What are some tips for the first period

Clinical training preparation: organization and tips

Abstract

In the course of their medical studies, all students have to complete so-called clinical traineeships (from the Latin famulus = "helper"). According to the license to practice medicine (ÄApprO), a four-month internship period is provided between the first and second section of the medical examination. These can either be spent in an outpatient facility or on a hospital ward. The aim of the clinical internship is to give the students an initial practical insight.

The focus of the clinical traineeship is the practical training, i.e. the application of the theoretically acquired knowledge in everyday clinical practice. During this time, you will be closely accompanied by the practicing doctors in the hospital or practice. Your medical colleagues will be aware that you are still in training and cannot yet know everything! The clinical traineeship is therefore not about memorizing, but rather about getting a feel for the topics and activities. You should definitely take the chance to learn under supervision and you can benefit enormously from these sections of your medical studies. Some of them have already found their later subject in this way.

At this point we have put together important topics for planning, organizing and preparing your clinical traineeships as well as some tips. In the chapter "Clinical training preparation: practical skills" you will find a compilation of important topics for the various subjects (e.g. internal medicine, surgery, neurology). You can find more information on the subject of clinical traineeships on STEIGBÜGEL - the AMBOSS clinic database (you can find the link under “Tips & Links” at the end of this chapter).

Requirements

Basics

  • Definition: clinical traineeships (from the Latin "famulus" = "helper") = practical sections of medical studies in outpatient or inpatient care

The focus of the clinical traineeship is the application of the theoretical knowledge and basic skills that have been learned so far. The clinical traineeship will be less about doing things yourself and more about observing and assisting!

Requirements for the clinical traineeship

  • Minimum duration of four months
    • 1 month: Outpatient care, so-called "clinical traineeship"
    • 2 months in total: Inpatient care ("hospital clinical training")
    • 1 month: General practitioner care
  • Period: During the lecture-free period (semester, Christmas & Easter holidays)
  • Services: There are no regular late, night or weekend services
  • Illness: Illness days must be made up at the end of the internship period
  • Remuneration: Usually there is no remuneration, but there are exceptions (see organizational matters - questions about clinical traineeship planning)
  • Internship certificates: Each section of an internship must be certified on a corresponding form
    • Each certificate must be stamped and signed by the training physician
    • When registering for the second section of the medical examination, the certificates of the clinical traineeships must be presented
    • Corresponding forms for certificates in German and English as well as for self-completion on the PC can be found under “Tips & Links” at the end of this chapter

The examination offices of the individual federal states have different requirements for the time division of the clinical traineeship (so, in some cases, 15-day sections are also recognized). You should definitely inquire about this in advance of the clinical traineeship, because in case of doubt there may otherwise be problems when registering for the exam!

When it comes to the question of which category your possible clinical traineeship belongs to (outpatient or inpatient), a request to the respective state examination office can provide clarification!

Questions about clinical traineeship planning

In the run-up to the clinical internship, you should clarify the following points:

  1. When is the best time for me to do my first internship?
    • In principle possible immediately after entering the clinical stage of study
    • It may be advisable to wait for the examination courses in the first clinical semesters in order to acquire the necessary skills
  2. In which department should I complete my first clinical traineeship?
    • The large, exam-relevant subjects of internal medicine and surgery are ideal for entry
    • Practical skills can be imparted well in outpatient clinics, as these are used more frequently there
  3. In which department should I plan my internship at a later date?
    • Pay attention to your own learning goals and interests
    • Fill your own "knowledge gaps"
    • Suggestions and ideas from fellow students
  4. Is there any special preparation in advance of the clinical internship?
    • Many faculties offer courses or peer teaching in order to learn practical skills in advance, which can then be applied or deepened during the clinical internship
  5. How do I find a suitable internship position?
    • Take a look at our clinic database "STEIGBÜGEL", here you will find reviews, experience reports and information on remuneration, meals, clothing, etc. for various clinics (see under tips and links)!
  6. Is there an internship allowance in my federal state?
    • In some federal states, remuneration is paid, especially in the outpatient and / or rural area
    • You can also find more information on remuneration in our clinic database "STEIGBÜGEL" (see under tips and links)
  7. When should I apply for an internship?
    • The earlier the better, because popular traineeship places can be allocated early
  8. How do I apply for an internship?
    • The application is usually relatively straightforward; it is best to contact the relevant department's secretariat or doctor's office directly
    • If you are interested in an internship in a certain subject, you can, for example, speak to the lecturer directly after an exciting lecture
  9. What should I explicitly ask when applying before starting my clinical traineeship?
    • Time and place of the performance on the first day
    • Food and work clothes during the internship
    • Necessity of a visit to the company doctor or family doctor
  10. Do I need any special vaccinations?
    • You may have to go to the company doctor at your university before the start of your first clinical traineeship to catch up on vaccinations or have them refreshed
    • In the case of clinical traineeships in a pediatric facility, more evidence of vaccinations may be required
    • If you are planning an internship abroad, you should, for example, inquire beforehand at the tropical institute of your university which vaccinations you need
  11. Is there insurance coverage during my clinical traineeship?
    • In any case, you should have private liability insurance during your studies
    • In the event of commuting and work-related accidents, there is insurance coverage through the statutory accident insurance (the same applies to needle stick injuries!)
    • The hospital or practice's public liability insurance usually also insures the trainees

In the event of a needlestick injury, a presentation to the responsible doctor and the D-doctor must take place immediately!

Necessary materials and equipment

The necessary utensils sometimes differ from station to station, but you should definitely have some important materials organized before the first day of your internship. In many clinics in Germany, the lab coat is provided for interns - in practices, on the other hand, you usually have to find the right work clothes yourself. If you are doing an internship abroad, you may also need your own smock and, depending on the situation, somewhat more elegant work clothes (shirt, blouse, trousers under the smock). It is also advisable to get clean and, above all, comfortable shoes for the ward, as you are likely to be out and about in the building for a blood sample, an examination, a diagnosis, an errand or further training during the day.

dress

  • Gown, if this is not provided by the hospital
  • Comfortable and clean shoes, e.g. light-colored sneakers
  • Comfortable, simple clothing

For the smock pocket

  • Notepad and pen
  • stethoscope
  • Reflex hammer
  • (Pupil) light
  • Possibly an EKG ruler
  • Tourniquet tube or belt
  • Doctors will be happy to lend you special equipment (e.g. otoscope, dermatoscope, tuning fork for neurology or fundoscopy lenses in ophthalmology)
  • AMBOSS knowledge app on the smartphone :‑)

Rules of conduct for the time in practice

DO - You should keep this in mind during your clinical traineeship!

  1. Introduce yourself by name and role to all people you deal with! If necessary, also several times. Sometimes it also makes sense to briefly explain your own position to patients.
  2. Observe basic hygienic rules! You should also pay attention to thorough hand disinfection if superiors and colleagues do not always serve as role models on this point. However, it is essential for personal and patient protection! The same applies when handling instruments and needles (no need to "re-cap" cannulas, safely dispose of all used disposable instruments in the "Sharp Safe", etc.).
  3. Observe medical confidentiality! Section 203 of the Criminal Code includes information on the areas of life of patients and staff as well as trade secrets.
  4. Ask questions if you don't understand something or don't know exactly what to do!
  5. If you are unsure about certain tasks, ask for further guidance and explanation!
  6. You should speak out on your own accord about what you would like to learn or see (e.g. a certain functional department or a special operation).
  7. If possible, take part in a service.
  8. Take care of your own health and avoid unnecessary stress!
  9. If you don't want to do something or if you don't (yet) trust yourself to do it, just say so openly and honestly!
  10. Look up teaching content that you do not understand in everyday clinical practice or write it down so that you can remember it later!
  11. Get the best out of chores for you from chores!
  12. Speak openly about problems that may arise or point out conditions that are bothering you! Your successors will surely thank you!

DON'T - You'd better avoid this during your clinical internship!

  1. Do not overestimate yourself!
    • The clinical traineeship should primarily be about gaining initial clinical experience, learning from observations and using your questions to gain new clinical knowledge
    • You should only work on the patient under close guidance and supervision
    • You can also reject tasks that overwhelm you!
  2. Do not be arrogant towards patients or staff
  3. Do not push yourself or make demands, but politely ask everyone involved for help or advice.
  4. Don't let everything fall to you!
  5. Do not answer patient questions that you cannot answer precisely!

The work in the hospital is teamwork and therefore all employees are dependent on each other. So you should by no means consider yourself to be something better. In addition, working in a relaxed environment is much more fun!

It doesn't matter if you make mistakes in everyday clinical practice. However, you should address them openly and not try to hide them, because even supposedly minor errors can have serious effects!

Internship abroad

It is generally possible to complete clinical traineeships abroad as an outpatient or inpatient. If an entire semester abroad is too time-consuming or too long for you, the internship offers a good opportunity for a shorter stay abroad during your studies.

We have put together some important aspects for planning and implementation in this section. It is important that you think early on when you want to complete an internship abroad and plan a corresponding amount of time for the organization.

  1. Search for a suitable traineeship place
    • Many faculties offer advice on a planned stay abroad or are in contact with partner faculties abroad
    • The local federal representation of medical students in Germany (bvmd) can also help if necessary
    • With the independent organization you can benefit from the experiences of others (friends, acquaintances or experience reports on the Internet)
  2. Clarify accommodation
    • Is there a student residence or does the accommodation have to be found privately and / or financed?
  3. Financing the stay abroad
  4. Clarify important insurance issues
    • International health insurance (with repatriation)
    • Professional liability insurance (to be discussed with the on-site clinical trainee)
    • Private liability insurance (including protection abroad)
  5. Get important documents
    • passport
    • If necessary, visa
    • Language certificates
  6. Complete travel vaccinations
  7. Obtain internship certificate: You can find the appropriate forms for certificates in German and English as well as to fill out yourself on the PC under "Tips & Links"

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