Sydney Medical Program

Doctor of Medicine (MD)

Bachelor of Medicine and Bachelor of Surgery (MBBS) (not open for new enrolments)

 

In 2014, Sydney Medical School introduced a Doctor of Medicine (MD) degree to replace the existing Bachelor of Medicine and Bachelor of Surgery degree (MBBS). New enrolments in the MBBS degree ceased in 2013. The first MD cohort entered the Sydney Medical Program in February 2014 and will complete the MD course at the end of the 2017 academic year.

All MD students must complete a unit of study in Research Methods and a research or capstone project. In other respects, the curriculum, assessment and arrangements for clinical training will be similar to that of the MBBS. Distinctive features of the Sydney Medical Program, including the early introduction of clinical experience and the integration of clinical learning and teaching with basic sciences, population health concepts and the development of professionalism, will be retained.

The option of undertaking an Honours project, which has been available for selected MBBS candidates, is not available for MD candidates.

Students who enrolled in the Medical Program prior to 2014 will graduate with an MBBS. There is currently no opportunity for MBBS students or graduates to convert to MD. The MBBS is not open to new enrolments.

Essential data on the MD and the MBBS degree programs are as follows.

	Doctor of Medicine	Bachelor of Medicine and Bachelor of Surgery*
Course code	KC105 or MAMEDICI3000	KH006 or BGMEDSUR7000
CRICOS code	079216J	006451B
Degree Abbreviation	MD	MBBS
Credit points required to complete	192	192
Time to complete full-time	4 years	4 years

*not open for new enrolments; information is provided for continuing students.

 

The following links provide further information about the Sydney Medical Program (MD and MBBS):

1. Teaching and learning objectives of the Sydney Medical Program
2. Statement of Expectations, Professionalism and Progress
3. Distinctive features of the program
4. Goals and Themes
5. Outline of the Curriculum

1. Teaching and learning objectives of the Sydney Medical Program

The Sydney Medical Program Graduate Outcome statement is as follows:

To improve the health and wellbeing of people in Australia, including Aboriginal and Torres Strait islander peoples, by educating and supporting, to the highest level, compassionate clinicians, medical scientists, health professionals and researchers whose work forms the basis of advances in health both locally and globally.

The success of the Medical Program is reflected in the extent to which graduates maintain lifelong, self-directed learning and the pursuit of evidence-based medical practice, and the extent to which they initiate, lead and implement advances in clinical medicine, research, education and community service.

2. Statement of Expectations, Professionalism and Progress

On commencement of the program, all students are introduced to the Sydney Medical Program’s Statement of Expectations (PDF). This statement has been formally endorsed within the University and provides positive guidance on conduct for students within a professional context.

Students’ academic progression from one year to the next depends not only on academic performance and demonstration of competence in the requisite written and practical assessments, but also on adherence to the principles of professionalism listed in the Statement of Expectations. The requirements for progression are set out in Professionalism and Satisfactory Progress Provisions. Significant breaches of the principles in the Statement of Expectations attract penalties which may include termination of candidature.

Copies of the Statement of Expectations and the Progress Provisions are available on the University of Sydney Policy Register website under Local Provisions:

SMP Statement of Expectations Provisions 2013
SMP Professionalism and Satisfactory Progress Provisions 2013

3. Distinctive features of the Sydney Medical Program

Graduate students from diverse backgrounds

Students may enter the Medical Program after completion of any degree from a recognised university. Consequently the student community comprises individuals with a diverse range of academic and life experience.

As with all graduate-entry medical programs, students in the Sydney Medical Program are expected to have made a mature and considered commitment to prepare for a medical career.

A four-year integrated learning curriculum

Learning in the Medical Program is integrated across basic medical sciences, clinical sciences and clinical and public health disciplines. Four continuous themes frame the structure of the curriculum throughout the four years: the Basic and Clinical Sciences Theme, the Patient and Doctor Theme, the Population Medicine Theme and the Personal and Professional Development Theme. These are outlined below.

Clinical contact from the start

On accepting a place in the Medical Program, students are allocated to one of six Clinical Schools.

In the first week of the Medical Program, students undertake induction in their allocated Clinical Schools, and from the second week their learning and teaching experience involves contact with patients in hospital wards and clinics. Students spend at least one day each week in their Clinical Schools throughout Years 1 and 2, and they are based entirely in clinical settings throughout Years 3 and 4.

Extensive and diverse clinical training

Later in the program, students undertake a wide range of community and specialty rotations. They receive training in paediatrics and adolescent health at The Children’s Hospital, Westmead, and they are placed in metropolitan and rural general practices to gain experience in primary care and community medicine. They may opt for an extended rural placement at the School of Rural Health, which has Clinical Schools at Dubbo and Orange Base Hospitals, the University Centre for Rural Health in Lismore or the University Department of Rural Health in Broken Hill University.

Clinical training is undertaken at large urban teaching hospitals and smaller suburban and rural hospitals. This offers students a balanced view of urban and rural health care and insights into the differences in medical practice among these sites. The various sites cater for the different fields of medicine that make up the curriculum.

A structured teaching program accompanies practical clinical training and experience in Stage 3 (the latter two years of the Medical Program). Clinical learning and teaching activities include clinical clerkships, small-group clinical tutorials, problem-based clinical reasoning sessions and short placements with various clinical teams.

Students have access to most parts of the hospitals to which they are allocated. In addition to scheduled teaching sessions, they are expected to pursue clinical learning opportunities independently in the wards. They may also be invited to observe surgical procedures and visit acute-care areas.

All Clinical Schools provide students with excellent learning resources. These include internet access, on-site libraries, online learning materials, materials for studying pathology and microbiology, and simulation equipment. Other facilities include common rooms, lounge areas and common-use kitchens. Some sites offer access to child-care facilities.

Development of problem-solving and clinical reasoning skills

A major component of the learning process in the first year (known as Stage 1) and the second year (known as Stage 2) consists of enquiry-based learning in which concepts of health and disease are related to the basic biomedical sciences. This will be a combination of Problem Based-Learning (PBL) and Team-Based Learning (TBL) sessions.

The PBL/TBL sessions in Stages 1 and 2 make use of a comprehensive set of online resources that enable groups of students to work through an authentic clinical case each week. The case of the week reflects the topics covered in other learning and teaching activities during that week.

This approach also encourages students to become skilled independent learners, able to identify their own learning needs and evaluate their progress.

Clinical Reasoning Sessions in Stage 3 (Years 3 and 4) allow students to apply this understanding in clinical settings, with reference to actual patients whom they encounter in their clinical work.

Research and an evidence-based approach

During Stages 1 and 2, all students attend sessions in which they learn how to frame clinical and research questions and search the literature using electronic databases, the latter with comprehensive instruction from a Medical Liaison Librarian. They also learn how to evaluate the quality of research-based evidence and how to use it in problem-solving and decision-making. In Stage 3, they develop their ability to apply research-based evidence in clinical encounters with patients.

Throughout the Medical Program, students have free access to a wide range of online learning and reference resources variously provided by individual teaching departments and the University of Sydney Library system. They may obtain access to these resources on the main campus, in their Clinical Schools, or on their own computers in any location where internet access is available. They also have access to extensive library collections (printed and online texts).

During Stage 1, MD students also spend three weeks learning about research methods in a range of paradigms (clinical, epidemiological, biomedical and qualitative). The training in research methods is intended to give students an understanding of the scope of health and medical research and its contribution to knowledge in clinical and public health practice. It is also intended to contribute to students’ preparation for their research or capstone project, known as the MD Project.

MD Projects

All MD students must complete an MD Project by the end of Stage 3 Year 3. The MD Project is intended to be a scholarly investigation into a topic relevant to health or medicine, leading to a formal report submitted for summative assessment. Students’ MD Project work is based in their allocated Clinical School, or in the Clinical School of the Children’s Hospital at Westmead, the School of Rural Health at Dubbo or Orange, the University Centre for Rural Health at Lismore, the University Department of Rural Health at Broken Hill, the School of Public Health, or in a project group within the Sydney Medical Program Education Office. Each student is allocated to an MD Project Group supervised by an academic staff member or affiliate. Typically an MD Project Group comprises about five students and a supervisor, who is known as a Research Tutor.

Students have the opportunity to express preferences for MD topic areas. Each year, prospective MD Tutors propose topic areas within their fields of expertise. Sydney Medical Program staff managing MD research processes allocate students to topic areas – and hence MD Project Groups and Research Tutors – that reflect students’ preferences as far as possible.

MD Project Groups are convened in the second half of the Stage 1 academic year. With Research Tutors’ guidance, each student identifies and undertakes a specific project in his or her allocated topic areas. Students who have substantial previous research experience and wish to pursue their previous line of research may be permitted to do so if appropriate additional supervision is available in the cognate field. This is determined on a case-by-case basis.

Each MD Project Group meets formally a total of five times between the latter part of Stage 1 and the latter part of Stage 3 Year 3. Each meeting corresponds to a project milestone that is assessed. Students may not progress from Stage 1 to Stage 2 or from Stage 2 to Stage 3 if they have not adequately fulfilled the relevant milestone assessment criteria.

Students submit their final MD Project report at the end of Stage 3 Year 3 (the 2014 entry cohort must submit by early in Year 4). This comprises a formal, fully-referenced scientific report of maximum length 3,000 words. While students may be permitted to collaborate in their research work, each MD Project Report must be an independent piece of work and will be examined as such. Students who produce the best MD Projects will be invited to present their work in a conference session at the end of Stage 3 Year 4 to an audience comprising their peers, students from Years 1-3 and members of staff.

4. Goals and Themes

Goals of the Sydney Medical Program

The four curriculum themes group the curriculum content and specify graduate attributes in their respective domains. Elements within the four themes necessarily overlap. The following Medical Program graduate attributes should be read as in combination.

Basic and Clinical Sciences Theme:

Graduates of the Sydney Medical Program will demonstrate the ability to:

• apply an understanding of normal and abnormal human structure, function and behaviour to the diagnosis, management and prevention of health problems
• use the best available evidence on outcomes to prevent or cure disease, relieve symptoms or minimise disability
• analyse clinical data and published work to determine their validity and application
• participate in the generation, interpretation, application and dissemination of significant advances in medical knowledge
• recognise the limits to scientific knowledge and understanding, and the continuing nature of all scientific endeavour.

Patient and Doctor Theme:

Graduates of the Sydney Medical Program will demonstrate:

• understanding of the therapeutic nature of the patient-doctor relationship and the effects on that relationship of the individual characteristics of both patient and doctor
• the ability to listen, to identify issues of concern to patients, families and carers and to respond to those concerns, using whatever means are necessary for effective communication
• the capacity to make rational and sensitive decisions based on the best available evidence, recognising that many decisions will inevitably be made in the face of uncertainty
• the ability to elicit and interpret clinical symptoms and signs by interviewing and examining patients systematically and with sensitivity, and to use this information to guide further investigations
• the ability to perform important clinical procedures, particularly those vital in life-threatening situations
• the ability to prescribe medications safely, effectively and economically using objective evidence. Safely administer other therapeutic agents including fluid, electrolytes, blood products and selected inhalational agents
• ethical behaviour in meeting the needs of patients, families, colleagues and the broader community
• concern for confidentiality and respect for individual autonomy, enabling patients and their families to make informed decisions in relation to their medical care
• understanding of the principles of care for patients at the end of their lives, avoiding unnecessary investigations or treatment, and ensuring physical comfort including pain relief, psychosocial support and other components of palliative care
• the ability to obtain and use research-based information in health-care decisions and in advising patients on health-care choices
• understanding of the principles of the design and analysis of health and medical research, including the ability to advise patients who might consider participating in research (such as clinical trials).

Population Medicine Theme:

Graduates of the Sydney Medical Program will demonstrate the ability to:

• evaluate the distribution of and risk factors for disease and injury
• understand prevention practices in the care of individual patients and communities
• make evidence-based, ethical and economically responsible decisions about the most appropriate management of health problems in individuals and in communities
• identify the economic, psychological, occupational and socio-cultural factors that contribute to the development and/or continuation of poor health and to explain how poor health affects individuals and communities
• evaluate the economic, political, social and legal factors which determine the way that individuals and communities respond to health problems and to describe how public and population health strategies are systematically planned and implemented
• understand and describe the factors that contribute to the health and wellbeing of Aboriginal and Torres Strait Islander peoples, including history, spirituality and relationship to land, diversity of cultures and communities, epidemiology, social and political determinants of health and health experiences
• communicate and care for Aboriginal and Torres Strait Islander peoples effectively and in a culturally competent manner

Personal and Professional Development Theme:

Graduates of the Sydney Medical Program will:

• show commitment to compassionate, ethical professional behaviour
• be able to work cooperatively as a member of a team, accepting and providing leadership as appropriate
• be able to recognise their personal physical and emotional needs and responses to stress, and be open to assistance when it is required
• show commitment to the advancement of learning within a community of medical scholars
• have skills in the recording, organisation and management of information, with appropriate use of information technology
• demonstrate awareness of and explain the options available when personal values or beliefs may influence patient care, including the obligation to refer to another practitioner
• describe and apply the fundamental legal responsibilities of health professionals especially those relating to ability to complete relevant certificates and documents, informed consent, duty of care to patients and colleagues, privacy, confidentiality, mandatory reporting and notification
• demonstrate awareness of financial and other conflicts of interest.

5. Outline of the curriculum

The four curriculum themes (outlined above) that continue throughout the four years of the Sydney Medical Program ensure that students' knowledge and skills develop systematically.

The relative contributions of the themes vary at different stages of the curriculum. The initial focus is on basic sciences and basic clinical skills, with progressively increasing emphasis on clinical knowledge, skills and judgement.

The academic year runs from early February to late November for Stages 1 and 2, and mid-January to November for Stage 3, Years 3, and from January until December (including a remedial term in November-December) for Stage 3, Year 4. Students in Year 4 who are not required to undertake remediation finish in late October.

The teaching is delivered in five blocks throughout each year. In Stages 1 and 2, the blocks range from four to 10 weeks’ duration. All Stage 3 blocks are of eight weeks’ duration. Between most blocks, the timetable allows for a break of at least one week.

Please note that the Medical Program does not follow the normal semester pattern undertaken by other courses offered by the University of Sydney.

Importantly, please note that Medical Program is a full-time course. Students are expected to be available to attend classes or other assigned activities five days per week.

The broad curriculum structure for each year in the Medical Program is outlined in the table below.

Stages 1 and 2

The 10 Blocks in Stages 1 and 2 are as follows.

Stage 1
1	Foundation Studies; Infection & Immunology
2	Musculo-skeletal System
3	Respiratory System
4	Haematology
5	Cardiovascular System

Stage 2
6	Neurosciences and Vision
7	Endocrinology and Sexual Health
8	Kidney and Urology
9	Gastrointestinal System, Nutrition, Drug & Alcohol
10	Oncology & Palliative Care

Within each Stage 1-2 Block, the curriculum is structured so that each week gives coherent coverage of a major aspect of the relevant body system or field of medicine. Enquiry-based learning methods serve to integrate and reinforce the week’s learning and are designed to develop students' ability to relate clinical problems to basic sciences, enhance their clinical reasoning abilities and enhance their teamwork skills.

Attendance at the enquiry-based learning tutorials are compulsory for all students: Sydney Medical Program Attendance and Leave Policy

Students attend at least six plenary lectures each week. Lectures provide up-to-date information and a broad context for students’ own detailed learning. Increasingly, traditional didactic lectures are being replaced by seminars, interactive sessions and prescribed online learning. Seminars are usually longer than lectures (1.5-2.0 hr compared with 1.0 hr) and often involve two or more speakers giving complementary expert perspectives on a topic.

Several interactive learning and teaching formats are being introduced. Most depend on students’ completion of some self-directed learning before the scheduled session, with classroom time used for highlighting essential knowledge and reasoning processes as well as asking questions. Most plenary sessions are recorded and can be viewed online soon afterwards.

Students are strongly encouraged to attend all plenary sessions because of the benefits of ‘being there’ – direct interaction with staff and students undoubtedly affords some additional learning.

Students also attend laboratory sessions each week. Many laboratory sessions are linked to online materials, enabling students to be fully prepared for practical work.

Teaching in the Clinical Schools is mostly conducted in small groups. The teaching sessions include bedside tutorials, tutorials in simulation laboratories to learn basic procedural skills, and SCORPIO (structured, clinical, objective, referenced, problem-based, integrated, organised) sessions in which students rotate through a number of stations with a short lecture-demonstration at each station.

Training in communication skills includes the use of actors, and training in physical examination skills includes the use of volunteers. Large-group interactive tutorials, such as clinico-pathological conferences, are designed to link clinical learning and learning about pathology.

In addition to the formal teaching, students are expected to visit the wards singly or in pairs and (with appropriate permissions and consent) talk to patients and practice taking clinical histories and performing physical examinations.

Block 4 (Haematology, Stage 1) and Block 10 (Oncology & Palliative Care, Stage 2) are taught mainly in the Clinical Schools. They are intended to give students periods of immersion in a clinical setting, providing the opportunity for significant development of clinical skills. Tutorials and other teaching sessions are conducted in each Clinical School, while large-group plenary sessions are concentrated in one day on the main University campus.

Stage 3 (Years 3 and 4)

Students in Years 3 and 4 undertake a total of ten clinical blocks comprising nine eight-week terms and one four-week term. Barrier assessments are held after the fourth term (in Year 3) and after the ninth term (in Year 4). The four-week term is a Pre-Internship Term, held after the final written assessment.

The nine eight-week terms are used for the following Blocks:

• Medicine (Year 3)
• Medicine (Year 4)
• Surgery
• Critical Care
• Community
• Perinatal and Women's Health
• Child and Adolescent Health
• Psychiatry and Addiction Medicine
• Elective.

Medicine (Year 3), Medicine (Year 4), Surgery and Critical Care are called 'Core Blocks'. Community (i.e. primary care), Perinatal and Women's Health, Child and Adolescent Health and Psychiatry and Addiction Medicine are called 'Specialty Blocks'.

Each cohort of students is divided into four streams, each does these eight of these Blocks in a different order. The timing of the elective is fixed for all four streams to be undertaken between January and March of Year 4.

All four streams begin Year 3 with a Core Block. The last Block before the final assessment in Year 4 is also a Core Block.

Practical clinical experience forms the substrate for all learning in Years 3 and 4, supported by a continuing structured teaching program. A balance is maintained between clerkship-based activities and scheduled teaching sessions. Formats used include:

• Lectures and seminars relevant to all four themes
• Evidence-based medicine tutorials
• Structured 'hands-on' demonstrations
• Interactive case presentations
• Clinical reasoning sessions supported by information technology
• Basic science updates
• Clinico-pathological correlation sessions.

Core Blocks

As described, the four Core Blocks in Years 3 and 4 are:

• Medicine 3
• Medicine 4
• Surgery (SURG)
• Critical Care (CC).

In all of these Blocks, students participate in ward services and outpatient clinics in the teaching hospitals of their allocated Clinical Schools. Students are exposed to mainstream medicine and surgery as well as to some subspecialty areas such as geriatrics, ophthalmology, urology and ear, nose and throat surgery. The Critical Care Block includes anaesthetics, emergency medicine and intensive care medicine.

One day each week (Friday) is dedicated to structured teaching, with topics drawn from all four curriculum theme areas. Time is also allocated for self-directed learning. At least half of each week is spent directly involved in the activities of the clinical service to which students are attached. A progressive increase in clinical responsibility is expected as students progress through Stage 3 towards their final assessments and their Pre-Internship Term.

Students are allocated to one or more clinical supervisors for each of their Medicine, Surgery and Critical Care Blocks. The clinical supervisors are senior clinicians from the Disciplines or Sub-Disciplines where the student is located. For example, a neurologist and a geriatrician might act as supervisors for a student undertaking a Medicine Block which is composed of attachments to Clinical Departments of Neurology and Aged Care. Students are required to contact their supervisors (or delegate) to arrange formal meetings on at least a weekly basis. A protocol of scheduled tasks must be completed to the supervisors' satisfaction over the duration of the attachment or Block. This assists in formulating an assessment of the student's progressive mastery of the knowledge and clinical skills relevant to the field concerned.

Specialty Blocks

The Specialty Blocks in Stage 3 are also of eight weeks duration (including time for assessment and review), and are distributed throughout Years 3 and 4.

The four Specialty Blocks are:

• Community (COM)
• Perinatal and Women's Health (PWH)
• Child and Adolescent Health (CAH)
• Psychiatry and Addiction Medicine (PAAM)

As in the Core Blocks, students undertaking Specialty Blocks participate in a variety of clinical activities in hospital wards and outpatient clinics and community-based clinics.

Not all of the teaching hospitals associated with the Clinical Schools offer a full range of specialty clinical services, and all students therefore rotate through sites other than their allocated base Clinical School. These include The Children's Hospital at Westmead (for at least part of the Child and Adolescent Health Block) and private-sector general practice (for attachments during the Community Block).

All students will undertake 8 weeks of general practice and community health placements in a variety of settings including rural, remote area and urban practice.

Elective Block

The eight-week Elective Block, timetabled for the beginning of Year 4, provides students with an opportunity to extend their knowledge and understanding of healthcare through clinical and/or research placements. These placements may be undertaken in Australia or overseas.

As the intent is to expose students to healthcare settings other than those with which they are most familiar, students may not undertake electives in their own Clinical School other than in exceptional circumstances.

Elective placements and nominated local supervisors must be approved prospectively by Sydney Medical School. Supervisors are required to provide a report on the student's performance at the end of the elective. Students are required to complete a number of tasks relevant to their placement(s). These include appropriate preparation for the placement and a written report to be completed on return.

Students themselves are expected to fund travel, accommodation and other expenses for electives. While on approved placements, enrolled students are indemnified by the University of Sydney.

Pre-Internship Term

The Pre-Internship (PRINT) Term aims to provide the final preparation for internship, ensuring that interns will be competent and confident in their role.

In PRINT, each student is responsible for his/her own learning, and must also complete specified assessable tasks under observation by the allocated PRINT Supervisor (or delegate). The PRINT Supervisor (or delegate) is responsible for making a recommendation to a final Sydney Medical Program Examination Committee on the student's readiness (or otherwise) for graduation and internship.

The PRINT Block is normally of four weeks’ duration.

Rural placements

In line with Australian Government policy, 25 percent of domestic students must complete 50 percent of their clinical experience in Stage 3 (Years 3-4) at the School of Rural Health, which has Clinical Schools at Dubbo and Orange Base Hospitals, or at a University Department of Rural Health (Lismore and Broken Hill).

Accordingly, domestic students may opt to undertake an extended rural placement in Year 3 or Year 4 at one of these sites. Rural placements are usually very popular and a ballot is held in Year 2 for allocations. Sydney Medical Program provides self-contained accommodation and comprehensive study facilities at all four sites.

International students, while not required to undertake rural placements, are encouraged to spend time at rural teaching facilities associated with Sydney Medical School when opportunities arise.