For Fourth Years

Please see below for some frequently asked questions we get from you fourth years about placements and exams :)

Note that there are lots of answers to FAQ’s on Blackboard in the Undergraduate Handbook and specific module sites, including the assessment module site where you will find comprehensive explanations of the assessment process.


Can I apply to placement with somebody else to end up at the same location?

If you have special consideration for priority placement allocations, the faculty deem it reasonable to apply with another student to a specific region for Fourth and Fifth Year placement allocations. Both students need to address this preference in their emails to the Placements Team. Unfortunately, it is not possible to guarantee this request will be granted but the Placements team will try their best to accommodate these kinds of requests.

Can I miss placement to attend a scientific conference to present my work?

If you are planning on missing placement to present your work at a scientific conference, then it is necessary to inform and get approval from your clinical supervisor. In principle it is considered acceptable to miss up to 2 days for a conference to present one’s own research at a national or international meeting. However, this is at the discretion of the placement lead and you should do everything you can to avoid key induction or assessment dates within modules, in other words activities that cannot be replicated on a different date.

Will I get reimbursed for travel to and from placement at weekends?

No. Placement hubs/spokes are not obliged to refund students for transport to/from Southampton at weekends during placement if they are offering the student accommodation during the week and weekend. This includes students based on the Isle of Wight and Jersey. If a student has any concerns regarding this, then they are advised to speak to their hub/spoke centre directly as Health Education Wessex distributes the tariff money directly to individual centres to fund student accommodation and travel reimbursement. The Hubs and spokes that provide accommodation are generally obliged to refund students for one journey there and one journey back during the entirety of their placement. However, individual arrangements may vary and if in doubt you should check with your hub/spoke. These issues are all outside of the control of Faculty because of the nature of the direct funding from Health Education Wessex. If during the middle of a placement, you need to return to Southampton for something the Faculty are requesting that you attend or something the Faculty are organising that you are involved with e.g. a medical school representative meeting, then the faculty will reimburse your travel to and from your hub/spoke centre.

If I have a placement-specific problem during a module, who do I contact?

If your problem relates to practicalities such as accommodation or timetabling, contact your placement administrator or placement lead. In some cases it may be worth also contacting the University placements team, particularly if you have not been able to resolve the problem locally. If your problem is academic, contact your placement lead. If necessary you may also contact the overall module lead from the list below:

Module leads and administrators:

  • Year 4 lead: Dr Helen Lotery

  • ENT/Head&Neck: Mr Nimesh Patel

  • Ophthalmology: Mr Jay Self

  • Dermatology: Dr Michelle Oakford (Southampton); Dr Cathy Christie (Portsmouth)

  • Neurology: Dr Rhiannon Morris

  • Acute care: Dr Jonathan Fennell

  • Obstetrics and Gynaecology: Mr Obinna Mba

  • Child Health: Dr James Nurse

  • Psychiatry: Dr Carlos Hoyos

You will also be assigned a clinical supervisor at your Spoke for the attachment, so they may be suitable people to contact for more specific questions. The Placements Team are also happy to be contacted if there are any concerns.

What to do if you are not happy with an ACC?

You will also receive 1 to 1 feedback immediately after the ACC about your performance and how you can develop for future practice. Your examiner is not allowed to negotiate your scores with you and their judgement is final. University regulations allow students to appeal against the decision of a board of examiners and the regulations concerning appeal are available on the University website. However, please note that the board of examiners will sit after each sitting of finals and will only decide the outcome after finals has been sat. Therefore, formal appeal is only open to students after the Board of examiners has determined that a student has failed a component. You are however asked to countersign the ACC form to confirm that the ACC was conducted properly (the rules regarding the proper conduct of the assessment are printed on the first page of the ACC forms) and if for example it was not, then you cannot sign this statement. In this situation, you should report your concerns in the first instance to the specialty lead for the placement concerned and failing that then escalate the matter via the faculty student office.

What happens if I need to miss placement for any other reason?

The absence policy for the clinical years is laid out in the undergraduate handbook – here are extracts of information copied from the specific section about absence from placement:

Absences during ALL clinical placements should be reported to the appropriate placement co-ordinator & you should liaise directly with them to re-arrange any sessions missed. The course is full time so 100% attendance is the expected norm in the same way as for a F1 doctor. However the faculty also encourages students to pursue academic excellence, for example presenting their own research at conferences, and therefore it may be necessary to consider being absent for up to 2 days for this purpose. We also encourage students to take responsibility for their own health and that of their patients and colleagues, and therefore it may be necessary to have short (e.g. half day) absences for medical appointments. We realise of course that unanticipated absence may also occur, whether absence due to illness or due to bereavement or family crisis. This is on the background that some parts of the course are relatively easy to catch up on, whereas at the other end of the spectrum some structured parts of the course cannot be replicated on another date.

If leave can be anticipated such as a hospital appointment, then please give as much warning as possible to the placement in case there are any adjustments in the timetable that can be made in order to help enable you to achieve the learning outcomes.

 Ultimately a student can only pass a module if they have achieved the learning outcomes within the time period of the module. There may be situations where this is not possible and a student understands that they may have to complete some supplementary work. An example of this is the need to schedule an elective operation, although these should be scheduled in holiday periods whenever possible. Students are encouraged to seek advice from disability senior tutor.

Please note that absence of 4 continuous weeks or more will result in suspension from the year.

 It is impossible to cover all potential reasons for a student to be absent so some more complicated requests need to be considered more centrally in the faculty. Additionally if there is a recurrent pattern of missing single days then this will also be referred up centrally to the faculty.

When will I find out placement allocations for Final Year?

The Placements Team usually aim to have the emails confirming placement allocations sent out at the end of Jan/Feb. However, it may be delayed due to unforeseen issues.

When are the summer holidays and when will they be confirmed?

For 2019-20, the summer holiday will start on 30th May 2020.

How do I gain exemption from final year ACCs?

Your performance for each ACC is assessed by the examiner on a 6 point scale ranging from 1 well below expectations to 6 well above expectations. A score of 4 indicates you are meeting expectations. 3 ACCs are completed in each of O&G, Psychiatry, Child Health in fourth year and Surgery, Medicine and Primary care in fifth year. To gain exemption you will need to achieve an average of at least 4/6 (i.e. on average meet expectations) when your scores are averaged across 13 different elements. To gain exemption you must achieve or exceed this mean score for all 13 elements. If you have done this then you will gain exemption. The 13 elements are the 6 specialties and the 7 domains (history taking; communication skills; examination skills; professionalism; organisation; clinical judgment; overall achievement of the task). Therefore, your average must equal or exceed 4/6 when the scores in each and every domain are averaged across all 18 ACCs for each of the 7 domains and when your average equals or exceeds 4/6 in each and every specialty (i.e. the average of your 3 ACCs in each specialty).

When do we pick SSU choices for final year?

The information about choosing SSU will be sent out from the Placements team along with the information about Final Year placement allocations and we usually expect this to be the end of February. You willthen have until a specified date, usually around the end of March, to submit your SSU preferences.


What is the exam content based on?

For the 2 synoptic MCQ and short answer exams, the great majority of the questions will involve patients of the type you encounter during Year 4, and will thus test your knowledge of psychiatry, obstetrics and gynaecology, paediatrics, head and neck, neurology, ophthalmology, dermatology and acute care. However, the content of the questions will be based on the learning outcomes not only of the clinical modules in Year 4 but also of:

  • Years 1 to 3 learning outcomes

  • Cross over between specialities (e.g. Acute care occurs in all of the clinical modules)

The Clinical Ethics and Law paper is set based on the learning objectives for the module and the teaching sessions throughout the year.

Is there a syllabus of what to revise?

No syllabus is provided because the faculty cannot say what will and will not be relevant for your future practice. The best advice is to learn what you have been taught: make sure you understand important principles from previous years of the programme, revise what you have learnt during your clinical attachments this year, think about the patients you have seen and what you have read, and attend the revision lectures at the end of the year.

What exams make up Year 4 assessments?

  • Paper 1 – Synoptic MCQ

  • Paper 2 – Synoptic MCQ and a short, written answer section

  • Clinical Ethics and Law written paper

For more information about these examinations, please view the Year 4 Assessment area on blackboard.

Which Year 4 exams count towards our Foundation Programme rankings?

The Foundation Programme ranks students on a point system out of 100. There is a maximal 43 points for EPM (educational performance measure), 2 points maximum for publications, 5 points maximum for extra degrees and 50 points maximum for the SJT. The EPM is calculated based on a combination of exam results. Both year 4 examinations count towards this: 30% for the Year 4 MCQ exam and 20% for the Clinical Ethics and Law exam. The other 50% is for the third year OSCE. The EPM uses a decile ranking system from 34-43 points, 34 being the lowest points awarded and 43 being the highest, which is based on your ranking in the medical school with the results from all the examinations previously mentioned.

Why is the MCQ Paper 2 before Paper 1?

Paper 2 contains some written answer questions which take longer for the exam team to mark than Paper 1, which is exclusively MCQ questions. Paper 2 will therefore appear before Paper 1 on the exam timetable to ensure there is sufficient marking time within the quick turnaround period.


What is the formative CSE?

The clinical summary exam (CSE) has been designed to test skills of data summarisation, interpretation, synthesis and written communication, all of which are important skills for foundation doctors. This is strictly speaking not part of Year 4 assessments but is important practice for Fifth Year. To summarise this concisely, the CSE will consist of 2 papers:

  • Paper 1 is a written paper and will consists of tasks, such as writing a: discharge summary, referral letter, transfer letter, investigation request, death certificate

  • Paper 2 is a practical paper with 2 types of question:

  1. prescribing of discharge or in-patient medication

  2. audiovisual task, such as observe a ward round and keep written notes as the ward round proceeds; observe a GP consultation and keep notes; observe a psychiatric consultation and record the mental state examination; observe a handover and keep notes/ organise a task in order of priority

Further detail can be seen by reviewing the Year 4 Assessments page on blackboard and watching the recorded Panopto lecture.

What is the mock PSA and when will this be?

The PSA (prescribing safety assessment) forms part of the examinations in final year. In fourth year, the faculty offer a mock PSA, a half-length paper (30 questions/ 1hr), which can be completed online. This is highly recommended and proves useful practice for the real thing. Date to be confirmed.

When are the year 4 synoptic and clinical ethics and law exams?

The exam dates for 2019-20 are likely to be:  

  • Clinical Ethics and Law paper and Paper 2 on Tuesday 26th May 2020.

  • Paper 1 on Wednesday 27th May 2020.

When will exam results be released?

For 2019-20, exam results are expected to be released on Monday 22nd June 2020..

When is the resit period for fourth year?

For 2019-20, the resit period is likely to fall within the period Monday 1st June 2020 to Friday 24th July 2020. This period will include referral time for any clinical work required from year 4 modules that were not passed, as well as the supplementary exams which are expected to take place on 13th and 16th July 2020, with supplementary exam marks release expected to be 30th July 2020.

Will there be a revision period between the end of placement and the start of exams?

Yes. For 2019-20, the last day of placement is Friday 1st May 2020. The following two weeks consist of revision lectures at SGH. The revision timetable will be emailed out to students in advance. Then there is one week of private study before the examination week. The first exam for 2019-20 is Tuesday 26th May 2020.