How to make the best of being on the ward

Being on the wards for the first time as a medical student is your chance to finally interact with patients, find out first-hand about the impact of disease and learn how healthcare is delivered on the front line. Here are some tips on how to get the most out of your time on the wards:

Tip 1: Know your team

The first thing to do when you go to the ward is find out who everyone is and understand their role in the healthcare team. You should introduce yourself to the staff, particularly the foundation year (FY) doctors as you will spend most of your time with them, as well as get the most support and teaching from them. Get an idea of who the consultants are, particularly who you can shadow and learn the most from. Once you’ve done this, you are well on your way.

Tip 2: Don’t just focus on your log book

Most of you will have clinical log books to complete. Although it is great to get these filled up as soon as possible, don’t revolve your whole experience around it. You might have specific cases that you need to clerk and present, but you may miss a great learning opportunity if you only look for patients with those conditions. Speak to as many patients as possible and broaden your horizons.

Tip 3: Get involved

Get involved in ward rounds. This is the best way to get to know the patients on the ward and see how they are managed in real time. You can come back after the ward round, clerk the patient and find out about their disease. Carry a clinical handbook with you to make this easier. Presenting your case findings is a great way to discuss the case and think about the disease in more detail. FY doctors are usually happy to have you present to them and it also gives them a summary of the patient’s current condition to help them monitor their progress. Taking your time to speak to patients and empathising with them can help you uncover information that may be very relevant to the patient's condition and management. Developing a good rapport with patients will promote their engagement and make the experience pleasant for both parties. 

Tip 4: Practice, practice, practice

After clerking patients, be sure to read their admission notes and compare your examination findings to their initial assessment. This not only helps you learn about the different steps in managing a patient with a specific condition, but also enables you to appreciate how their condition has improved as a result of this. Try to interpret blood tests, electrocardiograms and X-rays with your existing skills to find out any areas for improvement. Talking through your interpretation with the FY doctors is a great way to consolidate your learning and fill any knowledge gaps. This will often promote discussions about changing guidelines and advances in treatments, broadening your understanding further. The Oxford Handbook of Clinical Medicine is a good tool to carry around the ward with you to look up additional information about a disease. The British National Formulary app is another great way to look up different drugs and their dosages.

Tip 5: Follow the patient’s journey 

Follow patients into imaging and surgery if possible. Patient journeys help you understand the process of managing different patients and give you an insight into possible avenues for quality improvement projects. You can often write case reports on interesting patients; this provides a great opportunity to produce submissions for journals. 
If you are competent and trained in venepuncture and cannulation, don’t be afraid to ask the nurses or the FY doctors if they have any outstanding jobs that need to be done. This reduces their workload, while also giving you an opportunity to practise vital clinical skills. 
Get the FY doctors or consultants to observe you while you examine patients and make sure you have a list of objectives you want to achieve each day. The more you clerk patients, the more confident you will feel for your exams and as a medical student.

Take home message 

Don’t be afraid to ask questions and get involved wherever you can. Most doctors and nurses are happy to talk to you and this is the best way to learn. Always keep a smile on your face and look forward to your ward days. Most importantly, have fun! 

Withma Muthukumara, medical student representative for the RCPs Student and Foundation Doctor Network.