QUEEN’S UNIVERSITY BELFAST

SCHOOL OF MEDICINE
AND
DENTISTRY

Undergraduate
Medical Curriculum
2005-2006

Division of Medical Education

 About this Handbook

This handbook provides an overview of the Undergraduate Medical Curriculum at Queen’s

University Belfast.
The content, aims and learning outcomes for each phase are outlined in detail.

2
 Table of Contents
Page

Background 5

Curriculum Development 7

Division of Medical Education 7

Aims and learning outcomes of the Undergraduate 8

Medical Programme

Overview of Undergraduate Programme 10

Structure of Undergraduate Programme 10

Philosophy Underpinning the Curriculum 12

Student Selected Components Programme 14

Induction Programme 17

Outline of Phase One 19

Phase One Modules:

Cell & Molecular Biology 21

Microanatomy & Development 23
Science Society & Medicine 25
Early Medical Contact Scheme 27
Communication Skills Training 29

Outline of Phase Two: 31

Systems Course One 32
Phase Two Student Selected Components Programme 34

Introductory Clinical Skills Course 36

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Outline of Phase Three 37

Phase Three Student Selected Components Programme 39

Pathobiology of Systems 40
General Medicine 42
Cardiology 43
Neuroscience 45
The Individual in Society 46
Haematology 48
Endocrinology & Diabetes 49
Nephrology 50
General Surgery 52
Otolaryngology 53
Musculoskeletal 54
Dermatology 56
Ophthalmology 57

Outline of Phase Four 59

Reproductive Medicine 60
Healthcare of Children 61
Perioperative and Emergency Medicine 64
Mental Health 67
Ageing and Health 67
Primary Care 69
Cancer Studies 71

Outline of Phase Five 74

Intercalated Degrees 76

4
 Background to the Curriculum at
Queen’s University Belfast

The Belfast Medical School has been responsible for the delivery of medical education in
Northern Ireland since 1835. Medicine was included as a founding degree in Queen’s
University Belfast when it opened in 1849. During the following 150 years the teaching
programme was reviewed and modified on a number of occasions. The most recent and
perhaps the most radical of these was in 1996 when a new undergraduate curriculum was
implemented.

This teaching programme differs from the previous curriculum in a number of ways:
- didactic teaching has been substantially reduced and is replaced by
self-directed learning activities
- case based learning material is used for both basic science and clinical teaching
- clinical and basic science subjects are integrated vertically and horizontally
throughout the programme
- the curriculum is organised and delivered as a systems course with a “first pass”
through the systems’ in years one and two and a “second pass” through the
systems in year three
- approximately twenty five percent of curriculum time is devoted to
Student Selected Components this part of the course provides students with an
opportunity to study subjects which are not part of the core curriculum and to
acquire and refine transferable skills
- basic clinical skills training begins in first year
- students are introduced to basic clinical examination and
communication skills in a Clinical Skills Education Centre
- community based clinical settings play an important role in the
teaching of clinical skills
- during phase three the teaching of laboratory sciences is integrated
with teaching of clinical subjects
- students have completed the core curriculum by the end of fourth year
- during fifth year students spend four weeks “shadowing” the Pre-Registration
House Officer in the Unit in which they will take up employment following
graduation

The following themes recommended by the General Medical Council in

“Tomorrow’s Doctors” are integrated throughout the teaching programme:-

- The scientific basis of practice

- Treatment
- Clinical and practical skills
- Communication skills
- General skills
- The working environment
- Disability and rehabilitation
- Medico – legal and ethical issues
- Disability and rehabilitation
- The health of the public
- The individual in society

5
Co-ordinators have been appointed to monitor the integration of the themes of
communication skills, the health of the public, disability and rehabilitation,
medical-legal and ethical issues and the individual in society.

6
 Curriculum Development at Queen’s University Belfast

The Division of Medical Education of the School of Medicine and Dentistry was
established in 1995 to oversee the development and implementation of curricular
initiatives.

The Undergraduate Medical Education Committee, chaired by the Director for Medical
Education, endorses the overall strategy and recommendations of the Division of Medical
Education.

Staff of the Division of Medical Education

Director: Professor J M Savage

Assistant Director: Dr K McGlade
Director Clinical Skills Education Centre: Dr K Collins
Head of Division: Ms M Boohan
Lecturer: Dr M Corrigan
Teaching Fellows: Dr G Gormley
Teaching Associates: Mrs C Ross
Dr H Wilson

Administrator: Mrs G Carse

Secretaries: Ms B Shannon
Mrs C Smith
Mrs L McGuinness
Mrs J Fox
Miss K O’Donnell

Address: The Division of Medical Education

Ground Floor
Whitla Medical Building
97 Lisburn Road
Belfast
BT9 7BL

Telephone: (02890) 272183/2180

Fax: (02890) 330571
E Mail: B.Shannon@qub.ac.uk

• Details of the management structure for the Undergraduate Curriculum can be found
at: http://WWW.qub.ac.uk/cm/med_curr/med.html

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 Aims and Objectives of the Undergraduate Medical
Programme at Queen’s

The aims of the undergraduate programme are to:

A. Provide a high quality education programme for undergraduate medical students

that meets the current GMC recommendations

B. Continue to attract students of a high calibre

C. Provide an educational environment within which students can develop enthusiasm

for and interest in medicine, as well as scientific and technical skills and attitudes
relevant to good medical practice

D. Prepare students for independent and life-long learning by encouraging

self-directed study

E. Provide a range of opportunities for students to acquire key transferable skills

F. Foster learning through the study of original research evidence

G. Provide a framework of opportunities for early patient contact in the primary and
secondary health care sectors around which students can build a scientific picture
of a holistic approach to medicine

H. Develop increased confidence in scientific presentation, and further encourage a

self-directed approach to increasing knowledge of the current scientific principles
underlying health, disease and treatment and, through the intercalated degree
programme basic research skills

Learning Outcomes

On successful completion of a programme of study for the MB BCh BAO degree, a

student will be able to demonstrate achievement within the three aspects that support
Medical Practice as follows:

Knowledge and Understanding

On successful completion of a programme of study for the MB BCh BAO degree, a student
should be able to describe the:
1. Scientific concepts underpinning normal structure and function of the body systems
2. Importance of molecular, biochemical and cellular mechanisms in the maintenance of
homeostasis
3. Aetiology and mechanisms of disease
4. Causes of disease and the associated risk factors and disease prevention
5. Development of disease related changes to structure and function
6. Pharmacological principles of drug therapy, their efficacy in the treatment and relief of
symptoms and associated adverse reactions
7. Principles of non-pharmacological treatments and their function in the management of
illness and disability
8. Procedures for 4disease surveillance and screening, control of communicable
diseases, organisation and structure of the NHS
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 9. Principles of healthcare planning, service prioritization, and health economics
10. Principles of demography and biological variability
11. Ethical and legal principles underpinning the practice of medicine
12. Disease prevention, assessment of health needs and health promotion
13. Development of age related change to structure and function
14. Principles of treatment and rehabilitation of patients with impairment, disability or
handicap
15. Social and psychological factors that impact on relationships between the individual
and family/partners, and others in society
16. Psychological consequences of illness for the patient, family and society.
17. Demonstrate an awareness of understanding the healthcare needs of diverse a
diverse multicultural population.

Subject-specific Skills

Students should be competent in the following practical, clinical and interpersonal skills:

18 Perform clinical procedures routinely carried out by Foundation One Doctors

19 Recognise and carry out the initial treatment of the following emergency situations:
20 Cardiac arrest, anaphylactic shock and the unconscious patient
21 Obtain and record a comprehensive patient-centered history
22 Perform a relevant and systematic physical and mental state examination appropriate
for the patient’s age, gender, culture and the clinical environment
23 Define problems and reach a differential diagnosis
24 Select appropriate investigations and interpret the results
25 Make appropriate clinical decisions based on findings and evidence
26 Plan a patient management strategy ensuring that it is appropriate for the patient’s age
and social circumstances
27 Discuss a management plan with the patient and/relative/carer
28 Make appropriate referrals
29 Obtain informed consent from a patient
30 Demonstrate appropriate listening skills
31 Provide concise jargon free explanations to patients, carers and other members of the
health care team
32 Negotiation and mediation skills
33 Demonstrate the skills necessary to provide feedback on performance and deliver a
teaching session

Cognitive Skills

34 Solve basic clinical problems

35 Recognise the signs and symptoms of commonly presenting diseases

Transferable Skills

36 Oral and written communication skills including the presentation of reflective and
scientific information
37 Use information technology in particular the recording of information and data
retrieval
38 Apply scientific research principles and audit
39 Work effectively as a team member
40 Manage time and prioritise tasks

Overview of Undergraduate Programme

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The five year undergraduate course is divided into five consecutive phases as follows:

• Phase one
First semester of first year. This serves as an introduction to the programme introducing
students to the sciences basic to medicine while providing opportunities for the acquisition
of self-directed learning skills

• Phase two
Second semester of first year and all of second year. Students complete the “first pass”
through the body systems and begin clinical skills training during this phase. Students
also take three Student Selected Components

• Phase three
Third year. “Second pass” through the body systems and enhancement of clinical skills.
Two Student Selected Components also completed during this phase

• Phase four
Fourth year. Training in medical specialties continues. Students have completed the core
curriculum by the end of this phase

• Phase five
Fifth year. Overseas elective, submission of clinical project, completion of local
attachments, Preparation for Practice days and ‘workshadowing’.

Each phase must be completed satisfactorily before progression to the subsequent phase.

Structure of Undergraduate Programme

The programme is divided between a core curriculum and a Student Selected
Components Programme and is designed to implement the recommendations outlined in
“Tomorrow’s Doctors”.

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 MEDICAL CURRICULUM (OVERVIEW)

Years Phase Time Content

1 Science, Medicine & Society
Autumn 1 15 weeks Cell & Molecular Biology
Semester Microanatomy and Development
1 Systems Course 1
Spring Semester 2 15 weeks (Blood, Cardiovascular, Respiratory and Renal
systems)
Introductory Clinical Skills
Student Selected Components
2 Systems Course 1
Autumn 2 15 weeks (Gastrointestinal, Metabolism & Nutrition,
Neurosciences (including Special Senses))
Clinical Skills
Student Selected Components
2 Systems Course 1
Spring 2 15 weeks (Immunology, Endocrine, Musculoskeletal,
Reproduction, Life Cycle, Mechanisms of
Disease)
Clinical Skills
Student Selected Components
3 3 2 x 19 week Systems Course 2
semesters Block A: Pathobiology of Systems:
General Medicine, Endocrinology & Diabetes,
Nephrology, Neurosciences*, Haematology,
6 Lectures in Forensic Medicine,
(*including The Individual in Society)

Block B: Pathobiology of Systems:

General Surgery, ENT, Musculoskeletal,
Dermatology, Ophthalmology

Student Selected Components (one per

semester)
Perioperative and Emergency Medicine
4 4 40 weeks Healthcare of Children
Reproductive Medicine
Cancer Studies and Psychiatry
Primary Healthcare and Ageing and Health
Clinical Overseas Elective
5 5 31 weeks + Clinical Project
examination Vacation
periods Therapeutics Teaching/Study Days
Clinical Attachments (3 weeks Medicine, 3
weeks Surgery, 3 weeks Specialties)
Study Days/Seminars
Revision Lectures & Revision Time for Final MB
Part One
Final MB Pat One (Written Examinations)
Clinical Attachments (3 weeks Medicine, 3
weeks Surgery, 3 weeks Specialty)
Final MB Par Two (Clinical Examinations)
Workshadowing

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 Philosophy Underpinning the Undergraduate Curriculum

The undergraduate programme is designed to foster the development of self-directed

learning skills and to encourage learning through curiosity. The emphasis is on learning
rather than teaching. To achieve this aim and encourage students to take responsibility
for their learning, study guides are available for all parts of the programme. These guides
empower students to assume responsibility for their own learning by stating the aims and
objectives for each course, any relevant reading and methods of assessment.
The curriculum is delivered using a combination of student led tutorials, seminars,
laboratory practicals and clinical experience combined with a small number of
lectures. These lectures are used to introduce students to key concepts and principles.
Students are expected to further enhance their knowledge base through private study,
tutorial discussions, laboratory work and clinical experience.
This approach to curriculum delivery ensures that all students have an opportunity to learn
in an environment which matches their preferred style of learning.

The ethos throughout the programme is to maintain students’ motivation and interest in
medicine by emphasising the relevance of all aspects of student learning to the practice
of clinical medicine.

During phases one and two a lot of emphasis is placed on providing opportunities for
students to acquire transferable skills.
Students have opportunities to acquire the following skills:

Information Technology
• Use of Microsoft Word
• Excel
• Electronic Mail
• Use of the World Wide Web

Presentation Skills
• Preparation of transparencies using PowerPoint
• Preparation and delivery of oral presentations

Interpersonal Skills
In addition to clinical communication skills students acquire the following generic skills:
• Structuring and delivering an explanation
• Interviewing skills
• Interpreting and understanding body language
• Debating and group work
• Group leadership

• Research Skills
• Interrogating library data bases
• Literature evaluation
• Use of questionnaires
• Statistical analysis
• Essay writing
• Poster preparation and presentation
• Report writing and presentation
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Other
• Problem solving
• Management of learning

While many of the skills listed above are acquired during the early phases of the
programme students are afforded opportunities to maintain and further enhance these
skills as they progress through the course. For example, during years three and four
students are expected to research the material which they use for case presentations and
a lot of emphasis is placed on the quality and style of the presentation. Final year
students are required to undertake a piece of research and provide a report on their work.
Students are encouraged to maintain their IT skills by use of Electronic Mail to
communicate with each other and also with members of staff.
The skill of problem solving is developed particularly during clinical training in years three,
four and five. The structure of the curriculum ensures that the skills associated with
managing and directing learning are maintained and developed throughout the
programme.

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 The Student Selected Components Programme
Professor Madeleine Ennis has overall responsibility for the Student Selected Components
Programme. The following members of staff oversee the components of this programme.

Co-ordinators: Year 1 Spring Semester Dr VLS Crawford

Year Two Autumn Semester Dr D Bell
Year Two Spring Semester Dr J Woodside
Year Three Autumn Semester Dr K Williamson
Year Three Spring Semester Professor D Johnston
Final Year Clinical Projects Dr LG Heaney

Overview
The curriculum is defined in terms of a core and student selected components
programme. The aim of the core curriculum is to produce competent pre-registration
house officers with life-long learning skills. The structure and delivery of the Student
Selected Components programme facilitates the achievement of this aim.

Aim of the Student Selected Components Programme

To provide students with an opportunity to explore subjects of particular interest to them in
greater depth than the core course allows.

Goals of the Student Selected Components Programme

To provide opportunities for students to:
• develop group work and group leadership skills
• acquire data acquisition and processing skills
• develop an understanding of statistical methods
• develop an understanding of scientific methods
• acquire essay writing skills
• develop the skills required to critically evaluate scientific literature
• practice evidence based medicine
• acquire computer and information technology skills
• understand the principles underpinning scientific research

Learning Outcomes
On completion of the Student Selected Components programme the student should be
able to:
• retrieve information
• evaluate and critically appraise scientific literature
• demonstrate proficiency in written and oral communication
• demonstrate an ability to work as part of a team
• demonstrate proficiency in self-directed learning
• demonstrate an understanding of the principles involved in undertaking scientific
research

The student selected components programme is delivered during phases two, three and
five.

A handbook outlining the Students Selected Components Programme can be consulted at

the following WEB address: - http://www.qub.ac.uk/cm/me/docs/ssc-handbook0304.pdf
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 Delivery of the Students Selected Components Programme during
Phases Two and Three

Time allocated
Students should spend a total of 120 hours on each SSC. However, this is not contact
time. In Phase 2 a maximum of 6 hours contact time per week is timetabled.

Overview
During phases two and three a range of Student Selected Components are offered. Some
of these are delivered as taught courses while others are library based research projects.
The number of modules offered varies from semester to semester.

Each semester students are required to prioritise all the choices.

In the event of a module being oversubscribed all applicants enter a lottery. Those who
are unsuccessful are allocated to one of the other modules they have chosen and are
given preference in the selection of student selected components in the subsequent
semester. To foster the development of self-directed learning skills the number of students
admitted to each of these modules is restricted to a maximum of fifty. The minimum is
normally two.

In addition to the phase co-ordinators listed above, each student selected component has
a co-ordinator.

The specific objectives for each student selected components are set out in the study
guides which accompany each module.
See page 32 for a list of the student selected components delivered during phase two.
Details of the modules delivered during phase three can be found on page 41.

Assessment
In keeping with the ethos of the acquisition and assessment of key transferable skills,
examinations are not used to assess student competence at the end of a student selected
component. The following assessment techniques are currently used to assess
knowledge and skills:

A) Essay, project or dissertation

B) Poster presentation
C) Web presentation
D) Oral presentation
E) Practical skill (could be laboratory, clinical, etc)
F) Literature review
G) Design of multiple choice questions
H) Class tests
I) Short questions
J) Oral examination
K) Study journal
L) Reflective portfolio

Co-ordinators select at least two of the above assessment techniques; although other
forms of assessment may also be used. Care is taken to ensure that the assessment
methods selected match the learning.

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Delivery of the Student Selected Components Programme during Phase
Five

The clinical project is an integral part of the final year programme. Each student will carry
out a piece of research (singly or as part of a small group) on a topic which is of clinical
interest and will produce an individual project of between 6,000 – 8,000 words which will
be assessed. (A satisfactory assessment must be achieved before a student is eligible to
take Final MB Part II).

Students are encouraged to propose a topic for their own project and to seek a Faculty
Supervisor from the relevant clinical area. Although an academic member of staff will
normally supervise the work, projects may be carried out in conjunction with a doctor or
health professional that do not hold an academic position. In this case, students may
initiate contact where appropriate but they will also need to have a Faculty academic
supervisor. (A list of relevant supervisors will be available for consultation in the Electives
Room, Ground Floor, WMB).

Further information regarding the clinical project is available on the Faculty Web Site:
www.qub.ac.uk/fmhs/news.html

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 Induction Programme

During the first week of the first semester the Faculty of Medicine and Health Sciences
organises an induction programme for first year medical students.

The aims of this programme are to:

- introduce students to the Medical School
- provide students with training in basic First Aid
- familiarise students with the Faculty Student Support System
- introduce students to the skills required for self-directed learning

The programme includes:

• a formal welcome by the Dean

• advice from the Occupational Health Physician on vaccinations
• an overview of the undergraduate medical curriculum
• training in First Aid
• workshops on study skills
• provision of information about the Student Support System offered by the School of
Medicine. During this session students are introduced to the pastoral support provided
by staff and other students.

In addition to the Medical School programme the University organises an induction

seminar for all new students during the week prior to the first semester.

17
 Undergraduate Medical Curriculum
Overview of Phase 1

Year Semester Content (Modules)

1 Autumn Cell & Molecular Biology

Microanatomy &
Development

Science, Society &

Medicine

18
 Outline of Phase 1

Year 1 Autumn Semester

Phase One Co-ordinator: Dr J S McCullough

Phase one serves as an introduction to the course.

During this phase students receive training in self-directed study skills. This training is
experiential, students are provided with opportunities to develop the competencies
required to function as active learners. These include information retrieval and evaluation,
the use of information technology, group work and group leadership skills. In addition
students acquire essay writing and presentation skills.

Overview of Phase One

Students complete the following three modules during this phase:

• Cells and Molecular Biology

• Microanatomy and Development
• Science, Society and Medicine

This phase focuses on the study of normal human structure and function at the molecular
and cellular levels.
Students are also introduced to the sociological, epidemiological, ethical and scientific
aspects of medical practice.

Students are provided with opportunities to develop the skills which will equip them to
begin to function as ‘active learners’. These include data acquisition and processing skills,
statistical methods, use of spread sheets, use of information technology, group work, and
evaluation of information and presentation skills.

Communication skills training also begins in phase I.

The Earl Medical Contact Programme (also known as The Family Attachment
Programme) runs throughout phases one and two and provides students with an
opportunity to observe the psycho-social aspects of illness.

Goals of Phase One

To provide opportunities for students to:

• Develop an understanding of human structure and function at the molecular and
cellular levels
• Develop an appreciation of the sociological, epidemiological, ethical and scientific
aspects of medical practice
• Acquire basic communication skills
• Enhance written presentation skills
• Develop independent learning skills

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Instructional Methods

• A small number of lectures combined with problem-solving tutorials are used to provide
instruction in basic principles and concepts
• Role-play and video feedback are used to provide training in communication skills

20
 Phase One Modules

Cell & Molecular Biology

Teaching Staff Biochemistry

Dr M Lewis (Co-ordinator)
Dr B Wisdom

Medical Genetics
Professor A Hughes
Professor Patrick Morrison
Dr Shane McKee

Molecular Biology
Dr Paul Duprex

Therapeutics/Pharmacology
Dr D Bell
Professor B McDermott

Description
Core

Time Allocated
Four and a half hours each week

Module Overview

This module focuses on the molecular basis of medicine.

The disciplines contributing to the course include biochemistry, molecular biology,

medical genetics, therapeutics and pharmacology.

The course involves lectures and seminars, augmented with tutorials and discussion
classes. A series of clinical case studies is presented, and self-directed learning is
encouraged by multifarious self-assessment exercises.

Aim

To introduce students to the molecular basis of medicine.

Objectives
On completion of this module the student should be able to:

• explain the basic features of protein structure and function, particularly the roles of
conformation and stereospicific binding sites
• describe how myoglobin and haemoglobin bind oxygen and, in the case of the latter,
how this binding is modified by other molecules in a physiologically appropriate way

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• explain how genetic information, stored in DNA, is transcribed into RNA, and the
translation of RNA into proteins; describe the post-transactional modifications of
proteins; describe the control of gene expression
• describe in brief the structures and functions of chromosomes and genes, and the use
of molecular methods in disease susceptibility
• interpret patterns of inheritance and calculate risks for genetic disorders
• explain the basic characteristics of enzymes, the nature of catalysis and the way in
which enzymes regulate metabolism
• describe the fluid mosaic model of membrane structure and the basic functions of
cellular membranes
• describe the production and utilisation of energy in anabolic and catabolic processes
and the roles of ATP and creatine phosphate; indicate the functions of cytochromes in
cellular respiration; distinguish aerobic and anaerobic metabolism
• assess the metabolic significance of glycolysis, glycogenolysis and the pentose
phosphate pathway; Cori cycle, glycogenesis and glyco(neo)genesis; Kreb cycle;
oxidative phosphorylation and electron transport; transamination, ammonia and the
urea cycle; oxidation and biosynthesis of lipids
• integrate the major metabolic pathways and list those factors, including kinetic,
hormonal and genetic factors, by which they are controlled
• appreciate the central role of the “receptor” as the site of action of drugs and
endogenous chemical mediators
• graphically present and interpret drug concentration-response curves
• recognise fundamental differences between the four main classes of receptor in terms
of their molecular structures and receptor-effector coupling mechanisms
• define drug action in terms of single transduction through G proteins, ion channels,
second messenger substances and kinases

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 Microanatomy and Development

Teaching Staff: Anatomy

Dr J.S. McCullough (Module co-ordinator)
Dr D.J. Wilson

Description
Core

Contact Time Allocated

Four and a half hours each week

Module Overview
This module provides a grounding in normal cellular and tissue patterns, including an
introduction to embryology, through the study of microscope slides, pictures, specimens
and reference material. It involves theory classes, tutorials and a series of practical
classes during which small groups undertake tasks.

In terms of skills, the module seeks to give students experience in systematic observation
and description, comparing normal tissue patterns, working in groups, time management
and use of microscopes.

There are regular, brief formative assessments with speedy feedback, to allow students to
judge their progress on the course. The end-of-course examinations will comprise both
written and practical components.

Aims
To illustrate aspects of normal cell and tissue structure and their embryological origins. To
introduce several important anatomical principles.

Learning Outcomes
1 List and describe the major components of the mammalian cell. Relate the structure
of subcellular features to their functions and use them as markers for different cell
types.
2 State that all cells are categorised into one of 4 basic tissue types; (epithelium,
muscle, nerve and connective tissue) and that organs are made up of different
tissues in varying proportions.
3 Describe the histological features of skin and its component parts and to identify
these in micrographs and microscope slides. Describe the differences between
normal and abnormal skin using non-technical language.
4 Describe the histological features of ordinary connective tissue, fat, cartilage and
bone and to identify these in micrographs and microscope slides.
5 Describe the histological and ultrastructural features of the three types of muscle
(skeletal, cardiac and smooth) and to identify these in micrographs and microscope
slides.
6 Describe the histological features of the nervous system, including neurons; the role
played by glial cells, especially Schwann cells; the spinal cord and spinal ganglia;
peripheral nerves; and to identify these in micrographs and microscope slides.
7 Describe and classify different types of epithelium (lining and glandular) from their
histological features and identify these in micrographs and microscope slides.

23
8 Identify the site of fertilisation and define the chromosomal status of gametes at this
time.
9 Briefly explain the importance of sperm capacitation
10 Describe the events involved in fertilisation and the results of fertilisation in terms of
chromosome number and genetic makeup of the individual
11 Describe the cellular events in the embryo and the uterine wall up to and including
implantation
12 Identify at least three sites of abnormal implantation
13 Describe the transformation of the bilaminar disc to a trilaminar embryo comprising
the 3 germ layers (ecto-, meso- and endoderm); list the tissues/organs derived from
these layers
14 Describe the process of neurulation and list the main types of cell derived from the
neural crest.
15 Describe somitogenesis and list the derivatives of the sclerotome, myotome and
dermatome.
16 Identify the maternal and fetal components of the placenta and list their functions;
describe the layers of the fetal-maternal interface in early and late pregnancy.
17 Describe the components of the definitive umbilical cord.
18 As a group, successfully complete a given practical task within a given time frame.
19 Observe, interpret and record observations on a specimen in a systematic way.
20 Interpret a structure cut in different planes of section.
21 Describe the differences in histological appearance of the tissues with different
physiological states and age groups and in disease (cancer), using mammary gland
as an example.

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 Science, Society & Medicine

Co-ordinators: Dr M E Cupples (Medicine & Society)

Dr VLS Crawford (Science and Computing Skills)

Description
Core

Time Allocated
Five hours per week

Module Overview
This module facilitates the development of an understanding of the issues surrounding the
interaction between medicine and science and medicine and social issues. Central to this
module are discussions about the role of the doctor and the dentist in contemporary
society, the demographic structure of our society and the impact of lifestyle variations on
health and health care. Ethical frameworks for medical decision making are introduced
and some major ethical issues are explored. The rigour of the scientific method as applied
to medical research, the availability of evidence for medical interventions and the ethics of
scientific research are discussed. Students have an opportunity to acquire basic word-
processing skills and to use electronic communication. Practical advice on good writing
skills is also provided.

Integrated theory classes, student-led tutorials and seminars are used to deliver the
course. The tutorial groups have eight to ten students and are facilitated by a member of
staff. Each student submits two assignments during the module. The first is formative
and students receive individual feedback on this work. The second is summative and the
mark contributes to the final assessment score for the module. These assignments take
the form of essays and their presentation and submission require the use of computer
skills. On completion of the module students take a two hour written examination. This is
designed to test factual knowledge, attitudes and problem-solving skills.

Aim

To facilitate the development of an understanding of the complexities surrounding the

interaction of medicine, science and society.

Objectives

On completion of this module the student should be able to:

• discuss the inter-relationship between science, society and the practice of medicine
and dentistry
• demonstrate an understanding of the ethical principles which apply to the work of
medical and dental professionals
• critically appraise published scientific work
• write informed and literate essays
• perform basic word-processing tasks

25
• use E-mail and the internet effectively

The following topics are included in this module:

• The development of the professions of medicine and Dentistry in the United Kingdom
• The role of the General Medical Council/General Dental Council
• Guidelines for professional practice
• Ethical principles of medical practice, including research
• Truth telling
• Confidentiality
• Consent
• The organisation of health care
• Principles of epidemiology
• Measurement of health outcomes
• The relationship between socio-economic factors and health
• Complementary Medicine
• Social, cultural and psychological factors influencing health and illness
• Health promotion
• Research methods used in medical research
• Computing Skills

26
 Early Medical Contact Scheme

Co-ordinator: Dr K J McGlade

Description
Core

Time Allocated
Thirty hours during phases one and two

Overview
During phases one and two students participate in the Early Medical Contact Programme.
Under the supervision of a General Practitioner students pay regular visits to a family.
One or more members of this family will be suffering from a chronic illness or disability.

Aims
To provide the student with an opportunity to:

• observe at first hand the process of family life and health care
• begin to develop an understanding of human relationships
• begin to acquire and develop good communication skills
• appreciate the importance of good communication with both patients and their relatives
and with other professionals involved in their care
• become aware of the organisation of care in the community
• become aware of the importance of Health Promotion n the community
• become aware of the ethical responsibilities involved in patient care
• begin to develop an understanding of the interactions between the patient, illness, and
the social and physical environment

Objectives
On completion of this programme the student should be able to:

• describe the cultural, social and environment of the families/households visited

• describe how social class, accommodation, neighbourhood, schooling, work, and
leisure pursuits inter-relate with illness and disease
• construct a family tree and use this to describe the household and the broader family
structure
• describe the sources of social support available to the family
• list the family’s recent and continuing illness events
• describe how the family has dealt with these illness events including occupancy of the
sick role
• describe the definition of illness from the standpoint of the family and the professional
• list the medical and social resources available in the community
• evaluate the extent to which family/household health care needs have been met by
available resources
• identify why needs remain unmet
• discuss how community efforts to prevent and promote health impinge on the family
• discuss the specific family visited in relation to the known demography, epidemiology
and psychological factors of illness and disease
27
• discuss the potential impact of the student’s presence on the family
• discuss the difficulties and satisfactions encountered in the interaction with the family

Keeping Notes and Assessment

Students should keep a log of their own visits and tutorials and should record details of
their learning experiences in a notebook. This will prove invaluable in writing up a formal
report at the end of second year. This report forms the end of course assessment.

Confidentiality

When keeping notes students should always be careful to preserve confidentiality by not
using the real names of patients or doctors. It is particularly important when using public
areas such as libraries and computer sites, not to leave any confidential material lying
around.

Course Integration

The Early Medical Contact Programme, (Family Attachment Scheme) has important links
with other parts of the curriculum including: The Communication Skills Courses, The
Individual in Society and Public Health. Integration of all these elements by students will
improve the learning experience. These issues and opportunities will be discussed at the
introductory seminars at the start of each semester.

28
 Communication Skills Training

Co-ordinators: Ms M Boohan and Dr K J McGlade

Secretary: Mrs C Smith

Description
Core

Time Allocated
Three afternoons during phase one. One afternoon during each semester of phase two.

Overview
Formal training in communication skills begins during phase one. Throughout phases one
and two students attend six communication skills workshops. These small group teaching
sessions are facilitated by specially trained staff and provide students with an opportunity
to practice basic communication skills in a safe environment and receive constructive
feedback on performance.
The facilities in the Clinical Skills Education Centre are used for communication skills
training during phases one and two.

Aim

To facilitate the development of the skills required to communicate sensitively with

patients, their relatives and colleagues in a variety of settings.

Objectives
On completion of this course the student should be able to:

• describe the range of communication channels used by the doctor

• demonstrate an understanding of the importance of good communication
skills in health care
• demonstrate proficiency in the following communication skills:
- appropriate introduction to patients
- history taking
- explaining
- use of open and closed questions
- interpretation of body language

• discuss the problems associated with the consultation when more than
one person is present

29
 Undergraduate Medical Curriculum
Overview of Phase 2

Year Semester Content (Modules)

1 Spring Systems 1
Blood/Cardiovascular/
Respiratory/Renal

Introductory Clinical Skills

Student Selected Components

2 Autumn Systems 1

Gastrointestinal, Metabolism & Nutrition,

Neurosciences (including special senses)

Introductory Clinical Skills

Student Selected Components

2 Spring Systems 1

(Immunology, Endocrine, Musculoskeletal,

Reproduction, Life Cycle)

Introductory Clinical Skills

Student Selected Components

30
 Outline of Phase 2

Year 1 Spring Semester and Year 2 Autumn and Spring

Semesters

Phase Two Co-ordinator Professor F Kee

During this phase students complete the “first pass” through the body systems. The
Student Selected Components programme commences during this phase, six hours per
week are allocated to this part of the programme. The remainder of curriculum time is
devoted to the core curriculum. Throughout this phase students are encouraged to
continue to take responsibility for their own learning and continue to be provided with
opportunities to further develop their self-directed learning skills and continue to
During each semester of this phase students take the following modules:

• Systems Course One

• Introductory Clinical skills
• A Student Selected Component

Overview of Phase Two

This phase encompasses the study of the normal structure and function of each body
system. The teaching of scientific, clinical, behavioural and epidemiological material is
integrated across each system. While the focus of this “first pass” through the systems is
on normal structure and function common problems of dysfunction are also presented to
enable students to develop an understanding of general principles of pathology and
therapeutics.
Basic clinical skills training commences during this phase. This programme focuses on
the acquisition of clinical skills relevant to each body systems.
Communication Skills Training and the Early Medical Contact Programme continue
throughout this phase.

Goals of Phase Two

To provide opportunities for students to:

• Develop an understanding of normal structure and function
• Develop an understanding of the basic principles of pathology
• Develop an awareness of the importance of a holistic approach to the practice of
medicine
• Acquire basic clinical skills
• Develop an understanding of the primary and secondary care environments
• Develop research, oral and written presentation skills through the SSC Programme

Instructional Methods

• Clinical case vignettes are used as triggers for discussions during tutorials
• Training in basic clinical skills is provided in hospital and community clinical settings
and a Clinical Skills Education Centre

31
 Systems Course One

Systems Course Co-ordinators

Dr D Fogarty (Year One Spring Semester)

Dr D Allen (Year Two Autumn Semester)
Dr M Rooney (Year Two Spring Semester)

Description
Core

Time Allocated
Five mornings and one afternoon each week

Overview of Systems Course One

This course runs throughout phase two and focuses primarily on human biology. It also
serves as an introduction to the structural and functional abnormalities produced by
disease. It is integrated, with anatomy, physiology, principles of biochemistry, medical
genetics, pathology, microbiology, therapeutics, epidemiology and behavioural
sciences relevant to each body system being taught around the same time.

The principle underpinning this course is that learning is relevant to patient problems.
Clinical case scenarios are used during tutorials and practical classes to enable students
to recognise how knowledge of human structure and function facilitates understanding of
the disease process.
During each semester of this phase students learn about the structure and function of four
body systems as indicated below.

Year One Spring Semester

System Duration
Blood Two weeks
Cardiovascular Three weeks
Respiratory Four weeks
Renal Three weeks

Year Two Autumn Semester

System Duration
Gastrointestinal Three weeks
Metabolism and Nutrition Two weeks
Neurosciences (including special senses) Seven weeks

32
 Year Two Spring Semester

System Duration
Immunology Three weeks
Endocrine Two weeks
Musculoskeletal Four weeks
Reproductive Two weeks
Life Cycle One week

Objectives for Systems Course One

On completion of this course the student should be able to:

Knowledge
• demonstrate an understanding of the principles of anatomical structure function
relevant to each body system
• demonstrate an understanding of the principles of physiology underpinning the function
of each body system
• describe general pathological principles and provide examples which relate to disease
of the relevant body system
• discuss the psychosocial factors associated with illness and the maintenance of health
• demonstrate an understanding of the application of the principles of epidemiology to
medical practice, disease prevention and the public health
• comment on the relevant application of therapeutics to each body system
• discuss the contribution of medical genetics to our understanding of human functioning

Skills
• communicate competently with patients and their relatives
• communicate effectively with colleagues
• prepare and present well sourced, cogent and literate essays
• perform basic statistical computations

Attitudes
• demonstrate empathy towards patients particularly those suffering from a physical
disability or handicap

33
 Phase Two Student Selected Components Programme

Student Selected Components Available in the Spring Semester of Year One

Allergy & orofacial disease
Alternative therapies – do they work?
Bone fracture: fixation and healing biomechanics
Candidal infection of the orofacial region
Care in the community
Cell migration and chemotaxis
Coronary bypass grafts
Cyclooxygenase-2 in inflammation and oncogenesis
Endothelial dysfunction in cardiovascular disease
Forensic dentistry
Haemostasis, inflammation and cardiovascular disease
Herpes infection of the orofacial region
Male habitus
Medical informatics
Micronutrients in health and disease
Molecular based therapies for cancer treatment
Multicultural medicine
Ocular neovascularisation
Ocular neurobiology
The molecular biology in retinal disease
The retinal microvasculature in health & disease

Student Selected Components Available in the Autumn Semester of Year Two

Addictions Studies
Alzheimer’s disease: causes and cures
Exercise and Applied Physiology
Immunological laboratory methods in Clinical Medicine
Learning to Teach
Meningococcal Disease
Microbial Infection
Murder or mercy?
Nutritional requirements throughout the life cycle
Osteoporosis - The New Epidemic
Paediatric Pain Management
Proteins in Disease and Therapy
Working with children with disabilities
What’s to come for the broken hearted? - novel drugs for the management of heart failure.
Cardiovascular and Diabetes Mellitus Library-based Research
Library-based SSCs
Cell Signal Transduction Section Messengers
Understanding the multi-step process of carcinogensis: sunlight and skin cancer as a model
Understanding the multi-step process of breast cancer & metastasis as a model

Student Selected Components Available in the Spring Semester of Year Two

Avoidable disease and its prevention
Essential Hypertension
Ethical issues in paediatrics
Computers in Cancer Diagnosis
Hypermobility and Joint pain in children: Is there an association?
Autonomic cardiovascular control: rewriting the rules
34
 Growth factors and cancer
Molecular biology in medicine
New insights on the structure, molecular biology, function and pathology of tight junctions
Public Health Medicine in Practice
Reproductive technology
Treatment of bladder cancer
Educating Arthritis Patients about their drugs
Sign Language & Communication Tactics with deaf, hard of hearing and deaf blind people
Cardiorespiratory Physiology – the basis of neonatal medicine
Entrepreneurship in Medicine
Chronic Pain-manifestations and management
The cytoskeleton in health and disease
The anatomy of the lumbar vertebrae and its clinical relevance

35
 Introductory Clinical Skills Course

Co-ordinator : Dr K Collins (Clinical Skills Education Centre)

Dr K Steele (Primary Care Attachments)
Dr G McVeigh (Hospital Attachments)

Description : Core

Time Allocated Two afternoons each week

Overview
This course introduces students to basic clinical skills and runs throughout phase two.

The programme is delivered in three settings. These are the Clinical Skills Education
Centre located at the Belfast City Hospital where students receive training in basic clinical
skills and Hospitals and General Practices in the surrounding Greater Belfast area
where students complete clinical attachments.

The philosophy underpinning this course is to teach students how to carry out the various
skills. Having done that they can go forward to learn why these procedures are done.
They are taught the norm initially and then are introduced to the abnormal and its clinical
significance.

The focus is on the individual student and every effort is made to ensure that they each
are given the opportunity to learn and practice the necessary skills. The skills taught in
the various semesters are in accordance with the subject matter of the associated
systems course. They are taught in collaboration with Communication Skills and Family
Attachment.

Aim
To introduce first and second year students to basic clinical skills.

Objectives
On completion of this course the student should be able to:

• perform the designated clinical skills

• recognise the normal clinical findings
• differentiate the abnormal clinical findings and interpret these findings
• apply their communication skills to the clinical setting
• begin to develop their clinical professionalism
• demonstrate appropriate attitudes towards patients in clinical settings

36
 Overview of Phase 3

Year Three Autumn and Spring Semesters

Phase Three Co-odinator: Dr M F McMullin

During each of the semesters of this phase students complete two core modules and one
Student Selected Components. The core modules are:

• Systems Course Two

• Clinical Skills

Overview

Students study each of the body systems again. The focus of this “second pass” through
the systems is on abnormal structure and function. Students rotate through a series of
clinical attachments which provide opportunities for the study of patients presenting with
abnormal structure and function of body systems. Clinical science teaching complements
clinical experience. The epidemiology, aetiology, and natural history of disease processes
are investigated in greater depth than in phase two. The principles of therapeutics are
included in a consideration of the medical management of specific disease processes.
The ethical implications of medical interventions are considered and the psychological and
social consequences both of disease and medical intervention are reviewed.
A feature of this course is the integration of training in laboratory medicine throughout
the programme. Ward based teaching is delivered in the mornings while associated
laboratory based teaching is time-tabled in the afternoons. An innovation of this phase of
the curriculum is the teaching of laboratory medicine in the Area Hospitals.
The phase three programme is divided into two blocks (A & B ) and is delivered in the
main teaching hospitals and also in Area Hospitals.
Half of the students complete block A during the Autumn Semester while the other half
complete block B. Students take the outstanding block during the Spring Semester.
Students work on the core teaching programme from Monday until Thursday. Friday is
devoted to Student Selected Components teaching.

Details of Block A
• General Medicine (including Cardiology)
• Neurosciences
• Haematology
• Metabolic Medicine
• Nephrology

Details of Block B
• General Surgery
• ENT
• Musculoskeletal Medicine
• Dermatology
• Ophthalmology

The teaching of Clinical and Laboratory Science is integrated throughout both blocks.

Goals of Phase Three

37
To provide opportunities for students to:
• Continue the study of basic medical science in the context of clinical problems
• Continue to acquire and refine clinical skills
• Develop an understanding of the pathobiology of systems
• Progress from an understanding of normal structure, function and behaviour to
diagnosing disease and developing patient management programmes
• Develop an understanding of the disease process
• Develop clinical problem solving skills
• Continue to develop proficiency in interpersonal communication skills
• Acquire data handling and critical appraisal skills
• Continue to develop research, oral and written presentation skills through the SSC
programme
• Foster the continued development of independent learning

Instructional Methods
• small group problem-solving activities using clinical trigger material
• preparation and presentation of clinical cases
• bedside teaching
• teaching in outpatient facilities

Aims and Learning Outcomes for each attachment and the laboratory sciences
programme taught during phase three are outlined below.

38
 Phase Three Student Selected Components Programme

Student Selected Components Available in the Autumn Semester

A framework for Clinical Reasoning

A short course on Wound Healing
Acute Poisoning
Anatomy of the Knee
Breast Cancer
Cancer Genetics
Cardiovascular risk in diabetes
Colorectal Cancer
History of Medicine
Living with Sensory Disability
Neuropsychopharmacology
The Role & Functions of the Forensic Pathologist
Topical Occupational Health Issues
Sports and Exercise Medicine

Student Selected Components Available in the Spring Semester of Year Three

Breast Cancer
Chemical Detectives - Cases in Clinical Biochemistry
Clinical Genetics
The Diagnostic Pathologist in the Clinical Team
The Role & Functions of the Forensic Pathologist
Ovarian Cancer
Sports & Exercise Medicine
Topical Occupational Health Issues
History of Medicine
Advanced Medical Informatics
Design a New Hip Joint
Radiation Oncology
Respiratory Inflammation
Palliative Care

39
 Pathobiology of Systems
Teaching Staff: Professor Peter A Hall
Honorary Academic Staff employed by NHS Trusts in
Belfast (BCH & RVH) as well as Antrim, Altnagelvin &
Craigavon

Secretary: Mrs Priscilla Clark

Duration of Programme: Sixteen weeks during the Autumn Semester and sixteen
weeks during the Spring Semester

Format of Programme

This is the first year of a new course in Pathology that we are calling ‘Pathobiology of
Systems’. The name emphasises the linking nature of the course and its important place
in the Systems course. There are three key threads:

First, the basic core material is presented to the student body through lectures (24 in
systems pathology and 6 in Forensic Pathology) and related teaching sessions (4
seminars on the use and application of pathology to patients).

Secondly, there are case materials available via the web that illustrate how pathology
applies to patients and allows you to understand how disease affects patients and how
pathology can be used to solve clinical problems.

Thirdly, there are tutorials where the web based case material can be discussed in a small
group and the answers to the questions considered and discussed.

Finally, there are some ‘hot topics’ that illustrate important principles or applications of
pathology in relation to contemporary items in the lay or medical literature.

Aims

• To build on the knowledge of biomedical science and diseases mechanisms, which

students have acquired during phases one and two. This is to be achieved through
the study of disease processes in specific body ‘systems’ and organs.

• To have an understanding of the common disease processes affecting organ

systems of the body and their clinical implications. To use such knowledge to
interpret clinical scenarios and solve clinical problems

• To enable the student to appreciate the role of the Laboratory in clinical practice.

• To develop a basic understanding of the principles and procedures underlying the

use of forensic pathology to investigate specific common causes of injury, disease
and death.

40
Objectives

On completion of this course the student should be able to:

• Explain how the basic mechanisms of disease operating in specific body systems
and organs, produce the typical features of a range of common diseases.

• List the causes, risk factors, clinico-pathological features, outcomes and

complications of these diseases.

• Describe the principle of the laboratory investigations that should be undertaken to

assist in arriving at a diagnosis for a range of common clinical conditions.

• Describe and explain the causes, mechanisms and characteristic features of injury,
disease and death as encountered in the course of forensic pathological
examination.

• Critically evaluate the laboratory reports used by the main laboratory disciplines.

41
 General Medicine

Teaching staff: Dr L McGarvey (Course co-ordinator)

Dr D McCluskey

Secretary: Mrs E Burns

Duration of Attachment: Eight weeks

Format of Programme
This clerkship provides the student with an opportunity to further develop the skills of
history taking and examination of patients. As the attachment progresses students are
expected to use the clinical information obtained to formulate diagnostic hypotheses and
to develop problem solving skills.
Bedside teaching, case based tutorials and student led case presentations are used to
deliver this programme.

Aim

To facilitate the development of problem solving skills and clinical decision making skills.

Objectives
On completion of this attachment the student should be able to:

• take a full patient history encompassing the presenting complaint, past history,
occupational history, family history and assessment of personal and family
circumstances
• perform an examination of all systems focusing particularly on the system which is
most likely to provide information which will assist diagnosis
• record the findings of the examination
• recognise when it is appropriate to perform a mental state examination
• formulate a problem list and make a differential diagnosis
• list the investigations considered appropriate
• describe the purpose of the appropriate investigation and summarise it for the patient
using suitable language
• describe all forms of appropriate therapy for a given diagnosis
• demonstrate an understanding of the mode of action of frequently prescribed drugs
and their known side-effects and interactions
• assess the disability likely to result from a given medical diagnosis and decide on
appropriate measures for rehabilitation
• provide advice to patients

42
 Cardiology

Teaching staff: Dr Pascal McKeown (Course co-ordinator)

Secretary: Mrs E Burns

Duration of Attachment: 8 Sessions, either as 2 week block during the 8

week attachment in Medicine or as one session per
week for the 8 week block (will depend on the
Hospital to which students are attached).

Format of Programme
This course is included as part of the eight week Medicine attachment. The teaching
programme combines bedside teaching with case based tutorials and student led case
presentations. The programme is delivered in the Belfast Hospitals and the Area
Hospitals. Students will also receive formal training using the ‘Harvey Simulator’,
which can mimic the clinical signs of many cardiac diseases.

Aims
To provide students with an opportunity to examine patients with a wide variety of
cardiological problems and to learn about appropriate investigation and management
of cardiovascular disease. In addition students will have an opportunity to observe the
range of diagnostic procedures used in the assessment of patients.

LEARNING OUTCOMES

KNOWLEDGE
On completion of this course the successful student should be able to:

¾ List the recognised risk factors for the development of heart disease
¾ Describe the typical clinical presentation and management of patients presenting
with cardiac diseases, including ischaemic heart disease, valvular heart disease,
hypertension, infective endocarditis, cardiomyopathies, aortic dissection, and
pericardial disease
¾ Summarise the investigations used in assessment of heart disease
¾ List the major classes of drugs available for the treatment of cardiovascular disease
and discuss the indications for and potential side-effects of these drugs
¾ Summarise the common causes of and discuss the management of atrial and
ventricular rhythm disorders

SKILLS
On completion of this course the successful student should be able to:

¾ Obtain and record a comprehensive clinical history, with particular regard to a

patient presenting with cardiovascular disease
¾ Undertake clinical examination of the cardiovascular system
¾ Interpret the findings from the history and examination and formulate a problem list
and management plan for the patient
¾ Use ‘Harvey’ for self-directed learning.
¾ Perform Basic life support

43
ATTITUDES
On completion of this course the successful student should be able to:

¾ Assume responsibility for self-directed learning

¾ Recognise the skills and knowledge of the professions allied to medicine which are
involved in the overall care of patients with heart disease

44
 Neuroscience

Teachers: Dr S A Hawkins (Course co-ordinator)

and staff from the Belfast Hospitals

Secretary: Mrs J Harper – Part Time Hours

0915 – 1445 Monday, Tuesday
0915 – 1600 Thursday

Duration of Attachment: Three weeks

Students need to report to Ward 4F at 9.00 am in the
new part of the Royal on the 1st day of their
attachment.

Format of Programme
This attachment introduces students to clinical neurology and neurosurgery. Teaching in
neuroradiology, neuropathology and neurophysiology is integrated where appropriate
throughout this programme.

Aims

• to enable students to develop an understanding of common

neurological diseases
• to acquire the skills required to take a history and perform a physical
examination on a patient

Objectives

Knowledge
On completion of this attachment the student should be able to:

• explain how lesions in the brain, spinal cord, peripheral nerves and muscles interfere
with the normal function of the body
• name the common neurological and neurosurgical diseases and how they present
• demonstrate an understanding of how the common neurological and neurosurgical
diseases are investigated
• state the steps involved in the diagnosis of common diseases
• describe the principles of treatment of the common neurological diseases
• assess neurological emergencies, in particular the unconscious patient and epilepsy

Skills

• take a history from a patient with a neurological illness

• examine the mental state – orientation, memory and perceptions
• perform a physical examination of the brain, cranial nerves, motor system and sensory
system
• present cases in an organised, coherent way with a valid list of differential diagnoses,
plan of investigations and treatment

45
Attitudes

• demonstrate empathy with patients of all levels of intelligence and educational

attainment
• approach patients who are disabled as a consequence of diseases of the nervous
system and inquire about how their disabilities and impairments alter their lives

46
 The Individual in Society

During this attachment students attend a number of lectures on the theme of The
Individual in Society.

Co-ordinator: Ms M Boohan
Duration: Three weeks

Secretary: Mrs C Smith

Aims

• to introduce students to aspects of neuropsychology

• to provide students with an opportunity to explore topics relating to health psychology
in greater depth than in phase two.

Objectives
On completion of this course the student should be able to:

• explain what is meant by the term neuropsychology

• differentiate between Broca’s Aphasia and Wernicke’s Aphasia
• describe what is meant by the terms “episodic memory” and “semantic memory”
• explain how information is encoded in memory
• describe the process involved in storing information in memory
• list the factors which influence the retrieval of information
• discuss the relevance of information about human memory to the practice of medicine

47
 Haematology

Teaching Staff Professor TRJ Lappin

Dr M F McMullin (Course co-ordinator)

Secretary Mrs L Megrath

Duration of Attachment One week

Format of Programme

This programme is delivered in the Belfast Hospitals. Students gain clinical experience in
the morning. This is integrated with laboratory based training in the afternoon. Clinical
bedside teaching, laboratory based teaching, and case based tutorials are used to deliver
this programme.

Aim

To facilitate the acquisition of the knowledge and skills which will empower the medical
graduate to make appropriate use of the Haematology Service from both the clinical and
laboratory perspective.

Learning Outcomes

By the end of the course the student should be able to:

1. Diagnose and investigate haematological disease

2. Discuss the broad principles of management of haematological disease

3. Discuss the impact of serious disabling and sometimes terminal haematological

disease on the patients and their family

4. Use the laboratory appropriately for the management of all patients

5. Interpret laboratory reports.

48
 Endocrinology & Diabetes

Teaching staff: Dr SJ Hunter (Course co-ordinator)

Dr D R McCance

Secretary: Mrs T Butler

Duration of Attachment: Two weeks

Format of Programme
Students attend the Regional Centre for Endocrinology and Diabetes of the Royal Victoria
Hospital for this attachment. Students attend eight sessions of clinical bedside teaching
and one outpatient clinic, with attachments to clinical dietetic and specialist nursing teams.

Aims
To provide students with an opportunity to apply knowledge of anatomy, physiology and
biochemistry to the practice of endocrine medicine

Objectives
On completion of this attachment the student should be able to:

• take a history from a patient with an endocrine disorder

• examine patients suffering from diabetes and endocrine diseases
• formulate a management plan for patients with diabetes and endocrine disease

49
 Nephrology

Teacher: Prof A P Maxwell (Course co-ordinator)

Duration of Attachment: One week

Format of Programme:

Students attend the Renal Unit, Level 11, Belfast City Hospital for this attachment. Case-
based bedside clinical teaching combined with a series of linked short seminars is used to
facilitate learning during this attachment. All teachers are consultants or SpRs.

Aims:

You will encounter patients with renal disease in a wide variety of hospital settings and in
primary care particularly in association with hypertension and diabetes. The aim of this
short clerkship is to provide you with an opportunity to meet patients with a variety of
kidney problems, to be able to recognise symptoms and signs of renal disease and to
enable you to interpret the necessary investigations. The ethical dilemmas and cost
implications posed by the successful treatment of renal failure will be highlighted during
the week.

Learning objectives:

The student should be able to perform the following:

1. Obtain and record a comprehensive clinical history with particular emphasis on the
presentation of renal disease and its impact on the individual
2. Assess whether a patient is dehydrated (extracellular fluid volume contraction) or has
fluid overload (extracellular fluid volume expansion)
3. Perform a dipstick urinalysis
4. Accurately record blood pressure

The student should be able to interpret the following investigations:

1. Urea and electrolytes

2. Creatinine clearance, 24 hour urine protein estimation and microalbuminuria screening
3. Arterial blood gases
4. Determine the anion gap based on the serum [Na+], [Cl-], and [HCO3-]

Learning outcomes

At the end of the attachment you should be able to :

1. Describe the anatomy and physiology of glomerular blood flow and tubular function
2. Illustrate the relationship between serum creatinine and GFR (or % renal function)
3. List the common causes of chronic renal failure: realise that hypertension, urine
abnormalities and raised creatinine are the subtle hallmarks of renal disease/failure.
4. Describe key differences between acute and chronic renal failure
50
5. Identify a clinical situation of deteriorating renal function and be able to assess whether
this represents pre-renal, renal or post-renal failure
6. Recognise the life threatening risk of hyperkalaemia and describe its immediate
management
7. Identify the major causes of acid-base disturbances
8. Define the clinical importance of screening for microalbuminuria in patients with
diabetes
9. Summarise the clinical features of polycystic kidney disease
10. Recognise the cardinal features of nephrotic syndrome and describe its clinical
management
11. Outline the care required in prescribing drugs for patients with renal impairment
12. Summarise the risks of drug-induced immunosuppression

Attitudes:

The student should be able to demonstrate the generic attitudes essential to the practice
of medicine as embodied in the GMC document “Tomorrow’s Doctors” 2002 edition
(www.gmc-uk.org). In addition, it is expected that the student should become cognisant of
the potential impact of chronic renal disease on the survival, employment and lifestyle of
the patient and his/her family.

51
 General Surgery

Teaching Staff: Professor F C Campbell

Mr D Harkin (Course co-ordinator)

Secretary: Ms A Franks

Duration of Attachment: Six weeks

Hospitals: Royal Victoria Hospital, Belfast City Hospital,

Ulster Hospital Dundonald, Mater Hospital Belfast,
Antrim Area Hospital, Craigavon Area Hospital,
Altnagelvin Hospital

Format of Programme
Students attend an introductory course on the first morning of the programme in the
Clinical Skills Education Centre. The remainder of the attachment is spent in a Surgical
Unit. Seven hospitals throughout the province participate in this programme. During this
attachment the following are used to provide students with learning opportunities; bedside
teaching, attendance in theatre and case based tutorials.

Aim
To introduce students to the principles underpinning the approach to history taking,
investigation, diagnosis and management of patients with surgically treated problems. To
impact an understanding of the role of surgical interventions and procedures in patient
management.

Objectives
On completion of this attachment the student should be able to:

- apply anatomy, physiology and basic pathology to surgical decision making

- identify and understand pathological conditions which are treated surgically
- take a history and examine a patient suspected of having surgical disease
- make a differential diagnosis
- plan investigation, management and treatment of the surgical patient
- communicate effectively with the anxious patient and help them to overcome their
fear and anxiety
- describe the process of pre-operative preparation and post-operative care of the
surgical patient
- demonstrate an understanding of the way in which an operating theatre works
- assist at an operation

52
 Otolaryngology

Teaching Staff: Mr D A Adams (Course Co-ordinator)

Secretary: Ms P Trainor

Duration of Attachment: Two weeks

Format of Programme:
Students will spend the entire attachment in one of the Otolaryngology units in Northern
Ireland. All of the teaching hospitals in the province participate. Bedside teaching and
case based tutorials are used. The study guide annually, is available on the web.

Aims

• To facilitate the acquisition of the clinical skills required to examine the ear, nose,
throat, head and neck
• To enable students to acquire the basic knowledge required for medical practitioners to
manage patients experiencing Otolaryngology symptoms

Objectives
On completion of this attachment the student should be able to:

• Take a history from a patient experiencing symptoms in the following areas:

ear, nose, throat, head and neck.
• Perform a clinical examination on a patient experiencing ear, nose, throat symptoms.
• Interpret simple audiometric tests.
• Differentiate between emergency and elective conditions in otolaryngology.
• Recognise when it is necessary to refer patients with otolaryngology for specialist
treatment.
• Know how to manage common ENT conditions e.g. acute otitis media.

53
 Musculoskeletal

Teaching Staff: Professor JR Nixon

Dr A Bell (Course co-ordinator)
Dr M Rooney
Dr R Davies

Secretary: Mrs G Haire

Duration of Attachment Four weeks

Format of Programme
This programme is centered at Musgrave Park Hospital and delivered in Altnagelvin Area
Hospital. As well as the use of case base learning material and clinical bedside teaching
CAL material is used to deliver this teaching programme.

Aims
- To enable the student to develop an understanding of the principles underpinning
the practice of musculoskeletal medicine
- To facilitate the acquisition of the skills required to apply this knowledge in a clinical
setting

Learning Outcomes

At the end of this course, the successful student will be able to:

Describe and explain the aetiology and pathogenesis of common acute and chronic
diseases of bones and joints:-
- diseases affecting bone
- inflammatory arthritis
- osteoarthritis and spinal disorders
- systemic autoimmune rheumatic disorders and musculoskeletal conditions affecting
the extremities

List key clinical features, including course, prognosis and outcome in acute and chronic
bone and joint diseases

Obtain a comprehensive history from a patient with musculoskeletal complaints

Distinguish normality from disorder by physical examination of the locomotor system, as a

whole and of individual joints

Examine efficiently the major joint and joint groups of the musculoskeletal system and
perform the rapid GALS screen (gait-arms-legs-spine) for clinically significant locomotor
abnormality (revision from phase 1, year 2 autumn semester)

Describe and demonstrate during patient interaction clinical pointers (symptoms and
signs) towards specific diagnosis in patients with musculoskeletal disorders

Define the terms impairment, disability and handicap: explain the differences and conflicts
between medical and psychosocial models of disability

54
Classify the major categories of drugs used in bone and joint conditions, define their
indications and review common problems associated with their use:-

- Analgesics and nonsteroidal anti-inflammatory drugs

- Corticosteroids
- DMARDs and Methotrexate
- Biologic agents for inflammatory arthritis
- Xanthine oxidase inhibitors and uricosurics
- Bisphosphonates, calcium, vitamin D preparations, calcitonin, SERMS and PTH

Describe common surgical procedures effective in bone and joint disease, outlining their
indications, complications and outcome

List key points which should be discussed with a patient considering surgery for bone or
joint disease

List and describe key investigations for each major category of bone and joint disease

Design a management plan addressing the clinical problems and tailored to the specific
needs of an individual with chronic bone or joint disease:-

- pain relief
- prevention and correction of deformity
- restoration of function
- disease suppression or containment
- education and counselling needs

Construct an appropriate emergency management plan for a patient with

- Acute red hot joint

- Acute severe back pain
- Fever, systemic illness and joint pains
- Painful swelling of bone
- Acute, severe pain in a prosthetic joint
(Fractures will be considered in the 4th year)

55
 Dermatology

Teachers: Dr N McLoone (Course co-ordinator)

and Consultant Dermatologists in the Belfast Hospitals

Secretary: Mrs E Burns

Duration of Attachment: Two weeks

Format of Programme
This attachment combines a series of case based tutorials with clinical experience in
Outpatient Clinics in all of the hospitals in the Greater Belfast Area.

Aims
• to introduce students to the principles of the practice of dermatology
• enable students to develop an appreciation of the differences in the management and
treatment of the dermatological patient and the patient with other medical conditions

Objectives
On completion of this attachment the student should be able to:

Knowledge
• identify the normal structure and function of the skin and the skin appendages
• use the terminology employed to describe skin lesions
• describe pathological processes as they affect the skin
• demonstrate an understanding of the pattern and presentation of skin disease in
different age groups
• discuss the interaction of skin disease, mental factors, social factors, occupational
factors and environmental
• describe the investigations routinely used in dermatology practice
• describe the therapeutic options available in managing skin disease, including topical
preparations and cryotherapy

Skills
• take a dermatological history
• take an occupational history where appropriate
• perform an examination of the skin
• perform simple skin investigations
• communicate with patients, who may be anxious due to fear of cancer or frustrated by
chronic symptoms
• inform patients regarding the nature of their skin disease
• understand the basic principles of management and be able to prescribe simple first-
line therapy for the common skin disorders
• diagnose the major disease processes including eczema psoriasis, acne, infections,
the common skin tumours and the blistering disorders
• discuss skin care, the skin and the sun, and the prevention of skin cancer
• recognise those skin conditions that are commonly markers of systemic disease and to
be able to suggest appropriate investigations to help in making a diagnosis
• recognise the common skin emergencies
• offer immediate management for potentially life threatening skin diseases
56
 Ophthalmology

Teaching Staff: Miss G Silvestri

Mr C Willoughby (Course Co-ordinator)
Mr ST White (Honorary Lecturer)
Mr NK Sharma (Consultant Ophthalmologist
Altnagelvin Hospital)

Secretary: Miss P Trainor

Duration of Attachment: Two weeks

Format of Programme
This programme is delivered in the Royal Victoria Hospital and Altnagelvin Hospital.

The first week of the attachment is spent “in the classroom” at the RVH. Teaching will be
case-based and will form the theoretical and practical foundation for the clinical
attachment in Week 2. During week 2, students will be attached to Consultant firms for a
series of outpatient clinics, theatre sessions and ward rounds.

Aims
• to equip the student with the skills required to take a history and
perform an ophthalmic examination.
• to instil in the student a sense of the importance of visual impairment
and disability

Objectives
On completion of this attachment the student should be able to:

• Have a working knowledge of the clinical anatomy of the eye, the orbit and the
cranial nerves
• Be proficient in taking an ophthalmic history and in eliciting physical signs related to
ocular disease.
• Have an understanding of the clinical manifestation of common ocular conditions
• Be aware of the importance of the ophthalmic manifestations of systemic disease.
• Have an appreciation of the importance of visual impairment and disability and the
support mechanisms available to the visually impaired in the community.

57
 Undergraduate Medial Curriculum
Overview of Phase 4

Year Semester Content (Clinical Blocks)

Reproductive Medicine
Spring (including STD) – 8 weeks

Healthcare of Children – 8 weeks

Preoperative and Emergency

Medicine – 8 weeks

Psychiatry – 6 weeks

Ageing and Health – 4 weeks

4
Primary Care – 4 weeks

Cancer Studies – 2 weeks

Autumn

58
 Outline of Phase 4

Year 4 Autumn and Spring Semesters

Phase Four Co-ordinator: Dr D Gilliland

All of the material presented during this phase is core.

During this phase students gain further clinical experience through speciality attachments.
Students rotate through the following attachments:

• Reproductive Medicine
• Healthcare of Children
• Perioperative and Emergency Medicine
• Psychiatry
• Aging and Health
• Primary Care
• Cancer Studies

These attachments require students to demonstrate an integration of the knowledge and

skills acquired in earlier phases of the programme.

Goals of Phase Four

To provide students with opportunities to:

• Continue to develop clinical skills
• Build on knowledge acquired during the Phase Two Systems Course by completing
courses in the following areas of specialised medical practice; Ageing and Health,
Cancer Studies, Healthcare of Children, Mental Health, Perioperative and
Emergency Medicine, Primary Health Care, Reproductive Medicine
• Sustain and further develop clinical problem solving skills
• Sustain and further develop knowledge and understanding of medical and surgical
specialties
• Develop and refine data handling and critical appraisal skills
• Develop an understanding of the audit process
• Continue to develop communication and team working skills
• Develop an understanding of the role and function of members of the health care
team through the interprofessional education programme
• Continue to demonstrate an awareness of the importance of practicing holistic
medicine
• Develop an increased awareness of the role and function of community based
medical practice

Instructional Methods

• bedside teaching
• teaching in Primary Care settings
• teaching in outpatient and community based medical facilities
• preparation and presentation of clinical cases

59
 Reproductive Medicine

Teaching Staff: Professor N McClure (Course co-ordinator)

Dr I Cooke
Dr A Hunter

Secretary: Mrs A McGuinness

Duration of Attachment: Eight weeks

Format of Programme
Students attend an introductory session in the Royal Maternity Hospital on the first day of
the attachment and again for one day on completion of week three and week six. The
programme is delivered in the Belfast Hospitals and Area Hospitals throughout the
Province. Case-based problem-solving tutorials are combined with ward based teaching
and teaching in outpatient clinics.

Aims
To acquire the communication and clinical skills required to take a history from and
examine obstetrical and gynaecological patients

Learning Outcomes
On completion of this attachment, the student should be able to:

• examine the obstetric patient in various stages of pregnancy

• examine gynaecological and GUM patients effectively
• produce an effective management plan for simple obstetrical, gynaecological and GUM
problems for individual patients
• communicate effectively with obstetrical and gynaecological patients

60
 Healthcare of Children

Teaching Staff: Dr D J Carson (Head of Department)

Professor J M Savage
Professor H L Halliday
Dr M C Stewart (Course co-ordinator)
Professor M D Shields
Dr J Jenkins
Dr F Casey
Mr W McCallion
Dr N Kennedy

Secretary: Ms F Herbert
Ms C McWilliams

Duration of Attachment: Eight weeks

Format of Programme
This course includes normal child growth and development, preventive child health and
the study of diseases in children. Part of the attachment (core teaching) is spent in the
main Belfast training hospital (RBHSC) and the remainder (clinical attachment) in RBHSC
or DGH. Some time is also spent in the community child health service.

Core teaching in RBHSC includes symptom based lectures and clinical discussion with
clinical demonstrations from nurse specialists. The clinical attachment provides the
opportunity to clerk patients, present findings and assist with clinical investigations in
either an inpatient or outpatient setting. The emphasis is on helping the student acquire
basic clinical skills and teaching is concentrated at the bedside. Your clinical skills and
performance during your attachment will count towards your course assessment. Case
based tutorials are included to allow you to increase your knowledge of specific key topics.

Aims

1) To understand and recognise normal patterns of growth and development from

birth to adolescence.

2) To introduce the clinical skills needed in paediatrics (history taking and interviewing
children/parents, examination, communication skills (children/parents, case
presentations to medical staff at bedside or at seminars) and practical procedures).

3) To introduce the range of common or important (serious if missed / illustrate

important principles) paediatric problems and diseases.

4) To enable students to understand the impact of illness, poor parenting, deprivation,

nutritional deficiency on a child’s growth, physical and psycho-social development.

5) To enable students to understand the impact of a sick child on family and

community and what resources are available to help (eg. provision of care for the
child with special needs, or chronic illness).

61
6) To understand approaches used to protect children and ensure their health as they
grow:
♦ screening programmes – Guthrie test, inborn errors, cystic fibrosis, hearing
and vision, dislocated hips, undescended testes, neurodevelopment, height
and weight
♦ immunisation programmes
♦ child protection
♦ accident prevention

7) To enable the student to recognise the ‘seriously ill’ child and understand the
principles of management.

8) To introduce Evidence Based Medicine and, where possible, to highlight national

guidelines on the management of specific conditions.

9) To use the learning opportunities within paediatrics and child health (particularly
within clinical attachment) to develop reflective learning.

Learning Outcomes

The successful student should:

(1) be able to take a paediatric history and perform a clinical examination (appropriate
for a newborn, infant, dysmorphic child, pre-school and school child). (You should
develop and adapt the clinical skills you already have to allow you to use them in
childhood medicine.)

♦ From this information you should be able to form a differential diagnosis and
provide a list of relevant and directed investigations to help confirm the
diagnosis and draw up a management plan.
♦ You should practise presenting clinical and history examination findings to
medical staff at the bedside and at tutorials/seminars.

(2) be aware of parental anxieties and be able to communicate to parents/ children

(explaining the condition and its management). All too often important problems are
missed by failing to listen to carers (who are usually right!) (It takes time to develop
appropriate approaches towards children and their parents so that communication
failures can be avoided.)

(3) be competent in the listed practical skills (pages 15 – 18).

(4) list causes of common presenting symptoms and signs and be able to describe
(aetiology, presentation, natural history, investigation, diagnosis and management)
common and important paediatric disorders.

(More specific information follows in the section "The least any Final Year Student
should know". Basic information can be obtained by studying one of the texts
which we regard as essential reading. We believe that you will need to study
diseases from both a ‘disease specific’ and problem based angle - children present
with symptoms/signs).

(5) recognise ‘the seriously ill child’ using a structured approach to assessment.
62
 Students should know ABC approach to Resuscitation, and be competent in basic
life support.

(6) participate in IPE (interprofessional education) where possible (eg joint learning,
core capabilities such as, feeding and changing babies, administration of drugs)
with nursing students, and other professionals, to enhance clinical, teamwork and
communication skills. You should emphasise what you have learned in your
reflective case commentary.

(7) understand the principles of “consent” in children of different ages. (Lissauer &
Clayden (2nd Ed). Illustrated Textbook of Paediatrics; p44)

63
 Perioperative and Emergency Medicine

Teaching Staff: Dr JM Murray (Course co-ordinator)

Professor J Nixon
Dr B McNicholl
Dr M Morrow
Dr E Horan

Secretary: Mrs Brenda McNeill

Mrs Susan Flynn

Duration of Attachment: Eight weeks

Format of Programme
This course deals with acute conditions. The emphasis is on rapid assessment, initial
management and clinical skills more than elaborate diagnosis. The course is supported
by human patient simulation. The programme is mainly delivered in the Belfast Hospitals
and the Area Hospitals.

Accident and Emergency Medicine

Perioperative Medicine & Anaesthetics
Fractures

Aim
To introduce students to the principles of emergency medical care.

Learning Outcomes
Upon completion of this attachment the student should be able to:

• demonstrate competence in advanced cardiopulmonary resuscitation

• recognise a seriously ill patient and demonstrate an understanding of the principles of
initial management
• demonstrate an understanding of the principles of fracture management and healing
• interpret biochemical, haematological, radiological and other information
• demonstrate an understanding of the physiological and pharmacological principles of
good perioperative care

64
 Psychiatry

Teaching Staff: Dr SJ Cooper (Course co-ordinator)

Dr CC Mulholland
Dr FA O’Neill

Secretary: Mrs M Brooks

Duration of Attachment: Six weeks

Format of Programme
One week of introductory lectures and seminars in the Division of Psychiatry &
Neuroscience followed by a five week attachment in one of the 13 Psychiatric Units in
Northern Ireland. During Week 4 of the programme students attend seminars and
workshops on Learning Disability and Mental State Assessment and a tutorial on
Management of Illness in the Division of Psychiatry & Neuroscience.

Aims

• To provide students with knowledge of the main psychiatric disorders, the

principles underlying modern psychiatric theory and a basis on which to develop
this knowledge from reading.
• To assist students to develop the necessary skills to apply this knowledge in
clinical situations.
• To encourage students to develop the appropriate attitudes necessary to
respond empathically to psychological distress in all medical settings.

Learning Outcomes

KNOWLEDGE
On completion of the course the successful student should be able to:
• Describe the prevalence and clinical presentation of common psychiatric conditions
and how these may differ in people with learning disabilities or in old age.
• Explain the biological, psychological and social-cultural factors which may
predispose to, precipitate or maintain psychiatric illness.
• Describe the common psychological and physical treatments, including the
indications for their use, their method of action and any unwanted effects.
• Describe the range of services and professionals involved in the care of the mentally
ill.
• State the doctor’s duties and the patient’s rights under the Mental Health (NI) Order
1986.
• Describe how to assess and manage psychiatric emergencies, which may occur in a
psychiatric or general medical setting. In particular be able to apply their knowledge
to acute organic states and situations where there may be risk of suicide.
• Summarise the classification of mental illnesses.
• Appraise and apply information gained from in depth reading relating to a specific
clinical case.

65
SKILLS
On completion of the course the successful student will be able to:

• Take a full psychiatric history, assess the mental state and write up a case. This
includes being able to describe symptoms and mental state features, aetiological
factors, differential diagnoses, a plan of management and assessment of
prognosis.
• Present a case in an organised and coherent way and be able to discuss
management.
• Assess a patient’s potential risk to themselves and others.
• Explain to patients the nature of their illness, its management and prognosis.
• Evaluate information about family relationships and their impact on an individual
patient. Discuss with relatives the nature of the illness, management and prognosis.

ATTITUDES
On completion of the course the successful student will be able to:
• Utilise an empathic interviewing style, which is suitable, for interviewing disturbed
and distressed patients.
• Recognise the importance of the development of a therapeutic relationship with
patients and why this is particularly important in psychiatry.
• Show sensitivity to the concerns of patients and their families about the
stigmatisation of psychiatric illness.
• Recognise the importance of multidisciplinary teamwork in the field of mental illness
and understand the role of sub-speciality services (e.g. Liaison Psychiatry).

66
 Ageing & Health

Teaching Staff: Professor R W Stout

Dr P Passmore
Dr IM Rea - i.rea@qub.ac.uk (Course co-ordinator)
Dr H Taggart
Dr K Fullerton
Dr V Crawford
Dr D Craig
Mrs L Arthurs (Medical Ethics)

Secretary: Miss A Best

Duration of attachment: Four weeks

Format of Programme
The fourth year course in Ageing and Health is taught in collaboration with Primary Care.
Students are allocated to the courses in Ageing and Health and Primary Care in 2 rotating
4 week blocks.

Core Teaching Geriatric Medicine

During week 1 of the 8 week block, all students undertake 3 days of core teaching shared
between Ageing and Health and Primary Care. Core topics for Ageing & Health are
usually taught on Monday morning, Tuesday afternoon and Wednesday morning in the
Department of Geriatric Medicine, Whitla Medical Building (arrangements for bank holiday
weeks will be different). Please see notice board in Department of Geriatric Medicine for
details of time and venue.

Clinical Attachment.
The 3 week Clinical attachment begins on the Thursday of the week 1. Students will be
allocated placements on a preference system, organised by the Faculty of Medicine.
During the clinical attachments students form part of the clinical teams and are expected
to examine patients, attend ward rounds and multidisciplinary meetings. Students should
write up 2 clinical cases, undertake a self-directed learning and presentation project and
discuss and write up an ethical case during their attachments (see study guide for details).

Feedback, Ethics and Presentation of Projects.

Students return to Belfast during Week 4 to complete their attachment in the Department
of Geriatric Medicine, Whitla Medical Building. Group 1 students return for seminars on
Thursday and Friday and Group 2 students on Wednesday and Thursday of their
respective blocks (Timetables will be given to students in Week 1 of their blocks). During
these days there will be a feedback session on the clinical attachments and seminars for
presentation of projects and for ethical issues in the care of elderly patients. Students will
also return their 2 marked clinical cases and their ethics discussion to the Department of
Geriatric Medicine.

67
OSCE and Feedback
A combined Ageing and Health and Primary Care OSCE will take place on the final Friday
at the end of week 8 for all students in the block ( see study guide for details. A feedback
session will normally occur on Friday afternoon in the Department of General Practice

Aim

To introduce students to the clinical aspects of care of elderly people.

Objectives

To enable the student to study:

Knowledge

• the epidemiology of ageing and its implications

• the normal ageing process and its relationship to disease and disability in old age
the pattern and presentation of disease in old age.
• the interaction of physical, mental and social factors in the production of disease and
disability in old age
• the purpose, facilities and organisation of hospital care of elderly patients
the role, availability and organisation of community services in the care of elderly
people
the prevention of dependency in old age
ethical issues in the care of elderly people

Skills

To enable the student to acquire the following skills:

• the assessment of disease and disability in older people
• the principles of management of elderly patients

a) communication with older people, both those who are healthy and those who are
cognitively impaired
b) the value and limitation of investigation procedures
c) the appropriate use of drugs
d) rehabilitation
e) the value of the multidisciplinary health care team
f) continuing care
g) terminal care

Attitudes

• to have an attitude of optimism in the care of elderly people

68
 Primary Care

Teaching Staff : Professor P Reilly

Dr D Gilliland (Course co-ordinator)
Dr K McGlade
Dr M Cupples
Dr K W Steele
Dr N Hart
Dr M Hughes
Dr D MacDonagh
Dr D Wilson
Dr M Tully

Secretary: Miss C Agnew

Duration of Attachment: Four weeks

Format of Attachment
This course is part of an eight week block linked to Ageing and Health Care. Four weeks
of the block are assigned to Ageing and Health while the remaining four are allotted to
General Practice.
This focus of the General Practice attachment is on the acquisition of skills and attitudes
which will enable the student to cope with clinical situations which they may encounter as
graduates.
During the first week of this block students are taught in the Department of General
Practice. The remaining three weeks are spent completing a clerkship in a General
Practice. Approximately 100 practices throughout the province participate in this teaching
programme.

LEARNING OUTCOMES

KNOWLEDGE

On completion of this course the successful student should be able to:

1. Identify a patient’s reasons for consulting and elicit the main problems and/or
key complaints.

2. Elicit relevant information from a patient by relating effectively to the patient and
asking appropriate questions in an interesting way.

3. Determine the impact of a patient’s problems/complaints on lifestyle and

interpersonal relationships.

4. Define the likely underlying causes of common presenting symptoms.

5. Describe the Primary Healthcare team and the role of each individual member.

6. Describe the role of microcomputers in General Practice with particular

reference to recording of clinical data, preventative medicine, call and recall
69
 systems, practice administration and prescribing, including repeat prescribing
systems.

7. Interpret medical audit and its application.

8. Recognise and manage common dermatological conditions.

SKILLS

On completion of this course the successful student should be able to:

1. Exhibit a well-organised approach to information gathering.

2. Perform an appropriate physical examination to help confirm or refute a working

diagnosis.

3. Formulate management plans appropriate to the findings and circumstances for

acute and chronic conditions commonly encountered.

4. Identify opportunities for preventative clinical medicine and health education in the
primary care setting.

5. Distinguish between good and bad medical records and to understand Age/Sex
registers and be able to describe their use in epidemiology.

6. Critically appraise a scientific paper.

7. Develop skills in providing feedback on colleagues’ performance in a clinical setting

using Pendleton’s rules.

ATTITUDES

On completion of this course the successful student should be able to:

1. Identify moral issues within the consultation and develop skills when articulating
moral argument.

2. Demonstrate respect for patients and colleagues in the clinical setting.

70
 Cancer Studies
Teaching Staff: Dr S McAleer, MD, FRCP, FRCR
Co-ordinator - Oncology Undergraduate Education Programme

Dr J O’Sullivan MD, MRCPI, FFRRCSI

Senior Lecturer and Consultant in Clinical Oncology

Prof P G Johnston, MD, PhD, FRCP, FRCPI

Professor of Oncology

Prof RAJ Spence, OBE, MA, MD, FRCS

Consultant Surgeon

Teaching Staff Members:

Dr Richard Wilson, MD, FRCS, FRCR – Senior Lecturer

Dr Martin Eatock, MB, MRCP – Consultant in Medical Oncology
Dr Sarah McKenna, MD, MRCP – Consultant in Medical Oncology
Dr Paul Mullan, BSC, PhD – Postdoctoral Fellow
Dr Richard Kennedy MB MRCP Specialist Registrar
Dr Ultan McDermott, MB, MRCP - Specialist Registrar
Dr Colin James, MB, MRCP – Specialist Registrar
Dr Azura Ahmad, MB, MRCP – Specialist Registrar
Dr Paula Scullin, MB, MRCP – Specialist Registrar
Dr Audrey Fenton, MB, MRCP – Specialist Registrar
Dr Victoria Coyle, MB, MRCP – Specialist Registrar
Dr Colin Purcell, MB, MRCP – Specialist Registrar
Dr Lynn Campbell, MB, MRCP – Specialist Registrar
Dr Bode Oladipo, MB, MRCP – Specialist Registrar

Course Teachers:

Dr Sheila Kelly, Medical Director, The Marie Curie Centre, Belfast 5

Dr Bernie Corcoran, Palliative Care Consultant, BCH
Sister Lesley Rutherford, Lung Cancer Nurse Specialist, BCH
Dr Robert J Harte, Belvoir Park Hospital, Hospital Road, Belfast 8
Dr Neil Anderson, Department of Pathology, Royal Victoria Hospital
Mr Kieran McManus, Dept of Thoracic Surgery, Royal Victoria Hospital
Dr Anna Gavin, NI Cancer Registry, Mulhouse Building, RVH, Grosvenor Road,
Belfast
Rev Brian Hughes, Presbyterian Chaplain, A Floor, Belfast City Hospital
Dr AEW Gilliland, Department of General Practice, Dunluce Health Centre, Belfast 9
Dr G Johnston, MacMillan Cancer Relief, 82 Eglantine Avenue, Belfast BT9

Secretary: Mrs Mary Carmichael

Duration of Attachment : Two weeks

71
Format of Programme

This course combines ward-based clinical teaching with seminars and tutorials on the
major aspects of cancer treatment and palliative medicine. There is an emphasis on
patient contact and bed-side teaching.

Aim

To provide students with an understanding of the principles determining the diagnosis,

investigation and management of the most frequently presenting cancers.

Learning Outcomes

On completion of this attachment the student should be able to demonstrate an

appreciation of:

• importance of listening and communication - treating the patient as a fellow

human being not as a cancer
• the meaning of Curative, Palliative and Terminal Care.
• what is meant by early diagnosis and how the stage of disease changes effects
outcome
• the extent of the problem, how this changes with the age structure of the
population and the financial burden that it imposes now and into the future
• the presentation, investigation and management of the common cancers such
as Breast, Gynae, GI Tract, Testicular and Lung
• the fact that the doctor is only one member of a co-ordinated team and that
centralised multi-disciplinary team management is essential
• the integration of surgery, radiotherapy and chemotherapy in the management
of common cancers; successes, limitations and outcomes
• the new concepts of Cancer Units and Centres, especially as they will apply to
Northern Ireland after the Calman and Campbell reports
• the role of basic laboratory science in investigating the causation and opening
the doors to future treatments in cancer
the importance of Clinical Trials in assessing new treatments

72
 Undergraduate Medical Curriculum
Overview of Phase 5
PROGRAMME FOR 2005 – 2006
Dates No of weeks
4 – 8 July 2005 1 Vacation/ preparation/ travel time for clinical elective and project

11 July – 16 September 2005 10 Clinical Elective (6 weeks)

Clinical Project (4 weeks)
19 Sept – 7 Oct 2005 3 VACATION : (except for students who have failed 4th year OSCE – 2
weeks remedial work + week beginning 3 October for repeat OSCEs)
10 – 14 October 2005 1 Therapeutics Teaching / Study Days

17 Oct – 16 Dec 2005 9 Clinical Attachments

(3 weeks Medicine, 3 weeks Surgery and 3 weeks Specialties)

Group MEDICINE SURGERY SPECIALTY 1 SPECIALTY SPECIALTY 3

A 2
17 Oct – 4 Nov 28 Nov – 16 7 – 11 Nov 14 – 18 Nov 21 – 25 Nov
Dec
Group MEDICINE SURGERY SPECIALTY 1 SPECIALTY SPECIALTY 3
B 2
7 Nov – 25 Nov 17 Oct – 4 Nov 28 Nov – 2 Dec 5 – 9 Dec 12 – 16 Dec
Group MEDICINE SURGERY SPECIALTY 1 SPECIALTY SPECIALTY 3
C 2
28 Nov – 16 Dec 7 Nov – 25 Nov 17 – 21 Oct 24 – 28 Oct 31 Oct – 4 Nov

Monday 17 October Last date for submission of Clinical Project to Supervisor.

It is preferable, though, if students can give the Supervisor as long as possible
before the project needs to be submitted to Faculty.
Monday 24 October Deadline for submission of clinical project to Faculty Office (2 copies +
Supervisor’s assessment sheet)
24 Oct – 16 Dec 2005 8 weeks Probable dates for the repeat of any 8 week fourth year course if any student has
failed the OSCE twice
19 – 22 Dec 2005 4 days Study Days/ Seminars

Fri 23 Dec – Fri 6 Jan 2006 2 weeks CHRISTMAS VACATION

(inclusive) +
1 day
9 Jan – 27 Jan 2006 3 weeks Revision Lectures + Revision time for Final MB Part I

30 Jan – 3 Feb 2006 1 week Final MB Part I (Final written examinations)

6 Feb – 7 April 2006 9 weeks Clinical Attachments

(3 weeks Medicine, 3 weeks Surgery and 3 weeks Specialties)

Group MEDICINE SURGERY SPECIALTY 1 SPECIALTY 2 SPECIALTY

A 3
6 – 24 Feb 20 Mar – 7 Apr 27 Feb – 3 Mar 6 – 10 Mar 13 – 17 Mar
Group MEDICINE SURGERY SPECIALTY 1 SPECIALTY 2 SPECIALTY
B 3
27 Feb – 17 Mar 6 – 24 Feb 20 – 24 Mar 27 – 31 Mar 3 – 7 Apr
Group MEDICINE SURGERY SPECIALTY 1 SPECIALTY 2 SPECIALTY
C 3
20 Mar – 7 Apr 27 Feb – 17 Mar 6 – 10 Feb 13 – 17 Feb 20 – 24 Feb

3 – 7 April 2006 1 week Proposed dates for repeat Final MB Part I examinations

10 April – 21 April 2006 2 weeks EASTER VACATION

24 April – 28 April 2006 1 week Final Part II Clinical Examinations

1 May – 5 May 2006 5 days Medals and Prize Examinations *

73
8 May – 2 June 4 weeks Workshadowing

Week beginning 3 July 2006 Graduation

It is anticipated that repeat Final MB Part II examinations will be scheduled around the end of November.
* It is proposed to schedule the clinical component of Medals & Prize exams during this week with the written papers
having been held much earlier in the year.

Outline of Phase 5
Year 5 Autumn and Spring semesters

Phase Five Co-ordinator: Dr Peter Watson

Overview
By the end of phase four students have covered the core curriculum.

Goals of Phase Five

To produce a doctor who can:

• take a comprehensive history
• perform an examination and identify patient problems
• critically evaluate management options for common medical conditions
• identify uncommon medical conditions and recognize the need to seek advice on
management
• undertake a range of procedures including suturing, venepuncture, inserting a
cannula into peripheral veins
• assist patients and relatives to deal with emotional distress
• demonstrate the ability to work effectively as a team member
• demonstrate an understanding of the importance of effective time management
• recognise the importance of establishing and maintaining an appropriate balance
between work and personal commitments

Instructional Methods

• the final year relates learning to practice and requires “hands on” experience by
students as a clinical apprentice
• a series of presentations, overviews and small group problem-solving activities provide
an opportunity for the integration of clinical experience and factual information

In addition to taking the written and clinical final examinations there are five elements to
this phase.

1. Students undertake an overseas elective. This elective lasts for six weeks.

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2. At the end of this elective students are required to prepare and submit a seven
thousand word project on an aspect of clinical medicine of particular interest to them.
This project represents the Student Selected Component element of phase five.

3. Students attend a week of Preparation for Practice days. The Preparation for
Practice days address topics pertinent to the work of the medical graduate during the
Foundation One and Foundation Two years.
The topics covered during the Study Days include:

• Prescribing and adverse drug reactions

• Therapeutics
• Communicable disease surveillance and control
• Electrolyte and acid base disturbance
• GMC and Doctors in Trouble
• HIV Disease
• Interprofessional education with the Schools of Nursing and Pharmacy
• Living with disability
• Medicine and Law
• Poisoning, drugs of addictions and confusional states
• Stress Management

4. During the Autumn and Spring Semesters students complete eighteen weeks of
specialty clinical attachments (nine weeks per semester). This must include three
weeks attachment in a Medical Unit and three weeks in a Surgical Unit each semester.

5. On completion of the final written examination students spend four weeks

“shadowing” the Pre-Registration House Officer in the Unit in which they will take up
employment in August following graduation. Under the supervision a Pre-Registration
House Officer or other junior member of medical staff students are required to perform
tasks routinely undertaken by Pre-Registration House Officers. Students are required to
complete a log diary which lists most of the tasks performed by Pre-Registration House
Officers. On execution of each of the prescribed tasks a brief description of what was
done and how it was done must be entered in the appropriate section of the diary which
must then be signed by the student and the supervising member of staff.

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 Intercalated Degrees

Co-ordinator of Intercalated Degree Programme Professor B McDermott

Students have the opportunity to intercalate a year of study leading to the award of a B.Sc
(Hons) degree. Intercalated degrees can be taken on completion of either phase 2 or
phase 3 of the undergraduate programme.

The following subjects can be taken after phase 2 or 3:

• Anatomy
• Biochemistry
• Molecular Biology
• Physiology
• Microbiology
• Cardiovascular Science
• Neuroscience (from 2006/7 – subject to approval)
• Healthcare Ethics and Law (from 2006/7 – subject to approval)

The following subjects can be taken only after phase 3:

• Pathology
• Pharmacology

A separate handbook outlining the regulations, and details of the above degree courses is
available and can be accessed at http://www.qub.ac.uk/cm/pat/ibsc

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