Medicine :: Undergraduate Teaching

4th Year Teaching

Clinical Skills/Gastroenterology

This module will be split between Hutt Clinical Skills teaching and Gastrointestinal (GI) teaching at Wellington Hospital. Weeks 1-3 will be spent in Hutt Hospital and weeks 4 and 5 at Wellington. In addition there is whole class teaching every Wednesday afternoon in Wellington.

In this module it is intended that you will further develop the basic history taking and examination skills taught in the introductory course, with an emphasis mostly on respiratory and cardiovascular examination, and GI examination. The emphasis at Hutt will be on seeing and examining patients and learning to write up case histories. We encourage you to attend Hutt ED and see acute patients at least once during this attachment. The run also provides opportunities to start learning ECG and CXR interpretation.

The aims of the gastrointestinal curriculum are to enable students to recognise, investigate and manage patients with gastrointestinal disease.  These skills will be based on an understanding of the pathophysiology underlying gastrointestinal disease processes.

Medicine

The Internal Medicine and the Elderly part of this 5-week module is based at Kenepuru Hospital, in the Acute Medicine ward; Assessment, Treatment and Rehabilitation ward, as well as in the community.  The Endocrinology part is based at Department of Medicine, Level G, Wellington School of Medicine and Health Sciences, Friday afternoons.
The Neurology part is based in Wellington Hospital.

For internal medicine and the elderly, the objectives are that you will be able to take a patient’s history; perform a physical examination of an adult; and describe and classify specific features of medicine in the older adult, including mental health.

For endocrinology, the emphasis will be on thyroid, adrenal, pituitary disease and diabetes.    Tutorials will revise material from the Dunedin course as well as covering pathophysiology of symptoms, investigation and treatment of disease.  Students will evaluate and present endocrine problems in patients attending tutorials.  There is an MCQ evaluation of the theoretical aspects of clinical Endocrinology taken from the course reference material.

The neurology teaching provides clinical experience with ambulatory patients.  It emphasises history-taking and examination skills, and the integration of information obtained with a knowledge of anatomy, physiology and pathology to produce a working diagnosis.  The teaching concentrates on disorders which are clinically significant because they are either common, or treatable with serious consequences if not diagnosed and treated promptly.  Strategies for lifelong learning are encouraged.

5th Year Teaching

General Medicine and Subspecialities
This module will integrate teaching/learning for 5th year students in general medicine and the following subspecialities: Renal, Respiratory, Cardiology, and Oncology.

Students will be able to demonstrate a patient-centred and problem-based approach to history-taking, physical examination and investigation of patients with ailments in the above fields. Competent students will be able to show that they understand the pathophysiology involved and will be capable of assessing the severity of the clinical problems affecting their patients. They will also be able to synthesize their cases, propose a differential diagnosis, make recommendations for investigations and discuss the ethical issues raised by the patient under review.

6th Year Teaching

As a Trainee Intern you are expected to gain expertise in clinical medicine by undertaking supervised clinical responsibility for patients allocated to you on each attachment, and being responsible for their documentation and day to day attention.  You are expected to pursue an educational programme in Internal Medicine through practical experience, discussion, tutorials and the use of journals and reference material.  The senior staff of the Department will be concerned to see that your clinical techniques are appropriate, that you understand the medical knowledge required, that you are able to communicate your findings, and that you have developed attitudes such as a concern for the interests and dignity of people and an awareness of the doctor’s role.  Trainee Interns must be aware of the ethical rules governing medical practice and the importance of recent legislation regarding privacy, accident compensation, the Health and Disability Commission, and health service reforms.  Assistance and advice on these issues is available from senior staff.

Specific Educational Objectives for Medicine:

• Demonstrate clinical competence when consulting with a new patient presenting to internal medicine.
• Be able to demonstrate bedside clinical skills needed to take a problem-based history and make an efficient and appropriate physical examination.
• Be capable of organising the relevant investigative procedures needed in managing patients encountered in internal medicine.

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