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During the pre-clinical years of medicine (usually Years 1-2), you'll focus a lot more on the scientific concepts that underpin diseases and treatments - i.e. pathophysiology, anatomy, and pharmacology. However, once you have a solid foundation in biomedical science, the focus shifts towards learning how to translate that knowledge into clinical practice with real patients.
For your clinical years of medicine (year 3 onwards), a practical approach to learning starts to yield better results. It becomes less important to know about what is going on at a molecular level for a disease, and more important to know how to diagnose and treat it. Therefore, different revision methods are needed to help keep up with the new clinical content you have to learn and then put it into real-life practice.
My personal method of note-taking in my clinical years has been in the form of a patient history for each condition I could be examined on. This helps me assimilate this knowledge easier if I was to actually meet a patient with said condition and for OSCEs, killing multiple birds with one stone:
📝 Presenting complaint (PC): What would the chief symptom of this condition be? What would be some keywords the patient would use to describe it?
📝 History of presenting complaint (HPC): Is this an acute or chronic condition? How long do symptoms usually last?
📝 Past medical history (PMH): Causes of the condition. Are there any associated conditions etc. that cause or are caused by this condition?
📝 Family history (FH): Any genetic causes? If so, what is the pattern of inheritance?
📝 Social history (SH): All risk factors of the condition (and why they cause the disease)
📝 Drug history (DH): What medications is this patient likely to be on and what would they do? Particularly important 💊 ⚠️ Any iatrogenic causes of disease.
🔬 Investigations (Ix): What would I do given the likely diagnosis? What ORDER would I do these in / what is the main priority?
🔬 Management (Mx): What are the first-, second- and even third-line management choices (using NICE guildelines)? Particularly important ⚠️ Remember to make notes on contraindications + special cases that need specific management (e.g. pregnancy)
🔬Differential diagnoses (DDx): What else could it be and why? How would it be ruled out?
I then make notes on any other important information I could refer back to. Download my example on Angina here
Below are some of my favourite resources for clinical studies.
Osmosis is a great website and YouTube channel for brief, easy-to-follow explanations on the pathophysiology of diseases, common symptoms, and how to diagnose and treat them. Despite the treatment summaries being based on U.S. guidelines and medications, they have some great high-yield videos of patient cases that you can go through at your own pace. I would pause these videos to see if I could figure out the diagnoses before the answer was revealed, for example, and then how I would treat it. This is a paid-for resource but they have snippets of most of their videos for free on YouTube.
The NICE website is the holy grail for UK medical students and doctors as it contains all the guidelines we need for clinical practice. The clinical knowledge summaries page is a fantastic resource that was actually made for GPs so they could easily look up the diagnostic criteria and the stages of treatment/management for a range of diseases.
I would visit the NICE CKS page every day during exam revision and write notes on diagnostic criteria and treatments of key conditions I had covered in my 2nd and 3rd years of medical school. The clinical knowledge summaries are split up into specialties and I would aim to do one specialty a week and revisit it before I moved onto the next.
This helped me start to memorise first-, second- and even third-line treatments quicker and get better scores when I was doing practice exam questions. Guidelines ARE important to know. Do not underestimate them. Even better, see if you notice them being put into practice on placement and impress the clinicians you're shadowing!
Every medical student has probably heard of 'PassMed' and it is rightly raved about. For £12, you can gain access to a bank of clinical scenario-based questions which is what your clinical exams will consist of. PassMed has a textbook that is based on all of the NICE guidelines but writes them in a nice, concise way that you can refer to if you get exam questions wrong / want to learn more about a condition. I used this in conjunction with NICE CKS because sometimes, I required a bit more detail and to check if guidelines were up-to-date.
The PassMed question bank is amazing and has over 1000 questions that will really test your diagnostic and treatment knowledge. It tracks how well you are doing, and even compares you to other students who have signed up from your medical school (but take this with a pinch of salt). It is crucial to do questions and even timed mock papers using the PassMed system to get used to what it will be like in the real exam.
Zero to Finals is a great website that I actually discovered quite late in medical school! It's designed to prep medical students for their exams with written educational material and diagrams on important topics, helpful videos, and a testing section. Medicine is a vast topic, so to include every detail would be impractical from a time and energy perspective. Zero to Finals focuses on high-yield facts for exams and allows you to build on a strong foundation that can improve as you specialise in your career. You can regularly review all the resources on the site and most of them are free! There are also some amazing books and flashcards you can purchase to test your clinical knowledge even further. I listen to their podcast on the way to placements if I want to go through cases on certain conditions.
Quesmed integrates exam questions and explanations with flashcards to help you understand and memorise information efficiently. As you answer questions, the Quesmed system learns about the gaps in your knowledge and suggests a daily feed of flashcards. This is a great site for active recall! I tend to go through flashcards or question on my breaks or at work.
Mind the Gap, Google AND PLACEMENT!
One of the most effective ways that diseases and their associated symptoms have stuck in my head is by meeting patients with them or visualising what they look like.
Mind the Gap is a clinical handbook of signs and symptoms in black and brown skin - this is particularly important for the practical aspect of meeting patients and diagnosing them. Remember, at this stage, you should be learning content beyond the purpose of just passing the exams, but for patient safety. You'll need to put your knowledge into practice in OSCEs, on placement and in real life as you inch closer to being a fully qualified doctor.
I hope this blog post helps anyone entering or studying for their clinical years! Check out my current medic study resources page for more.
