Studying for a medical degree is a long, six-year slog. But, after four years of studying in a lab, it’s the final two years that the hard work really kicks in, when students begin their clinical studies in a hospital.
So, what’s the difference between pre-clinical and clinical studies? Young Post spoke to three Year Five medical students from Chinese University (CUHK) and Hong Kong University (HKU) – the two institutions in the city which offer medical programmes – to find out how their studies changed once they began their hospital placements.
“As a pre-clinical medical student, your life is somewhat similar to other university students – you have lectures and tutorials with some clinically related attachments, but ultimately you are just a student,” explains Alex Deng, 22, a student at CUHK.
“In the clinical years, though, you spend most of your time in hospital with patients and doctors, whether that be in the wards, operating theatre, or clinic. There, you are treated as a future colleague, not just a student, and you are expected to take the initiative to make the most out of your learning experience.”
“You become part of a frontline medical team,” adds Elizabeth Ng, 22, who studies at HKU.
During their pre-clinical studies, students build a foundation of medical knowledge. In their clinical studies, they need to apply this knowledge to real-life medical cases.
“I’ve learned to take down patients’ medical history and do physical examinations,” says Deng. “Combined with my pre-existing medical knowledge, I’m able to formulate a list of possible diagnoses.”
But it isn’t just their medical knowledge that students needs to improve. Communication and interpersonal skills become very important during their clinical years.
“During history-taking, we must be considerate of the patient’s emotions as well as collect useful information for diagnosis,” explains 22-year-old CUHK student Toby Leung. “There was once a woman with cardiac failure who suddenly started crying
in front of me when I was taking her medical history. We are taught to be very sensitive and cautious in situations like this.”
The learning style in clinical studies is drastically different from pre-clinical, too. Typically, students will rotate around different wards or departments to gain hands-on experience in different specialities. They’ll get to observe different clinical procedures, from surgeries to taking lab samples.
“The learning style changes entirely from passive to proactive,” says Leung. “In my pre-clinical years, lessons were limited to lecture halls and laboratories. In clinical studies, my patients become my teachers.”
For example, while Leung can memorise a textbook description of different heart murmurs, it’s only thanks to his clinical training that he is able to identify them in practice.
With all this on-the-job training, it’s up to students to ensure they are keeping up with everything they are learning.
“A lot more independent self-study is expected,” explains Ng. “Spending all our time in hospital means there is no set curriculum. There’s more uncertainty in terms of what you are expected to know.”
Ng says that all HKU students are subjected to a “grilling session” from one of the doctors, who will ask them one question after another. She jokingly adds that the “grilling” goes on “until you become charcoal”.
Leung finds one of the biggest challenges of working in a hospital is building and maintaining doctor-patient rapport and trust. He says he always makes sure to choose his words extra carefully.
“For example, there are quite a lot of expressions to describe menstruation in Cantonese,” he says. “We must be very careful to pick the right one to prevent any awkward or offensive moments during history-taking.”
Despite the difficulties, clinical medicine is incredibly rewarding.
Ng says she most enjoys establishing a meaningful connection with patients. “The role of medical students is indeed a special one for patients; we may not be able to treat their disease, but we can provide psychological comfort through conversation.”
“All my hard work during my pre-clinical studies has helped to prepare me for my clinical years,” adds Leung. “Without my basic scientific knowledge, I could never enjoy the beauty of medicine now.”
Edited by Charlotte Ames-Ettridge