Second BM

Differences from 2017/18 to 2023/24

Second Examination for the Degree of Bachelor of Medicine

1. A candidate may be admitted to the Second Examination if his or hertheir name has been entered on the University Register of Clinical Students and hethey or she hashave satisfied one of the following conditions:

  • (a) hethey or she hashave passed in all the subjects of the First Examination and the Qualifying Examination in the Principles of Clinical Anatomy and has either been admitted to the Degree of Bachelor of Arts with Honours or obtained a bachelor's degree at another university; or

  • (b)  hethey or she hashave passed in all the subjects of the Preliminary Examination in Graduate-entry Medicine and the Year 2 Examination in Graduate-entry Medicine; or

  • (c) hethey or she hashave both

    • (i)  successfully completed at a university in the United Kingdom a GMC-approved course of study in medical sciences that has included the subjects of the First Examination and the Principles of Clinical Anatomy, and is deemed by the Medical Sciences Board to qualify the candidate for admission; and

    • (ii) obtained a bachelor's degree in science or arts at a university, such degree having been approved by the Board.

2. [Until MT 2018: Candidates for the Second Examination for the Degree of Bachelor of Medicine are required to pursue their studies during a period of: normally 38 weeks in Year 1; normally 45 weeks in Year 2; normally 46 weeks in Year 3; provided that the Medical Sciences Board shall have power to permit candidates to vary the dates of their studies so long as the overall programme requirement is met.] [From MT 2018: Candidates for the Second Examination for the Degree of Bachelor of Medicine are required to pursue their studies during a period of: normally 38 weeks in Year 4; normally 45 weeks in Year 5; normally 46 weeks in Year 6; provided that the Medical Sciences Board shall have power to permit candidates to vary the dates of their studies so long as the overall programme requirement is met.]

3. The Second Examination for the Degree of Bachelor of Medicine shall be under the supervision of the Medical Sciences Board. 

4. The Board shall have power to require candidates for admission to any partParts of the Secondassessment Examinationin Year 5/Graduate-entry Year 3 and Year 6/Graduate-entry Year 4 will comprise the Medical Licensing Assessment (MLA) which is required by the General Medical Council to producetest certificatesthe core knowledge, skills and behaviours of attendancedoctors atnew coursesto medical practice in the UK. The two parts of practicalthe instruction,MLA are:

(a) Clinical and suchProfessional otherSkills certificatesAssessment (CPSA): the clinical examination in Year 5/Graduate-entry Year 3 and the clinical examination in Year 6/Graduate-entry Year 4 together make up the CPSA.

(b) Applied Knowledge Test (AKT): this is the Applied Knowledge Test in Year 6/Graduate-entry Year 4, which is a nationally-constructed, university-delivered examination, which has a common format, test standard, delivery process and policy framework. The MLA Board acts as the Boardmain may from time to time determine,oversight and togovernance definegroup theresponsible formfor ofall such certificates. It shall be the dutyelements of the RegistrarUK toMLA see that these conditions are observedAKT.

45. The subject of the Second Examination shall be clinical medicine in all its aspects.

  • (a)  The Second Examination shall cover three years, the subjects for each year being prescribed by regulation of the Medical Sciences Board.

  • (b)  [Until MT 2018: Each of Years 1 and 2 shall involve a form of assessment prescribed by regulation of the Board which shall be notified to candidates. No candidate shall commence Year 2 or 3 until he or she has satisfactorily completed Year 1 or 2 respectively (except that a candidate shall be permitted to commence Year 2 if he or she has passed in all the subjects in the Preliminary Examination in Medicine, unless the Director of Clinical Studies and the Associate Director of Clinical Studies, at their discretion and in exceptional circumstances, decide that the candidate may proceed to the next year of study on condition that he or she should undertake remedial work and if necessary be reassessed at a later date.] [From MT 2018: Each of Years 4 and 5 shall involve a form of assessment prescribed by regulation of the Board which shall be notified to candidates. No candidate shall commence Year 5 or 6 until he or she has satisfactorily completed Year 4 or 5 respectively (except that a candidate shall be permitted to commence Year 5 if he or she has passed in all the subjects in the Preliminary Examination in Medicine and satisfactorily completed those additional courses of instruction and assessments specified in clause 8 of the regulations for the Preliminary Examination in Medicine Part II), unless the Director of Clinical Studies and the Associate Director of Clinical Studies, at their discretion and in exceptional circumstances, decide that the candidate may proceed to the next year of study on condition that he or she should undertake remedial work and if necessary be reassessed at a later date.]

  • (c) [Until MT 2018: Year 3 shall involve written and clinical examinations and may involve oral examinations. No candidate shall be examined on the Year 3 Vocational Skills Course until he or she has passed the assessments for Years 1 and 2 and the Year 3 General Clinical Studies Course.] [From MT 2018: Year 6 shall involve written and clinical examinations and may involve oral examinations. No candidate shall be examined on the Year 6 Vocational Skills Course until he or she has passed the assessments for Years 4 and 5 and the Year 6 General Clinical Studies Course.]

5.  [Until MT 2018: A candidate who has passed in all the subjects of the Preliminary Examination in Medicine shall be exempted from the Year 1 assessments of the Second Examination and shall be permitted to proceed directly to commence Year 2.] [From MT 2018: A candidate who has passed in all the subjects of the Preliminary Examination in Medicine and has satisfactorily completed the additional courses of instruction and assessments specified in clause 8 of the regulations for the Preliminary Examination in Medicine Part II shall be permitted to proceed directly to commence Year 5.]

6.  The examiners may award a Distinction for outstanding performance over the three years. Criteria for Distinctions will be determinedset byout in the MedicalExamination Sciences BoardConventions.

7.  The examiners may award merits in each of the examined subjects in [YearsYear 1, 24 and 3.]Year [From6 MT/ 2018:Graduate-entry YearsYear 4,. The examiners may award a merit for overall performance in the Integrated Summative Assessment in Year 5 and/ 6Graduate-entry Year 3.]

8.  Breach of the Code of Conduct for Medical Students, as approved and from time to time amended by Council's General Purposes Committee on the recommendation of the Medical Sciences Board, may be deemed to be a ground for removal of a student's name from the University Register of Clinical Students according to procedures which shall always be subject to approval by Council's General Purposes Committee on the recommendation of the Medical Sciences Board.

9. No Thecandidate provisionsmay ofoffer theany appropriateassessment regulations,unit concerningon themore timesthan oftwo holding examinations and the entry of names, and the special regulation concerning dress shall not, unless otherwise prescribed by regulation of the board, apply to Years 1 and 2occasions, except in theexceptional casecircumstances.  ofA afurther formalexceptional examinationopportunity setto byoffer theany examinersassessment of these stages, as prescribed by regulation of the Board.

[Until MT 2018: Regulations for Assessment in Years 1, 2, and 3]

[From MT 2018: Regulations for Assessmentunit in Years 4, 5,/Graduate-entry Year 3 or Year 6/Graduate-entry Year 4 shall require application to and 6]

Proposalsapproval foron the assessment of candidates in [Until MT 2018: Years 1, 2, and 3behalf of the examinationEducational shall be drawn up by each specialty group, or in the case of Year 3] [From MT 2018: Years 4, 5,Policy and 6 of the examination shall be drawn up by each specialty group, or in the case of Year 6] by the Board’s Clinical EducationStandards Committee and submitted for approval to the Medical Sciences Board, at such times as the Board shall determine. The form or forms of assessment are chosen from among the following:

  • (a) clinical examination including long and short cases;

  • (b) competency check sheets, logbooks, or portfolios;

  • (c) examination and comment (written or viva voce) on specimens;

  • (d) objective structured clinical examinations;

  • (e) poster presentations;

  • (f) case presentations;

  • (g) written tests, which may consist in whole or in part of, for example, multiple choice questions, short answer questions, extended matching questions or essays;

  • (h) case histories and commentaries;

  • (i) prepared essays;

  • (j) viva voce examinations; and

  • (k) other tests individually approved by the Board.

In clinical subjects, all assessments shall include a test of clinical competence. In addition, reports on candidates’ attendance and general aptitude shown during the course of instruction shall be made by those responsible for the course and taken into consideration in association with the performance of candidates in the assessment.

A candidate shall be warned (in writing with a copy to the Director of Clinical Studies) by those responsible for the course in question before the assessment takes place, if his or her attendance and general aptitude are such as seems likely to jeopardise his or her chances of passing the assessment.

[Until MT 2018: The first assessment of candidates shall be carried out during or at the conclusion of each component of the course by the staff, as appointed by the head of the relevant department, or, in the case of Year 3, by the examiners and/or assessors. Candidates in Years 1 and 3 shall be permitted a maximum of three attempts to pass an assessment. In Year 2 the Examination Board may require candidates to be assessed in a specified module or modules on one further occasion. Candidates in Year 2 shall be permitted a maximum of two attempts in order to pass Year 2.] [From MT 2018: The first assessment of candidates shall be carried out during or at the conclusion of each component of the course by the staff, as appointed by the head of the relevant department, or, in the case of Year 6, by the examiners and/or assessors. Candidates in Years 4 and 6 shall be permitted a maximum of three attempts to pass an assessment. In Year 5 the Examination Board may require candidates to be assessed in a specified module or modules on one further occasion. Candidates in Year 5 shall be permitted a maximum of two attempts in order to pass Year 5.]

It shall be the responsibility of the staff concerned, under the supervision of the Medical Sciences Board, according to give the candidatespublished and‘Procedure for Exceptional Attempts at the relevantSecond examinersBM and/orExamination’.  assessorsIf granted, reasonablethis noticeexceptional resit attempt shall normally be taken at the next opportunity, but may be deferred once, i.e. it must be taken at one of the datesnext ontwo whichopportunities. In the assessmentsevent willthat takea place,candidate’s performance is judged to decidebe onunsatisfactory at the outcomesecond of each assessmentattempt, and toany keepapplication departmentalthat records of each assessment. A candidate should not normally be assessed exclusively by staff members whomay have been responsiblemade for hisan orexceptional herfurther instruction.

Yearname 1shall

Year 4

Syllabus and Examination

In Year 14,  students are required to satisfy the examiners in the:

  • (a) the Laboratory Medicine course (concerning the application to human disease of the principles of Laboratory Medicine, including Histopathology, Microbiology and Infection, Clinical Biochemistry, Immunology, and Haematology);

  • (b) (b)Integrated Clinical Course: Medicine;

  • (c) and Surgery.

Each candidateThere will be assessedthree accordingexaminations:

  • (a) toPaper theA methods(Laboratory approvedMedicine). byThis thewill Medicalbe Sciencesan BoardApplied Knowledge Test (AKT) consisting of multiple choice questions.
  • (b) Paper B (Integrated paper in Medicine, Surgery and notifiedApplied toPathology). candidatesThis beforewill thebe commencementan Applied Knowledge Test (AKT) consisting of eachmultiple coursechoice ofquestions.
  • (c) instructionAn Objective Structured Clinical Examination (OSCE).

Candidates must satisfy the relevant head of department or his or hertheir deputy, or the Director of Clinical Studies and the Associate Director of Clinical Studies, that they have attended a course of instruction, and attained the necessary skills, knowledge and understanding in:

  • (a) The Patient Doctor 2Course CourseII: introduction to clinical practice (being an introduction to clinical methods, history taking and physical examination);

  • (b) Anaesthetics;

  • (c) Clinical Pharmacology;

  • (d) Communication Skills;

  • (ec)  Medical Ethics and Law;

  • (fd)  Primary Health Care;

  • (ge) RadiologyPopulation Health;

  • (hf) Special Study.

A approvedcandidate onin behalfYear 4 who has been deemed to have failed in any unit of assessment at the first attempt will be permitted one further attempt and will only be required to be reassessed in the assessment unit they have failed.

Progression from Year 4 to Year 5 

If a candidate has passed all of the Medical Sciences Board.

No candidate shall commence Year 24 untilmeet hethe requirements in one or shemore hasof satisfactorilythe completedother Yearbeyond 1their control, at unlessthe discretion of the Director of Clinical Studies and the relevant Associate Director of Clinical Studies, to continue as a student enrolled on Year 5 of the Clinical Medicine course, subject to the condition that they complete the outstanding course components by a specified date. 

If a candidate has passed all of the Year 4 examinations but has failed to meet the requirements in one or more of the other course components, they may be allowed, at theirthe discretion shouldof the Director of Clinical Studies and the relevant Associate Director of Clinical Studies, to continue as a student enrolled on Year 5 of the Clinical Medicine course, subject to the condition that they complete the outstanding course components by a specified date. 

If a candidate has failed one or more of the Year 4 examinations after one attempt but has not had the opportunity to make a second attempt at that examination / those examinations by the normal time of the second sitting of the examinations, they shall not be allowed to continue as a student enrolled on Year 5 of the Clinical Medicine course until they have passed the outstanding examinations. 

If a candidate has failed one or more of the Year 4 examinations after two attempts, they shall not be allowed to continue as a student enrolled on Year 5 of the Clinical Medicine course, even if they are awaiting the outcome of an academic appeal or an application for an exceptional third attempt.

Year 5 / Graduate-entry Year 3

In order to pass Year 5 / Graduate-entry Year 3, candidates are required to have satisfactorily attended all courses and fulfilled individual course requirements, including completing all relevant formative assessments, for all the subjects specified in (a) to (f) below; and to have satisfied the examiners in the 5 / Graduate-entry Year 3 Integrated Summative Assessment, both written and clinical examinations. 

No candidate may sit the Integrated Summative Assessment if they have not satisfactorily attended and fulfilled all of the individual course requirements in at least five of the six subjects specified in (a) to (f) below, except in exceptional circumstances, decide thatwith the candidatepermission mayof proceedthe Director and the relevant Associate Director of Clinical Studies. 

  • 1.  (a) Clinical Neurosciences;
  • (b) Community-based Medicine;
  • (c) Orthopaedic Surgery, Rheumatology, Trauma and Emergency Medicine;
  • (d) Paediatrics;
  • (e) Psychiatry;
  • (f) Women’s and Reproductive Health.
  •  
  • 2. The Integrated Summative Assessment consists of:
    • (a) An Applied Knowledge Test (AKT) consisting of multiple choice questions.
    • (b) An Objective Structured Clinical Examination (OSCE)

The Integrated Summative Assessment will assess the subjects specified in (a) to Year 2 on condition that he or she should undertake remedial work and if necessary be reassessed at a later dateabove.

Assessment

A candidate in Year 15 who failshas been deemed to reachhave a satisfactory standardfailed in any part of the assessmentIntegrated Summative Assessment at the first attempt maywill offerbe himself or herself for reassessment onpermitted one further occasionattempt and will only be required to be reassessed in the part or parts of the assessment they have failed.

Progression from Year 5 / Graduate-entry Year 3 to Year 6 / Graduate-entry Year 4 

If a candidate failshas passed all of the Year 5 / Graduate-entry Year 3 examinations but has failed to reachmeet athe satisfactoryrequirements standardin one or more of the other course components due to circumstances beyond their control, they will normally be allowed, at the second attempt in any partdiscretion of the assessment, the head of department concerned, or his or her deputy, shall require the candidate to be reassessed in the part or parts of the assessment previously failed after completing the necessary coursework; this assessment shall be carried out and adjudged by the staff appointed by the relevant head of department. In the event that a candidate’s performance is judged to be unsatisfactory at this third attempt then his or her name shall be removed from the Register of Clinical Students subject to appeal to the Medical Sciences Board.

Duties of the Examiners

In the first assessment of candidates in Year 1  each relevant pair of examiners shall be required to attend, and if they so wish participate, on at least one occasion each year.

In the reassessment of any candidate who has been deemed to have failed the whole assessment in Year 1, the external examiner shall be present and may participate if he or she wishes.

Year 3  examiners may assist with the assessment in Year 1 .

Year 5

Syllabus and Examination

In Year 5, students are required to satisfy the examiners in:

  • (a) Clinical Neurosciences, Ophthalmology and Otolaryngology;

  • (b) Community-based Subjects (encompassing Geratology, Dermatology, Palliative Care, Primary Care and Population Health 2: Public Health);

  • (c) Orthopaedics, Rheumatology, Trauma and Emergency Medicine; 

  • (d) Paediatrics;

  • (e) Psychiatry;

  • (f) Women’s and Reproductive Health with integrated Sexual Health.

Each candidate will be assessed according to the methods approved by the Medical Sciences Board and notified to candidates before the commencement of each course of instruction.

No candidate shall commence Year 6 until he or she has satisfactorily completed Year 5, unless the Director of Clinical Studies and the relevant Associate Director of Clinical Studies at their discretion should, into exceptionalcontinue circumstances,as decidea thatstudent theenrolled candidate may proceed toon Year 6 onof the Clinical Medicine course / Year 4 of the Graduate-entry Medicine course, subject to the condition that hethey orcomplete shethe shouldoutstanding undertakecourse remedialcomponents work and if necessary be reassessed atby a laterspecified date. 

Assessment

AIf a candidate inhas passed all of the Year 5 who/ failsGraduate-entry Year 3 examinations but has failed to reachmeet athe satisfactory standardrequirements in anyone individualor more of the other course modulecomponents, assessmentthey may be allowed, at the first attempt and is required by the Examination Board to be reassessed, will only be required to be reassessed in the part or partsdiscretion of the assessment they have failed.

A candidate must reach the threshold pass mark for Year 5 (from the sum of cumulative marks awarded from each course module assessment) and satisfy the Examination Board in a minimum of five out of the six modules, or the candidate will be deemed to have failed the fifth year of the course. A candidate who has been deemed to have failed will be allowed only one further attempt to pass Year 5 and will be required to repeat the fifth year of the course in its entirety. In the event that a candidate’s performance is judged to be unsatisfactory at this second attempt then his or her name shall be removed from the University Register of Clinical Students subject to appeal to the Medical Sciences Board.

Duties of the Examiners

In the first assessment of candidates in the individual course module assessments of Year 5 each relevant pair of examiners/specialty advisors shall be required to attend on at least one occasion in each year.

Year 6

 Syllabus and Examination

In Year 6, students are required to satisfy: (a) the examiners in General Clinical Studies; and (b) the Director of Clinical Studies and the relevant Associate Director of Clinical Studies, into Vocationalcontinue Skills.as Eacha candidatestudent willenrolled beon assessedYear according6 of the Clinical Medicine course / Year 4 of the Graduate-entry Medicine course, subject to the methodscondition approvedthat they complete the outstanding course components by a specified date. 

If a candidate has failed one or more of the Year 5 / Graduate-entry Year 3 examinations after one attempt but has not had the opportunity to make a second attempt at that examination / those examinations by the Medicalnormal Sciencestime Boardof andthe notifiedsecond sitting of the examinations, they shall not be allowed to candidatescontinue beforeas a student enrolled on Year 6 of the commencementClinical Medicine course / Year 4 of eachthe Graduate-entry Medicine course until they have passed the outstanding examinations. 

If a candidate has failed one or more of instructionthe Year 5 / Graduate-entry Year 3 examinations after two attempts, they shall not be allowed to continue as a student enrolled on Year 6 of the Clinical Medicine course / Year 4 of the Graduate-entry Medicine course, even if they are awaiting the outcome of an academic appeal or an application for an exceptional third attempt. 

Year 6 / Graduate Entry Year 4

Students who fail an assessment willmay have to forfeit part or all of the elective for a period of intensive clinical training.

  • 1. General Clinical Studies

There will be two examinations:

Students

  • (a) areApplied requiredKnowledge toTest satisfy(AKT) theconsisting examinersof inmultiple Medicinechoice andquestions. 
  • (b) SurgeryAn encompassingObjective Communication Skills, Radiology, andStructured Clinical PharmacologyExamination (OSCE).

     

Candidates must satisfy the Director of Clinical Studies and the relevant Associate Director of Clinical Studies that they have attended a course of instruction in Clinical Options approved by the Medical Sciences Board.

  • 2. Vocational Skills

No candidate shall be deemed to have completed the Year 6 / Graduate-entry Year 4 Vocational Skills Course until they have passed the assessments for Year 4 / Graduate-entry Year 2 and Year 5 / Graduate-entry Year 3 and the Year 6 / Graduate-entry Year 4 General Clinical Studies Course.

Students are required to satisfy the Director of Clinical Studies and the relevant Associate Director of Clinical Studies that they have provided work to a satisfactory standard in: 

  • (a)  Special Study approved on behalf of the Medical Sciences  Board;

     

  • (b) A Course to prepare students for work as a Foundation 1 doctor;

  • (c)  An Elective (students who fail an assessment may be required to complete remedial clinical work. These students will forfeit part, or all, of the elective and instead will be required to produce a satisfactory report at the end of an additional clinical attachment);

     

  • (dc)  A student assistantship with a clinical  team; and

     
  • (d) A Course to prepare students for work as a Foundation 1 doctor; 

  • (e) AnPractical assessment in procedural skillsSkills.

Assessment

A candidate in Year 6 / Graduate-entry Year 4 who failshas been deemed to reachhave afailed satisfactoryin standardany assessment unit at the first attempt in any part of the assessment in medicine and surgery will be deemed, normally, to have failed the complete assessment and may offer himself or herself for reassessment onpermitted one further occasion.attempt A candidate in this positionand will usuallyonly be required to be reassessed in all parts of the assessment, unlessunit the examiners specifically direct that there be reassessment only in the part or parts in which the candidate has failed to reach a satisfactory standard.

If a candidate fails to reach a satisfactory standard at the second attempt in any part of the assessment, then the candidate shall be deemed tothey have failed the complete assessment. The examiners shall require the candidate to be reassessed after completing the  necessary coursework; this assessment shall be carried out and adjudged by the examiners. In the event that a candidate’s performance is judged to be unsatisfactory at this third attempt then his or her name shall be removed from the University Register of Clinical Students subject to appeal to the Medical Sciences Board.

Duties of the Examiners

1. General Clinical Studies

The examination shall be arranged and conducted by the Year 6 Examination Board under the direction of the Chair of Examiners and the Principal Examiners in Medicine and Surgery.

In considering whether a candidate has passed the assessment, the examiners may fail a candidate who does not satisfy them in one part of the assessment, even if he or she has satisfied them in other parts at that stage.

2. Vocational Skills

Candidates shall be required to submit to the Director of Clinical Studies and the Associate Director of Clinical Studies such evidence as they require of the successful completion of their work.

In considering whether candidates shall have passed the assessment, the Director of Clinical Studies and the Associate Director of Clinical Studies may fail a candidate who has provided either none or insufficient evidence of satisfactory completion of one part of the course, even if he or she has satisfied them in other parts of the course.