In the final year of the MD course your focus will be on internship readiness, preparing you for the transition to a junior doctor role by developing and demonstrating your clinical skills, knowledge, and professional behaviour in diverse hospital environments. At the Year 4 level, all streams converge within the Applied Clinical Knowledge (ACK) stream, which provides a structured yet flexible framework for consolidating prior learning and applying it in real-world clinical environments. Through hospital placements in key specialties—including internal medicine, surgery, psychiatry, women’s health, children’s health, and critical care—you will gain hands-on experience in both rural and regional settings, refining your clinical judgement, decision-making, and professional identity as you prepare for independent practice. In addition to core placements, an elective term allows you to explore areas of particular interest, deepening your clinical exposure in preparation for your chosen career path. Your learning is further reinforced through structured activities that enhance clinical reasoning, adaptability, and patient-centred care. To complement hospital placements, MDNEW9000 provides structured learning activities that enhance clinical knowledge, professional competencies, and reflective practice. These include Case-Based Discussions, The Medical Practitioner Expert Hot Topics, and Practical Approach in Becoming an Intern, which bridge the gap between medical education and clinical practice. These activities offer structured opportunities to engage with complex clinical scenarios, refine decision-making skills, and develop effective communication strategies. By simulating real-world challenges, these sessions equip you with the critical thinking and adaptability required for intern-level responsibilities, ensuring a seamless transition to professional practice. Your learning in MDNEW9000 culminates in two structured portfolio interviews. The first, held in the first half of the year, focuses on reflections relating to First Nations peoples’ health and perspectives, as well as your developing professional identity. The second, conducted later in the year, provides an opportunity to reflect on your clinical experiences across the program, articulate your career plan, and demonstrate your competence and readiness for internship. Supported by evidence from your portfolio, the final interview allows you to showcase your growth, resilience, and preparedness for independent practice within a healthcare team. Through this process, you will highlight your ability to integrate clinical reasoning, ethical considerations, and patient-centred care into your role as a junior doctor. In addition to hospital placements, Back-to-Base (B2B) weeks are integrated into MDNEW9000 to reinforce learning and provide opportunities for structured reflection, synthesis of clinical knowledge, and targeted skill development. These sessions include advanced workshops and simulations, guided by experienced mentors, allowing you to refine your critical thinking, teamwork, and patient-centred care. Through interactive learning, you will develop the adaptability and collaborative skills necessary for modern medical practice, ensuring you are well-prepared for the challenges of internship and beyond. Throughout your hospital placements, you will engage in supervised clinical interactions with patients and families, gaining hands-on experience under the guidance of physicians and other discipline experts. Your training will span six core disciplines: Women’s Health, Children’s Health, Mental Health, Internal Medicine, General Surgery, and Critical Care. The Unit Learning Outcomes (see section 4) will be achieved through your active participation in patient care, supported by highly trained clinical supervisors who provide regular feedback within a coaching model. Additionally, you will collaborate with other healthcare providers and social services, ensuring a well-rounded clinical experience that prepares you for the transition from medical student to a confident, capable, and accountable junior doctor.
First Nations Health The health of First Nations peoples is addressed specifically through the First Nations Curriculum as well as integrated throughout the program. Leadership in Cultural Safety: Prepares students to take on leadership roles in promoting culturally safe healthcare. Leadership skills are essential for driving change and improving healthcare practices at systemic levels. This skill is important to build allies for system changes. Advanced Clinical Practice: Focuses on advanced application of culturally safe practices in diverse clinical settings. Advanced clinical skills ensure that healthcare providers can deliver high-quality care to all patients, including those from First Nation communities.
Hospital Placements Hospital placements in Year 4 serve as the foundation for your transition to independent clinical practice, offering immersive learning experiences that span the patient journey from initial presentation to discharge and beyond. Through Entrustable Professional Activities (EPAs), you will demonstrate your capability with common clinical tasks under varying levels of supervision, aligning with the expectations for an intern. These placements will deepen your ability to diagnose and manage a broad range of conditions across key medical disciplines, while also highlighting the essential role of interdisciplinary collaboration in delivering comprehensive patient care. Your professional growth is further supported by weekly teaching sessions, which cover critical aspects of clinical practice, fostering effective communication, teamwork, and ethical decision-making. Additionally, assessments—including hospital supervisor term reports and the applied knowledge exam—ensure a structured evaluation of your clinical competencies and preparedness for internship. These assessments, along with your performance with EPAs, contribute to the mid-year Progress Panel meeting, allowing for early identification of students needing additional support before the End of Year Progress Panel review. Having completed your MD research project, you will also refine your professional presentation skills through the 5-Minute Project Presentation (5MP) presentation and an electronic poster, reinforcing your ability to succinctly communicate research findings, a crucial skill for evidence-based medical practice.
Back to Base (B2B) Complementing hospital placements, B2B weeks provide structured opportunities for reflection, synthesis, and targeted skill development. These sessions are integral to the ACK stream, which unites programmatic assessments, thematic learning streams, and practical experiences to integrate between academic learning and clinical application. During B2B weeks, you will engage in advanced discussions, workshops, and simulations, focusing on critical thinking, decision-making, and patient-centred care. These sessions, led by experienced mentors, reinforce the adaptability and problem-solving skills required for your transition to internship. Beyond academic preparation, B2B weeks also serve as a social and professional milestone, fostering peer support and professional identity formation. This comprehensive framework guarantees that you are fully prepared for the final year assessments and progression to internship, emerging as a competent, reflective, and patient-focused medical practitioner.
Placement Structure in Year 4 In Year 4 of the MD Program, you have the opportunity to engage in placements across five major clinical specialties, plus a six-week elective period focusing on a chosen area of interest. The elective will be proposed, reviewed and reported on by both you and your supervisor. 1. Internal Medicine (6 Weeks): This placement is designed to assist your transition from general practice to the complexities of hospital-based internal medicine. It emphasises applying health care principles in a hospital setting, focusing on advanced condition management, learning specific procedures, and improving diagnostic skills. Key aspects include interdisciplinary collaboration and ethical decision-making, aiming to provide a comprehensive and patient-centred approach to care. 2. Surgery (6 Weeks): Building on prior knowledge, this intensive placement deepens understanding and skills in surgical care within the hospital context. It bridges the gap between primary and specialised surgical care, highlighting advanced procedures, perioperative patient management, and interprofessional teamwork, all in the hospital setting. 3. Mental Health (6 Weeks): Both acute and chronic psychiatric care, as well as other specialty areas are covered in this placement. It should enhance your ability to recognise and manage common mental health disorders in a hospital setting. It covers advanced treatment approaches, crisis intervention, and the ethical aspects of involuntary treatment, preparing you to handle complex psychiatric cases effectively. 4. Women’s & Children’s Health (6 Weeks): This comprehensive placement covers advanced aspects of obstetrics, gynaecology, reproductive health, and paediatric care in a hospital environment. It prepares you to manage a variety of common and important scenarios, emphasising practical application, ethical considerations, and critical thinking in healthcare delivery for women and children. 5. Critical Care (8 Weeks) This placement aims to provide you with a grounding in emergency medicine, intensive care medicine, and anaesthesia, focusing on urgent and critical care scenarios. It encompasses emergency procedures, life-saving techniques, patient-centred care, and ethical decision-making, bridging the theoretical and practical aspects of medical care.
Alternative longitudinal integrated placement approach: MDNEW9000 may be undertaken in specific hospital settings as a longitudinal integrated placement across the 32-week hospital placement year. Learning outcomes will be the same as the traditional block rotations, and workplace-based assessments will continue, with EPAs and Hospital Supervisor term reports. Formal assessments, portfolio interviews and B2B weeks will be maintained. Timing of Elective in the second-half of the year will be individually determined.
Electives: In the second half of the year, you will embark on a six-week elective, choosing an area that reflects your interests. The Elective is undertaken full time (5 days per week). This period allows for exploration and deeper understanding of a specialised area of medicine, encouraging personal and professional growth within their medical journey. The elective requires a structured proposal from the student, which is reviewed; supervisor agreement; and student and supervisor reports. Please note electives, in particular overseas electives can take 12 months to arrange and finalise. Steps for Students to arrange Elective Placement Step 1: Submit Your Application on the Project Elective Proposal Template Step 2: Application Review and Approval Step 3: Student Placement Agreement Arrangements Step 4: Final Approval
Faculty Facilitated Learning Activities The breadth and depth of learning expected in a medical program is large. To further support you, extra classes have been scheduled to promote collaboration, discussion, strengthen understanding, consolidate your learning and provide the essential foundational insights required in medicine. What does Whole Person Care look like in the Hospital Environment? The generalist approach and Whole Person Care philosophy that you are familiar with also applies to the Hospital context. Generalism is present in hospitals: however, it is less obvious as the relationship between doctors and patients can be limited by systemic constraints, and other members of the team may focus only on some of the knowledge you are bringing together about the whole person. Further, the terminology used in the hospital context to discuss the complexities of patients' immediate needs and ongoing health concerns is going to be different to what you may understand using The program's approach to Whole Person Care and Generalism. As you progress through fourth year, take time to notice where (and who) cares for the inner and outer context of a person’s health in the hospital context. You can continue to learn and refine this aspect of your clinical care through learning from other members of the clinical team, and directly from each patient you care for. As final-year students you contribute to patient care. The skill of caring for an acute or urgent problem that has brought the person to the hospital, while being aware of their inner and outer context of health, is a sophisticated skill of good hospital based doctors. While you are learning in this space, look for expressions of this approach as you proceed throughout the year, and consider how you can apply these principles when the opportunity arises.
What does Clinical Reasoning look like in the Hospital environment? The Clinical Reasoning Framework is vital in all clinical contexts, including the hospital. You will remember that Clinical Reasoning is the "clear and coherent, plausible, and agile explanation behind a specific decision.” When confronted by unfamiliar problems or patient concerns, and especially when you are unsure about where to begin to analyse the many components involved, the Framework will give a structure for you to methodically begin to resolve your questions. This tool will also be helpful to direct your conversations with supervisors and colleagues, and will help you explore not only how you reach decisions, but also understand how others have too.
Synchronous activities The Medical Practitioner Expert Hot Topics These one-hour sessions address current, pressing issues in hospital-based medicine that are essential for senior medical students transitioning to internship. Each topic is chosen for its relevance to emerging trends or challenges in clinical practice, aligning with the realities that students will encounter during their upcoming internships. Presented by experienced discipline experts, these sessions allow students to deepen their understanding of complex clinical scenarios and management protocols. The primary purpose is to keep students informed of the latest evidence-based guidelines and clinical innovations, ensuring they remain adaptable and prepared for dynamic healthcare environments. The sessions encourage active engagement, with opportunities for questions and case-based discussions, fostering a deeper understanding of the practical application of knowledge.
Practical Approach in Becoming an Intern These sessions focus on equipping students with essential skills for effective practice during their intern year. The "On Call" sessions simulate common scenarios encountered during shifts, emphasising decision-making, clinical prioritisation, and effective communication under pressure. By focusing on practical, high-pressure situations, these sessions help develop the competencies necessary for handling unpredictable and acute patient presentations. "Medication Safety" sessions are equally crucial, teaching students safe prescribing practices, the management of high-risk medications, and error prevention strategies. These training sessions link directly to real-world applications in hospital settings, providing students with the confidence and competence to safely manage medications and clinical scenarios they will face in their intern year.
Case-based Discussions Case-Based Discussions are designed to enhance reflective learning and integrate clinical experiences with theoretical knowledge. In these two-hour, small-group sessions, students present real cases from their placements, encouraging in-depth analysis and reflection. The rationale for this format is to build critical thinking and communication skills, as well as foster peer learning through group discussion. Clinical Academics and other clinicians attend these sessions as facilitators. They may give feedback and ask some questions to clarify a student's explanation in the case presentation. In the student reflection time, they may help to guide the choice and use of resources in the hospital environment, with debriefing as necessary, and help students adjust to the hospital environment and their new role. These CBDs extend the previous (Year 3) depth/level into complex hospital scenarios. CBDs provide an opportunity for students to explore complex cases, drawing on knowledge from various streams such as Digital Health, Professionalism, and First Nations Health. The focus on real-world cases ensures that learning is grounded in the practical challenges students will face as junior doctors, fostering their ability to manage complex, multifaceted conditions with confidence and competence.
Asynchronous activities Asynchronous activities have been developed within each discipline, including specific modules to support your learning, provide further resources and give you an opportunity for consolidating cases seen in the hospital setting. Completing these activities will help you achieve the learning outcomes irrespective of your hospital placement.
A significant amount of self-directed learning (SDL) is required in this unit, and you should take advantage of any free time for this during each week.
Programmatic Assessment The key principles underpinning the assessment framework include its programmatic nature, proportionality, focus on feedback dialogue, focus on growth and continuous monitoring of progress towards defined learning outcomes. This longitudinal approach integrates various assessment methods over time to provide a nuanced understanding of learner progress and competence, spanning "Knows," "Knows How," "Shows How," "Does," and "Is" (revised Miller pyramid). Central to this programmatic philosophy is the longitudinal and integrative perspective: rather than relying on isolated single-event data points of assessments, programmatic assessment emphasises the importance of longitudinal ongoing evaluation and meaningful integration of assessment information. Information from individual assessments is integrated, allowing for holistic judgements to be formed through triangulation of evidence from multiple sources. High-stakes progression decisions are underpinned by rich data, ensuring transparent, credible, accountable and fair judgments. This program of assessment for learning is grounded in evidence-based practice and promotes learning rather than simply measuring performance. Assessment for learning is designed to help students recognise and develop strengths in areas of knowledge and skills that require improvement. It aims to provide ongoing feedback and support throughout the learning journey, and it is hence a foundational element of programmatic assessment for learning. Assessment of learning (AoL) is used to demonstrate ‘readiness to progress’ and supports decisions about progression to the next stage of education. Through Assessment as learning (AaL), students are active participants in the assessment process and their progress, with reflection, self-assessment and agency, guided by the Portfolio. While the emphasis is heavily on learning and development (AfL and AaL), programmatic assessment also fulfills the need for AoL, for progress and completion of the program. To support this each assessment outcome is feedback rich and rubrics are designed to report progress against the defined criteria in three categories are: - Targeted advancement required
- Must address feedback
- Opportunity to address feedback
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