Transition to Practice (TTP) is the capstone subject for the Melbourne MD, rounding off the fourth year of your studies. TTP consists of four 4-week terms, one of which is Vocational Selective.
The Vocational Selective is intended to provide you with an opportunity to explore an area of medical practice of interest to you and which you might consider as a possible vocation.
Along with the MD Research Project that precedes it, the Vocational Selective (VS) is a formal part of the curriculum that carries expectations of the activities you will undertake under the dedicated supervision of clinical supervisor(s). The VS is conducted within the Melbourne Medical School's network of clinical placement sites however, this is not the usual range of intern settings. As much as possible, you will experience the vocation in the same way as a Fellow of the discipline.
This is an opportunity to consolidate your knowledge of the breadth of clinical medicine as viewed from the perspective of a Fellow of a chosen discipline. It is also intended that you will be involved in clinical care of patients as appropriate and to engage with suitable educational opportunities.
- choose to add a clinical perspective to research activities by undertaking a Vocational Selective in the same discipline in which you undertook your Scholarly Selective
- choose a discipline or context in which you feel you have unmet learning needs
- choose a clinical area about which you are uncertain, as much to exclude it from your vocational considerations as to include it
- negotiate and organise your own VS - 'Student-initiated'
- preference those proposed by a supervisor - 'Supervisor-initiated'.
You are encouraged to think carefully about the selective you choose, while also being open to a range of possibilities. Try not to become fixated on securing a selective in a particular sub-specialty (or at a particular location with a particular supervisor) and narrow your choices unreasonably.
Those students who wish to organise their own Vocational Selective may approach practising clinicians who have a current affiliation with the Melbourne Medical School and ask if they will supervise them. Ideally, the student will have an existing mentoring relationship with this supervisor.
PRIOR to approaching a proposed supervisor, students MUST check with the Clinical School or Department with which the proposed Supervisor is associated. This helps ensure the supervisory capacity of clinicians who are required for PCP2, PCP3 or Trainee Intern roles is not compromised. A list of relevant contacts is available here; with the form to be used for information gathering and approval of proposals located here. This form can be completed online or alternatively printed, completed in hardcopy and scanned for emailing. Clinical Schools and Departments will grant permission to approach prospective supervisors on a "first come, first served" basis.
All Vocational Selectives must be based in Victoria, but do not need to be undertaken at the clinical school students were allocated to for PCP2/PCP3. The guidelines used to assess these proposals are available on the MD policies, procedures and forms webpage.
It is important to recognise that busy clinicians have limited supervisory capacity and will not be able to agree to all requests.
Once the supervisor's agreement is obtained, the student is obligated to undertake their selective with that supervisor and may not change their mind.
Students who do not wish to organise their own Vocational Selective are able to express their preferences for a pool of selectives initiated by individual supervisors, private clinics or hospital-based units. In choosing your preferences, make sure you:
- think broadly about disciplines in which you are interested
- consider the likely workforce demand for that discipline into the future
- keep an open mind about where you are prepared to go to undertake a selective in that discipline.
Disciplines such as Paediatrics, Obstetrics & Gynaecology, and Emergency Medicine are likely to be heavily subscribed, especially in inner metropolitan areas. Opportunities may be easier to find in other localities.
Example Weekly Schedules
Some examples of what a week during a Vocational Selective might look like.
|Supervisor||Ms White (Lead)||Mr Black||Mr Black||Ms White||Mr Black||Ms White|
|AM||Northern Hospital OPD||Epping Rooms||Bacchus Marsh Theatre & Wards||Epping Rooms||Grand Rounds & Wards||John Fawkner Theatre (optional)|
|PM||NH Wards||Student Self-Study||Bacchus Marsh Rooms||Student Self-Study||Year 2 MD Teaching|
General Practice Placement
|Supervisor||Dr Green (Lead)||Dr Green||Dr Green||Dr Brown||Dr Green||Dr Brown|
|AM||Clinic||Clinic||Home / Nursing Home visits||Clinic||Well-Woman Clinic (Prac Nurse)||Clinic (Optional)|
|PM||Clinic||Student Self-study||Asylum Seeker Resource Centre||Student Self-Study||Clinic||Clinic (Optional)|
|Supervisor||Dr Blue (Lead)||Dr Blue||Dr Blue||Dr Blue||Dr Blue||N/A|
|AM||Ward Rounds & Admissions||General Unit OPD||Private Consulting Suite||Ward Round & Failure to Thrive OPD||Hume Community Clinic||N/A|
|PM||Ward Work inc. MD3 Teaching Ward Rounds||Student Self-Study||Ward Work or Endoscopy List||Student Self-Study||Rumbalara Aboriginal Health Service||N/A|
Safety and Quality Improvement Project Plan
As part of the Vocational Selective assessment, you are required to design a safety and quality improvement project plan. A 1000 word report is to be submitted via your host clinical school by the end of the selective and a copy discussed with your supervisor. It is intended that your project will contribute useful information to the supervisor and his or her clinical team as well as increasing your understanding of and participation in the discipline's approach to these issues.
Suitable projects might include, for example, an audit of medication charts, an analysis of compliance with hand washing procedures, or a report on the appropriateness of patient information within the clinic. Consider this carefully and consult with your supervisor(s) as to the appropriateness / usefulness of project ideas.
You will undertake at least two 30-minute case-based discussions with your supervisor during the 4 week term, involving a structured reporting of a patient's clinical presentation, management plan and the medical issues relevant to the case, at a level appropriate for a final year medical student. This may be undertaken as a presentation at a unit or clinic meeting if appropriate.
Supervisors are required to complete a structured report on your performance during the term, and are encouraged to discuss it with you before submitting it. You will be provided with a copy of this report to add to your vocational portfolio if you wish.
Can I set up my own Vocational Selective?
Yes. Students are encouraged to set up selectives in disciplines in which they are particularly interested from a vocational point of view. As per the above, students MUST consult with the relevant clinical school or department before approaching a potential supervisor.
What happens if I don't want to or can't set up my own selective?
You will be able to choose a selective that has been proposed by a supervisor.
Can I do my Vocational Selective interstate or overseas?
No. Selectives must be undertaken within the Melbourne Medical School's network of clinical placement sites throughout Victoria, with a supervisor who has a current connection to the Medical School.
What happens if I can't set up or choose a selective in the exact discipline or location that I want?
Flexibility will improve your chances of satisfaction. You should be able to gain the knowledge and experience you need in a different location or a similar discipline.
Do I have to spend all of my time in public hospitals?
No. Where appropriate, supervisors are encouraged to take their students to their private rooms and into private hospitals (with the hospital's approval). This model has been well embedded in general practice and in rural areas for many years.
What about insurance?
MD students undertaking an approved Vocational Selective are automatically covered by the University's public liability and professional indemnity policies, whether in public or private clinical settings.
Details are available.
Why are we all asked to keep Thursday afternoons for self-study?
Ideally, students will arrange to come together in their local areas at these times to discuss their selectives and to meet with their Transition to Practice mentor. It may be that Thursday afternoons are unsuitable (for example there is a valuable learning opportunity which unavoidably clashes). On the whole it is expected that you will spend time with your peers and Transition to Practice mentor, reflecting on and consolidating the learning experiences from the Vocational Selective.
I have a question not covered above – where can I get an answer?
Any queries can be directed to firstname.lastname@example.org.