The curriculum at Queen Mary University of London has been developed in accordance with the GMC’s Outcomes for Graduates (2018). This included recommendations that in all medical school curricula should: 

• place a greater emphasis on teaching outside the lecture theatre, hospital and laboratory, in community settings 

• enable a broader understanding of public health 

• include a greater degree of “vertical” integration of clinical and non-clinical subjects throughout the medical curriculum 

• ensure the principles of professional practice form the basis of medical education. 

Aims 

The overall aims of the Medicine in Society Year 1 unit are:

• to introduce you to patients and their experience of health and ill-health over the course of their lives 
• for you to start to develop and explore your professional identity. 

Learning Outcomes  

By the end of the course you should be able to: 

• explain how patients are affected by their condition/s 

• recognise how environmental, social, behavioural and cultural factors influence the experience of health and healthcare services 

• list the public health influences that affect the development of ill-health and the restoration of health 

• describe the roles of different members of the primary health care team 

• demonstrate effective communication skills with patients, peers, and other healthcare professionals 

• understand the importance of key ethical and professional principles e.g., confidentiality, consent, and capacity 

• identify the consultation skills of healthcare professionals 
  

• review your own learning needs and professional development, including using reflective practice and engaging with the giving and receiving of feedback 

Before placement starts: 

1. Find the MedSoc 2024-25 course guide on CBME tutor website - please ensure you are using this year’s guide.    https://qmplus.qmul.ac.uk/mod/page/view.php?id=794077 (UPDATE)

2. Attend MedSoc induction training  in person  Thursday 19th September 2024 2-5pm  
   

3. Please review our raising concerns policy for students and tutors via this link
   

1. Share student learning agreement with students.  Collect signed student learning agreement (SLA) from students, countersign and return copies to students.  This can be found in the Medicine in Society section on QMPlus.

2. Agree group ground rules, routes for contact (email, WhatsApp etc) and reporting absences. 

Preparatory work  

Complete the following activities to prepare for Day 2:

•  Watch this video  above about health promotion for wellbeing and equity.  After watching is there anything particularly that stood out for you that is important for good health?  

• Find a definition and considered the main principles of health promotion.  

• Read the General Medical Council’s (GMC) good medical practice: guidance for students, p1 – 19.  Page 17 will be an area for further discussion in your groups. (GMC)  

• The British Medical Association’s (BMA) ethics toolkit for medical students contains useful and accessible information for students.  In particular, review the pages on the key principles of ethics for medical students and confidentiality as a medical student.   

Aims  

• To introduce you to the professional and ethical framework of the health professional-patient relationship in clinical consultation.   

• To orientate you to the practice area.  

• To introduce health promotion and illness prevention activities in primary care.  

Learning Outcomes  

By the end of the day, you should be able to:  

• Explain the ethical and practical guidelines for interviewing patients, including how to obtain consent from a patient for history-taking  

• Describe some reasons why patients present in general practice  

• Identify some of the skills healthcare professionals use in their relationships with patients  

• Start to build a community profile of the local area and reflect upon what their observations tell them about the area and the community  

• State some health promotion interventions that occur in primary care, such as a new patient check  

Example timetable  

Suggested Activities  

• Tutorial - What is professionalism? Could include ethics, consent, social media/confidentiality, professional relationships; how students are expected to conduct themselves – attendance, group conduct, dress code, to include ethical issues and obtaining consent for interviewing and physical examination.  

• Breakout task - ethical cases given to students to discuss in small groups e.g.  consent, confidentiality, unprofessional colleague, inappropriate use social media. Regroup and debrief after small group discussions.   

• Community area profile – group discussion of pre-reading, PHE’s profiles for the borough and the practice. What did students notice for London/specific borough/practice compared to national data? e.g. see age profile graph showing younger age of London/Newham’s population - how might this affect health and socioeconomic issues in area?   

• Walkabout – students are assigned a patch/road in practice catchment area. Could use Google maps.  You could also use this excellent planning map for Newham which gives further specific insight. e.g. https://www.newham.gov.uk/LocalPlanMap 

• Signpost where else students could find local information to help them build a community profile, such as local press and social media or searching for other online resources e.g. YouTube video (watch from 6.30-9.30) walking through the Stratford centre. 

• Each group notes down their key observations to present to the group. After this, students should attempt to generate hypotheses about possible health and social problems (and opportunities) for the practice population; there is further guidance for students in appendix 8.2.  

• Health promotion; note generally what health promotion information the practice displays on its website and within the waiting and clinical areas e.g. posters/screen displays.   

• Impact of COVID-19 on primary care e.g.  increased use of remote consultation and telemedicine, possible group discussion of benefits and disadvantages of this.   

• Observe a member of the primary care team carry out a health promotion intervention e.g. new patient check, dietary advice, routine health check.  

Questions for you to consider  

• What reasons do patients present in general practice? Do you think patients communicate differently with non-clinical and with clinical staff?   

• Why should you ensure patient’s consent to any examination and treatment has been obtained?  

• Having completed your community profile, what did you think of the area?  Were you taken aback by anything?  Did you think the facilities in the area would help people to live a healthy lifestyle?  What would you like to change about the area and why?  

• Why is health promotion important in primary care?  What do you think the GPs role is in health promotion?  Which other healthcare professionals have health promotion roles?  

• How has the COVID-19 pandemic changed the day-to-day workings of primary care and the patient’s experience of “seeing” their GP? 

In preparation, you should have:  

Video on social prescribing 

• Looked at the World Health Organisation’s (WHO) information about  the social determinants of health and the definition as well as examples of health inequities and their causes.  

• Looked at some of the public health profiles e.g. the Marmot indicators of the local practice area.   

• Read NHS England's introductory information on social prescribing or watch the video on social prescribing.   

• Reviewed communication skills teaching on person-centred interviewing and thought about how you might start a conversation with a patient and what questions you would ask.  

Aims  

• To introduce you to the social issues that can impact on patients’ health and their response to ill-health, and the role of the health service and other agencies in supporting these patients.  

• For you to meet your first patient as a medical student, either as an observer or a participant in a patient encounter.   

Learning outcomes  

By the end of the day you should be able to:  

• List some of the social issues that can impact on patient’s health and their experience of healthcare.   

• Demonstrate an awareness of the importance of considering social factors when treating patients.  

• Discuss the role of the GP and other members of the primary healthcare team in the support and treatment of patients whose social circumstances impact on their health.   

• Reflect on your first experience of meeting a patient for the first time as a medical student.  

Example timetable  

Suggested Activities  

• Tutorial/group discussion based on preparatory reading and student’s knowledge and awareness of social issues that might impact on patient’s health and their experiences of the healthcare system.  

• Interview with a social prescriber, or other healthcare professional, on their role and experience of social issues that are of particular significance in the practice area.  

• Join a practice or MDT meeting where complex patients, who often have significant social issues, are discussed.   

• Prepare to meet their ‘first’ patient - prepare questions, how to begin and end an interview with a patient, discuss dos and don’ts. Interview a real or simulated patient (using role-play) having first gained consent. NB – these patients won’t necessarily have significant social issues.  

• Observations of different staff-patient interactions; students to look out for consultation skills healthcare professionals use to build rapport and facilitate open communication with patients. Students can also make observations of any social issues that are identified, their possible impact and how these are discussed.  

• Case studies focussing on the effect of various social issues.  

• Research organisations providing support for local people with social issues e.g. homeless shelter, cultural centre, refugee support organisation etc. Working in pairs/small groups, students could choose a particular social issue to focus on and conduct their research then present their findings back to group.   

Questions for you to consider  

• Were you surprised at the impact social factors had on the patient you met or discussed? Are these problems the doctor should address?  

• Is the health service doing enough to make services accessible to people of all social groups e.g. those of different ethnicities, sexualities, homeless people etc?  What do you think could/should be done differently?  

• If you met a patient today, how did you feel you did when you were interviewing them?  Did you feel the patient felt comfortable talking to you?   

Preparatory work  

Example timetable  

Preparatory work  

In preparation you should have reviewed the following resources;  

• Watch this 3 minute video by Asthma and Lung UK outlining the extent of respiratory conditions within the UK.  You should note down 1 key statistic and cause for respiratory conditions to discuss further on the day. 

• Watch Pam  discuss her experience of living with Chronic Obstructive Pulmonary disease (COPD) in this 7-minute video.    What had a particular impact on you from this video? 

• In this patient information video, Debbie, a respiratory nurse specialist indicates some key things to look out for in asthma in children.  On the day you might discuss why these features occur in asthma?  What did you observe how she communicated the features? 

Aims  

To introduce you to respiratory illness, its impact on patients, society and the practice workload; and to introduce students to health promotion measures designed to improve respiratory health.  

Learning outcomes  

By the end of the day you should be able to:  

• List common respiratory illnesses in children and adults that are seen in primary care  

• Describe the basic assessment of a child with an upper respiratory tract illness (URTI)  

• Describe and reflect on the impact of chronic respiratory disease from a patient’s perspective, focusing on the issues of loss of function, autonomy, and well-being and its impact on daily life  

• Outline the health promotion interventions, including smoking cessation interventions, provided by the practice team to prevent or manage respiratory illness  

• Demonstrate a basic examination of the respiratory system  

• Demonstrate the measurement and interpretation of peak expiratory flow  

Example timetable  

Suggested Activities  

• Tutorial on respiratory illnesses – could include brainstorm of common respiratory symptoms presenting in primary care, long term respiratory diseases and their impact on patients and the practice team’s workload, students presenting pre-agreed topics based around preparatory work, ‘hot topics.’ e.g. COVID-19.  

• Sit in on a routine clinic with a member of the primary care team and observe particularly respiratory presentations, including acute and chronic symptoms, long term condition management e.g. asthma checks, health promotion activities e.g. flu jabs.  

• Interview a patient with a respiratory condition.  

• Teaching session with practice nurse to demonstrate spirometry and/or peak flow measurement (NB-there are lots of videos of this if no one can deliver the teaching session) and/or case studies interpreting peak flow and spirometry results.   See an example video here  

• Introduction to examination of the respiratory system, adults and/or children 

• Review the  British Thoracic Society website which has lots of useful resources e.g. clinical guidelines for respiratory conditions. 

• Review the  Asthma UK website which also has useful resources e.g. asthma action plans. 

• Review the BMJ best practice website on Coronavirus disease 2019 (COVID-19) which has comprehensive and free online resources that covers various aspects of COVID-19, including epidemiology, diagnosis, management and follow up. 

Questions for you to consider  

• If you met a patient with COPD or asthma– how did they describe their life, what did they find most difficult, did they see themselves as ill?  

• Did you see or discuss acute respiratory illnesses?  How did this impact on the GP’s workload?  Should patients do more to self-manage minor illness?  How can healthcare professionals support them to do this?  

In preparation you should have: 

• Watched this NHS video on how to ACT FAST.  You should be able to recall what FAST stands for.  Thinking specifically about Health promotion, what do you think makes this an effective video or not? 

• Visit the NHS Act FAST website.  Read 2 of the patient portrait stories on here.  Reflect upon these stories.  Think of 3 key messages you have taken from this that you will discuss on the day.  Think of the impact on the patient, how it has affected them and what it means to them going forward.  

• Watch Rosie talk about her experience as a speech and language therapist in Stroke care.  Laura discusses her role as a senior occupational therapist occupational therapist.  Katie is a physiotherapist and talks about her role in stroke after care.   What was significant about when physiotherapy might start?  What were the significant things Rosie might prevent?  Did you know what activities of daily living were?  Why do you think a multi-disciplinary team is critical to good care in stroke patients?  Be ready to discuss these points on the day. 

Aims   

To introduce you to the effects of stroke, particularly in relation to mobility and the part played by environmental factors, healthcare and other agencies in supporting the impaired person.  

Learning outcomes  

By the end of the day, you should be able to:  

• Discuss the impact of stroke on an individual and their family and the role of voluntary agencies in providing support  

• Demonstrate an understanding of the effect of poor mobility on the individual and the changes needed within the community to be more inclusive of them  

• Identify important members of the MDT in assessment and care of patients with impaired mobility  

• Identify and review a health promotion intervention that can reduce the risk of stroke in an individual at risk  

• Practise pulse checks, blood pressure measurement, examination of central and peripheral pulses and communication skills  

Example timetable  

Suggested Activities  

• Tutorial on stroke – could cover stroke and TIA, risk factors, possible short and long term sequalae, stroke MDT members and roles, and health promotion interventions that can reduce a patient’s risk; students could work on these areas in breakout groups then present back to whole group.   Discuss the key points from the preparatory work. 

• Meet with member of MDT to discuss role of team members for stroke / disability care; or join an MDT meeting.  

• Research into or visit to a local voluntary agency providing support to stroke patients, and/or interview person working for such an organisation.   

• Prepare questions to interview  a patient who has problems with mobility.  Include a brief review of their home and work circumstances etc with respect to how well different environments are adapted to help overcome the patient’s disability  

• Visit a patient with impaired mobility at home, discuss with them any home modifications, impact on travel, work and accessibility.   

• Session teaching clinical skills e.g. pulse checks, blood pressure measurement, examination of central and peripheral pulses and practise these. Possibility for students to observe new patient checks and/or work alongside practice nurse/HCA to complete initial examinations, including pulse, BP, weight, height. Also, consider how these parameters are being carried out remotely using telemedicine.  

• Have an individual formative feedback discussion with GP tutor on progress on the course so far, including first written assessment, plan for poster assignment and professional attitude and conduct.  

Questions for you to consider  

• How did you feel meeting a person that had suffered a stroke/had a mobility problem?  What aspects of the meeting were most difficult?  Did the patient seem comfortable with you?  Were you surprised at the impact it has had on their life?  

• Did anything about the MDT surprise you? Were you aware that so many different professionals were involved in the care of patients with mobility problems?  What role did the GP play?  Was this what you had expected the GPs role to be?  

• Consider the health promotion interventions you have heard about or observed today; what effect do you think that being told you are at high risk of stroke or heart disease has on an individual?   

Preparatory work  

Preparatory work  

• Reflective piece on professional identity

• Reflective piece on a patient encounter 

• Health promotion poster  

• Student attendance and professionalism

Tutors will be asked to submit each student's attendance record after each placement day, marks for reflective pieces, marks for the poster, and comments on professionalism on a Microsoft Form sent in the introductory email. The same form can be used throughout the module. 

Attendance 

Students need to have attended the placement, passed both pieces of reflection, presented the health promotion poster and passed the professionalism assessment to successfully complete Medicine in Society and progress. 

Repeated and/or unexplained absences will be dealt with on a case-by-case basis.