Clinical attachments started in the 1960s to help the International medical graduates (IMGs) ‘understand the role of the doctor and the nature of UK clinical practice, particularly its legal, ethical, and cultural aspects’.
Remember, it is not a requirement to do a clinical attachment for seeking a job but definitely adds to the advantage since you get a local reference and NHS experience.
However, don't just do an attachment for the sake of doing it or just to be able to highlight them in your CV, rather utilise every penny of opportunity you get and make sure to get the best out of it.
It is advisable to learn the NHS culture, the policies, the referral system, IT system like ICE, Vital PACS, Sunrise, eDN Ward/discharge manager etc. being used in the NHS. Trust us this will help you tremendously when you start your first job and of course, is an added advantage for you. Let us see what BMJ has to say regarding the Clinical Attachment:
You get used to the NHS
You learn the UK way of working—communication, English language and accent, teamwork, consent, patients' involvement, etc
You get to know the role of nursing and other staff
You (hopefully) impress the consultants and others
You learn about the clinical speciality and acquire some useful skills
You have a local referee
You get a job
You spend time usefully, particularly if you are worried about job and future.
There is a plethora of stuff that you can undertake while doing your attachment and can be a game-changer for your job. I have listed down few of it for future clinical attachee.
Try to make an online portfolio(speak to your line manager/consultant) and start doing Mini CEX, CBDs, DOPS (if your consultant and trust allow you) etc. and get them signed off by your consultant or Registrar and make sure to highlight them in your NHS profile and CV.
This does not end here, you can very well be a part of an audit process and learn about them. Attend all the teaching sessions for FY1/FY2 etc. conducted every weekend.
If you are good at teaching, make sure to take an informal class for the medical student and get their feedbacks which would again add to your portfolio.
The one's that we have mentioned above about the portfolio is a part of Supervised Learning Events (SLEs) and assessment. Let us discuss in brief to understand them better. Shall we?
📝 Mini-CEX, also known as Mini-Clinical evaluation exercise, is a doctor/patient encounter where you will be observed speaking to and/or examining a patient and receive feedback on your performance from your Supervisor/ On-call reg.
💉DOPS, Direct observation of procedural skills, is a skill which evaluates you performing a clinical skill and receiving feedback on your interaction with the patient.
📚CBD, Case-based discussion, is an event where you will present and discuss a case (or an aspect of a complex case) you have been closely involved in and discuss the clinical reasoning and rationale.
Remember an attachment is never just an attachment if you are motivated enough to learn. Work hard, make an impression and let others tell the tale. Request your Reg/consultant to help you make a Personal Development Plan (PDP) for the duration of your attachment. I'll give an example of what I did:
"This is my personal development plan during my Clinical Attachment at ________ Foundation Trust from 13/09/2020 to 30/10/2020. I have discussed with my Supervisor in the initial meeting to achieve the following milestones during my placement:
1. To establish an e-portfolio account to work on my competencies.
2. To-do 5-10 CBD
3. To-do 5-10 Mini CEX
4. Do e-learning Modules to familiarise me with the NHS culture of practice.
5. Participate in teaching activities/presentations.
I believe this plan can be achieved during my tenure at the hospital and looking forward to learning from my colleagues, supervisors and seniors.
Put your name & signature and ask your supervisor to sign it too.
This not only shows your commitment and planning towards your future but also is very much appreciated.
Commitment starts when we start acting. There were times when we stayed back till 7-7:30 pm to complete the CBD with our On-call reg. This
gave us one-to-one time with the senior to learn more about the system and to do a few Clerking (Mini-CEX).
All in all, you have got tons of opportunities during your placement, provided you take the initiative and work for it.
Hope this idea helps a bit for those who are planning to take up Clinical attachment shortly.
Good Luck 🤞