Medicine at Warwick – Core Clinical Education

What is Core Clinical Education (CCE)?

As a graduate entry medical student at Warwick, there is a significant change in the course structure which takes place about a quarter of the way through second year. From January, a 30-week block begins, called Core Clinical Education (CCE), which runs all the way through to August and represents the transition from pre-clinical to clinical (hospital-based) learning. CCE is split into 3x 10-week blocks, each centred around a core aspect of the degree – Medicine, Surgery and Specialties. As you can imagine, the Medicine block covers most medical specialties (e.g. cardiology, gastroenterology, neurology), the Surgery block covers most surgical specialties (e.g. general surgery, ENT, orthopaedics) and the Specialties block covers those that don’t quite fit into either of the previous category (e.g. anaesthetics, obstetrics & gynaecology, paediatrics). You are nominated a consultant within each 10-week block who helps guide your learning and serves as a point of contact. CCE is designed to give us broad exposure to all the different areas of medicine and surgery, allowing us to familiarise ourselves with the day-to-day workings of hospital life and practise our clinical skills.

What is the structure?

The structure is widely variable depending on your Trust, your nominated consultant and your own goals for placement. Your Trust creates your timetable which can include ward allocations, workshops and clinical skills teaching. Your consultant may ask you to attend ward rounds, surgeries or clinics. Except for workshops and clinical skills teaching which take a register, generally speaking any sessions organised by your consultant take priority over ward allocations.

Any time remaining outside of these timetabled activities is to spend in any way you see fit. In the hospital, I would usually practise my history-taking, examination and practical skills. I would also spend a good amount of time doing self-directed studying at home, working through the presentation list. There are 26 ‘presentations’ per block which are ways in which a patient may present to the health service e.g. ‘chest pain’. We must learn how to take a history from and examine a patient presenting in this way, which investigations to order (e.g. blood tests) and how to manage a patient presenting in this way. We must also learn about the differential diagnoses for each presentation, for example a differential diagnosis for a patient presenting with chest pain could be a myocardial infarction (heart attack).

My tips

As CCE draws to a close for me, I feel in a good position to share my tips and advice for any current or prospective Warwick medical students on how to get the most out of CCE:

• Have a goal for each day — if you are heading into hospital when there are no timetabled activities for the day, set yourself a goal for the day. This will give you a sense of purpose so whenever you leave you will know you haven’t wasted your time.
• Be proactive — in a hospital environment, opportunities don’t find you so you need to actively seek them out. If you want to practise taking bloods, ask a member of staff on the ward if there are any to do. If you don’t know what’s going on in a surgery, ask the surgeon or anyone else in the theatre. This can seem daunting at first but the more you do it, the less scary it becomes.
• Know when to cut your losses — if the wards are extremely busy and no doctors are free to supervise you, or you’re simply not getting much out of your day, don’t feel guilty about heading home to study. Knowing the theory is as important as improving your practical skills as clinical reasoning is vital when it comes to assessing and treating patients.