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Medicine student Emily Iliadis on an LIC placement at Mowbray House Surgery in Northallerton with a patient and GP tutor Dr Duncan Rogers

Longitudinal Integrated Clerkship

Here at Hull York Medical School, we believe that to be brilliant doctors you need to understand the whole patient journey. We offer the opportunity for students to follow patients from initial consultation/diagnosis in primary care through to secondary, specialist and community care. We do this through our innovative patient-centred clinical placement, the Longitudinal Integrated Clerkship (LIC).

Introduction

Experience the entire patient journey

The Longitudinal Integrated Clerkship (LIC), which we launched in 2019, allows you to follow patients longitudinally over time, seeing patients through all phases of diagnosis and treatment as they navigate different aspects of their care - from GP surgeries, to hospitals and community settings.

This continuity in patient interaction allows you to become truly involved in the patient journey and build long-term rapport, to the benefit of both yourself and patients alike.

The LIC placement is based in the heart of North Yorkshire, centred in and around Northallerton in North Yorkshire with additional scheduled secondary care placement time in Middlesbrough.

You will be primarily based in a GP surgery and become part of a multidisciplinary team, developing teamwork skills crucial to being a doctor. This experience enhances your clinical learning and understanding of other roles within each healthcare team.

James Cook Hospital major trauma centre entrance
LIC student on a clinical placement examining a patient in Mowbray House Surgery in Northallerton
LIC students and staff
Rebecca Leckonby

HULL YORK MEDICAL SCHOOL Stories

The main reason I chose to take part in the LIC was because of the opportunity for frequent 1-on-1 contact with your GP and having the chance follow the patients journey from start to finish. I feel the LIC will prepare me for F1 and begin to bridge the gap from medical student to doctor.
2021 graduate

Rebecca Leckonby

When does the LIC take place?

You can choose to do the LIC in Year 4 instead of the standard clinical placement rotations.

The LIC is delivered over the full academic year (with up to 32 weeks on placement). There is no difference in term dates to the traditional Year 4 clinical placements.

Where does the LIC take place?

The LIC placement is based in the Hambleton and Richmond area, centred in and around Northallerton.

The Friarage Hospital, Northallerton is part of South Tees Foundation Hospitals NHS Trust. Northallerton GP Training Programme is part of the Yorkshire and the Humber Deanery School of Primary Care based at the Friarage Hospital, Northallerton.

You will spend on average three days a week in a primary care setting, one day per week in a hospital setting (mainly at the Friarage Hospital in Northallerton, with some of the experiences taking place at James Cook in Middlesbrough) and one day per week undertaking self-directed learning and other learning activities such as educational supervision and pharmacology prescribing and therapeutics.

How is the LIC different to the ‘standard’ Year 4?

The principal difference between the ‘traditional’ year 4 and the LIC is the format of your clinical placement. Rather than rotating around four 8-week clinical blocks, with a rotation change to a new secondary and primary care placement after 16 weeks, you will remain with the same GP practice for the academic year.

You will also spend time in wards, clinics and theatres at the Friarage Hospital as well as some scheduled time in James Cook Hospital to cover learning outcomes that you may not experience at the Friarage Hospital or your GP surgery.

Student learning is further enhanced at the Friarage Hospital by a brand new, cutting-edge medical education facility which opened in 2021.

How do the LIC placements work?

The blocks that you would have completed in four rotations in Year 4 will be delivered longitudinally across the whole academic year. The areas covered include:

  • Child health
  • ENT
  • Ophthalmology
  • Women’s health (including sexual health)
  • Dermatology
  • Acute care
  • Elderly and neuromuscular (including palliative care)

With the support of your GP tutor, the patients you meet will guide your day-to-day learning. By participating in regular clinics, you will meet patients that will open windows on other conditions and you will be expected to read around the conditions that patients present with.

Meeting these patients, you will develop and refine your skills in formulating a differential diagnosis, understanding the diagnostic process, learning the pathophysiology of the condition and formulating management plans that are patient-centred, taking into account their wishes and social situation.

You will follow some of these patients into hospital when they are admitted (either as an emergency or electively) to help you understand the interface between primary and secondary care and to understand healthcare from the patient perspective.

What is the curriculum and how are students assessed?

You will work towards the same learning outcomes as the existing Year 4 curriculum and be assessed in the same way as students on Year 4 clinical placements.

These learning outcomes will be achieved through the activities and experiences encountered in both community and hospital sessions, some scheduled group sessions in a hospital setting, and with the support of an educational supervisor.

Alongside your clinical placements you will also undertake a Scholarship and Special Interest (SSIP) project. This is your opportunity to immerse yourself in the design and research of an individual project, with support from your supervisor. This will either be a selected project that will reflect your own interest, or one that will be in direct support of your primary care placement. We hope that you find this a rewarding experience, which will help build your CV and could lead to academic publication.

What support is available?

The Hull York Medical School team are here to help, support and guide you.

Just as in Year 3, your main student contact at each placement location is the student liaison team, based at the Friarage Hospital.

Again, as in Year 3, you will continue to have an Educational Supervisor. However rather than changing supervisor after 16 weeks, you will have same supervisor across the entire LIC year.

In addition to our existing Student Support Team and Programme Delivery Team, you will be supported on a day-to-day basis by the LIC administration and clinical skills teams based at the Friarage Hospital and James Cook Hospital.

What is the area like?

Northallerton, the county town of North Yorkshire, is a very pleasant market town in the northern part of the Vale of York, between the North York Moors and the Dales. Northallerton has a variety of national retailers mixed with local independent or regional retailers – and is home of the famous Betty’s tea rooms.

There are excellent recreational facilities and it is within easy reach of the urban centres of York, Leeds, Teesside and Newcastle. The town is on the main London to Edinburgh railway line and has services to Thirsk, Middlesbrough and Darlington.

Travelling by car is easy too. Northallerton is approximately five miles from both the A1(M) and A19. Durham Tees Valley, Newcastle and Leeds Bradford airports are all easily accessible too.

The Northallerton area is semi-rural and the GP practices are spread over quite a large area. Commuting is relatively simple and all of the practices involved with the LIC in 2021/22 are within 20 miles of the Friarage.

We hope that you will take opportunities to experience all that this beautiful region of North Yorkshire has to offer during the course of the academic year.

What accommodation is available?

Students will be provided with NHS accommodation at no charge, based at the Friarage Hospital in Northallerton.

We require that students maintain rented accommodation elsewhere.