to ensure compliance with best practice described by the GMC (Tomorrow’s Doctors) and the QAA (Benchmark Statement for Medicine.
Introduction - 1.4 weeks
Students spend five days in the West Suffolk Hospital where they are introduced to the environment in which they will learn clinical medicine, have instruction in essential health and safety and have their first experience of clinical situations in hospital and General Practice. Then one day is spent at the Clinical School in Cambridge where students are introduced to the learning facilities provided on site; one day is spent in College.
During the Introduction, students meet their CGC Tutor to discuss their strengths and weaknesses and to identify specific learning needs; and also their General Practitioner tutor.
Level 1: Core Medical Science and Clinical Medicine - 20 Months
Core Medical Science (5 x 8-week terms) – see http://www.bio.cam.ac.uk/sbs/facbiol/mvst/courses.html
CGC students work alongside Standard Course students attending the same programme of lectures, seminars, tutorials, practical classes and supervisions.
Functional Architecture of the Body: topographical anatomy of the human body by dissection and demonstration with strong emphasis on functional, living and surface anatomy.
Introduction to the Scientific Basis of Medicine: three sets of lectures covering history and philosophy; principles of epidemiology; principles of medical statistics.
Homeostasis: physiological systems which underpin regulation of the body’s internal environment and its responses to external threats; related practical classes in experimental physiology and histology.
Social Context of Health and Illness: introduction to the broader cultural aspects of healthcare and the medical profession.
Molecules in Medical Science: molecular basis of how cells and organisms work including structure, function, biosynthesis and control, metabolic processes and the ways in which the genetic information in DNA is organised, expressed and inherited; core principles illustrated, where possible, by examples relevant to medical science to emphasise the significance of this basic knowledge to clinical practice - a practical course uses a range of biochemical techniques and includes a problem-solving component.
Principles of Cell Biology (optional): a short course introducing basic principles.
Biology of Disease: the nature and mechanisms of disease processes, includes cellular pathology, immunology, microbiology, parasitology and virology - practical classes integrated with lectures.
Mechanisms of Drug Action: general principles of drug action and specific effects of some drugs; selective toxicity and effects on neuromuscular, endocrine, cardiovascular and respiratory systems.
Neurobiology & Human Behaviour: the brain and mind; structure and function of the sense organs and CNS, effects of drugs on brain function; physiological aspects including emotion and emotional disorders (especially depression, anxiety, schizophrenia) child development, intelligence, learning and memory.
Scientific, Social & Ethical Aspects of Reproduction and Populations: the biology of human reproduction, its clinical relevance, social context and influence on demographic trends; ethical and legal principles surrounding the practice of medicine in general and reproduction in particular.
Opportunistic Learning - initially, student learning is largely tutor-led and there is little opportunity for self-directed clinical experience. When students have acquired the basic clinical skills, they can benefit from opportunistic, self-directed learning by finding patients on the wards. Students can do this through: allocation to Consultant Tutors and their teams in medicine and surgery; joining designated Consultant Tutor teams while on emergency intake; identifying patients on the ward (with the help of the Clinical Co-ordinator and F1/F2 trainees) who will form the basis of the portfolio cases.
Clinical placements are based in West Suffolk and occur during the University vacations. One-and-a-half days of each week are spent in General Practice and the remainder of the time in the hospital.
During each placement, different clinical systems are addressed: signs and symptoms relating to the system are demonstrated in the hospital setting with clinical case demonstrations based on the Clinical Problem List, all being reinforced in General Practice.
During the early clinical placements, students aim to develop clinical method (process) and in later placements the emphasis is more on content.
Similarly, the student’s time during the early placements is well structured, but later there is more emphasis on self-directed study on the wards.
Clinical Skills 1: (4 weeks) Learning the framework of Clinical Method, withintroduction to examination of major systems.
Clinical Skills 2: (4 weeks) Reinforcment of Clinical Method.
Clinical Skills 3: (10 weeks) Further development of Clinical Method and clinical features of the systems in general practice and on the wards so that the student has a basic competence in “clinical clerking” and a working clinical knowledge of all the body systems. Exposure to patients with a wide range of general surgical and medical problems.
Clinical Skills 4: (4 - 5 weeks) Continuing to develop clinical method with Pathology and Public Health topics covered in the Standard Course R & I weeks 1 and 2.
Clinical Skills 5: (3 - 4 weeks) Review of the clinical aspects of all the systems and further clinical experience.
Review and Integration Weeks 1 - 2: dedicated CGC course, 3 - 10: jointly with the Standard Course.
Regional Clinical Placements (3 weeks): two clinical placements, one in medicine and one in surgery: the first is based in a regional hospital, the second is based in Addenbrooke’s. Students integrate into a medical or surgical firm, they shadow junior staff in the team and present when the team is ‘on-take’. On ward rounds, the may be asked to present patients whom they have clerked. They may also observe out-patient clinics..
Level 2 Life Course - 6 Months
Level 2 comprises four placements (8-weeks each) based on the stages of human lifespan. CGC students join the Standard Course students for four of the five Life Course components.
- Growth, Development and Childhood Illness;
- Women’s Health
- Major Adult Diseases: Cardiothoracic Medicine, Oncology Essentials, Infectious Disease
- Neurosciences, Rheumatology & Orthopaedics
[Psychiatry is in Level 3 at the West Suffolk Hospital]
In each Level 2 placement students are attached to a relevant specialist hospital firm with coordinated input from other specialists representing the curricular themes.
Primary Care - 3 x two weeks: Students spend the last two weeks of three of the Life Course placements studying General Practice and Community Care. They learn about the relevant specialty in primary care and the community. Students are placed in groups of four and are based in a single General Practice throughout Level 2. Students work with allied health professionals and gather data for later presentation. They also spend time in small groups, undertaking guided student-selected learning related to community-based clinical scenarios. They explore the realities of living with illness in the community including meeting with community- based carers and organizations. At the end of each two-week period, students give an assessed presentation.
Review and Integration Weeks 4 - 8: all students meet the same material, irrespective of the area of life that their previous placement addressed. Pathology teaching occupies approximately 1.5 days of each of each week. The “Frontiers in Medicine”, and “Humanities in Medicine” and “Patients’ Voice” courses continue.
Portfolio: Students continue to assemble their portfolio based on patients that they have seen. This includes case write-ups and pieces relating to the various curricular themes.
Level 3 Preparation for Practice - 13 Months
SSC/Elective - 5 weeks: the final year begins with the Elective which is an opportunity for students to exercise initiative and responsibility in organising a clinical or scientific elective of their own choice. Although some students choose to spend the five weeks in a particular department within the Clinical School, most leave Cambridge for their elective, with about 90 % going abroad.
Cambridge Medicine and Surgery (4 weeks each): placements in General Medicine and General Surgery at Addenbrooke’s and revision of clinical method and the elements of medicine and surgery.
General Practice with Community Psychiatry (3 weeks): Studentsspend time in General Practice to further develop consulting skills and to have experience of mental health in the community in preparation for the hospital psychiatry placement.
Palliative Care, Public Health, Specialties (3 weeks): choice of clinical activities in one or more specialties from a menu; the Public Health and Palliative Care courses are completed.
Psychiatry (6 weeks): completes the Life Course.
Acute Care (6 weeks): practicalities of assessing and managing patients with serious, acute and life - threatening illness across all specialties, to ensure that they are both competent and confident in this area before qualification.
General Medicine and General Surgery (6 weeks each): placements with medical and surgical teams at West Suffolk Hospital complete the clinical course and prepares students for Final MB and their role in the Foundation Programme year one.
Review and Integration Weeks 9-10: Review and integration programmes continue, the focus in the final year being on clinical management and all aspects of professionalism. The “Frontiers in Medicine”, Patient’s Voice and “Humanities in Medicine” courses continue.
Portfolio: Students complete their portfolio based on patients that they have seen including case write-ups and pieces relating to the various curricular themes.
Practical Prescribing: an on-line teaching programme at the end of which students should be able to use the British National Formulary (BNF) correctly to support decisions about drug prescription; apply BNF general prescribing advice and current legislation regarding prescribing controlled drugs; record and report adverse drug reactions; carry out a range of drug dosage calculations and use Trust guidelines on good prescribing to identify and resolve inappropriate prescribing practice.
Post Final MB Foundation Year One Destination Post Shadowing (1 week): students shadow the doctor in their first post-qualification post. Objectives of the week include:
- Gaining insight into the organizational and operational problems to be faced as a newly-qualified doctor;
- Improving clinical skills; obtaining direct experience of some of the practical procedures required and gaining experience of working in a multidisciplinary team.
Students are not permitted to graduate until their certificate of satisfactory attendance has been submitted.
Foundation Programme (2 years)
To be eligible for full registration with the General Medical Council, a doctor must complete a period of supervised service in a combination of approved posts.
The University is responsible for certifying to the GMC that its graduates have satisfactorily completed their pre-registration training and requires certificates of service from employing authorities. Recruitment is by open competition and Cambridge graduates are likely to secure a post in the East Anglian region which meets their requirements.