Education: Transition Year students try out medicine

It's not for the fainthearted, but hundreds of students applied to take part in a week-long immersion in the life of the medic at Beaumont Hospital last week. They stitched and sutured, took pulses and wrapped plaster casts and, to the relief of the staff at the Royal College of Surgeons in Ireland (RCSI), there were no fainters when the students sat down to watch live surgery.

Sixteen-year-old Saira Munir from Coláiste Mhuire in Ballymote, Co Sligo took it in her stride. "We did a heart dissection in biology class before, so I knew I wouldn't be squeamish," she says. "Some people looked uncomfortable but everyone managed to get through it. There were a few people who became faint looking at pictures they saw earlier in the week, though."

Munir is one of 150 lucky Transition Year students who made it on to this year's MiniMed programme, run by the RCSI. This is the seventh year of the programme, which gives transition-year students with an interest in medicine the chance to experience the life of a medic, to learn more about the profession and to spend time in a teaching hospital and on campus.

The 150 students, who come from 90 schools around the country, are selected by their career-guidance counsellors. There are many more applications than places, so only those likely to get the most benefit from the programme get a spot.

The week starts with lectures on campus but quickly moves to a hospital setting where the students get some very practical insights into the life of the working doctor and nurse.

Claire Condron is a lecturer in simulation at RCSI and co-ordinator of the MiniMed programme. As she speaks, she's in her lab coat, fresh from guiding a cluster of teenagers with syringes and rubber arms.

On the Thursday of the programme, students are engaged in a sort of medical speed-dating exercise, where they move from station to station learning different skills. There are seven stations, and over the course of an afternoon they get to try various procedures, from injections and CPR to stitching and inserting nasogastric tubes.

“It’s interesting to see how the students develop over the course of the week,” says Condron. “At the beginning they are shy of their peers and the questions asked are not medical. Two of the most common questions I’m asked are ‘How much does the job pay?’ and ‘What are the hours like?’. However, as the week goes on they tend to get more involved in the real work of the medic. It’s a chance for them to get a handle on what life is like for an RCSI med student. This is important, because many students who get high points in their Leaving Cert go for medicine, and some don’t really have an understanding of what is involved. It’s not just about getting 600 points. They need to know what life will actually be like as a medical student.”

According to neurologist Robert Magee, who's busy showing students how to test reflexes, it involves drinking a lot of coffee, among other things. Twenty students are sitting around him, banging each others' knees with plastic hammers. They are tickled to hear Magee admit that one part of his job in testing a patient's neurological health is to figure out if that patient is answering his questions truthfully.

"Patients lie, you know. Haven't any of you seen House?" he asks. It seems nobody has.

Meanwhile, next door, students are on the floor trying to save the lives of legless rubber victims in urgent need of CPR. Inevitably the first few MiniMeds are mortified at the prospect of getting down on their knees to administer mouth-to-mouth resuscitation, and there are ripples of laughter from their watching peers.

Their first lesson in CPR is to take the chewing gum out of their mouths. However, as they get stuck into the very physical business of pumping the dummy's chest and trying to get air into its lungs, the students quickly start to take the whole business more seriously as they realise that these skills really could mean the difference between life and death.

Sam the simulated patient
At the last station the students get to meet Sam. He's a very expensive patient whose care, which includes frequent software updates, costs Beaumont Hospital around €200,000 per year. Sam is a simulated human who can sweat, cough, convulse and converse. He can be programmed to say anything and display a range of symptoms.

"We look after him as if he was a real patient, he needs that much attention," says Dr Robert Quirke, co-ordinator of the final-year medicine simulator programme at RCSI. "He can have heart attacks, sepsis, seizures and a whole range of other conditions: the students can respond to him as they would a living patient. His system is updated frequently to reflect changes in medical practice and advances in computer simulation."
As the next group of students enter the room, Sam is sweating and calling for the nurse. A final year medical student dries him off as another wave of mini-consultants floods into the room.

In a neighbouring ward, a real consultant is entreating students not to stab themselves as they set about stitching simulated wounds. They're getting tips on how to stitch without leaving a scar. One student, Christian Peace from Wesley College, Dublin is really enjoying himself.

“I wasn’t so sure before doing this week that I really wanted to be a doctor, but I have enjoyed every minute of this,” says Peace. “The lectures were very interesting, especially one called ‘chemical chaos’ and another on ethics in medicine. But I really enjoyed watching the surgery. It was fascinating and I didn’t feel queasy at all.”

Leading medical professionals from RCSI and Beaumont Hospital deliver the programme, together with Prof Marie Cassidy, State pathologist and head of forensic medicine, and Prof Arnold Hill, consultant breast, endocrine and general surgeon at Beaumont Hospital. He is also head of the school of medicine at RCSI.

According to Condron, the week is very useful for those students who have an interest in medicine but perhaps need to fine-tune their ambitions.

“Many students come away with a better idea of the area of medicine they might like to get into. Often it’s not general medicine they want at all, but physiotherapy, pharmacy or nursing instead. It’s hard to get that insight when they’re still in school.”

The students are dressed in MiniMed T-shirts of green, red, white and blue. Each colour denotes membership of a team and there are various challenges throughout the week, culminating in a prize-giving session at the end of the programme.

The RCSI has also provided a web resource with links to various subjects of interest but, perhaps inevitably, the heaviest traffic goes to the social-media part of the website where new friendships are forged among the next generation of Irish medics.

Some of the students are not entirely sure, after their week of blood, sweat and tears, whether they still want to be doctors but many more are now determined to put the hours in and get their place on a course in medicine.

"I was definitely a bit sceptical when I decided to do the MiniMed programme," says Munir. "I applied to do the programme because I wanted to rule medicine in or out before making any decisions next year. However, after spending a week living the life of a doctor my mind is made up. This is the career for me."

For more information on the RCSI
transition-year MiniMed programme, email robertmagee@rcsi.ie or see rcsi.ie.