Learning Medicine in the Community

Dr Janette McGuinness, GP & Lecturer in General Practice

By the time you reach the Medicine in the Community module, you will have learned many clinical skills and we hope your experiences with us will allow you to build on this. We believe that the knowledge, skills and understanding you will gain in this module will stand to you throughout your career in medicine regardless of the discipline you choose. This module has been designed to provide you with an understanding of how medicine is provided in the community setting.  Within this framework we also hope to give you an insight into how disease impacts the patient, their families and the community. 

During the module you will spend four weeks on clinical placements, which includes two clinical placements in Medicine for the Elderly and two clinical placements in General Practice.  This section of the guide should help prepare you to make the most of your community placements. Your placements in General Practice will give you an opportunity to experience the contrast between the delivery of medicine in an urban versus a rural setting.

You will get out of these placements as much as you put in. In this regard it is important that you attempt to integrate yourself into the day to day business of the practice. Make yourself available to help nursing staff, for example with vaccine clinics or chronic care clinics. Reception staff and practice managers will give you an insight into the business matters involved in running a practice.  Be professional in all your dealings with ancillary staff and keep in mind that they are running a business and at times it may not be possible to facilitate you.

Placements provide you with a unique opportunity to have one to one teaching from an experienced General Practitioner as well as giving you direct individual access to patients with a wide range of pathologies to both examine and take histories from. Ideally we would like all students to see and examine patients alone and to experience home visits. If there is not adequate room available to see patients alone, can we suggest you discuss with your GP tutor some alternative arrangements. For example, this may include bringing in a patient 15 minutes prior to the beginning of surgery to interview before your tutor sees them.

To get the most from your clinical placement in general practice we also recommend that you identify your learning needs prior to your attachment and communicate these to your respective GP tutors when contacting them. This allows them to focus their teaching on areas which will most benefit you.

  • You should contact your GP a week in advance to confirm arrangements regarding starting times, meeting place and also learning needs.
  • You should ensure you are punctual and have researched appropriate transportation in advance.
  • You should dress in a professional and conservative manner in accordance with the dress code guidelines set out in this document. White coats are not necessary in General Practice.
  • Remember the requirement for confidentiality in respect of any information with which you are entrusted during the placements. This applies not only to case discussions within the course but also to any written or other materials which you might access while reviewing cases.  
  • You may sit in with your GP or review patients by yourself or visit patients in their homes. Identify yourself as a student in each of these settings but be aware that patients may still be influenced by your opinions and explanations. Your interactions in these consultations must be as professional as those of a qualified doctor.
  • Patients may sometimes entrust students with key pieces of information or with questions which have troubled them for some time. Acknowledge the importance of the issue to the patient but do not feel any pressure to offer your own judgements on such topics. Ensure that your tutor is aware of the issue raised.
  • When working with other members of the practice staff or primary care team, observe the same high standards of professional behaviour. Be adaptable in terms of opportunities to work with colleagues such as the Public Health Nurse, the Social Worker or a counsellor – these are very valuable learning opportunities which are unique to individual practices.
  • General Practice is, by its nature unpredictable, there may be times within the day that are quiet or that you will be not able to sit in- please use this down time to your advantage, ensure you have reading material with you so you can research cases you have seen that day or look up medications you may be unfamiliar with.
  • Most practices have internet access. Check with your GP if you are allowed to use this for medical research purposes. It is unacceptable to use a practice internet connection for personal matters unless you have the specific permission of the GP concerned. Some practices have an internet usage policy – check for this at the beginning of your attachment.
  • Please familiarise yourself with the Codes of Conduct and Ethical Guidelines for Medical Students, published by the Medical Council.
  • Enjoy yourself.