RCSI GEP1 Summary

Hi all,

I've seen posts from current UCD/UCC/UL GEP students outlining their experiences of the course to date. As far as I know there's nothing for RCSI yet so I'll give it a shot. I'll make it as detailed as I can, but feel free to reply here if I miss anything. I've just finished 1st GEP, so that's obviously all I can comment on.

The Class:
There's about 65 of us now, we lost 1 or 2 along the way. Canadians probably just take the majority with just over 40%, Irish about 40%, Americans about 10% and the rest from a mix of exotic places. Everyone gets on very well with each other and the year in Sandyford has made us a pretty close class. The ages range from about 22 up to 40+, with the average age being circa 26.

Before the Coursework Starts:
The first time the class actually forms up is the weekend before you begin (13th Sept for us). The outgoing GEP1 class will have setup a facebook page for the incoming GEP1's and they organise an icebreaker in a pub in Dublin,more than likely The Swan beside RCSI. That Monday you meet in Stephen's Green to do some admin. They give you a goodie bag with all sorts of stuff in it, including your laptop. A few high-ups in RCSI have a chat with you and they host dinner in the board room. Student services talk to you about what they do, and the student's union tell you about the GEP Fresher's Week they've organised which started that night. That's where all the niceties end, because less than 24 hours later you'll be in the anatomy room with a cadaver in front of you, wondering what and where the "femoral triangle" is.

Semester 1:
The modules are:

• Genitourinary(GU)
• Health, Behaviour and Society(HBS)
• Neuromuscular(NM)
• Molecular Medicine(MM)
• Haemopoietic and Immune Systems(HIS)
• Nutrition and Energy(NE)

All systems based modules have anatomy, physiology and pharmacology components which are delivered (mostly) concurrently. The anatomy is almost exclusively taught on mondays and tuesdays in Sandyford, after which you hop on the Luas and go into the anatomy room in Stephen's Green to see/tough/dissect what we just learned about. The middle lectures of each module are mainly physiology, followed by the pharmacology of everything relevant to that system and the embryology of whatever anatomy you've covered. I.T. is well integrated into the various courses, with histology tutorials, anatomy videos, various ebooks etc available online.
GU- This deals with all things genital and kidney. It's one of the shorter modules but really important.
HBS- Explains the various reasons why society behaves the way that it does with regards to health. There's a certain amount of psychology in this module when examining behaviour, why people smoke/drink/do drugs. Additionally, learn about intellectual development during childhood, parenting styles and outcomes, mental disabilities and the impact of disease on the individual+ their family.
NM- Nerves, muscles, action potentials and upper/lower limb anatomy. I can't remember if this is a double module, but there's quite a lot to it. The anatomy alone will take up a huge amount of your time.
MM- This is by far the most 'sciency' module of the semester. My undergrad was in a biological area and I was shocked at how fast we made our was through this stuff. It's essentially an intense course in genetics, cell biology, basic lab techniques and cancer biology. Pharmacology is quite intense in this module and includes chemotherapeutics, anti-virals, anti-bacterials and pharmacogenetics. No anatomy in this module.
HIS- All about blood/haemodynamics, how the immune system works, what happens when things go wrong and immunosupressant pharmacology. No anatomy here either.
NE- In my opinion the toughest module of the semester. Over 50 lectures on everything to do with food, digestion, nutrient transport and energy utilisation/storage. Loads of anatomy on this one, as you can imagine.

Continuous assessment (CA) is a huge part of the course. It keeps you under pressure to keep on top of the stuff, whether you actually do or not is your call. There are anatomy orals every 2 weeks and MCQs every 2 weeks. It makes for a particularly crappy week when they overlap. The MCQs examine all the lectures you've done to date and the orals examine all the anatomy you've done to date. Both tend to focus on the material from the previous 2 weeks though. There's an anatomy final at the end of each semester which is a bit of a ballbreaker. The only other CA is in the form of PBL, which I'll go into in a minute. Overall, CA accounts for a decent percentage of your overall grade. This % is variable between modules and semesters, but it's around 20%.
PBL is delivered through weekly cases. On monday an actor comes in and simulates a patient with a particular complaint. This will invariably be a disease which is significant in whichever system your lecturers are teaching you about that week. It's then up to the class to take a detailed patient history (not as easy as it sounds). They get some pretty impressive lecturers/consultants to facilitate these sessions. There will be a Word file online which gives an outline of the diseases within that organ system, the diagnostic investigations you can do to differentiate between them and a list of questions on that patient presentation (differential diagnosis, medical/surgical management etc.). On the tuesday there are group based tutorials with a GP or surgeon where all aspects of the patient, disease, diagnosis and treatment can be discussed. The group then has to split up the questions and do them in detail by that thursday. On the friday the class forms up and random people are called up and asked random questions from that question list. Your group mark will be based on the quality of your case upload and how well the person from your group does when called up. In other words, you're expected to learn all the questions. The uploads can reach 5000 words so this can be a pain, but they're very clinically relevant so the info tends to stick when you do it on the tuesday.

Semester 1 Exams:
They take place just after new years (the 10th if I remember correctly). Definitely the worst part of the year for me. From Stephens' Day onward was a nightmare. Each module is examined with an MCQ paper and a short notes paper, both of which take place on the same day. They both have questions from everything you've studied all semester, including anatomy (even though you've already been examined on it loads of times). This month was spent by the class either in the library, studying at home, commuting around home/library or bitching about the whole process on facebook. Having said that, the nights out at the end of each of these exams almost make up for the hardship. And you'll amaze yourself at the amount of info you can soak up in a few short months. There's a 3 week break after the exams, complete godsend.

Semester 2:
Modules are:

• Cardiovascular and Respiratory (CVR)
• Neuroscience (NS)
• Endocrine (END)
• Population and International Health (PIH)
• Evidence Based Health (EBH)

Same module format as for semester 1 except the CA carries a higher percentage than before.
CVR- Heart and lungs, veins and arteries. Teaches you the intricacies about dynamics and regulation of cardiac output and respiratory function. To do this you have to cover how blood flow to the brain, skin and organs is regulated and how the CVR system adapts. Also goes through the various congenital and acquired diseases or defects within the system.
END- Many people said this was their favourite module. You learn the role of the main endocrine organs, the role of their secretions and the interaction between them. One of the more straightforward modules and it's relatively short. Very clinically useful given the prevalence of endocrine disorders (diabetes, thyroid over/underactivity, contraception difficulties etc.).
NS- Physiology and function of the different parts of the brain, psychological and neurological disorders, the special senses and the dreaded cranial nerves. It's a large module but anatomy takes up the bulk, so you should be comfortable with much of it by the time the written exam comes around.
EBH/PIH- These are delivered separately but examined as part of the same exam. There's some really interresting stuff in this module, but also some mind numbing stuff. I'd be here all day if I went into the aspects of PIH/EBH, so I'm going to have to ask ye to google the two terms if interrested. Together that account for the largest module of the year. Chances are there will be modifications to this course next year anyway so whatever I say could be redundant.

Semester 2 Exams:As per semester 1, but I think people found it less intense. Maybe just because you're used to it at this stage. There's a 2 week break towards the end of the semester so most people use that to get a head start on the exams. The main anatomy exam is right after that break though so the temptation is to focus on that.

That's it for the modules. The only other examinable material you'll cover is in Clinical Competencies (CC). Every friday you'll have group based tutorials with an actor and a GP/surgeon tutor. These will cover basic history taking and the clinical examination of the main systems. At the end of each semester (right after the written exams) you'll have a practical exam on this stuff. It'll be you, a doctor and an actor in a room and you'll be asked to do some of the examinations you've covered and to take a patient history and present it back. Not the worst of the exams at all because there's a finite amount of things you'll be asked, whereas anatomy can seem like a black hole.

So to summarise the academic aspects of the course: There's 11 modules totaling 21 exams (if you separate short notes and MCQ), MCQs every 2 weeks, anatomy orals every 2 weeks, PBL every week, CC every week and end of semester exams in anatomy and CC. There's the odd group project too but these are likely to change every year so I won't get into it.

The Compulsory Stuff That Won't Be Examined:
Exactly as it says on the tin. You have to go, you'll learn a lot, but you won't be examined on it. This is in the form of surgical grand rounds (SGR), medical grand rounds(MGR) and wednesday rotations in the hospital.
SGR- Every thursday morning at 8am (!) in Sandyford. You'll be video linked to Beaumont grand rounds where every big wig surgeon in the hospital gathers to discuss cases and recent research/developments. It's not strictly a spectator sport because the consultant running rounds in Beaumont will ask people in Sandyford questions. Only 1 per week to keep us awake thank god.
MGR- The same thing but with the medics. These only begin in 2nd semester.
Rotations- In the second semester you'll go to the hospital every wednesday and rotate through the major specialties. You'll be attached to a team and get some patient interaction. I really enjoyed most of these and it puts a great context on everything you've only done in theory so far. A great strength of the programme in my opinion.
After the semester 2 exams you do a 1 month attachment full-time. That's what we're doing right now. It is examined but only the clinical stuff you covered in CC can be asked. The exam is essentially the same as other CC ones but you do it as a team of 4 and on a real patient. They rotate the team members through different parts of the history and examination. I'm actually really surprised at how much we're getting to do considering we have only finished first year. There's as much patient contact as you're comfortable with and most (difinitely not all) of the docs are keen to teach.

Last, but quite the opposite to least, comes the social aspects of the year. There have been more nights out than I care to count and the whole class tends to get involved. I'll be honest, I was expecting people doing gradmed to be less social than they have turned out to be. The North Americans gel really well too, so there's no divide. If drinking isn't your thing there's loads of clubs that the GEPs tend to be involved in. There's also a few new societies next year being set up courtesy of our class so be sure to get involved in them!

That's a much longer post than I intended to compose and I still know I've missed a gaping part of GEP1. Anyway, it's a great course with great people. I can't see how the teaching and facilities at our disposal could realistically be improved. I'm sure people from every college will say that, but hopefully the course breakdown above will backup my claims somewhat. If anyone has made it this far into the post, congrats and feel free to ask about anything I've poorly explained. I'm heading away soon but will still check this thread when I can. There's a few RCSI GEP students on this forum so they should be able to answer if I can't.

Bio.

EDIT: I almost forgot to add the only source of gradmed info that trumps boards. Anyone with any interest in gradmed, or just anything medical for that matter, should take a look at www.doc2be.ie. Great blog that goes back to the application and GAMSAT stage.