How to make the most out of outpatient clinics as a medical student

Whether it’s quick-fire fracture clinics or extensive multidisciplinary reviews of complex immunological patients, as a medical student you will find yourself sitting in on outpatient clinics and be expected to learn. This guide will help you make the most of this time and ensure the common part of the curriculum isn’t wasted with you sat in the corner.

Before the clinic

Tip 1: Introduce yourself early

There are many ways to introduce yourself depending on how your timetable is arranged. One good way is to find the consultant in the hospital before clinic day. This is often easier for consultants on the ward or in theatres. If you’ve got some freedom in your timetable, you can associate yourself with the consultant and their team; I’ve always found that building this rapport leads to time better spent.

Another option is to go to outpatients before the clinic, find out which consultant is doing clinic and arrive early to introduce yourself before any patients arrive. The consultant can then arrange the clinic how they would like to. I’ve often found this means being allocated patients to independently interview and examine first, which is a very useful learning opportunity.

Tip 2: Read about common conditions before the clinic

We’ve all been there: The consultant asks you a question in front of the patient and you haven’t got a clue. Reading about common conditions before the clinic is really helpful in avoiding embarrassing moments and also in making the most out of the placement.

If you’re in a vascular clinic and you can show you understand the basics of claudication, you show the consultant you’re interested and can spend the same teaching time going through a formal examination, not something which is as easily picked up from a book. Clinical medicine handbooks are the perfect place to start when looking at what’s going to be common in clinics.

During the clinic

Tip 3: Engage with the patient

The consultant is likely to have a much shorter list of questions to ask compared to how you would take a history for your learning. Don’t be afraid to use silences to ask short questions that are of interest to you.

Judgement on what to ask is up to you but I’ve asked about a person’s pain, their personal experience of a disease and about other conditions that they’ve mentioned. Engaging with the patient makes them feel more comfortable about someone else being in the room, especially if you’re asking relevant questions or enquiring about their personal experiences of illness.

Tip 4: Be part of the team

A clinic doesn’t always rely on just the consultant interview. Specialist clinics, such as breast or cardiology, will often have useful opportunities outside of the consulting room.

Join the specialist nurses or radiographers to learn about mammography, see how specialist nurses support patients or get practice with essential clinical skills such as electrocardiograms and bloods. This is especially useful if you’re in a clinic for a prolonged period, perhaps on a student selected block with a consultant. Having a rounded knowledge of how a specialty functions can help you to decide on future careers and getting to know the nursing staff is always handy when someone decides to bring cake!

After the clinic

Tip 5: Read over the conditions you’ve seen

Seeing and talking to patients gives you a great point to hang learning from. When you want to recall some distant fact from renal failure, having seen a patient in dialysis clinic, understood their story and looked at their estimated glomerular filtration rate with a consultant is a real reference point.

Reading more about diabetic nephropathy and renal transplantation afterwards can also get associated with that and this is a great trick for improving your recall in exams and on the wards.

Tom Newman, medical student representative for the RCP's Student and Foundation Doctor Network