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By Ian Allan

While numerous generations of small boys can have dreamed of turning into engine drivers, and the top-link motive force at the nice named expresses of the age of steam could have been the top of the railways, when it comes to well known notion, those members may possibly in basic terms have gotten there with the help of myriad different trades and after years of progressing during the extra junior grades of footplate employees. From the standard junior porter via to the chairman of the board, the railways hired an enormous array of alternative trades, all of whom have been crucial in retaining the trains operating. a few of these jobs, comparable to that of the song gangs, are nonetheless an immense a part of the upkeep of the fashionable railway, yet many others, similar to blacksmiths, have now disappeared.

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These are still usually in hospital specialties such as medicine, surgery, paediatrics, obstetrics and gynaecology. This is now followed by Foundation Year 2, with a further three posts of 4 months duration, including a wider range of specialties, including general practice. These general practice posts have proved a great success and are very popular with young doctors. Following these 2 years, doctors enter specialty training. The time to complete such training varies, from 3 years for general practice to 8 years for some of the surgical specialties.

Early clinical experience can take place within a wide variety of settings. While the majority takes place in community health settings, some is based in hospitals. A few involve nonclinical settings such as schools, voluntary organizations or community groups. The setting depends on the specific learning outcomes that are intended from the experience. There is no evidence from the literature that any one approach is best. Any form of integration within the curriculum raises challenges as to who owns the curriculum.

While there is a correlation between knowledge and clinical performance, the two are not identical. It is now recognized that the ability to apply knowledge appropriately is the important measure. ’ (Corbett & Whitcomb 2004). Following the Flexner Report in 1910, the conventional medical undergraduate curriculum had two distinct phases. In the preclinical phase the students learnt the basic science underlying medical practice and had little contact with patients. During the clinical phase, most learning took place in clinical placements or clerkships with little input from the basic sciences.

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