Aims of the First Two Years

Section A - Your Duties as a Medical Student

Standards of Behaviour

Medical Students Code of Conduct

Student Support and Guidance

Monitoring and mentoring student progress

The Medical and Veterinary Student Progress Panel

Patient Safety- Your Legal Position as a Student

Confidential Sources of Advice

Assessment and Exams

Attendance at Teaching Sessions

Welcome to Cambridge, and congratulations on gaining a place to study medicine. This is the beginning of an exciting and challenging time: going to University, perhaps leaving home for the first time, and embarking on a demanding course which will lead you to qualification in a highly respected profession.

This booklet provides a general introduction to the Cambridge medical course for students starting their course in October 2011, and covers mainly the first two years.

Director of Education (Biological Sciences)

Our knowledge of the biology, physics and chemistry underpinning the practice of medicine has increased enormously in the past half century, and is still increasing. In the first two years of your medical course we aim to give you a thorough knowledge of that science base, but also to make you aware that because this knowledge base is continually changing, you will need to develop and add to this knowledge and its applications during your professional career.

We will encourage you to adopt an approach to learning based on curiosity and the exploration of knowledge rather than on its passive acquisition, because we believe it is important for you to develop this ability to apply new knowledge, and to adapt to changing circumstances in your professional life.

We will also help you to develop your intellectual skills, such as the understanding and interpretation of scientific evidence, problem solving skills, and skills in oral and written communication; skills which can be transferred to later stages of your medical education.

However, being a doctor involves a lot more than just knowing about biomedical science and the effects of illness on people. By the end of the first two years we aim to give you a sound grounding in the medical sciences and the basic knowledge and the skills to prepare you for contact with patients in the clinical part of the course. You will also learn technical skills, but there are other skills - the skills of listening and talking to people, generically known as communication skills - which are essential for a doctor.

We expect you to practice and develop these skills, both in the Preparing for Patients programme, and also in the supervisions arranged by your College. Do participate in supervisions - they are not just teaching sessions, they are learning sessions, and learning requires self-expression.

Finally, we aim to introduce you to the fact that doctors have an obligation to practise medicine in the best interest of patients, and that this obligation requires not only knowledge and skills, but development of certain attitudes to your work and in your approach to it.

Section A - Your Duties as a Medical Student

At the Introductory Session, at the start of term, you will be given a copy of the General Medical Council's (GMC) "Duties of a Doctor". This summarises the duties of a doctor registered with the GMC and you should familiarise yourself with these from the start of the course. They apply equally to your private and professional lives. You will also be admitted to the Medical Student Register, a copy of which is included in this handbook. Please read this carefully, because in signing this Register you are making a formal commitment to observe the standards of attitudes and behavior appropriate to an entrant to the medical profession.

Standards of Behaviour

As a student of the University, you are of course subject to the disciplinary provisions set out in the University Statutes. As a student doctor you are studying for a degree that will allow you to register provisionally as a medical professional. During your studies you will be working within this professional environment and the General Medical Council (GMC) expects you to behave in a manner appropriate to your future role.

The The standards of behaviour expected of you are set out in guidance published by the GMC and Medical Schools Council: "Medical students: professional values and fitness to practice” (November 2009), paragraphs 15 – 38;

A copy of the guidance will be provided on your first day. The University has also agreed a Code of Conduct for student doctors to guide you during your studies. This is reproduced below. You are expected to have read this and the GMC guidance before you come up to Cambridge. Make sure you understand these and if you have any concerns consult your tutor.

On the first day of term you will be asked to confirm that you are willing to adhere to these standards by signing the declaration which is copied at the end of this booklet. Your name will then be entered in the Medical Students Register and this entitles you to have patient contact, which begins in the first year of medical studies. Throughout your course you will receive reminders about the importance of the Register.

Students whose health or conduct give rise to concerns that they may be a risk to patients will be removed from the Medical Student Register and will be subject to Fitness for Practice procedures. This can lead to students being prevented from entering the Final MB examinations for the award of the MB/BChir Provisional registration with the GMC is subject to a declaration of fitness to practise.

Details of the Fitness for Practice procedures can be found on the web.

And on page 212 of the University’s regulations:

Although most of the teaching which you receive during years one to three is under the supervision of the Faculty Board of Biology, it is the Faculty Board of Clinical Medicine, working through the Director of Medical Education in the Clinical School (Dr Diana Wood), which is formally responsible for the supervision of your contact with patients.

Reproduced here is the University’s formal Code of Conduct for student doctors. On the first day of your course you will be asked to sign a declaration (reproduced at the back of this handbook) stating that you have read these documents

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In the first two years of the course, you will study biological sciences relevant to medicine both as subjects in their own right, as well as means to solve medical problems. The official title of the course reflects this: it is called "The Medical and Veterinary Sciences Tripos", usually abbreviated to MVST (a Tripos is Cambridge-speak for a series of courses leading to a degree). This is a traditional way of teaching medicine: learn the biomedical science first, and then study its application to medical practice. Many students prefer to study this way, and by choosing the Cambridge course you have declared your preference. During these first two years these courses will give you instruction leading to both your professional medical qualifications (Second MB), and to your Cambridge degree (BA). In order to proceed to a clinical school (where you take the Final part of your MB), you have to pass all subjects in the Second MB and gain your BA.

An advantage of the Cambridge course is that all medical students have the opportunity in the third year either to specialise in a medically related subject such as pathology, anatomy or psychology, or to widen their educational horizons by taking courses in, for example, social science, management or philosophy. This freedom of choice gives a wide range of educational opportunities.

You will also acquire experience of meeting patients from an early stage in your studies, in the "Preparing for Patients" component of the course, which forms a clinical strand through first, second and third years.

You will graduate with a BA after three years but the degree course also gives you the science grounding needed for professional education, which should result in your acquiring the degrees of Bachelor of Medicine and Bachelor of Surgery after your clinical study. The table below gives an outline of the course.

Following on from this, in the clinical part of the course, you will acquire clinical skills and apply your scientific knowledge to clinical problems. Under the Medical Acts, students who have qualified in the United Kingdom are provisionally registered with the General Medical Council on passing their Final MB examinations. The initials vary: MB, BChir (if you stay in Cambridge), MB, BS (if you complete your course in London), BM, BCh (if you go to Oxford), or MB, ChB (if you go to various other places).

To achieve full registration, you will then need to complete a two-year period of satisfactory service in a Foundation Programme post approved by a UK University, for details, see national and local websites:

http://www.wsh.nhs.uk/pgme/eastern-deanery.htm

Cambridge is a collegiate University, and responsibility for your education is shared between the University and your College.You were admitted by a College and you will, I hope, soon make friends with other students in your College. Your College Director of Studies will get to know you as an individual, and will organise the provision of supervisions to support and enhance the formal teaching given by Departments. Your College Supervisors, Director of Studies and Tutor provide a unique pastoral network designed to support your studies while at Cambridge.

Within the University, the Faculty of Biology is responsible for organising your teaching for the first three years. The Faculty delegates responsibility for delivery of this formal teaching to Departments, or to course management committees: the majority of your formal teaching (lectures and practicals) is delivered by staff from six departments (Biochemistry; Experimental Psychology; Genetics; Pathology; Pharmacology; and Physiology, Development and Neuroscience). This teaching will be augmented and enhanced by small-group teaching (supervisions) organised by your College.

Departments will provide course handbooks for each of the courses you take, and these will include details of the rrangements for lectures and practical classes in that subject, and detailed guidance about the form and conduct of examinations. Much more information, especially on timetables, is available on the Faculty of Biology web site and you should become accustomed to consulting this:

University is not like school, so don’t expect it to be. There are huge differences between the way you were taught at school and the way you will be taught at University, and some of you will feel bewildered by the transition. In place of relatively small groups, you will be taught in large classes of over 300 students, and the teaching will be delivered by means of lectures, (essentially a 50-minute monologue). Lecturers will issue handouts, but you will also need to develop your listening, concentration and note-taking skills, to get the best out of this. The material will be delivered quickly, and it is then up to you to understand and assimilate it.

The supervision system is there to complement the formal teaching and the onus is very much on you to make use of it, and to develop study and time management skills to help you cope with, and master the material. College supervisions will play a very important part in your education. Make them interactive and take full advantage of them to ask questions about any parts of the course you need help with.

You will need to use the internet to consult library resources, past examination papers, databases of scientific literature, timetables - and much, much more. The departments which provide your teaching are providing an increasing amount of supplementary information in the form of on-line course materials on their web sites, and the Faculty of Biology website also provides a lot of basic information.

You need to be aware that the University takes plagiarism very seriously. You can read more about Plagiarism on the Faculty website.

A perennial question is, “how much do I need to know to pass the exams?” The bottom line is that to pass your professional qualification (Second MB) you will be expected to show a good working knowledge of the subject material in all your courses. Furthermore, you will be expected not merely to know this material but, more importantly, to understand it and apply that understanding to the solving of problems.

Individual courses will focus on the “core” scientific knowledge, which doctors need to have in order to cope with clinical practice, but we are also trying to make you realise that learning is a continuous process and that practitioners will have to continue to develop their knowledge and skills throughout their working careers. To do well in the Tripos, you will need to show a deeper understanding of the material, and to be able to marshal facts into coherent arguments. Courses have been designed to allow students, wherever possible, to learn for themselves rather than being passive recipients of instruction, and you will get far more out of your course if you regard it as an opportunity to study what interests you, rather than just learning the syllabus to pass the exams.

You will encounter two kinds of assessment.

Formative assessment is designed to indicate to you how you are progressing, on a weekly or termly basis. Your College supervisor and Director of Studies are the persons mainly responsible for providing this kind of feedback and continuous performance review. Formative assessment, more or less informal, may also form part of some University-based teaching.

Summative assessment (end of year exams) determines your ability to proceed with the rest of the course. The main science courses in your first and second year will be examined in this way for two qualifications:

• Second MB, which determines whether you are able to proceed to the clinical part of your medical course
• Tripos, on the basis of which you are classed and will receive your BA degree.

Each of the exams for the major courses is divided into three sections, and the marks awarded to Sections I and II count for he Second MB qualification. The general format is a 1-hour theory exam (Section I), which covers the lecture material and consists of MCQs or short notes, and a 1 or 2 hour practical exam (Section II) covering the practical material. Because these Second MB exams constitute a professional qualification, you will be expected to pass them at a qualifying level, and to demonstrate a good knowledge and understanding of the whole of the subject material in the courses. The marks obtained in these two sections will then be added to those of Section III, to give a final Tripos mark.

If you do not pass the Second MB sections, you are allowed one further attempt at a separate Second MB examination in September. Students are permitted only two attempts at Second MB examinations unless there are extenuating circumstances, such as illness or other good cause. If you require a third attempt, your College has to apply for this on your behalf to the Faculty Board of Clinical Medicine.

Section III consists of a 2-hour exam, during which you will be asked to write essays from a wide choice of topics; this section oes not figure in your professional qualification, and the marks obtained count only towards your Tripos class.

In addition to the main science courses, there are other courses, for example the Social Context of Health and Illness, which are assessed only for the Second MB.

You should be aware that details of your academic performance in all aspects of the course currently counts as a major factor in your application for Foundation Year placements at the end of your undergraduate medical programme. The consequence of this is that the best strategy is to aim to pass not just your Second MB exams, but also to secure a good performance in the Tripos, because this strengthens your application.

Further details of these exams and how they relate to the course can be found here.

Complaints

(a) About courses

For each course that you take there is a Course Organiser. If you have problems with the organisation of a particular course, you should communicate with him/her. You can also tell the student representatives who sit on the management committee for the course you are concerned about, and ask them to raise the problem on your behalf. It may be a general problem, and this is one way of bringing it to the notice of the organisers. A problem arising within a particular department may be raised, if all else fails, with the Head of the Department.

Problems with the teaching provided for you by your College should be raised with your Director of Studies or, if that fails, with your Tutor or with the Senior Tutor.

(b) Queries or complaints about examinations

Any complaints about the conduct or the results of examinations must be raised in the first instance with your College Tutor, and not directly with the Examiners concerned. It is your Tutor’s responsibility to advise on these matters. Cambridge exam rules and regulations make provision for cases of illness or other misfortune; if you encounter any kind of illness or other impediment to exam preparation, the sooner you inform your College Tutor, the better. All liaison between a student and the central administration, particularly in matters relating to examinations, must be conducted through your College Tutor.

Attendance at practical classes (but not lectures) is recorded, and if your attendance at the practical classes is unsatisfactory, the Head of the Department concerned will be unable to provide a certificate of diligent attendance, and your progression in the course and professional future may be put in jeopardy.

If there are good reasons why you are unable to attend a practical class then you should tell your Director of Studies and the appropriate Course Organiser. It may be possible for you to do the practical at some other time. Organisers of practical classes may notify students and their Colleges if a student’s attendance record is unsatisfactory.

As a student your timetable is likely to be very full. Most of the teaching in the first three years is carried out on the University’s Downing site. If you haven’t time to return to College for lunch, undergraduates are welcome at the University Centre which is at the end of Mill Lane.

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Three courses are assessed for Second MB and Tripos. They cover the following topics:

• the overall layout of the structures of the body in Functional Architecture of the Body (FAB)
  
  
• the chemical and molecular mechanisms underlying the functions of the body and the mechanisms that govern inheritance in Molecules in Medical Science (MIMS)
  
  
• the mechanisms that underlie communication within the body, and the maintenance of the stability of the internal environment in Homeostasis (HOM) and Histology
  

  Three other courses are assessed only for Second MB and during these you will:

• be introduced to the broader cultural aspects of healthcare and the medical profession in the Social Context of Health and Illness (SCHI) and cover epidemiology and basic statistics in Introduction to the Basis of Medicine (ISBM).



• encounter patients in the community in Preparing for Patients A (PfPA). This is a patient contact strand, where you will begin to acquire the skills of listening and talking with patients, and it runs through the first three years of your course. Subsequent parts of this course will take place in second year (PfPB and PfPC) and in your third year (PfPD), and satisfactory completion of all four parts is required for Second MB qualification.

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Four courses are assessed for Second MB and Tripos, and they cover:

• the mechanisms by which drugs act upon the body in Mechanisms of Drug Action (MODA)
  
  
• the biological processes underlying disease in Biology of Disease (BOD)
  
  
• the structure and function of the reproductive system in Human Reproduction (HR)
  
  
• the structure and function of the sense organs and the central nervous system and the study of mental processes in Neurobiology and Human Behaviour (NHB)

You will also have the opportunity to study aspects of these subjects in more detail in two Option courses, chosen from a range of subjects and also to continue to develop your experience in Preparing for Patients B and C (PfPB and C).

Summaries of the subject matter in these courses and detailed timetables will be provided in the individual course handbooks and on the MVST website.

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After two years of preclinical study you do a further year’s study and take a final Tripos exam to complete the requirements for the BA degree. This year allows you to choose which course you want to study, and a big advantage of the Cambridge system is that it offers an enormous range of courses in your third year. You may choose to take in-depth courses in many of the subjects you studied in the first two years, or you may take courses in something completely different, such as Anthropology, Management Studies or Philosophy, or you may decide to combine different subjects via a course such as NST Part II Biological and Biomedical Sciences.

Your Director of Studies will be able to help you make a decision about what to take in your third year, and there will also be the opportunity to attend the "Subjects Fair" in March 2013, where the various course organisers will explain what they offer. In April 2013, you will be asked to state preferences for which course(s) you want to take in your third year.

If you are an affiliated student, you will start the clinical part of your course in Cambridge or elsewhere after two years of undergraduate study.

The Preparing for Patients strand continues in your third year (PfPD).

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Many of you will stay in Cambridge and go on to clinical study at Addenbrooke’s, but some may choose to go to the John Radcliffe in Oxford, or to one of the several London Clinical Schools.

Your College Director of Studies in Clinical Medicine should be able to advise you, and the various clinical schools run Open Days and are also represented at an annual meeting organised by the Medical Society at which the Deans of the various London schools come to Cambridge to tell you about what they offer. In November 2013 (or November 2012 for affiliated students) you will have to complete an application form for your Clinical study and attend interviews.

Information about the Clinical School selection process is published on the Clinical School Intranet:

http://www.medschl.cam.ac.uk/Intranet/students/az/Interviews.htm

Course organisers will actively solicit opinions from you about the teaching you receive. We do change our teaching as a response to comments and suggestions made by previous students, and you owe it to those coming after you to respond to questionnaires, so that those responsible for organising the teaching know when something is right, and when something is wrong. When you complete a teaching questionnaire try to be honest, informative, and, if possible, helpful.

Course liaison committees also have student representatives and it is at this level that most of the useful work is done in providing feedback to those who teach from those who are trying to learn.

The Faculty Board also has student representatives, and we hope that some of you will wish to contribute in this way to discussions about how the teaching is organised. The student elected to the Faculty Board from the medical and veterinary students also sits on the Medical Education Committee, which maintains an overview of Cambridge medical education from admission to qualification. There is also a Faculty Committee, the MVST Part I Committee, which oversees MVST IA and IB, and includes student representatives. Please feel free to raise issues of concern with any of your student representatives.

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Within Cambridge there are various societies organised by and run for medical students. Here are “welcome” messages from two of them:

MEDSOC

The Cambridge University Medical Society warmly invites all undergraduate medics to join. Members will receive invitations to fantastic social functions and enthralling guest speakers at reduced prices. We organise trips to clinical schools in Oxford and London and members will also get a copy of Murmur, our very own publication, and receive book discounts at Waterstone's. For more information, visit us at

http://www.srcf.ucam.org/medsoc/

MEDSIN

Could you work abroad as a doctor one day? Or go into schools right now and teach first aid or sex education? Do you care about access to healthcare in the developing world, the AIDS crisis or refugees? And would you like to meet medics from all over the country, and go to conferences all over the world? The Medical Students International Network may be just what you’re looking for - opportunities to look at medicine in its widest sense, as well as some of the most original social events Cambridge has to offer. Take a look at http://www.societies.cam.ac.uk/medsin/ to find out more.

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Estimated additional course costs 2011-12

In addition to the standard living costs, preclinical medics should expect to have to meet the following estimated costs:

Lab coat	£13.00
Dissection kit, gloves, manual*, loan of locker and key	£45.00 - £50.00
Anatomy white coat	£13.00
University approved calculator	£14 - £16.00
Preparing for Patients: - maximum for travel in first year - 2nd year College rent fees, up to - 3rd year travel up to	£25.00 £130.00 £25.00
Electron micrographs (optional)	£2.00

*This manual essentially replaces the need for a text book.

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MEDICAL STUDENT REGISTER AGREEMENT

If you have a difficulty with any element of this declaration, please contact your college Senior Tutor to discuss how this might be resolved. In exceptional circumstances, resolution may require GMC approval for special pre-registration experience.

1. I have read the following documents, and I agree to abide by the principles laid down in them:
   • The GMC and Medical Schools Council guidance “Medical students: professional values and fitness for practice” (March 2009), paragraphs 15 – 38;
   • The University’s Medical Student Code of Conduct and explanatory notes ;
   • The Clinical Course Clinical School’s notes on the Legal Position of Clinical Students ;
   
I have also read the following information:
• The University’s Confidential Sources of Help and Advice.

I will comply with these and other rules and procedures which may from time to time be laid down by the Faculty Boards of Biology and Clinical Medicine, the Director of Education (Biological Sciences), the Director of Medical Education, the supervising Consultant, General Practitioner, Ward Manager or their deputies;

4. I will inform the Director of Medical Education immediately if I am no longer able to meet the requirements of this agreement or if I become aware of any change to my physical or mental health which may put at risk the health and well-being of patients.
   
5. I understand that the Fitness for Medical Practice Committee may share information about my registration with other bodies in the public interest and has the authority to remove my name, either temporarily or permanently, for failing to observe the Medical Student Code of Conduct or failing to progress academically.
   
6. I understand that I will remain on the Cambridge Medical Student Register and observe the University’s Medical Student Code of Conduct until I have:
   • progressed to a clinical course elsewhere or withdrawn from the medical course;
   • sat any MB examination on two occasions without passing;
   • completed the requirements of the clinical course satisfactorily and been accepted onto the provisional GMC register;
   • been suspended by the Fitness for Practice Committee.
   
7. I understand that, if I fail to abide by this agreement and the Code of Conduct, I will be responsible for paying any reasonable costs arising from a review of my fitness for practice in the event that such review leads to me being found unfit to practise or fit to practise only on certain conditions.
   
I give my consent to the processing of my data by the University.

Student Name: ……….....................……………………… Witness Name: ……….........................................................

Signature: ………................................................................ Signature: ………................................................................

Date: ............................................

Note that you will be reminded annually of the importance of these statements


Please complete this form at your first Functional Architecture of the Body (FAB) practical on the morning of Wednesday, 5 October 2011, with Mr C Constant / Dr Cecelia Brassett.