Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

Senior Cycle

Senior Cycle occurs over two years, with Senior Cycle 1 being equivalent to the old 4th medical year. During this year students complete five clinical rotations:
  • General Practice
  • Medicine & Surgery
  • Obstetrics & Gynaecology
  • Paediatrics
  • Psychiatry

Each rotation lasts seven weeks.

Curriculum

The SC1 RCSI General Practice Curriculum is mapped to the RCSI Medical Graduate Profile. In addition it is regularly modified in response to student evaluation. The Oxford handbook of General Practice 2014 is the main textbook/ e-book for the rotation. Core topics within this Handbook are identified for students by the department of General Practice.

The curriculum for the rotation in General Practice includes:

  • identified topics from the Oxford Handbook of General Practice
  • all topics covered in lectures/tutorials/workshops
  • all material on the GP Moodle page
  • common conditions encountered during the clinical attachments in General Practice

There are 13 learning outcomes for the SC1 General Practice rotation:

  • Demonstrate appropriate and effective communication skills with patients and staff.
  • Take an appropriate history from patients.
  • Perform appropriate physical examinations of patients.
  • Perform appropriate core clinical procedures.
  • Integrate symptoms, signs and relevant diagnostic tests to formulate a differential diagnosis for common medical conditions.
  • Consider patients’ illness experiences and contextualise their care with respect to family, cultural and other social factors.
  • Propose and negotiate a management plan including investigations, referrals and appropriate therapeutics for common medical conditions.
  • Identify appropriate drug and non-drug options for management of common medical conditions in primary care.
  • Promote lifestyle changes to improve health outcomes.
  • Discuss the role of primary medical care in health care systems.
  • Apply the principles of evidence based medicine in clinical practice.
  • Apply an ethical and legal framework to solve common ethical dilemmas.
  • Demonstrate professionalism including the ability to reflect on experiences in order to identify and address learning needs.

Educational content

Over the course of the rotation (two weeks of department teaching, just under five weeks of clinical attachments and self-directed learning time throughout) students will learn the following:

educational content of general practice 

Moodle Virtual Learning Environment (VLE) is the platform used for online curriculum delivery. A wide range of teaching modalities are used in a blended learning environment which aims to meet the majority of students’ learning needs.

These teaching modalities include:

  • online learning modules on the VLE
  • large group teaching
  • small group teaching in interactive workshops
  • one-to-one teaching with GP tutor
  • case presentations with Augmented Teaching Practice (ATP) and palliative care tutors

In the SC1 General Practice rotation, the seven weeks are apportioned as follows:

A. Departmental teaching at RCSI (two weeks)

  • Students will attend small group teaching sessions, workshops and lectures, delivered by Clinical Lecturers in the Department of General Practice. Students will also participate in a palliative care workshop and deliver palliative care case presentations to Palliative Care Tutors in St Francis' Hospice Raheny and Blanchardstown. Students will also present cases to ATP Tutors.
  • The departmental teaching will take place in: Week 1, part of Week 4, part of Week 7

B. GP Clinical Attachments (just under five weeks)

  • Students will spend just under five of the seven weeks in General Practice - with two attachments in two separate practices. During the attachment students will hone their clinical skills by taking histories, performing physical examinations, making differential diagnoses and formulating management plans. Teaching is on a one-to-one basis with one student per surgery for each attachment. Students are given the opportunity to experience one attachment in a rural setting and one attachment in an urban setting.
  • The GP Clinical Attachments will take place in: Week 2-3; Week 4-6 (including half of Week 4).
  • Students will spend time with other professionals in the primary healthcare team e.g. the Practice Nurse. In addition they will accompany the GP on home visits to housebound patient or visit patients in local nursing homes. They may also experience out-of-hours care in the community.
  • During these five weeks they will collect anonymised patient information for the completion of a range of portfolio assignments to be submitted online at rotation-end. The portfolio is worth 30% of year-end overall marks for the GP rotation (see below for more information on the SC1 General Practice Portfolio).

Assessment

Students will be assessed by both summative and formative assessment.

A. Summative Assessment

Summative assessment examines if a student has achieved the learning outcomes set at the beginning of the teaching period. Within the department of General Practice, summative assessments are conducted both at rotation-end and at year-end.

Summative Assessment 
 Portfolio (30%)

Five components from the SC1 GP Portfolio are summatively marked at the end of the rotation:

  • Reflective account (6%)
  • Evidence-based medicine assignment (6%)
  • Ethical case (6%)
  • Medication review (6%)
  • Referral letter (6%) 
 End-of-year examination (70%)  End-of-year Clinical OSCE (30%)
 End-of-year Written Paper Examination (40%) Key Feature Problems (KFPs)
 Single Best Answer (SBA) Questions

B. Formative Assessment

Formative assessment describes tests and processes designed to give the student feedback on progress, thereby contributing to deeper learning.

  • Students receive formative feedback from a variety of sources:
  • GP Lecturers: Feedback during interactive workshops during teaching weeks
  • GP Tutors*: Feedback during clinical attachments; discussions around portfolio assignments
  • ATP/Palliative Care Tutors*: Formative feedback from ATP and Palliative Care Tutors during and post case presentations
  • Peers: During all the interactive workshops and case presentations
  • Self: Pre and Post course MCQs

*The GP, ATP and Palliative Care Tutors provide written as well as verbal feedback to students. Their written assessments are conveyed to the department of General Practice by hand or electronically.

Evaluation

Course evaluation has enabled the curriculum in General Practice to evolve and this process is a key part of curriculum development. The students complete an anonymised evaluation which is sent to them by the RCSI Quality Enhancement Office on all aspects of their rotation in General Practice. This evaluation is reviewed and discussed by departmental staff after each rotation.

Awards

Students in 4th and 5th year are invited to submit a literature review, a systematic review or an original piece of research which is relevant to General Practice and Primary Care. After assessing the submissions, the Dr John O'Leary Gold medal is awarded to one student by the Department of General Practice.