Course structure
Your course is divided into three distinct phases. During Phase 1 (the first year in North Wales), you will learn the core science and clinical practice building on your existing knowledge from either the first year in Cardiff or your previous degree depending on your route of entry. Phase 2 (Years 2 and 3) you learn to care for patients by an integrated contemporary clinical experience, whilst during Phase 3 you will be learning from and at work, consolidating your preparation for practice. All parts of the course and learning outcomes in North Wales are equivalent to the C21 MBBCh but delivered in a different environment.
The C21 North Wales/ Gogledd Cymru stream, in the same way as the standard C21 course, is non-modular and therefore it is impossible to compartmentalise learning. The idea of C21 is to build and gain new knowledge and ideas by expanding and developing on what you already know. A “spiral curriculum” gives you opportunities to revisit aspects of learning thus deepening understanding.
The primary mode of delivery in your first year in North Wales will be via case based learning, where you are supported in small groups by a trained facilitator. You will learn basic and clinical science via the theme of the ‘Chronological Life Course’. Each unit of study will consist of a series of patient cases, typically lasting about two weeks.
In your Years 2 and 3 of the North Wales stream, you will apply and build upon earlier learning through increased clinical time in hospitals and GP surgeries in North Wales. Learning will be centred around the patient experience as you follow patients along the care pathway from community settings into hospital care and back into the community on placements. Year 2 of the C21 North Wales/ Gogledd Cymru stream will be undertake using the innovative Longitudinal Integrated Clerkship approach know as CARER/LLAW (Community and Rural Education Route/ LLwybr Addysg Wledig). You will be embedded within a General Practice benefitting from a sustained educational supervision experience to allow you to develop as a professional. Clinical placement learning will be complemented with further periods of instruction back in a University setting, where you will revisit core scientific principles and build upon these, but with an increased emphasis on generic themes which will equip you with the knowledge and skills to become an excellent doctor, e.g. evidence based medicine, clinical diagnostics and the care of the vulnerable patient. Year 3 will allow you to build on the skills learnt during Year 2 but also apply them in more specialist practice.
By your Year 4 (final year) in North Wales you will be ready to take a more active role within clinical teams. The emphasis is on consolidating knowledge and skills to prepare you for work as a doctor in the NHS, ensuring a smooth transition from student to Foundation Doctor.
The core learning of the course is supplemented by a series of “Student Selected Components” (SSCs) in all years of the programme, allowing you to choose projects from a list of available options, or to develop your own project. SSCs provide the stimulus and the opportunity for you, under appropriate guidance and direction, to acquire knowledge through a process of exploration and your own intellectual efforts.
SSCs complement core MBBCh teaching, allowing you to study areas of particular interest, introducing research skills and encouraging analytical and critical thought from your first year. You are encouraged to develop skills and knowledge in a variety of medical and scientific specialties, including those outside the realm of traditional medicine. In the final year you will have an opportunity to go on an ‘elective’ and visit medical settings anywhere in the UK or internationally. These ‘options’ enable you to pursue an aspect of medicine of particular interest to you.
The modules shown are an example of the typical curriculum and will be reviewed prior to the 2022/2023 academic year. The final modules will be published by September 2022.
Year one
This is a Graduate Entry course that starts in Year 2 in North Wales.
Year two
Your first year on C21 North Wales/ Gogledd Cymru is the equivalent of Year 2 for the standard C21 course undertaken by students studying in Cardiff University.
You will study 11 cases during this year of study, with each case typically lasting two weeks. As well as the core science learning, highlights of this year include:
1. Community based learning
The importance of seeing the patient in his/her community is emphasised and the Community Clinical Learning programme builds on the case-based learning. Each placement will involve task oriented learning, so that you collect a portfolio of clinical learning experience. This will help you link ‘real people’ to both the case you are studying and to more long term goals such as professional attitudes, understanding health service delivery and leadership. One of the highlights of the community clinical learning programme is a rural health day. This allows you to learn about the challenges of healthcare delivery in a rural setting comparing it to the services available in urban areas.
2. The Student Selected Components (SSC) Programme
The SSC programme in Year 1 consists of four distinct learning opportunities:
- Two experience projects
The two experience projects expose you to a wide range of settings and topics and you will have opportunity to develop research skills at a more advanced level. Importantly there are projects that will facilitate study beyond the boundaries of traditional medicine.
- A journalistic article
The journalistic article will enable you to demonstrate the critical academic skills of literature searching and appraisal of complex scientific evidence-based material and the subsequent uncomplicated coherent and concise communication thereof. It will also challenge you to convey your journalistic message in an entertaining yet thought provoking manner.
- A unique peer learning C21 conference
The conference will include plenary sessions with invited keynote speakers covering a range of themes around thriving & surviving in medical school and medical ethics. It is expected, that during the first years of the Bangor programme, that students on the Bangor stream will join students on the Cardiff stream until such time that this peer learning can take place within the Bangor cohort.
Year three
In Year 2 (North Wales) you learn the principles of integrated clinical care, to learn about clinical method and diagnostic reasoning and relate this to the underpinning scientific principles of medicine. You will learn by undertaking a Longitudinal Integrated Clerkship, which is an established form of medical education, proven in universities around the world. You will follow a range of patients for longer periods of time and develop a close relationship with a mentor who guides your learning. Longitudinal placements enhance students’ understanding of patient-centred care, the healthcare system and the importance of the life perspective, family dynamics and social contexts of patients’ presentations for healthcare. Students learn through experience and problem solving in a supportive clinical environment.
You will have the opportunity to undertake all Year 2 learning in a defined rural community, predominantly in primary care but with definite links to secondary care establishments that serve these communities. It will provide a platform for you to understand how care should be provided to those with common diseases. You will become competent in taking a holistic history, identifying and managing pertinent risk factors, recommending targeted interventions as well as considering the wider impact of ‘being a patient’ on the social and psychological wellbeing of the patient and their carers.
The patient will remain the basis for your learning. A major focus of the longitudinal clerkships is the “patient journey”, and you will have opportunities to follow a bank of patients presenting with common symptoms that make up the core of the learning outcomes for the year.
As with the preceding year of the course, clinical case studies, which focus on common presentations, will be used to structure learning. These will complement the experience gained whilst on clinical placement in a variety of healthcare settings where you will observe and assist in patient care whilst learning to take on increasing responsibility for care under direct supervision. This will be supplemented by self-directed and e-learning material.
Your learning will be supplemented with teaching from Bangor University and Betsi Cadwaladr health board to ensure that the generic themes and learning outcomes covered in the bookend weeks of the Cardiff delivered curriculum are also delivered and covered at Bangor. The teaching and learning will consist of a blend of plenaries, tutorials and e-learning material and will be delivered at timely intervals throughout the academic year.
Year four
During Year 3 (North Wales) your time will be concentrated on increasingly specialist cases, predominantly based in secondary care. You will continue to practise the core skills learnt in Year 2 but apply this in different clinical settings.
The year is divided into 4 separate learning opportunities: three clinical placements across North Wales hospitals, with bookend weeks facilitated at Bangor but in collaboration with senior core faculty at Cardiff, and an all year Student Selected Component (SSC) – an opportunity to go beyond core learning and study a subject which you have a particular interest.
Clinical Placements:
- Women, Children and Family
The overall aim of this placement is to enable you to acquire skills relevant to women and children, to make a clinical assessment of a problem, and develop a plan of care in its widest sense. You will spend time with obstetricians and paediatricians throughout North Wales and have the opportunity to witness first-hand the importance of multi-disciplinary working in both community and secondary care settings. The patient should remain the focus of the learning and there will be opportunities to interact with women, children and parents who are accessing the health care system.
- Clinical Neuroscience, Psychiatry and Ophthalmology
You will experience more specialist practice during the clinical neuroscience attachment but will see how an excellent grounding in generic skills facilitates clinical and diagnostic reasoning. These are essential skills for all good doctors to develop and perfect. You will also have excellent opportunities to see patients with psychiatric illnesses and come to appreciate the prevalence of psychiatric disorders in our population. You will learn about primary psychiatric disorders but will also see how mental health problems can influence how patients present with and manage other illnesses. The ophthalmology teaching will be a delivered by clinicians at North Wales and will be equivalent to the week which your peers undertake at Cardiff. During your placement in ophthalmology, you will be provided with opportunities to broaden your understanding of ophthalmological pathology, examination skills and management as well as highlighting the support requirements for visually impaired patients.
- Chronic Disease 2 - Geriatrics, Musculoskeletal Disease and Dermatology
We have an increasingly ageing population and a significant burden of chronic diseases in our population. These are priority areas to address for the current NHS and you need to understand the challenges posed by these illnesses. This placement builds on the principles of chronic disease management introduced in Year 3 but with particular emphasis on the elderly person and individuals with musculoskeletal and skin diseases.
ERASMUS exchange
During Year 3 (North Wales), students with language skills will have the opportunity to apply for the ERASMUS exchange scheme. Successful students can choose to study the women, children and family placement at one of our partner medical schools in France, Spain, Portugal and Italy.
