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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

Follow patients through their entire journey, from their initial consultation in primary care through to secondary, specialist and community care, through our Longitudinal Integrated Clerkship (LIC).

Introduction

Experience the entire patient journey

Our Longitudinal Integrated Clerkship (LIC) is an innovative, optional year-long clinical placement opportunity that allows around 16 students to be immersed in the whole patient journey; following the same patients over time in varied clinical settings, as they navigate different aspects of their care.

The LIC is delivered as part of our dedicated Academy of Primary Care, which provides a range of research-led opportunities to develop your skills and knowledge, including independent research projects, mentorship with academic GPs, dedicated master classes and seminars, and access to specialist conferences.

This continuity in patient interaction allows you to become involved in the entire patient journey and build long-term rapport with patients and clinicians, to the benefit of both yourself and patients alike. You will be actively encouraged to follow the patient journey into the hospital and be able to compare the primary and secondary care experience.

The LIC placement is based 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. Regardless of your final career goals, the skills that you learn will stand you in good stead across all aspects of healthcare.

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 one-on-one contact with your GP and having the chance follow the patient journey from start to finish. I feel the LIC will prepare me for Foundation Year 1 and begin to bridge the gap from medical student to doctor.
2021 graduate

Dr Rebecca Leckonby

When does the LIC take place?

You can choose to do the LIC in Year 4 instead of the standard 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. The Northallerton GP training programme is part of the Yorkshire and the Humber Deanery School of Primary Care based at the Friarage Hospital.

You will spend on at least two days a week in a primary care setting, one or two days 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.

The primary care practices are located within a commuting distance from Northallerton, but given the geography you will find yourself in some of North Yorkshire’s finest countryside. You will soon be able to appreciate how a ‘rural’ General Practice functions slightly differently to those of an urban setting and how you will be able to effectively reflect the adaptations that they have to make to deal with this.  

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 surgery for the academic year.

You will 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.

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

There is an expectation that you will be able to work independently. Given the smaller numbers of students, there are other opportunities that you will be encouraged to take, but again this needs to be driven by the student. This skill is best learnt early as it will stand you in good stead for your future medical career.

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 encounter 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, considering 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 Programme. 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 during the LIC?

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 Yorkshire 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.

The Northallerton area is semi-rural and the GP surgeries are spread over quite a large area. Commuting is relatively simple and all of the practices involved with the LIC 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.

A student's perspective

By Annabel Steele, Year 4 Medicine student

If you're interested in undertaking the LIC year, you might be wanting to know more about what this unique experience is really like from a student’s perspective.

Fourth year Medicine student Annabel gives an insight into her experience of the LIC and shares some tips to help you make the most of it.

Annabel's experience of the LIC
Annabel Steele