Objectives: By the end of Year 4, students will be expected to have mastered the skills in communication, history taking, and physical examination. Students will be able to generate a list of the patient s problems which includes the physical, emotional and psychosocial aspects of the case. For each problem, students will develop a plan for problem resolution. Students will learn much about management and drug treatment during Year 4 but only the principles of management and introductory aspects of therapeutics will be assessed at the end of Year 4. Students will be expected to interpret symptoms and signs in terms of disorders of structure and function; to understand the pathological basis of symptoms and signs; to know what special investigations are appropriate for the investigation of a problem and how to interpret the results; and to understand the social and preventative aspects of disease. The major component of the Year 4 program is the clinical attachments. While students will necessarily be assigned to subspecialty units (e.g. cardiology, neurology, etc.), the attachment is not designed primarily to teach the student the details of that discipline, but rather, the approach to a patient's problems and their resolutions, is to be emphasised. Structured teaching during clinical weeks will be limited. Pathology tutorials will be held each week, and one medical and one surgical lecture may be provided. A number of skills are to be acquired during Year 4 or 6 of the course and the acquisition of such skills will be noted in the student s logbook after an appropriate examination. By the end of year 4 students are expected to understand the health issues for populations especially disadvantaged groups and local communities. The social, environmental, economic and behavioural factors associated with illness, how the health system functions in the community, and how to assess the evidence for preventive care and population health interventions are also to be understood. For the 6 week population health term students will be attached to a clinical service which is community based or oriented for about 3 days per week. During this term they will also attend tutorials and workshops in evidence based preventive care and population health, critically appraise evidence, and work in a supervised group on a project about a community health issue. Systematic Pathology will be taught at all hospitals throughout the year and will be integrated with clinical teaching. The program includes one tutorial per week based on prepared clinical protocols (case presentations) which will explore the pathogenesis of those systematic diseases which were not covered in the context of Year 3 teaching in Pathology, or which require greater depth of coverage. Students will be required to prepare and expand on the topics listed, by reference to their own ward cases, by consultation with staff of the various departments in Pathology, as well as by reference to their recommended textbooks and specialised text or journal articles. Each student will be expected to attend a minimum number of autopsy demonstrations during the year. Additional exposure to Pathology will be attained by student attendance at Grand Rounds and Clinico-Pathological Conferences. Campus Weeks: All students will attend the University campus for three weeks throughout the year, during which lectures in Medicine, Surgery, Clinical Pharmacology, Pathology, and Population Health will be provided. Population Health teaching will utilise the knowledge and experience gained during clinical attachments to elucidate basic principles of epidemiology, public health, and continuing care. The Pathology lectures and demonstrations will concentrate on the pathogenesis of complex disease processes which cannot be effectively covered in a tutorial format. An excursion to the NSW State Government Forensic Laboratory and Coronial Courts is a compulsory activity. Where possible, days will be arranged so that a particular subject is approached in a multi-disciplinary way. A series of correlation clinics, held during campus weeks, will further emphasise the interdisciplinary approach to understanding a subject. Assessment: A multiple choice examination and a short answer paper will be given at the end of the year and will examine knowledge of Medicine, Surgery, Population Health, Clinical Pharmacology and Pathology discussed during the campus program and from the directed reading section in the syllabus. There will be two assessment tasks in the Population and Community Health term. Assessment of Pathology will also involve the submission of a project report and a viva examination. In addition to the written papers, a clinical short case examination will be held. Assessment will be based on the approach to clinical examination, eliciting of abnormal signs and the interpretation of their significance.