MD - Ambulatory Care (Information for Students)

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Placement Information

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During your Ambulatory Care term you will be allocated to a general practice which you will attend for four single days during the term.  The timing of this placement differs for each clinical school but usually it is one day per week for four weeks of the eight week term (except for rural students who will often attend over four consecutive days).  Students will be allocated to a general practice by the Department of General Practice. Allocation information with contact details for GPs will be announced via Curriculum Connect, usually prior to the end of the foundation term.  It is important that you telephone your allocated practice a few days prior to the first visit, to introduce yourself and clarify arrangements for the first day.

During this placement you will:

• gain an understanding of where general practice sits within the health care system;
• develop an introductory experience of clinical work and patients’ experiences of care in the health care setting to which they transition after leaving hospital; from which they enter hospital; and in which most are managed without ever going to hospital; and
• practise clinical history and examination skills under supervision and guidance.

Learning activities during this placement may include:

• interviewing a patient to ascertain: level of concordance between the doctors’ explanation or management plan and the patient’s understanding of this; degree of patient input into decisions about care and patient’s experiences of care in the primary health care system and during transitions into and out of this system
• analysing examples of communication between the GP and the hospital and/or other specialist, for example via referral letters, telephone calls or care plans;
• determining how the GP mobilises a care team for a chronic illness or other complex conditions, understanding the choice of allied health involvement;
• describing a ‘day in the life’ of a general practice or general practitioner noting the variety of cases and activities that occur  and noting the various systems assisting the process of care : appointment systems, triage,  follow-up, monitoring and referral.

Guidelines for Ethical Conduct on Clinical Attachments

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The following guidelines are emphasised for students attending General Practice placements:

Patients
Many of the patients you meet in the clinical setting will be unwell and concerned about their illness. You need to communicate with them sensitively and to treat them with respect, never forgetting the privilege and responsibilities of your position. It is important to respect people’s privacy.  Before commencing a physical examination, obtain consent and explain to the patient what you are going to do. Make sure only the area being examined is exposed at any one time. Do not leave a patient exposed for longer than necessary.

Consent

• Your clinic staff will explain the process of obtaining consent to interview a patient. You must not proceed to the patient unless you have this consent.
• If consent is granted, it is important that you introduce yourself to the patient you wish to interview, explaining that you are a medical student and why you are there.
• Your clinic will need to obtain consent from each patient you interview and/or examine.
• Patients must be made aware that their participation is voluntary - they are free to agree or refuse and need to be reassured that their medical care will in no way be affected by their decision.

Confidentiality

• You are expected to uphold the same standards of confidentiality as doctors.
• Take care not to identify or reveal the name of any patient to anyone not involved in the care of the patient.
• Remember that details other than name can be identifying in some circumstances so take care with these details.
• Discussing the patients you have seen with your tutors and fellow students is an important part of medical education.
• It is normal and acceptable to ‘debrief’ about your experiences with family and trusted friends but do so in a way that is respectful to patients and, again, avoids identifying them.

Other

• Remember to thank patients for agreeing to have you present - they are helping you with your education.
• Dress appropriately, out of regard and respect for the patients and doctors who will be helping you with your education.
• Remember to wear your photo ID.
• Mobile phones MUST be turned off when you are interacting with patients.

 

Patient Consent

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Patient consent must be obtained for all medical placements; either written or verbal (as a minimum).
Practices may choose to use the sample patient information and consent form provided to them by the Department of General Practice.

 

Attendance

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Attendance at this placement is compulsory. You must telephone the practice as soon as possible on the day of the placement if you are unwell and unable to attend, or are running late due to circumstances beyond your control.

You will be provided with an attendance form by your clinical school administrator and via Curriculum Connect.  A spare copy can be downloaded from the forms and resources section of this website. Both you and the supervising GP or Practice Manager need to sign this form. You must return it to your clinical school administrator prior to the end of your ambulatory care term.