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, but not in 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.
- choose a discipline in which you have a particular interest, or perhaps additional learning needs.
- negotiate and organise your own VS - 'Student-initiated' in Stage 1, for VS rotations additional to those which will be offered within your own clinical school.
- preference those proposed by a supervisor - 'Supervisor-initiated' in Stage 1, for selected sites (including RVEEH, and the Melbourne Clinic)
- choose to complete a rotation offered by your clinical school as part of the Stage 2 local match
- apply to do your VS in a Metro setting if you are usually at RCS, or at RCS if you are usually in a Metro school (via Stage 2 clinical school matching process)
- 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 usually with a current affiliation with the Melbourne Medical School for selected sites, or external to Melbourne Medical School only by specific arrangement and with the approval of the clinical school and DME coordinator.
Students may not arrange student-initiated VS terms during Stage 1 with supervisors at any Clinical School.
PRIOR to approaching a proposed supervisor, students MUST check with the Clinical School at the supervisor’s hospital. If the supervisor’s hospital does not have a clinical school, students MUST check with the 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, unless a valid reason for an external VS and a suitable supervisor arrangement can be made by the student and approved before the end of April. The guidelines used to assess these proposals are available on the MD policies, procedures and forms webpage. Students must attend their clinical schools for the Preparation for Practice term, and will not generally be approved for more than one overseas term during TTP. Students wishing to do a TTP term (including VS) overseas can only do so upon demonstrating the need for such, and with prior approval from their clinical school and DME, on the understanding that they are not applying for internship in Victoria.
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 stage 1, this will include any placements available at RVEEH and The Melbourne Clinic. Supervisor-initiated placements occur outside of the clinical schools.
In Stage 2, all students who did not receive a VS allocation in the Stage 1 match will be referred to their clinical school for local VS place matching. A local matching process will be offered for these VS terms, and preferences will be arranged via the local clinical school.
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.