Reflection on our first term of the LIC

We now approach the last few weeks of our first term doing the LIC. I thought it might be useful for others considering doing an LIC to hear some of the reasons why I have loved it at times, yet on other days have wished I’d stuck to the conventional fourth year. I hope it might help others to decide whether it’s right for them.

Part of a team

Firstly, the routine is a bit more like work. This makes me feel like I have more of a purpose than I did in third year doing conventional blocks. I enjoy being part of a team in primary care and feel I have a useful role.

I recognise that I am getting better at taking histories, identifying important information and using clinical reasoning to come up with differentials. I believe this is due to the sheer numbers of patients we see each week doing the LIC.

Equally, I believe the LIC is making me confident in summarising cases to senior colleagues in front of patients. I have found it easy to accumulate longitudinal patients and have had some positive experiences following them to appointments and continuing their care over time.

When not in primary care, we’re in hospital having teaching, following patients to appointments and spending time on the wards. I like that the Friarage is a small hospital where you can get to know staff. I feel I can walk onto any number of wards, recognise a familiar face and be supported to clerk patients and perform clinical skills. The time spent at James Cook hospital has given us a bit more exposure to some of the more acute presentations that you don’t always see in the Friarage hospital, which is helpful.

Busy schedule

I do, however, miss rotating around clinical specialties. I miss focusing in on one area of medicine and the feeling of covering a specialty thoroughly.  

In terms of logistics, the LIC involves a lot of travelling. I commute to GP three days a week, which takes up an hour of my day. This isn’t so bad, however combined with additional hospital appointments for longitudinal patients, and my commute home on the weekends, I do feel that I’m in the car a lot.

I am placed in Masham GP surgery. Whilst I feel lucky to be there because the staff are great, most the patients go to Harrogate Hospital when they’re admitted to secondary care. This means I’m travelling to a slightly less familiar hospital, where staff are unfamiliar with the LIC. I would be lying if I didn’t say this can be daunting.

Another aspect of the LIC I have found to be challenging is that you cannot entirely plan what is going to walk through the door in GP. This means that you aren’t necessary seeing patients relevant to fourth year outcomes every day. Due to a very full timetable and lack of ‘white space’, it can feel you just have no time to learn about the things we’re meant to learn about this year.

Learning curve

However we have been told about the ‘J curve’ students travel along whilst doing an LIC, where they dip before they exponentially improve in skill and knowledge. We all laugh and agree at this stage of the LIC we’re skimming the base of  the J curve!

For students considering doing an LIC, I would suggest reflecting upon the type of student you are before deciding either way. I think students considering doing the LIC need to be confident, able to manage a degree of uncertainty, flexible and motivated with regard to self-directed learning.

One month in (ish!)

Wow! How have we been here for over a month already? Time is flying by. This first month has really been all about settling in and finding our feet here in Northallerton. Things have got off to a great start.

Official Hull York Medical School LIC Merch.

GP life:

My GP is Mayford House based in Northallerton itself and it really didn’t take long to become part of their team. In the first month I spent a lot of time getting to know everyone both in the practice and in the community, with me spending a lot of afternoons with different teams such as the health visitors, palliative care nurses, district nurses, community midwife and the paramedics. This was a great way to fully integrate myself within the whole of the primary care and community setting right from the off. I am now doing 20 minutes appointments during the GP clinics with my GP alongside where I do the history taking and we both talk through the management plan and treatment options with the patients, followed by a short debrief after the patient has left which is time for me to get immediate feedback and to ask any questions. Within the next few weeks this will be changing. I will then be seeing the patients alone and the GP will join us after 15 minutes to talk through what I’ve done so far and then onto managements. As we progress through the year my knowledge will grow and I will hopefully be able to come up with a lot of the management plans and treatment options by myself. I look forward to seeing how this goes and improves through the year. 

I have already had the chance to follow a few patients through to the Friarage Hospital and to some outpatient appointments at the clinics. I can already see the benefit from seeing the patients right through from primary to secondary care, and then back to primary care. I currently have 2 longitudinal patients, both have been very keen to have me follow their journey which feels great. 

Free time:

Life in Northallerton is very chilled. Lots of time to explore the area as Emily has mentioned a few weeks ago. As well as this I’ve started road cycling and jogging and I’ve found that to be a great way to see more of the area and meet some local people. We have tried a few of the restaurants Northallerton has to offer and some of us even given blood! And of course, I’m really enjoying spending time procrasti-baking lots of sweet treats!! 

The All Saints Church in the centre of Northallerton one evening.
Baking 101.

All in all the first month or so here has been both fantastic and tiring and we are all looking forward to what the rest of the year here has to bring! 

Until next time!

Becca 🙂 x