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Is out and um bring it on. Um Hi, welcome to the, what I wish I knew before year for. So this is just um a short webinar just to give you guys some information on what year four is gonna be like, what kind of things it's made up of and just any tips and tricks that um we have for you guys, if you have any questions kind of along the way, just put them in the chat and um we'll answer them along the way. Um So yeah, just a disclaimer and the 10% of G medics code is just there. Um If you would like to use it. Um So what we're going to cover today is a general overview of fourth year. Um What placements like because it is different to third year um briefly go over PPD and the different requirements how the year actually works. Uh TCD exams, elective and AQ and A at the end. So before we start, um code Blue is hosting a social media giveaway so two people can win a year subscription for free um to all the resources on GKI Medics. So you just need to go to the Instagram page which is at COVID teaching, follow it like the post um and also follow GKI medics as well and then you'll find out by October the second if you've won. Um So just going to start by talking about the structure of the year. So fourth year is quite full on. It has basically all the specialties that are the nonmedical ones. So it's a lot to get through in one year. So you might have heard kind of the terms F and C and M and M thrown about. So FC stands for family and child. And in this side of the year, you'll have pediatrics or GGP breast oncology, dermatology, and infectious diseases. So you do all those specialties in the first semester. So that runs till like just after Christmas. So the big ones are four weeks and then the last four are just one week long. Um And then the other side of the year is called M and M and that has aging complex health. So geriatrics, it's got mental health MSK which is made up of rheumatology and orthopedics. You've got two weeks on neurology and then a week of ent and a week of ophthalmology. So the year is kind of split in half. So some people will do E and C first and then M and M second and some people will do it the other way around and then everyone on that side of the year will also do all these specialties in a completely different order. So everyone's kind of a bit jumbled up, but by the end of fourth year, you will have done everything. Um, you might be on it with a couple of other tracks. Obviously, it depends what hospital you're at. Um, but yeah, as you can see, it is quite a lot. Um, some of them are heavier than others, but we will go through that later. Um, in terms of your exams this year, you have, um, a set in winter. So like January time and then another set in summer, you have two progress tests and just like third year at the end and the summer progress test, you have your extra 50 questions. Um, and you have two sets of CCS. So your winter ones will be just on what you've done up until that point. So I can see your M and M and then your summer ones will mostly be the other side. So if you did M and M second, they'll be on that. But you might have some mixed stations as well in terms of your TCD, it's again, once a week, they're mostly in person. It can vary on your specialty, but most of them are on Friday in person and it can be just in your, with your track. But if you're at certain hospitals that either, so some of your specialties, you might be with multiple tracks from multiple different hospitals, um the contents on one med learn like always. But instead of in third year where you work through it every week and everyone's doing the same, you just do the, the like content that corresponds to the week you're on. So if you, if you're on peds, you go through peds on one med and then you'd go to week one if you're on your first week and you'd work through the cases on there and then as you're going through the weeks, that's how it works. Um There's also kind of a pre placement module within the specialty that you're doing, which is always good to read before you start placement as well. Um Yeah. Um in terms of AP sa again. So this is just a brief overview, um and your sign off. So it's three histories or patient assessments a week. There's no, as far as I'm aware, unless it's changed, there's no examinations that you need to be kind of signed in fourth year. Um And you'd still need a presentation each week including an enhanced presentation. If you're in your one week blocks, it, you don't have to get it enhanced. You just have to get a presentation. There are some things called co and procedural skills which um Aish is going to go over a bit later on. Um And then your options for fourth year are to do fundoscopy, which we recommend doing on your ophthalmology placement, female catheter. You can do it in OB Gynae, um especially in theater, if someone's having ac section, they give everyone a catheter if they're having ac section. So that's the perfect time to do it. And then Otoscopy, which you can do in GP or ENT and it's got the different levels that you need to be signed off to there. And then if you in third year haven't quite got um your up the side off to level three, it's always a good chance to do that in fourth year as well. Um, ok. Moving on to placements. Hi guys. So I'm Melissa, I'm 50 at Preston. Um, and I'm just gonna give you some tips and tricks for getting through placement. So year three versus year four as a whole, I found that year four was a lot more structured in third year. I felt like there was quite a lot of wondering about the wards trying to find opportunities to do things. But in year we had a lot more of a structured timetable in terms of having more clinics, more theaters, which meant that there was more 1 to 1 time with doctors and nurses. And that's really nice for you to be able to get your sign offs done and get a bit more personalized teaching. So that was once out of year four that I really enjoyed. Um, the other thing that's really nice is that there are times when you might be the first person to see a patient. So I found this on pediatrics because there's a pediatrics assessment unit where a patient has been sent by their GP to the hospital. And you might be the very first person to see this patient in the hospital and you might be the first person to take the history to examine them and to even write up the notes. So that's really nice because it helps you feel a bit more like a proper doctor in GP as well. It kind of varies between different practices. But for the most part, you do run your own clinics. So what I had was I was in a pair, um and we would see our own patients and then the GP would come in if the patient was complicated and we needed a bit more of a debrief. But that was really lovely because you felt like you were actually doing the duties of a junior doctor and it gave you a bit more confidence, seeing patients on your own. Um My advice to you would be to ask to see the things you're interested in. So if there's a particular thing that you're interested in, like on psychiatry, I wanted to see electroconvulsant therapy, for example, I asked my CPF and they were nice enough to accommodate the things that I was interested in. Um There's also scope to be able to attend placement. I was out of hours. I know that's not gonna be a very popular thing for some people, but there are opportunities to do weekend shifts and evening shifts and I think it's definitely worth considering. Um, and the reason for that is just on the weekdays it gets so busy sometimes and on specialties like S and G, for example, you're kind of in a way competing with other students to get opportunities to do things. But on the weekend when it's a bit quieter, you're more likely to be the first person they turn to when there's something interesting going on. So when I'm so for example, I did a shift on Saturday, which is really nice because I got to be in the delivery suite and I watch a child being born, which is really cool. So I feel like that was definitely worth it and it's something worth thinking about E forms wise. I know it's the most exciting, but it's just something that you need to get used to. The new thing this year is that you have mandatory tenants forms. So for sessions like TCD or your secondary component teaching, there's no tenant form in your E forms that you need to fill out for yourself and you need to get those done within a week of having the session. So, so your TCD is on the Friday, you need to have filled out that form within by the next Friday. And if you don't do that, it's really annoying, but they mark you as absent and you have to fill out an absence form. I don't know why they've chosen to do it in fourth there because you don't have it in fifth there. But I would just get into the habit of going through your E forms every day and just checking to make sure there aren't any outstanding attendance forms. The other thing that, um, it's a bit inconsistent across based hospitals, but you have a timetable, clinical learning form, which is just a record of everything you've done within the week. So like the clinics at theaters, the ward downs you attended and within a four week block, you have to fill out 24 of those sore is really strict and they do look to make sure that you've done those 24 E forms. Otherwise they don't sign you off from speaking to people from other base hospitals. It sounds like different, people do different things. So if you're from Preston definitely need to get those done. If you're at other base hospitals, I would just check with your supervisor to make sure you know what the expectations are in terms of filling out the TCL S, please don't want to be not getting signed up at the end just because you haven't done these forms. Um Another thing that's new this year that Eva mentioned earlier are core and procedural skills. So they're not quite up as, but um they're just skills that you need to get signed off on in each of the blocks. So in women's health, you've got two examinations, speculum and bimanual. If you're in person, it's really nice because the CPF S do them with you on your Induction day and you just practice on a model, get those signed off. So that's nice and easy for you. Again. At other base hospitals, they seem to do it differently. So I know either you're telling me itself or you actually did it on real patients. So as long as you make it clear to your supervisor that it's something you need to get done, then hopefully they will give you the helping you to get it signed off pediatrics. It's a growth chart. It is what it says on the tin. You're just putting the child's height and weight consultants do those all the time in clinic. So you can get that signed up fairly easily. Microbiological diagnostic sounds difficult, but I literally did a COVID swab and that counted. So it's fine on breast. The one that you need to get signed off is called a triple assessment. Um and you literally just need to observe it and get signed off. So what it is is that in a two week wait clinic where patients have been referred for potential cancer, the investigations they'd get done are an examination, some kind of imaging like an ultrasound or a mammogram and they get a biopsy done. So you just need to watch those three things and get signed off GP. You have a couple as well. So you've got critiquing patient information resources. And what I did for that was that I found a leaflet that they had lying around in the practice and then critiqued all the things that were good about it and things that were not so good. Um And the other one is dealing with external communications. So like it's the G P's contact with the hospital or discharging patients and you just need to watch the process of how that happens. Um So seven of those skills, they're not quite upset, but you do need to get them done and the best chance is in fourth year because otherwise it's hard to go back in fifth year. Try to find opportunities to get these done when you've got all your fifth year upsets to get them as well. Um Yeah, thank you. Um Hi. So I'm Patsy, I'm also 1/5 year out person and I'll talk you through a little bit about PPD. So it's obviously not the most interesting topic and it's at the end of the day for most people, it's just a tick box exercise. Um But PPD in fourth year is not as much as it is in third year, it's quite a lot more, you don't have as many reflective pieces and as many requirements for it, but obviously, as you know, make sure you get PPD done in time, make sure, you know, all the deadlines. Um So in terms of the deadlines, I couldn't actually find them yet on one med. So you'll have to check them yourself but make sure you do know them. Um So yeah, so there are some reflective pieces that are easier to possibly get patients for in certain specialties. Um but as long as you know, which reflective pieces you have just keep them in mind um whenever you see new patients, so certain things that you know, you do every year, declaration of probity, looking after your health Edward Gender program, you have to continue it this year as well. Um And then your score analyses and your PPD progress on me. So that's the same as it was last year um for your exams and things. Um But your critical analysis pieces this year. So one of them is an inclusive approach to patient management. Um I think that one is quite good to do in GP where you get a lot more of a holistic picture about patients. Um But I think for that one, I did that, I think I did do that in no, II did that in si think when there was one patient um who had a language barrier. So we got a interpreter in. Um So that was one useful scenario that you could do. Um And aging and complex health is actually quite good for things like this as well. So GP and aging um both of them are quite holistic in terms of specialties. So you see a lot more of like um pa patient social circumstances and that also goes into the second piece, which is your social determinants of health, which I'm sure at Manchester you all know very much about. Um but things like um like addiction, um homelessness, um financial constraints, domestic violence, things like that. Um Yeah, and like, yeah, financial constraints. But yeah, so again GP ach but of course you'll come across patients in every specialty just bear in mind which um yeah, like which cases that you need to be thinking about? Um Yeah, next slide I think. Yeah, that's it. Um So I'm just gonna give you a brief overview of like more E and C specific stuff. So like Pete and GGP um might be a bit of a repeat. But yeah. Um so one of my first tips is kind of at the beginning of your placement, identify the skills that as examinations that you either want to complete or practice on that block. So obviously like speculum by manual um pregnant abdomen have those things in your mind when you're on SG because that is what people will be doing. Go to Antenatal clinic, see a consultant, do it or a midwife and then have a go yourself and that's the best way to actually practice for your exams. Um Also asking them like, how would I present this? So when I was on Ops and Gyne, I did a pregnant Abdo exam and I said, how would I summarize? Like, what's the best way a consultant told me, gave me a spiel and then that was, I had that in my exam and I was able to present it really clearly and concisely because they're the people that, you know, will be writing the exams. So that's what I will say, make sure, you know, kind of near the beginning. So you can get things done but also practice and, and get used to seeing things. Um try and do the preplacement module like before you start because the fourth year has a lot of kind of focus history taking and the preplacement modules have the framework for that. So if you're going to g for example, it will have how to take, you know, like pregnancy history, menstrual history. So I really do recommend just reading through it um somewhat longer than other, but it will give you the relevant information you need as well as the examinations and just some basic knowledge as well. And I think you mentioned this, ask for like your opportunities if you want to do a pregnant abdo, if you want to do a speculum, if you want to do a catheter, just ask because even if you can't do it in that clinic or on that ward, they'll know where to go and they can be like, oh, go to this clinic, go to the theater, you'll be able to get it done, but they can't read your mind. So I know sometimes it's a bit like you're a bit nervous, you're a bit shy but just ask people and they will help you and they will tell you where to go. So it's a, sometimes it's a lot to get done. So you just need to ask and you will find the right place and even if you're not timetable to be in theater, just go like if you need to do a catheter, go and go and do it. So that would be my tips. Uh Women's health. Yeah, like I mentioned, observe the examinations in clinic and that's when you can also practice them. There's a consultant there, you've already got a chaperone, they can ask a patient if they would like if you would be allowed to do it. Um And then especially in women's health, there's a lot of clinics and the focus history taking has a lot in like, have you, are you up to date with your swabs? Have you been pregnant, blah, blah? So really practice, use those opportunities to practice your history taking because it's a lot of stuff to remember. Pediatrics. I'd say the main thing that you want to get used to is if you've not really been around Children, obviously, you haven't really taken history from Children before. So get used to either taking histories from them just having a really patients in a child friendly manner. So you will have to adapt your language. Um but also getting used to taking collateral histories from parents or carers as well. Uh in terms of the one week block. So breast oncology, um derm infectious diseases, um just kind of again your focused history taking especially in like infectious diseases, like travel history. And then in breast, you've only got a week and the breast exam can come up in your CCS and there's not much opportunity to practice it. So make use of, you should be taught on like a model, make use of that session, make sure you ask all the questions you need. Like what's the technique? What you know, how should I summarize? What should I say? I'm looking for? Um And then GPI I'd really use that block as revision, perfecting history taking because it's, it is obviously general. So you use it to really kind of revise brief like third year stuff just so keep it fresh. But also catching up on anything else that you might have not been able to do in your other blocks, like the core procedural skills and prescription tasks. You can get a lot of prescription tasks done in GPI, always forget about them, but you need to do them. And it's quite nice because you're usually the only student or one of two students in the GP and you have a supervisor, they prescribe stuff all the time or do medication. With these and stuff like that. So that's a really good block to get your prescription task done. Um In terms of tips for TCD, there is a lot of content in some of them or like a lot of conditions. It has like a conditions list at the beginning of each placement in the preplacement module. So it'll tell you all the conditions on the MLA peds is very heavy. S and G is very heavy, the is very heavy. So if you can get ahead or like just be aware that there's a lot to learn in those ones, like try not to leave it till the last minute, but GP is light or it's stuff that you've learned before, so you can catch up in that placement. Um And it helps if you know, because it a lot of it's new stuff in fourth year. So if you've already done a bit of your TCD, it will help you make sense of what's going on whilst you're on placement, definitely just have a look through preplacement because like it is helpful sometimes. Um and in terms of CCS, like they will use random stuff that's in TCD, even if it's like a paragraph about something really random or like practice explaining this to like a patient, they will probably use that as a station. So at least read through it. So I know that some people don't really go through it, but just have a read through if they've put it in there, it's because they might ask you a question later down the line. And I think Patty has a good tip. If in the resources, it's like got a link to a condition or a patient info website, it, it'll be because they might ask you to explain it in ACC. So I would recommend having a glance on one med. Um And also in TCD, some of them have role plays practice scenarios, actually volunteered to do them because it's really good practice for CCS. And again, they put them in TCD because they might be in your exam. So that's my TCD tests. Um I don't know if anyone else had the any other tips for TCD. Yeah. Um and then CCS, so they are different like Patty put in the chat. So they're both summit. So you do need to pass both sets. I think it's um it's 16 sessions over two days. So eight on one day, eight on the other and you have to pass 12, I think out of the 16. Um There's a lot of hybrid stations in F and C usually or well in both. So make sure you read your prompt carefully. So a lot of them you'll be doing more than you'll be doing at least two tasks and it's easy to just be focused on one. So a lot of them be history and exam or date and turp explain. So they are different it's not just a pure station, there's a lot of mixed ones, so just, just make sure you read it before. But also if you can't remember they have it in the station as well. Um, yeah, the new station is sbar signing for situation background assessment recommendation. You should have practice in your TCD, but there's also practice stations on one med and on geeky medics, which you can use your 10% off for. Um So that's a new station get used to like um observing handovers on the ward and things like that and that will get used to that structure. Focus history taking, like I said, so know your s and how to take it up s and down your history, how to take a Pete's history. I know this is all quite early but if you know what to look out, it, it can help you learn what to look out for whilst you're on placement. So that is easier when the time comes GP can include your three stuff. So we had an ABDO exam as a GP station and then like explaining a two week wait and stuff like that. So it's a bit just general stuff. Um Yeah, so the bigger placements will mean you have more stations. So you might have four S and G stations but you, you will only have one derm and one infectious diseases, for example. So when you're advising, obviously, maybe focus on the bigger placements um and you have two medication stations or prescribed medication, you will be e prescribing that is always a station using the BPS like platform, which you will have practice on through the year. And then the second one is usually explaining a medication as well. Yeah. Ok. Yes, I'm gonna give you a brief overview of M and M. Um So M SK is made up of orthopedics and rheumatology. So I didn't understand what rheumatology was, but it's basically inflammatory diseases of bones and muscles. So things like over different types of arthritis and lupus. And if I'm telling you something, you already know. I'm sorry, it's just that I didn't know what rheumatology was before fourth year. Um CCA wise, the tricky thing with, with MSK is that there are just loads of examinations that you need to learn. So, pretty much every joint hand and wrist, elbow, shoulder spine, hip, knee, ankle, all of those examinations. So I found it a bit overwhelming at first like opening the ear for an examination handbook and just seeing all the ones I had to learn. Um So my advice would be just to practice early and don't leave it to the last minute because it's too much to learn the night before. Um The other good thing is that all the examinations have the same structure. So you start by looking at the joint feeling around it, moving it and doing a few special tests and it's good to practice summarizing your findings at the end as well. So knowing how to stay concise without mentioning every single thing you've done is also a skill I think, sorry. The other thing you need to practice is extra interpretation, especially fractured hip. Um And this is kind of looking forward into your future as a junior doctor, but it's really be able, it's really important to be able to describe x-rays down the phone to a consultant. For example, if you get opportunities, it's good to describe into theater, especially for things like a hip replacement, knee replacement. Just so you've got an, an understanding of what it's like. So you're able to explain it in acc aging and complex health. Another one of your big blocks, this one does tend to be a bit more relaxed. So if you've got work that you need to catch up on, that's a really good time to do it. The other skill that is important to try to practice is collateral history taking, which is that you're not speaking to the patient, but you're speaking to their relative. And that's a little bit tricky at first because you kind of need to take, you need to make sure when you're speaking to the relative that you've got consent from the patient. So it's just knowing how to adjust your introduction when you're in the CC. Um I would recommend as well if you get the chance just to watch conversations that doctors are having with patients on DNA CPR and see what kind of language they're using. You will get teaching sessions on breaking bad news and doing DNA CPR. So it's just good to see the language that doctors use in real life. Um Yeah, and the other thing is it's good to practice your U three examinations while you're on this block. Mental health is another four week block. Uh and I would really try to nail these three skills of taking history, doing the mental state examination and doing a risk assessment. So mental state examination is a bit different. The exams you've done before, it's not like say a cardiac exam where you're palpating the pulses and auscultating the chest because you're not physically examining the patient as such, it's more kind of a history. And then at the end of it, it's your assessment of the patient's appearance of their behavior, their mood and then you ask them questions as well around symptoms of experiencing hallucinations. So my tip on your on placement is just to get really, really good at knowing what questions you need to ask and presenting the MSC because it does come up in CCS risk assessment is just establishing whether the patient has thoughts of self harm and of suicide. So when you're on placement, just take the opportunity to ask those questions and know how to phrase them in a like a sensitive manner because they are difficult questions to ask. So the more practice you get, the more helpful it'll be for you. Um, the final block is another really heavy one. So you spent two weeks on urology, one week on ent ear, nose throat and then ophthalmology. Um, again, I would say try to cover the TCD S early. And if you've got it cos for me, it was my very last block and I was really rushing to finish everything. I just wish like in my aging block, I'd done all the TCD. So I was a bit relaxed by the time I got to the final one. Um this is also the one where you do your two upset. So your oscopy, sorry, which is looking at people's ears and fundoscopy, which is looking at eyes. If you've got EF and C first you can also try to get those signed off in your GP block. Um Yeah, next slide, please. Ok. Yeah, I know it's really early days for CCS, but I just thought I'd mention some of the potential stations just so you've got an idea as you're going through the placements. Um, the caveat is that it's no, it's not an exhaustive list, but it's just some things to bear in mind. MS Ky, you're guaranteed to get at least one examination. So if you know examinations really well, that's one station that you have in the bag. Um Medication counseling is likely to come up. So for us, it was methotrexate which is one of the rheumatology, you medications, but you might also get steroids, which is another rheumatology one or bisphosphonates, which is an orthopedics one. and they used to kind of strengthen your bones. So in the stations, you will get to BNF. But if you've got an idea of the key things you need to mention before you go into the C, that's definitely really, really helpful. Um aging and complex health. the key presentations that you need to know and to understand really well are falls, is knowing how to take a false history, understand why they've fallen and be able to counsel them on how to prevent falls. Um Delirium is another one that came up for his last year. So delirium is uh something that happens in elderly people where they temporarily become really confused and that can be because of things like infection. So you need to be able to take a history, figure out why they've become delirious and then kind of come up with a management plan that was similar to one of our stations last year. Again, collateral history. That's just an important skill to be able to practice. Um in terms of your challenging conversation, you will get one every year. Uh The one they had last year for the other half of the year was DNA CPR lasting power of attorney type station. So just have a good understanding of what those are and how to speak to patients about that mental health block. So our examination was watching a video of a patient and then doing an M SE. So it was a patient with depression and we had to do an M SE present the findings and then present the risk assessment. So if you go online, you will be able to find videos of people doing MS ES. So I'd recommend just practicing taking notes and then being able to present it back for CCA S. Um history wise, the key presentations are depression, anxieties, eating disorders and to that, I would also add memory issues. So things like Alzheimer's and dementia for us, it was six minutes of taking a history and doing a risk assessment for a patient who had generalized anxiety disorder and then answering questions on what's the level of risk and how would you manage this patient? Just so you kind of have an idea of the kind of stations that crop up. It's really good as well. I know Eva's kind of mentioned, but as you go through the blocks, just go on the NHS website and read how they've explained the conditions in patient friend language. Because for mental health, I think the ones that are like you to come up with things like Alzheimer's dementia. So being able to counsel a patient's relative on a new diagnosis that they've had medications wise, it's good to have an understanding of your really common mental health one. So things like SSRI s um lithium for bipolar disorder. So just know what to say before you go into the CCA S. So final doc near ent ophthalmology, those tend to be your examination stations. So for us, we had a combination of doing an ear exam on an SP so doing you know, the Weber and release tests if you remember those from 1st and 2nd year and then we had a model head and we did the autoscopy on the model head. Um So for the autoscopy and fundoscopy, you're most likely to get them on a model head. And I don't have the links with me now, but I know they will be floating around somewhere. Someone will have the links for the key pictures that they have in the model heads. So what I did was I kind of went through and picked out the ones that were relevant to our TCD cases and just learned to spot, recognize them for when they came up in the model heads. Um Yeah. Overall, I think this year are definitely doable. It's just getting the practice in early and building up confidence. Speaking to patients, see you next slide. Mhm Yeah, I think I did this one. So this is just our general tips for exams. Obviously, if you have any other questions, just put them in the chart. And also we will be running uh online sessions based on like like a focused online sessions for both F and C and M and M and we will also be hopefully having some in person examination revision sessions at the end of each semester as well. So look out um like on the code blue kind of Instagram, Facebook kind of thing, just um have a look out at what sessions we're doing. Try to come along to those also using resources like passed the uni have given everyone a free subscription to pass test. So kind of like pass me just different questions and then obviously geeky medics as well, which you can get the 10% off code. But at the beginning, um use one med as well. So like I mentioned in the kind of TCD content, it does have suggestions of things that could potentially come up. It has its own resources and own links to like the NHS websites and other things. Um But also in terms of your progress tests, if you go on one me info and assessments, there is links to like mock papers for like progress style questions and they've also got like very limited but a couple of mock stations on there and that's on one of their different info. Um And the good thing with the mock stations on there, they do have a mark scheme. So you can kind of get the gist of what they would want from any station. Um go to our vision sessions, like I said, practice with people, even if it's people in your track, like just ask people will need others to revise with because acies are, you know, like your person to person. So even if it's your friend and you just examine them or you can use your geeky medics and give them just the script and they're your patient practice with people because it's good to get tips on your patient manner even if your friends aren't medical. Um Yeah, but you can arise by yourself, but it's obviously easier and better to arise with people. Um There is quite a few counseling sessions in fourth year. So whether it's describing a condition or a medication, um and it can be hard to, it can be easy to get stuck in using jargon. So use things like the NHS website. I find watching a youtube video quite helpful because there's a lot that are aimed at patients and it helps you get the wording right and things like that. So they're my tips for counseling stations, Ice Ice in every station because one, it would just help if you're a bit stuck. Um Like if you're not sure what to ask ice them and then like, trust me, it will help you, but you'll need it in histories, you'll need it in breaking bad news. You'll need it in counseling. And like literally we had a counseling one and that iced the person, they had iron deficiency anemia, but they thought they had leukemia. So it's really important to ice because it will reveal those patient concerns that you can, um, like address. Um, and like at least said practice M sk it may seem like a lot. But trust me, once you've gone through the exams, each of the exams, like twice, you, you'll feel so much more relaxed and be like, ok, I can do this but it is a lot. So don't, don't leave it to the last minute because once you have practiced, you feel better. Um Yeah, that was that those are our tips but it's, it is like I said, it's so doable but just, just be on top of it. Pay attention on placement because that will make your life a lot easier use. Gee medics attend our sessions as well. Yeah. Nice. OK. Thank you guys for that. So here's the fun part of year four. I think the thing with year four is you'll hear from literally everyone that it's the hardest year of medical school. It's so content heavy. You're busy all the time. You're on placement all the time and you have so much to study as well. Um But I think the good thing about it is you always have your elective to look forward to at the very end of it. So Manchester are nice enough to make us do elective in fourth year. Um So it's a nice way just to end such a intense year and a nice way to relax as well. Um, before going into your final year. Um, so I'm gonna split this up a little bit to get some more engagement going. Um, so I'm gonna put up a pole if you can see. So if you can see the poll, if you can just answer right now, if you're thinking, are you gonna do your elective in the UK overseas or have you not decided yet? Mm. Ok. It's quite split. Um, yeah, so currently, oh, no, it's changing. Yeah, it's quite split between all three options to be fair. Um, yeah, it's good. So it is the very start of the year. Um, and you still have technically quite a lot of time to plan your elective. Um, but it is very, very good to start planning and think, or at least just think about what you want to do for your elective as soon as possible because it is such, again, like such a heavy year. Um, you don't want the added stress of doing everything last minute for your elective. Ok, cool. So we'll move on. Um, so when it comes to choosing an elective elective is a very personal thing, but it's also a very, very unique experience that you won't really get again in your whole career. Really? So, it's a four week placement, um, that you do at the end of fourth year. The purpose of an elective is to experience, you know, some other specialties, some other healthcare system or really. To do whatever you want to do specifically in an elective, which I'll get on to, um, in a bit. Um, so when you're choosing an elective, if you already have one in mind or if you completely are stuck on it, ask yourself, what do you specifically want out of your elective? What's your priority? And we'll get on to that and how much money are you willing to part with for this experience? And also think about whether you want to travel because at the end of the day, it's not just another placement. Your elective is an opportunity, a very unique opportunity to have four entire weeks plus the summer, a few months of summer after, if you want um to go somewhere completely new or do something completely new because really, you're not gonna get that chance again in your whole time working in the NHS if you choose to stay there. Um So, yeah. OK. So if you go into the next slide, so here is a little, oh no, it's OK. Never mind it, it's supposed to go sequentially, but I get that. It's a PDF. So ignore that. Um But here's a little like flow chart that I made. It's obviously not a hard and fast rule, but if you're completely stuck on what you want out of your elective. So these are some of the questions that I was thinking about when I was thinking about my elective. So two main questions what do you want out of your elective? And what's your budget? So, elective, a good elective or a successful elective means something completely different to every single person. And for me, my g my like ideal elective, my idea of that changed throughout the year, I had initially planned to do a research elective down in Oxford and also down in London um to work in a very specialist cancer hospital. Um because I wanted, you know, an opportunity to do like a publication or work on research to go towards S FP applications when it's still counted, it doesn't anymore, but that's a different issue. Um And then later down the line, um I sort of realized that what I wanted was just an opportunity to travel and relax and that became more of a priority to me. So I actually ended up going overseas instead of doing it locally. Um So things that you can consider um in terms of what you want out of elective is, do you wanna travel, do you want to explore a specific specialty that you're interested in or in fourth year? Because you get exposed to so many new specialties, you might become interested in a new specialty and you want, you might want to spend more time doing that as well or there might be like, like what I said earlier, a very specialist center in the UK or somewhere abroad that you want to um experience as well. Um I know quite like a couple of people went to Mass Gen in Boston. Um, from my year group, some people did theirs at the Royal London Hospital, Royal Free Hospital. Um Some people did it at Christie because they're interested in cancer, things like that. Um Or do you want to explore a different healthcare system? I think there is so much value in getting to appreciate systems outside of the NHS or even within the UK and experiencing private health care. Um There's a lot of value to that as well. Um So think about if that's something that will benefit you in any way. So I'm quite interested in global health and global oncology. Um So that's what I wanna do as well. Um And if you're thinking more towards the future, if there's a city in the UK or a country that you're planning to move to in the future, or you'd love to see what it's like to work there. Some people went to Australia because they're planning to move there after F two. It's also an opportunity to explore somewhere that you might want to work in the future. Um And as I said, it can also be a really good opportunity to do a research project. The thing about doing research during elective is it makes you more eligible um or eligible for more bursaries. Um For example, again, I'll come back to me, but like, um I'm quite interested in oncology there's not a lot of oncology, elective bursaries. The only one that I really found you had to do a research project and it's the, for a lot of elective bursaries you have to do research in it. So if you do that, you might be eligible for some more funding towards your elective. Um, yeah. Or do you want none of the f, of organizing something really complicated overseas? You want it super easy to organize, you can do it in Preston. A lot of people um stayed at their base hospital. It's really easy to organize it with the medical school at any of the Sex in um Manchester. Um Yeah, and then in terms of budget. So are you, you know, do you not have a budget? Um Is this something that you're very willing to spend money on because it's such a unique opportunity? Sure, go abroad, do anything you want. Um Or again, if you're thinking and planning ahead and saving up for year five, which is your NHS Bursary year. So with the NHS Bursary, you don't get a lot of money. Let's be honest. A lot of people work during fifth year because I think on average you get around 3000 lbs for your maintenance loan, which is not a lot, you can still get a little bit of student finance, but again, not a lot. Um So it could be smart to not spend so much money during elective. Please bear that in mind because you do still have to survive the next year and also in your working year as well. Um, so probably not the best to like, absolutely blow all your savings on elective. Um, but also what I will say is just because it's expensive, for example, to go overseas doesn't mean that you should just completely dismiss it because if you really want to go somewhere specific, um, there are lots of options that like if you're really determined to you can explore. Um So I'll talk about this later as well, but there's lots of funding um that you can access through various sources. There's lots of competitions open for medical students that do offer quite big sums of money. Um Yeah, things like essay competitions and elective bursaries as well. A lot of specialties societies will offer that as well. Um So yeah, think about that. Ok, next slide. Um So I just wanted to give a little bit of insight onto my own experiences with my elective. Um Some of my thoughts about what I wanted to do and then pros and cons as well for my elective because I had quite a few. Um So I'm talking specifically about an international elective because I went overseas. Um But if you have any specific questions about local electives, if you put them in the chart, um I think Aba would be happy to sort of help with that as well. Um Yeah. Ok, So for me, I went to Sibu in the Philippines for my elective. So I went all the way across the world about a 22 hour travel flight. Um Yeah, so as I sort of alluded to earlier, um my idea of elective change throughout the year, I've been thinking about my elective during my intercalation. So I intercalated after third year. Um and during my intercalation, I realized, oh, there's some places I can no longer apply to because some places require two years advanced notice of applications, things like Australia Oxford, you have to apply two years before you're elected. So again, bear deadlines in mind. Um And then I went from organizing a local elective to organizing an international elective. So talking specifically about my international experience, um my priorities when it came to fourth year were just making the most out of this um dedicated time um to do something completely different, travel and just have fun. Really, after such a busy year, you honestly earned that re that relaxed sort of vacation vibes. And as I always say, like generally, always say life is better at the beach and I had a lot of beach that summer and it was great. Um Yeah, so I wanted to be somewhere that also wasn't completely foreign to me. Um So I am Filipino, I was born in the Philippines. Um But I grew up in the UK uh I speak a little bit of Filipino. Um but because I did interc going into fourth year, I didn't know anybody. So I had no, I had to plan my elective with the idea that I'd be doing it alone. Um So I didn't wanna be somewhere that was completely brand new. Um But still newish to me. So I've never been to Cebu, which is an island in the middle part of the Philippines. Um Yeah, but also one thing that I will say regarding that is if you are in the same boat and you don't really know a lot of people that want to go to the same places as you, that shouldn't stop you technically going there. Um So what I did was I put loads of messages in the year group chat saying if anyone wants to come to the Philippines, let me know. And in the end, there were around like 17 to 20 of us that went to the same hospital or at least the same area that I've never met before. So it's also a really good opportunity to meet other people. So just reach out to other people. Um form groups, it's always nicer uh to travel with other people as well, um especially uh at Manchester. But yeah, so I don't wanna go somewhere new, like completely new. Um I also wanted to experience a different style of health care um in a developing country. So I went to a private hospital as well. Um And it was a very different experience to the NHS, much lower patient caseload. But that I got to appreciate just how hard people work in other countries and how different medical school is. So for me that gave me more appreciation for the NHS um and sort of the looking at health on the global scale and the inequalities that we have there. Um So, yeah, so for me, it was a nice experience in that regard. Um Yeah, and I also wanted to, you know, sort of immerse myself a little bit more in my culture, I guess you could say. Um OK, so in terms of how I organize my elective, so I applied directly or not directly well directly through a hospital program. Um Yeah, sure, I applied directly through a hospital program. Um And I'll talk about it on this slide. Um which meant I had to pay for tuition for that hospital, but it was already a predetermined program and they would give me a supervisor. I did my elective in internal medicine and then a little bit of oncology as well. Um Yeah, and then I it was a very easy application actually. So some people think doing elective internationally is like super, super complicated. It was really easy for me. It might be different for other countries. For me, there were no visa requirements. Um Even if you're not Filipino, there's no visa requirements for the Philippines. Um there's not really any vaccination requirements as well, unless you don't have like your usual med school vaccinations, you should probably get them. Um, yeah, so no visas travel was easy. The hospital application, all you all I had to do was email and then they gave me a place and that's it really. Um So super, super easy. Um Yeah, in terms of pros and cons I, oh and I reached out around like 45 months before elective, I'd say the earlier, the better just in case it doesn't work out, then you should have a backup plan. So it's always good to have a local backup plan as well. Had a local supervisor um that I would have taken up if my travel plans did not go through very, very important. You know, there could be another COVID in the future and you might have to do it locally. Um Yeah, you can just never predict it. So it's always good to have a second option. Yeah. So in terms of pros and cons for me, I actually hated my elective. I will say that that's, that's why I'm doing this because I don't want you guys to like fall into the same trap. Um So I got very excited about just getting it out of the way. So I went, I applied to the same hospital that someone in the year above had went to. Um And that was my first mistake because I didn't do my research properly about what I wanted out of an elective. So when you're choosing an international elective specifically, ask yourself, do you want to experience private or public health care? I did private, but I realized the experience that I had wanted was in a public healthcare system. So I was sent home at like 10 a.m. every single day because there were no patients, there's nothing to do and no one really taught me anything. Um So for me, placement was like an utter waste of time. Um And it's ok if you don't wanna go placement, but you might as well enjoy it if you're there, you know. Um Yeah. And does your hospital have your specialty interest? So my hospital did not and I didn't realize that until I had already applied because again, I just did what the people above me had done as well. Um So I mean, interested in oncology. Um the hospital I went to was not a cancer center, they were cancer patients. Um but they didn't have any oncology trainees or you know, anything like that. They did, they didn't even have radiotherapy cause their machine broke ages ago. Um So yeah, so I didn't have a very good experience on elective. I know the other people that went to the same hospital had a similar experience. There wasn't a lot to do, there wasn't, you know, a lot that we could get involved with if you do a public health care like public hospital in the Philippines, you definitely will get more hands on experience. And that's another positive about going overseas. Sometimes they are a little bit more lenient than the NHS in terms of what you are and aren't allowed to do. Um, but yeah, it's also a good opportunity to, you know, practice clinical skills, talking to people and things like that. Um, ok. So other things to ask yourself. Um Oh, actually, no, sorry, I'm side tracking. I'm still on my pros and cons. So that's like my cons is it wasn't what I thought I wanted basically. Um And also the city that the hospital was based at I realized was so far away from things like beaches from all the holiday destinations. So during the week when we were on placement, um I just did not have fun. There was nothing to do. I basically wasted five days of the week and I could only go away on the weekends. Um So consider the location of your place as well if travel is one of your priorities. Um Yeah, cause you also don't wanna waste your time as well. So it's good to get placement experience but also balance it with um exploring somewhere new as well. Um Yeah, but some of the pros about my elective was it was really cheap. Um living, living wise. So food was really cheap, traveling around is really cheap, of course, going so far away to Asia. The initial flight is expensive but then consider traveling in between is a lot cheaper. Um Some of the people I went, they went on to travel to other places in Asia after their elective because the countries are so close to each other. So if that's something you've always wanted to do, it's also a good opportunity. Um, because elective is quite short, it's only four weeks. You still have like two months of summer, um which some people did spend the entire two months just traveling. Um So yes, so it's also a good opportunity for that. Um Other pros was because there were so many Manchester students um in the same area was able to meet new people, make new friends. Um didn't have to travel alone and that was quite nice. So it's always good to go somewhere where other people are going as well. Um And yeah, and it was a beautiful like experience going to all these wonderful places. Um Yeah, it was really nice. Ok, so other things to ask yourself on a international elective is are you comfortable going somewhere that you don't speak the language or are you willing to learn a little bit of the language? Because at the end of the day, if you completely don't speak the language and nobody speaks English, think about what you're actually getting out of that placement. Will you understand what's happening in the hospital or like? Is there a point of you being there? Yeah. Um Yeah, and Oh I forgot to finish that sentence. I forgot what it says. Um yeah and I mentioned earlier, are you traveling alone? Are you willing to travel there alone? Do you feel safe traveling there alone or are you gonna go and recruit people to come with you? Um Yeah and then definitely think about travel requirements. So for Philippines, it was quite easy. Um Other places that other people went to there were more visa requirements, um safety requirements. So when it comes to Manchester, your requirements for elective are very, very little. Um It's a very self like arranged thing, meaning there isn't a lot of guidance from them. You have to do everything yourself, but it gives you a lot of flexibility to do what you want to do. Um Yeah, so you can go really anywhere you want to go. Um I think I put this on another slide. So I'll come back to that. But yeah, so yeah, think about travel requirements. Do you need private insurance? If you've got health conditions, chronic health conditions, you might need your private insurance because it won't be covered under the university's insurance. Um Do you need vaccinations? Um You can get vaccinations for free from your GP. Um You can also get them from what are they called occupational health as well. Um And some hospital programs require things like chest x rays, blood tests to make sure you're healthy before you go as well. Ok. And then consider are there established programs? So as I said, I applied through a hospital program because of that, I had to pay 350 lbs tuition to the hospital, which is quite a lot. Um If you have contacts in that country specifically, you might bypass those fees and get to do it for free. So I knew some people that did that as well. Um Yeah, and some people did things like work. The world, which is a full tour package includes accommodation, um and like trips and also meeting new people. Those are quite expensive, but it reduces like all of the log logistics and admin sort of issues that come with it. So think about again, if you want just a super easy like plan um or if you're willing to do a little more extra research, book things yourself and then save a little money as well and have a backup plan is very, very important. Ok. So that's international elective and then the next slide should be choosing a local elective. Um So as I said, Alypa will be happy to answer any specific questions about local electives. Um But I'll just go through a few questions about things to consider during uh like if you're wanting to do a local elective. So again, do you want to apply through a program or do you have a supervisor in mind? So even in the UK, it costs a lot of money to do an elective program, for example, U cli know, costs like 4000 lbs, like 1000 to 4000 lbs just for an elective, which is ridiculous. Um But if you have a contact, for example, at UCL, one of my friends did at UCL applied directly to a supervisor that she didn't know she just emailed them directly. Um, and she managed to do it for free. So if you can do that, try to do that because you'll save a lot of money. Um But sometimes if you do it through a program, you typically have more benefits and more, more of a structured um sort of experience as well. Um So yeah, so bare tuition fees in mind, they can be very, very expensive. Um But also don't be afraid to reach out directly to people. You don't know. Um That's how I found many supervisors in the past. You know, if you google people on like institution websites or hospital websites that look cool, send a cold email, there's no harm in doing that as well. Um Yeah. And then also ask, do you wanna apply for a summer research grant? Um So again, I'll bring it back to oncology but the Royal College of Radiologists have a, a summer internship called the summer undergraduate research fellowship, which I know someone in my year also did that for their elective. Um Yeah. So, yeah. And do you have a supervisor that you wanna continue working? With during elective. It's also a good time to do research. Um I, like I said, is there a specific place you want to work at? Um, or do you wanna go home and save money on rent for the four weeks that you're there? Um Yeah, and also something that the university don't really advertise very much. But we find quite right, quite interesting to be fair is Manchester have their own elective programs that are really easy to apply to because they're very keen to get students to join. So if you're interested in medical education leadership or GP um Manchester, I don't know too much about this. So you might have to ask someone else um or I can get you a contact if you want as well. Um But they have a medical education leadership elective program where correct me if I'm wrong someone, um you get, you're based at a GP for your elective. A GP linked to Manchester. And then a couple of days during your elective, you get teaching from the university about leadership and medical education and then you do some teaching as well. So that's quite a nice program that you might actually not hear a lot about, but it does exist and it is a good established program as well. Um And then next slide um yeah, and then when it comes to planning your elective, it's very, very important to keep your deadlines in mind as well. Um So again, I could not find this on one med yet. I don't think it's updated. So do have a look yourself. Um, but key dates for elective, this was from last year, but it's gonna be very similar. Um So your elective, which I did check this, your elective will be ninth of June to the fourth of July. Um So it's four weeks and it follows immediately after your Aussies. So for me, I had my Aussies on the last half of the week, so I had to fly immediately. Um So it can be quite stressful um the university elective approval form. So whatever elective you plan to do, you have to tell the university the deadline for that is around spring time. However, if you're planning to get university funding, which is turing, um you have to apply by December the end of the year. Um Otherwise you, you might miss the internal deadlines for funding. Um So, yeah, so basically the university give you free will on your elective. They don't really give you much guidance. Um So it's up to you to plan your elective to reach out to programs um to find a placement and make sure that you submit everything on time. They won't tell you what vaccines and things you need, you need to be searching things yourself as well. So the only requirement about your actual elective is it has to be at least 50% patient facing. So, if you want to do research during elective. That's perfectly fine. However, you have to spend at least half the time with actual patients. It can't just be like lab in the lab for four weeks. You have to, you know, have some patient contact, at least you can do a split elective, which means you could do say two weeks at the Christie in Manchester and then two weeks at home, uh A GP back where you live, for example, or you could do two weeks in Manchester and then two weeks overseas, that's fine as well. Some people did that. Um But yeah, and then during your actual elective, there's no requirements about what you need to do. The only thing you have to do is sign an E form that says I'm here. I arrived and then a supervise your supervisor signs a form that says they are they attended and that's it. Yeah, that's all the requirements. So it is very chill, I would say so spend it wisely. Um Yeah, and then you do need, there are some other requirements which one med info does detail really quite well. Um So I'll let you read this in your own time but do check one med info for all the up to date information as well. Um Yeah, so the only thing is if you don't finish your ups in time, you will have to do a local elective in your Manchester bases. So make sure you finish your A S and if you fail your CCA S, you can still go on elective. Um, that's fine. But bear in mind you'll have to be studying during your elective because resets are after elective. Um, the only reason you have to do another local elective is if you fail either the last placement you have, then you have to stay and repeat that placement. Or if you fail two placements throughout the year, then you have to do a local elective as well. So make sure you do get your placement signed off because you don't, you, you wanna make sure you actually get to go with elective, you know. Um Yeah, and do your sis for sure. Um What else did I write? Yeah. Uh some of the documents that are required by the university for your applications. Um Again, it's all in one month info but the elective team email is super, super helpful. They reply very fast. So always just, just go to them. If you have any queries, they can provide you with letters of recommendation which you need for your um my placement application. So my placement is the platform that you apply to the medical school for. Um Yeah, and then transcripts as well you get from the academic team, et cetera, et cetera. Um Yeah. And then next slide. So last thing I think, I think this last thing is um funding your elective. So this is like a huge thing. That goes through people's minds is elective. If I wanna go overseas or even just in the UK, it can be very expensive. Um So the university offer funding through a program called Turing. Um So this is automatic once you apply through my placement. Um and the medical school, the, you know, like Manchester, once they approve your plans for elective, it will automatically go through, sorry, can you go back? Um it will automatically go through um Turing and turing will email you directly if you're eligible. So your eligibility for turing again, please check yourself in case it changes. Um It's to do with your parents' income mainly and any like widening participation type criteria. Um Yeah, so that's the main source of funding. They will fund things like your flights and they give you a stipend for accommodation as well. Um Yeah, I think it only applies to international electives, but I could be wrong. Um So again, please check um yeah, and the amount of money that you get from turing, it depends on how far away you go for elective. If it's closer, you get less money. So for example, Europe, you'll get less money um or if the country is more expensive, you'll get more money as well. Um Yeah. Oh, did I say more? I meant less, you'll get less money if it's closer like Europe. Um Yeah, so for me, I wasn't eligible for turing sadly. Um however, it doesn't mean that you can't get any funding. So I still managed to get around 900 lbs worth of funding for some reason, which is really good. Um So there are loads of elective bursaries out there. Um So I just put some examples. So Royal College of Physicians, this is the one that I got 500 lbs from. Um, so Royal College of Physicians for any medicine based specialty, you don't have to do research. Um You just apply and then I think they offer around 5 to 10 bursaries, I think, I don't know, a year that one's really good because it's a lot of money compared to other ones. Um And if there's a specific specialty you're doing, for example, surgery, Royal College of Surgeons, I know do one Royal College of Radiologists, do an elective Bursary as well. Um Yeah, like literally just Google elective Bursary cardiology for example. And you, I might be able to find quite a few things otherwise things like essay competitions, there's loads of those, they always offer money. Um If you're willing to put in the extra work. Um Yeah, the thing that I would say is not a lot of people surprisingly apply to these things because it's extra effort. Um So if you do, you have like a pretty decent chance of actually like winning these things or like getting these bursaries. So I OK, so back to that, that, so I got 500 lbs from Royal college of physicians for just sending in my CV and like some like whitespace questions and then I got 389 lbs refunded from NHS birth. So if you are on NHS Bursary in fourth year, ie if you're Saint Andrews, um if you intercalated like I did, if you did a foundation year, you'll already be on NHS Bursary. What some people don't know is NHS Bursary will, will reimburse accommodation if it's different to your term time accommodation. So that includes overseas. So I got the full cost of my accommodation um reimbursed, which is great. Um So bear that in mind as well. If you're on NHS Bursary, they also offer reimbursement for travel within your placement, not to your placement. So they won't cover flights but they'll cover like say taxis that you take to and from the hospital. Um Yeah, and other things like research grants as well. So there's a lot of research studentships that you can apply for, as I mentioned earlier as well. Um But again, make sure your elective is not more than 50% research, otherwise the uni the uni won't approve that. Um ok, cool. And then next slide um ok, and then just a little summary of what I sort of discussed there. So when it comes to elective, have a really, really good think about what exactly you want out of elective. What are you willing to compromise? How much money you, you're willing to spend, please don't make the same mistake as I did and just choose a random hospital. Make sure that you enjoy your placement as well as the travel that comes with a placement, you know, you don't. Yeah, like you also don't have to go overseas to have a good elective. Like I know people that did it here that had such an amazing elective, you know, a good elective looks different for everyone. Um So don't, don't feel bad that you're not going overseas or things like that, you know, who cares what other people are doing? If it's what you wanna do, that's what's important. Um Yeah, and it's not just a holiday as well. If you go overseas, you can enjoy the placement too. You know, some people just take it fully as a holiday. It is also a good experience to see different healthcare systems. Um Yeah, and don't be put off by costs, there's ways around it, funding bursaries competitions if you're willing and don't be afraid to ask if other people want to go with you as well. Um Yeah, cool. And then ok, so just to sort of wrap up the session, so we'll go, we'll answer any questions as well. So please do put questions in the chat if you have any. Um Yeah, so some useful resources um to sort of wrap up the whole session. So make sure you read your one med examination book just like in third year. It's very, very helpful. All the examinations in there are things that can come up in your CCA S including random things like a to E assessment is in there and it sort of threw everyone off last year. Um Yeah, so there's some non examinations in there but there are things that can actually still come up like nutrition assessment with the questions that came up once as well. Um Yeah, medics 10% off if you want it CBA crew 24 or you can enter our social media giveaway. We are giving away two subscriptions for a year, a year's worth of G Metics, ay resources that includes all their AUS stations. Um and other like I think I'm not sure if it includes the flash cars but like other ay resources, make sure you are aware of previous stations. Manchester. Absolutely love repeating stations. Um and to a point where they get really lazy with it. Um And you get shocked. Yeah, so make sure you have a copy of all the past patients that Manchester have done for you for um and make most, make the most. Does that make sense? Make make the most of time you have on placement to practice all your ay skills, get doctors to sort of observe, you give feedback on how you're doing um time yourself as well, get sleep um and things like that. And then next, oh wait, if we go back and I'm back Yeah. So, you know, we've given you all this information about fourth year. It is a very difficult year, but it's a very enjoyable year. It's a year where you really feel like all of your third year skills are coming into play and you feel a lot more confident going on the wards and doing all these skills. It's a year where you're focused more on sort of like learning content as opposed to learning how to talk to patients, for example. So it is really enjoyable, the specialties, I absolutely love all the placements to be honest. Um So it is fun and you do get to have a lot of fun on your elective as well. So enjoy it as much as you can. Um But what to do now make sure that you do prioritize your exams. It is a hard year. Um So get a head start on your os prep. Um So Cold Blue this year, we're doing a new thing where we are doing weekly sessions for year four a practice. So we are focusing on a teaching, so skills like how to counsel patients on oral contraceptive pills, um how to do a mental state examination, things like that. So the way Cold Blue works, I'm sure if you've joined us last year, it's half the session is focused on teaching skills and then the other half is focused on practicing the skills um under the supervision of senior medical students. And doctors. Um So it's a really great opportunity to get a head start if you want as well. So if you scan this QR code, it will take you to the Metal page and all of our event sign ups will be here as well. Um And then I think that's it from us. Don't forget to join our social media giveaway. Um And yeah, and then we'll open the floor to any questions if anybody has them. Um So I saw one question about elective, so I'll answer that. So uh yeah, so I also saw that. So the question is I found a lot of international medical schools require you to be in your final year. So Manchester is unusual that we do it in fourth year. Um A most medical schools do it in fifth year. Um It was the same for the hospital I applied to it said you have to be fine year I asked, they said it's fine. So just ask to be honest, if they would accept you explain that we do it in fourth year. Some places might be more strict. Um I know like places like America, Canada, you have to be in your final year. Um But there's no harm in asking, I would say. Um OK, and then the other question is what if the place you apply to opens for applications in January? Um Would you miss out on? Sure if you haven't done the form by 31st. No. So the university deadline for elective, it's not you applying to that place to like your hospital. It's you telling Manchester Medical School, this is your plans for elective. You have to do that. You can do that before you apply for your hospital. That's fine. Just make sure you do that by the deadlines for the university and then apply to the other places um when, when they open. Yeah. So it's an internal deadline and then the external one is wherever you're planning to be active. Yeah. Do we have to do electives in the dates they give the, yeah, your elective has to be done in June, July. You can't do it any other time. Um Manchester will only give you insurance for four weeks if you choose to do a longer elective, you can do that, but the university won't cover you for that. So, ii know quite a few people did that. Um But that's just sort of like on their own time type thing. So you'll run out of like touring funding. You won't get that for after that. So it's up to you really if you want to do longer. Yeah, I'm also maturing. I didn't get it. One of my friends got it. So you don't necessarily have to apply if you have, if you have applied for student finance that year. Cheering contact you and if you haven't applied, they will still contact you and say like you haven't applied for student finance if you want to be eligible, like apply so they can base it off your household income. So it's just that once you put in on the system where you're going, that's what they use to calculate how much to give you. But I'm pretty sure in our year you didn't have to like formally apply. They kind of got in touch with you once you put your details on and if you don't have your exact details, like your exact supervisor or something, you can just put in the form on my placement, like to be decided or whatever. It don't worry if you haven't got all your exact details when you apply because I didn't have mine and then also like mine kind of don't worry too much and if you're not sure that the electives like um email, they do respond quite. So that's why I would say for that. Um Yeah, and I always ask, how do you use summers? Eye? Eye relax? I don't, I don't think about uni until I return. Um I don't think you need to because oh wait, you're going into fourth year. Yeah. So your summer's over. So enjoy your elective, then enjoy your final big summer because yeah, you have after fifth year you start F one. So that's my reply to that. Yeah, I definitely say like relax. I feel like there's only a very minute amount of medical students that actually study during the summer, which I would say don't do that unless you find joy in studying then. Sure. Um But yeah, but like you work so hard during the year, especially in fourth year, you really have to spend that time relaxing. Like fifth year, honestly so far is like very chill compared to 3rd and 4th year. Um You're just revising stuff that you've already learned. Um Yeah, and you deserved it. Like relax. You, you've earned that. Ok? Any other questions? Yeah, but if anyone does wanna go, you will get sent a feedback form um automatically to your email. If you fill that in, you can get the slides. Um Yeah, and hopefully we'll see you during our um weekly year four sessions. Um but we'll stay for a bit if anyone does have any other questions, but thanks everyone for coming as well. Ok, I'm gonna assume there's no more questions uh even though there's still people here but yeah, so I think we'll end it there. Yeah. Ok, cool. Thanks God. Thank you. All right bye bye.