Stage 3 of 7 · typically Yr 3–5 · age ~21–24
Medical school: clinical years
Ward and clinic rotations through the main specialties, including a psychiatry posting. Ends with the final professional examination.
Background required for this path This stage in the matrix
What is learned at this stage, and how deeply?
Applies 8
- Communication & languages (BM, English and more)Takes histories in BM and English, presents cases clearly, and uses interpreters on the wards.
- Communication skills & professionalismApplies history-taking and explanation with real patients; assessed in OSCEs.
- Cultural & religious sensitivityAsks patients what they believe caused their illness and respects religious needs on the ward.
- Curiosity & lifelong learningReads around every patient seen; asks questions on ward rounds.
- Empathy & compassionTakes histories with warmth and respect, and notices distress in patients on every ward.
- English & study skillsApplies clear spoken and written English in case presentations and clerking.
- Ethics, integrity & professionalismApplies consent and confidentiality on the wards; behaves professionally with patients and staff.
- Resilience & self-careCopes with seeing suffering and death and with long ward days; keeps a balance with rest and relationships.
Understands 72
- Anaesthesiology & critical carePractises airway skills and observes anaesthesia and ICU care.
- Anatomy (incl. histology & embryology)Understands surface anatomy for examination and procedures.
- Anxiety disordersRecognises panic and generalised anxiety in a history and knows CBT and SSRIs as main treatments.
- Assessment, formulation & rating scalesUses simple screening scales and writes a basic biopsychosocial summary.
- Behavioural science & medical psychologyUnderstands illness behaviour and the psychological impact of disease on patients met on the wards.
- BiochemistryUnderstands how metabolic disease presents and what tests show.
- Bipolar disordersRecognises manic features on examination and can explain the difference between bipolar disorder and depression.
- Child & adolescent psychiatryTakes developmental histories in paediatrics and recognises common child mental health problems.
- Classification: ICD-11 & DSM-5-TRUses diagnostic criteria for common disorders in the psychiatry posting.
- Clinical pharmacotherapy & safe prescribingCan name first-line drugs for common disorders and their key side effects for exams and ward rounds.
- Cognitive psychology & neuropsychologyPerforms simple cognitive screening (orientation, recall) in medicine and psychiatry.
- Community medicine & public healthUnderstands community and public health aspects through postings and projects.
- Critical appraisal & evidence-based psychiatryAppraises simple papers in journal clubs and evidence-based medicine sessions.
- Cultural psychiatry (Malaysian context)Takes histories sensitively from patients of different backgrounds.
- Delirium, dementia & neurocognitive disordersPerforms brief cognitive tests and knows the difference between delirium and dementia.
- Depressive disordersTakes a depression history, screens for suicidal ideas and names common antidepressants.
- DermatologyDescribes skin lesions and recognises common skin diseases.
- Descriptive psychopathology & phenomenologyDefines and recognises the main symptoms during the psychiatry posting and in exams.
- Doctor wellbeing, burnout & resilienceUnderstands burnout signs in self and peers.
- Emergency medicineAssesses emergency patients, practises resuscitation in simulation and learns triage.
- Epidemiology & biostatisticsUnderstands how evidence shapes guidelines and how to interpret diagnostic tests.
- Ethics in psychiatryDiscusses real dilemmas in case-based teaching and OSCEs.
- Family medicine & primary careSees patients in clinics and learns the primary-care consultation.
- Feeding & eating disordersRecognises the main eating disorders and their physical signs; knows BMI and risk basics.
- Forensic medicineAttends post-mortems and learns medico-legal reporting.
- General surgeryExamines the abdomen, recognises surgical emergencies and passes the surgery posting assessments.
- Geriatric medicine & palliative carePerforms geriatric assessments and observes palliative care.
- Housemanship core skills (on-call, procedures, documentation)Practises skills on placements and in OSCE stations.
- Housemanship: emergency medicine & other postingsObserves and assists in the emergency department during student postings.
- Housemanship: general surgeryClerks surgical patients, observes operations and learns basic examination of the abdomen and lumps.
- Housemanship: internal medicineAs a student, clerks patients and presents cases on the medicine posting under close supervision.
- Housemanship: obstetrics & gynaecologyObserves and conducts supervised deliveries and learns antenatal examination.
- Housemanship: orthopaedicsLearns musculoskeletal examination and basic fracture recognition.
- Housemanship: paediatricsLearns paediatric history, examination and developmental assessment as a student.
- Human development & developmental psychologyUses developmental milestones in paediatrics and recognises developmental delay.
- Internal medicineClerks and presents medical patients, builds a differential diagnosis and passes the medicine long and short cases.
- Mathematics & basic statisticsUnderstands sensitivity, specificity and risk when interpreting tests.
- Medical ethics & lawUnderstands how ethics applies in real cases met on the wards.
- Mental health in primary care & district hospitalsSees mental health problems in family medicine postings.
- Mental health law (Mental Health Act 2001)Knows the purpose of the Mental Health Act and the principle of involuntary admission.
- MicrobiologyUnderstands how common infections present and are treated.
- Motivational interviewingPractises brief interventions such as smoking advice in OSCEs and clinics.
- NeuroanatomyUses neuroanatomy to localise lesions during neurological examination on the wards.
- NeurochemistryLinks neurotransmitters to common drugs met on the wards (opioids, benzodiazepines, antipsychotics).
- Neurodevelopmental disorders (ADHD, autism, intellectual disability)Recognises ADHD, autism and intellectual disability in paediatric and psychiatry postings.
- Neuroimaging & investigationsKnows which routine tests are ordered for common presentations and reads basic results.
- NeurologyPerforms a neurological examination and recognises common neurological diseases.
- NeurophysiologyRecognises when EEG or nerve studies are used and what basic findings mean.
- Neuropsychiatry (epilepsy, brain injury, movement disorders)Performs neurological examination and recognises mental symptoms of neurological disease in the neurology posting.
- Obsessive-compulsive & related disordersCan distinguish obsessions from delusions in principle and name ERP and SSRIs.
- Obstetrics & gynaecologyTakes obstetric histories, performs antenatal examinations and observes deliveries.
- OphthalmologyPerforms basic eye examination and recognises eye emergencies.
- OrthopaedicsExamines joints and spine and recognises common fractures.
- Otorhinolaryngology (ENT)Examines ears, nose and throat and recognises common conditions.
- PaediatricsTakes paediatric histories, examines children and assesses developmental milestones.
- PathologyUnderstands the pathology behind common clinical conditions.
- Perinatal psychiatryLearns about postnatal depression and baby blues during O&G and psychiatry postings.
- PharmacologyUnderstands how drugs are chosen for common conditions; begins writing practice prescriptions.
- Physical health in mental illnessPerforms physical examinations and recognises common medical conditions.
- PhysiologyUnderstands how disease disturbs normal physiology at the bedside.
- Psychiatric interview & mental state examinationTakes a structured psychiatric history and presents an MSE in the psychiatry posting and OSCE.
- Psychiatry (undergraduate posting)Takes psychiatric histories, performs mental state examinations and passes the psychiatry assessment.
- Psychoeducation & psychosocial interventionsExplains simple diagnoses and treatments in OSCE-style stations.
- Psychopharmacology (basic)Recognises common psychotropics and their major side effects in the psychiatry posting.
- RadiologyInterprets basic chest X-rays and common CT findings.
- Related background that helpsPsychiatry electives, community mental health visits, student research.
- Research methods & the dissertationApplies research concepts to reading papers; some complete elective research.
- Risk assessment & suicide preventionTakes a suicide risk history in OSCEs and psychiatry postings.
- Schizophrenia & other psychotic disordersCan recognise hallucinations and delusions in a ward patient, present a basic history and name first-line antipsychotics.
- Substance use disorders & addictionTakes an alcohol and drug history and uses brief screening tools such as AUDIT.
- Time, cost & career outlookPlan for housemanship placement and any bond obligations.
- Trauma- and stress-related disordersRecognises PTSD symptoms and knows the difference between normal and complicated grief.
Aware 41
- Alternative entry routesMedical students learn about allied mental health professions they will work with.
- BiologyRarely revisited directly; basic concepts sit in the background of clinical reasoning.
- ChemistryBackground only; resurfaces when interpreting electrolytes and blood gases.
- Clinical audit & quality improvement basicsAware; may join a student audit project.
- Cognitive behavioural therapy (CBT)Knows CBT exists and what conditions it helps.
- Community psychiatryMay join a home visit or community clinic during the psychiatry posting.
- Consultation-liaison (psychosomatic) psychiatryAware that psychiatry provides a referral service to other wards.
- Continuing professional development (CPD)Aware; begins attending talks and courses.
- Dialectical behaviour therapy (DBT)Aware of DBT as a treatment for borderline personality disorder.
- Dissociative & bodily distress (somatic symptom) disordersKnows these conditions exist and should not be dismissed.
- Electroconvulsive therapy (ECT)Knows what ECT is and its main indications from the psychiatry posting; may observe a session.
- Emergency psychiatrySees psychiatric presentations in the emergency department during postings.
- Entry to psychiatry training: MMed & MRCPsychStudents learn that psychiatry is a postgraduate specialty and what the routes look like.
- Family & couple therapyTakes a family history and meets relatives during the psychiatry posting.
- Forensic psychiatryAware of the link between mental disorder and the law, often via forensic medicine teaching.
- Gambling, gaming & behavioural addictionsAware that gambling and gaming can be disorders.
- Group therapyMay observe a ward or day-care group during the psychiatry posting.
- History & philosophy of psychiatryHears about the history of psychiatric care during the psychiatry posting.
- ImmunologyAware of immune-mediated diseases in clinical rotations.
- Leadership & service managementAware of how hospital teams are organised.
- Learning theory & behavioural psychologyRecognises behavioural principles in the psychiatry posting (e.g. exposure for phobias).
- Medical geneticsAware of genetic conditions encountered in paediatrics and O&G.
- Medical officer in psychiatryAware of psychiatric MO work through the undergraduate posting.
- Medico-legal reports & expert evidenceAware through forensic medicine posting.
- Old age psychiatryAware of how mental illness presents differently in older people during geriatric or psychiatry postings.
- Other therapies: IPT, supportive, ACT, mindfulnessRecognises that several talking therapies exist.
- Personality disordersAware of personality disorder as a concept and the stigma around it.
- PhysicsAware of imaging physics when learning radiology.
- Preparing for specialist training entryAware of specialist pathways through career talks.
- Psychiatric epidemiologyKnows the approximate frequency of common disorders seen in practice.
- Psychiatric geneticsIs aware that psychiatric disorders run in families when taking a family history.
- Psychiatric rehabilitation & recoveryAware of rehabilitation services from the psychiatry posting.
- Psychodynamic psychotherapyAware of psychodynamic therapy as one of the talking therapies.
- Religion, spirituality & mental healthTakes a basic spiritual history and respects religious needs.
- Research leadership & publicationAware; may take part in student research.
- rTMS & other neuromodulationHas heard of rTMS as a treatment option for depression.
- Sexual dysfunctions & sexual healthAware of common sexual dysfunctions and how to take a sensitive sexual history.
- Sleep–wake disordersAware of common sleep disorders and sleep hygiene advice.
- Social psychologyIs aware of how stigma and family attitudes affect patients on the wards.
- Teaching & medical educationTeaches junior students informally.
- Telepsychiatry & digital mental healthAware of telemedicine and digital health tools.