Graduate Entry Medicine

MB, BCh, BAO (Hons)
School of Medicine

What you will study

The four-year GEM programme is divided into three cycles:

  • Junior Cycle (one year)
  • Intermediate Cycle (one year)
  • Senior Cycle (two years)

In the first year (Junior Cycle), you will be taught in a mixture of lectures on the biomedical sciences and small group teaching involving weekly cases, facilitated case discussions, data interpretation tutorials, clinical skills training, group projects and anatomy practical labs. You will learn to take and present a history from as early as the third week of the programme.

During the second semester, you will spend one half-day per week in one of RCSI’s clinical sites, and the last month of the academic year on a clinical attachment at one of the teaching hospitals affiliated to RCSI.

In Intermediate Cycle (year 2), you will be based full-time at Connolly Hospital, Blanchardstown, which is one of the main RCSI-affiliated teaching hospitals in Dublin. In addition to lectures on pathology, microbiology and clinical sciences, you will also participate in small group tutorials (classroom or ward-based) on all aspects of patient care, including history taking, clinical examination, radiology, data interpretation and therapeutics. Two clinical attachments (each of one-month duration) take place at the end of each semester, providing you with the opportunity to become an active member of a clinical team within the hospital.

In Senior Cycle the majority of instruction is hospital-based teaching, where you will be attached to consultant-led (senior physicians) teams. In the third year of the programme, you will learn paediatrics, family medicine, psychiatry, and obstetrics and gynaecology, along with medicine and surgery. The final year of the programme concentrates on medicine and surgery.

Throughout your studies you will be provided with continuous appraisal, mentoring and case presentations on an individual basis, along with frequent reviews of your clinical progress with senior clinicians in the clinical years.

Curriculum

Length and structure

Junior Cycle (JC) consists of two semesters delivered from September to June of the first year.

  • Semester 1 (JC1) – from September to January
  • Semester 2 (JC2) – from February to June

Each semester comprises 12 direct-contact teaching weeks, two weeks of revision and two weeks of examinations.

The programme is delivered through systems-based modules, teaching you about how the body works in the healthy state.

The JC structure is as follows:

First semester/JC1

  • Neuromuscular (NM) (5 credits)
  • Nutrition and Energy (NE) (10 credits)
  • Hematopoietic and Immune Systems (HIS) (5 credits)
  • Molecular Medicine (MM) (5 credits)
  • Health, Behaviour, and Patient Safety (HBPS) (10 credits)
  • Genitourinary (GU) (5 credits)
  • Clinical Competencies (CC) (5 credits)

In addition to these modules, Journal Club and Surgical Grand Rounds take place throughout the first semester.

Second semester/JC2

  • Cardiovascular and Respiratory (CVR) (10 credits)
  • Neuroscience (NS) (10 credits)
  • Population Health Epidemiology/Evidence-Based Health (PHE/EBH) (10 credits)
  • Endocrinology (END) (5 credits)
  • Clinical Competencies (CC) (5 credits)

In addition to these modules, Journal Club, Surgical Grand Rounds, Medical Grand Rounds and Wednesday Hospital Placements take place in the second semester.

After the second semester final examinations, you will have one month of hospital placement in June.

Teaching styles

JC is delivered as:

  • Lectures
  • Tutorials
  • Online tutorials and self-directed learning
  • Weekly cases learning history taking skills
  • Small group facilitated case discussions
  • Diagnostic investigation tutorials
  • Clinical skills tutorials
  • Peer-led tutoring
  • Grand Rounds attendance
  • Weekly Journal Club
  • Anatomy dissection/radiology seminars
  • Group projects
  • Clinical attachments

The weekly cases and clinical skills will be related to the system and biomedical sciences that are being taught at the time to integrate learning.

Equally, tutorials and practicals serve to reinforce and enhance your understanding of the fundamental concepts covered in lectures and test your basic understanding through applied problems in a practical context.

Assessment

Each module is assessed independently by a combination of one or more continuous assessment modalities (fortnightly MCQ quizzes, anatomy card signings, clinical case reflections, assignments and group projects); and summative end of semester examinations (MCQ and short note question (SNQ) written papers, anatomy practical examinations and clinical competencies: objective structured clinical examinations (OSCEs)).

Feedback

In JC, students receive feedback following fortnightly quizzes. Any student who has not performed well will meet with the Director and Deputy Director of the programme to ensure appropriate supports are offered when required.

Feedback is also offered following SNQ examinations and on clinical assessments so that students know how to improve their performance.

Timetable

Below is an example of a typical week for a JC student.

Morning
Monday Tuesday Wednesday Thursday Friday
Lecture Lecture Journal Club Surgical Grand rounds Fortnightly quiz
Weekly case Diagnostic investigations Lecture Case discussion Lecture
Lecture Facilitated case discussions Lecture Lecture Small group
clinical skills tutorials
Afternoon
Monday Tuesday Wednesday Thursday Friday
Card signing
Anatomy practical lab
Anatomy practical lab Lecture Lecture Lecture
Anatomy practical lab Anatomy practical lab Lecture Lecture Lecture

Length and structure

Intermediate Cycle (IC) consists of two semesters delivered from September to June of the second year.

  • Semester 1 (IC1) – from September to December
  • Semester 2 (IC2) – from January to June

Each semester comprises 12 direct-contact teaching weeks (each with three modules of four weeks duration), two weeks of revision and one week of examinations, followed by four weeks of clinical attachments.

The programme is delivered through systems-based modules, where you will gain an understanding of the basic pathological and microbiological principles underlying human disease, in conjunction with detailed teaching on clinical aspects of relevant human conditions within each module.

Each module comprises small group tutorials encompassing weekly cases, clinical skills (including relevant history-taking and examination) and radiology. Clinical teaching is also facilitated by simulation scenarios using our state-of-the-art simulators. In addition, elements of the programme are supplemented via online education and attendance at postmortems, multidisciplinary team meetings, grand rounds, etc.

The two one-month clinical attachments during IC will provide you with the opportunity to become an active member of a clinical team within the hospital, and learn about the multiple aspects of patient management within this setting.

The IC structure is as follows:

First semester (30 credits)

  • Cardiology
  • Respiratory
  • Gastrointestinal and Hepatology (GIHEP)

Second semester (30 credits)

  • Renal, Endocrine, Genitourinary and Breast (REGUB)
  • Central Nervous System and Locomotor (CNSLM)
  • Haematolymphoid and Tropical Medicine (HLTM)

Both semesters (30 credits)

  • Clinical competencies

Teaching styles

IC is delivered as:

  • Didactic lectures (including joint lectures with multiple disciplines)
  • Small group teaching/tutorials of clinical skills, clinical competencies, data interpretation, etc.
  • Weekly case review/case of the week
  • Online/blended learning activity
  • Laboratory (postmortems)
  • Practical skills
  • Self-directed learning
  • Group projects
  • Clinical attachments

In IC you will also participate in two, four-week hospital-based clinical placements in medicine, surgery and orthopaedics. This occurs predominantly in Connolly Hospital, Blanchardstown, which is one of the main RCSI-affiliated teaching hospitals in Dublin.

Assessment

Each module is assessed independently by a combination of continuous assessment (e.g. end of module MCQ exams, case of the week reports, group projects) and summative end of semester written papers (MCQs, SNQs and clinical pathological correlations (CPCs)), microbiology and pathology data interpretation and observed clinical assessment.

Final assessment of clinical competencies occurs at the end of the last one-month clinical attachment (end of semester 2) via observed clinical examinations, including long case examination and clinical stations (OSCEs).

Feedback

In IC, you will receive feedback following the end of module MCQs and end of semester examinations. Any student who has not performed well will meet with the Director and Deputy Director of the programme to ensure appropriate supports are offered when required.

Feedback is also offered on clinical assessments so that you know how to improve your performance.

Timetable

Below is an example of a typical week for an IC student.

Morning
Monday Tuesday Wednesday Thursday Friday
Weekly case study        
Pathology Pathology Microbiology Microbiology Microbiology
Microbiology Tutorial   Tutorial  
Medicine/
surgery case-based
teaching
Medicine/
surgery case-based
teaching
Clinicopathological conference Tutorial Tutorial
Postmortem Postmortem   Medicine/
surgery case-based
teaching
Postmortem
    Grand Rounds    
Afternoon
Monday Tuesday Wednesday Thursday Friday
Lectures or self-directed
learning
Clinical investigation/case
discussion
GP tutorials Clinical skills Modular case (II)
Lectures or self-directed
learning
Clinical investigation/case
discussions
Clinical skills Clinical skills Self-directed learning
Lectures or self-directed
learning
Clinical investigation/case
discussions
  Clinical skills Modular case (II)

Inter-Professional Education (IPE)

IPE is an important step in developing competent healthcare professionals, who work in teams with professionals from different disciplines and specialities.

At RCSI, students in Medicine, Physiotherapy and Pharmacy work in teams on inter-professional themed projects. Through learning together, you will understand more about the healthcare professionals you will work with in the future.

Throughout your course (from first to final year, in the classroom and clinical setting) you will come together with your colleagues in Pharmacy and Physiotherapy in a range of IPE-themed activities from stroke care, to diabetes, low back pain, frozen shoulder and infection control. Working in small groups, facilitated by your lecturers and tutors, you will work through clinical scenarios together; each student is bringing their professions' perspective to the discussion to develop an appropriate care plan for the patient.

Length and structure

Senior Cycle (SC) is delivered over the final two years of the GEM programme in RCSI-affiliated teaching hospitals located throughout Ireland, providing you with different learning opportunities.

The SC structure is as follows:

SC1 rotations SC2 rotations
Medicine and Surgery, Ophthalmology,
Ear, Nose and Throat (ENT)
Medicine and Surgery (24 weeks)
Medicine and Surgery of Childhood
and Neonatal Medicine
Sub-internship (4 weeks)
Obstetrics and Gynaecology Student Selected Clinical Attachment (4 weeks)
Psychiatry
Family Practice

Teaching styles

During the first year of SC (SC1), you will be attached on a rotational basis for seven weeks to Obstetrics and Gynaecology, Medicine and Surgery, Family Medicine, Psychiatry, Neonatal and Paediatrics. You will be fully immersed in the speciality during each attachment and will participate fully with the clinical teams in both urban and rural settings.

During the final year (SC2), you will be attached to Medicine and Surgery disciplines at local, national and international hospitals. Of particular interest during SC2 is the sub-internship programme. This offers you the opportunity to function as a member of a clinical team in preparation for internship following graduation.

Assessment

Each rotation is assessed independently by a selection or combination of continuous assessment, portfolio, logbook, case presentations, end of rotation/end of year clinical examination, end of rotation/end of year written examination (MCQ, data paper, EMQ, SNQ).

Timetable

Below is an example of a seven-week rotation in Paediatrics/Neonatal Medicine for an SC1 student.

  • Week 1-2:All students attend RCSI Day 1 for orientation. One half of the class go on a Rotunda Hospital attachment, while the other half is attached to an affiliated hospital site outside of Dublin.
  • Week 3-4: One half of the class are attached to consultant teams at the Children's University Hospital, Temple Street while the other half are at affiliated sites attached to paediatric teams.
  • Week 5-6:The students who were at affiliated sites in weeks one to four now move to Our Lady’s Children’s Hospital in Crumlin for two weeks while the students who were in Children's University Hospital, Temple Street go to their affiliated sites for two weeks.
  • Week 7:All students spend the last week undertaking self-directed learning outside the hospitals. A pre-exam review will occur with the tutors. The end of course exams are held over two days in week 7 of your rotation.

During your attachments, you will ‘take call’ in the Emergency Department at Children's University Hospital, Temple Street and Our Lady’s Children’s Hospital, Crumlin.

When you undertake the neonatology rotation in either the Rotunda Hospital or the Coombe Women & Infants University Hospital, you will receive a brief introductory lecture on the care of the newborn, and small group teaching on neonatal examination and common problems in the neonate. You will spend time on postnatal wards, in outpatient clinics and the neonatal intensive care unit (NICU) as part of a teaching ward round. You will work closely with SHOs and registrars, with an emphasis on problem-based, consultant-delivered teaching. You will also learn to take a comprehensive perinatal history of an infant and perform newborn, discharge and six-week checks. You will also learn about the well and sick newborn.

You will be asked to complete a quiz during your rotation, and you may be asked to present a case. You will be assessed in a short neonatal clinical examination at the end of the paediatric rotation, and in an end of year written paper as part of paediatrics.