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As a final year medical student, I was particularly interested by the report from Mr Goodfellow and Dr Claydon (October 2001 JRSM, pp. 516-520). They showed that in eight core clinical skills—namely, venous cannulation, venepuncture, rectal examination, nasogastric intubation, suturing, arterial blood sampling, urinary catheterization and performing an ECG—many final year medical students had little or no experience. The lack of teaching in these skills needs to be addressed. Although many teaching hospitals now have clinical skills rooms with mannequins on which students can practise, there is no substitute for the real thing.
All of the skills discussed are applied in operating theatres and anaesthetic rooms every day and I suggest that the operating theatre environment is an ideal place for medical students to learn them—not only because of the large number of these procedures but also because supervision would be mainly by consultants.
At present most medical students will not spend much time in theatre during surgical attachments. I surveyed 25 of my final year colleagues who had just finished a general surgery attachment. The average amount of time spent in theatre was one day per week. Of this sample, only 8 students said that they had spent any time in the anaesthetic room when at medical school. I therefore wonder whether a new type of clinical attachment could be set up called ‘theatre medicine’. This could be a month long, during which the students would spend all their time in the operating theatre and anaesthetic room. Along with the clinical skills benefit of such an attachment, students would get to see many different operations, which will put them in a more knowledgeable position for when they have to seek patients' consent for surgery as junior doctors.