5th year in review

I have enjoyed 5th year, it was much more relaxed than the notoriously difficult 4th year, and it was nice to get back to general medicine and surgery after focusing on clinical specialities.

It started off with an amazing elective - I headed down under and spent most of my time on a massive road trip in a trusty bright yellow 4x4, and did very little medicine...

Choosing a deanery

Next 5th year begins, with a whirlwind of career talks it suddenly all feels very real - FPAS, UKFPO, SJT, EPM, PSA, what does it all mean!? Before I knew it was I was going to be making very serious life choices with very little information, as the foundation programme applications opened up in October.
This is a little gripe I think we all have in medicine, it's hard to think of many other job examples where you apply for the location of the job 10 months in advance, with very little information about the jobs/ availability/ working conditions, or anything really. My non-medic partner finds the whole process bizarre, and soon I felt like I needed to make a powerpoint to explain the convoluted application process to all my family members.
Eventually we decided to move down to London, and I tentatively researched the 3 deaneries and was horrified to see the score cut offs and competition ratios. This led to a lot of tooing and froing but I got a good decile + intercalation, and put down North East and Central London. This was mainly because most of the hospitals were actually in London, and it seemed a bit more affordable and nice to live in than North West London. South Thames was too sprawling for me, the idea of a guaranteed long commute didn't appeal!
Luckily this year we were allowed to change our deanery choices up to February, which I think a lot of people ended up doing last minute out of stress! I will leave it to you whether you think this is a good thing or a bad thing.

Our placements were mainly a mix of medicine and surgery with 4 weeks of GP. I found (to my horror) I was enjoying surgery more and more. I had always thought of myself as a proper medic, no cutting here thank you. But as I found myself gravitating to theatres (by choice!) and revelling in interesting cases, x-rays, and CT scans, I couldn't deny the growing enjoyment I was feeling. This led to some serious soul-searching, and massively influenced by job ranking for F1 and F2.

I've never been the best attendee... I did start to feel a bit guilty about missing empty afternoons on the ward, and or the 3rd IBD clinic of the month. I wonder if this is universal to medics? Talking to my friends it appeared lots of people skipped seemingly pointless aspects of placement, to go to the library and do more productive learning. I suppose it's an important part of being an adult learner, you identify what you actually need to go to! But I think now that I am a few weeks away from being an F1, I am desperately regretting leaving at 2pm on Friday - what if I missed a clinical scenario I will now be faced with alone! I suppose this is all part of the 'new doctor' jitters.

SJT and PSA

The year plodded on, I found the SJT a very challenging exam time-wise, and had about 30 seconds to spare at the end. I hadn't paid for any expensive courses, or bought any books, and I worried I would be at a disadvantage, but in the end did well. The PSA (prescribing exam) was fine really, if you can quickly search the BNF you will be okay!

I passed the PSA with a good margin, and managed to get 46 on my SJT! I was in absolute shock. It was a snowy day and I woke up to about 50 texts off various medic friends with their news and asking about mine. I still remember logging in and being manically happy and seeing I had got my first choice deanery. That good mood stayed with me for days!
There will also be friends who have not got what they wanted - it's important to check up on these people, and make sure they know they're cared for, and it's not a reflection of them as a person. I had a friend who missed out on his first choice deanery by one mark, and he was devastated - it's sad that the process appears to be such a lottery, and as he will honestly be a fantastic doctor.

Choosing jobs

Then comes the very stressful process of ranking jobs. In my deanery, you are essentially sent a spreadsheet with 300+ jobs, and are asked to rank them. There was no information online about any of the jobs, and I essentially just googled the hospitals. Luckily I was in a Facebook group where a few F1/F2s from the same deanery posted some reviews, I would have loved a bit more information though!
The process was markedly different across the deaneries - in some you were further subdivided and had to rank areas of the deanery before choosing jobs, in some they went even further and you picked hospitals and then only had about 10 job options to choose from.
I found the whole thing very stressful, it felt like it was a massive choice, deciding your entire life for the next 2 years.
It was a careful balance between location and jobs, with a seemingly perfect job combination, but one year is a bit of a commute away at a hospital with a bad reputation. In the end I tried to settle on location as my first priority.
My main job factors were to avoid A&E - I really did not fancy spending my winter in an understaffed, at-breaking-point A&E department. Many people were surprised at this, as they want to locum in A&E, but it's not for me at all. I also wanted a surgical job at the beginning of F2 to see if it seriously for me, and a possible career choice. This was actually incredibly difficult - there was at least 20+ with no surgery at all (not even OBGYN/ITU - apparently A&E can count?), and very few with surgery + no A&E.
In the end I managed to get my first choice at 2 fantastic hospitals (actually in London) - including 2 surgical jobs, gentle GP for a break, cardiology which I really enjoy, with no A&E or Psych (awful for some, but a dream for me!).
Ultimately you have to do whats best for you - if you don't have the most competitive score, you might put rotations with more undesirable specialities further up (i.e. psych) if its hospitals you really want, etc etc.

Finals

After all the excitement of everyone getting their jobs and deaneries, real life begins. I feel like finals snuck up on me, I had been so focused on other things. It didn't feel like last year, where I worked incredibly hard year round, terrified of the notoriously difficult exams.
Lots of people use 'Alasdair Scotts' notes - whilst they are a fantastic resource, I prefer writing and revising from my own, mainly using OHCM, patient.co.uk and passmedicine. Also some of his management plans are a little out of date.
I tend to revise in the library, finding being stuck at home too lonely. We all plodded through passmed and our notes, laughing at the same question comments and finding the same things hard.
I also spent 1-2 days a week doing about 5-6 hours of OSCE's. I find OSCE revision considerably more draining and difficult than revising for written/ picture exams. All the talking, all the preparation. As a little group we wrote our own stations and used books, which seemed to work well.


Now, all the advice from friends in the year above had been 'the written aspect is so simple you could sit it at the beginning of 5th year and pass, the OSCEs are brutal' - this turned out to the complete opposite. Perhaps med school like to mix it up?

The OSCEs were very fair and really okay, there was some stations I clearly messed up on and found challenging, but overall they were similar to what I was expecting. The written on the other hand, ye God. It was a brutal. Anyways, all over now!

After finals we had a long and good celebration, including lots of BBQs, nights out, and a weekend away medic grad ball, which was so fantastic, I will cherish all my memories dearly.


After all the ups and downs, the amazing experiences, friends, relationships, and genuinely farcical moments, I really can't believe it's all over.
Well med school, you've been a ride, what a joyous experience.
To a new chapter and beginning!