How to study medicine in Ireland, first year to intern year

Short answer first: there are two ways in. School leavers sit the HPAT-Ireland and have that score added to their Leaving Certificate points, with University of Galway setting a floor of 480 points in one sitting. Graduates sit the GAMSAT and apply to RCSI, UCC, UCD or UL. The degree runs five or six years, split at RCSI into two years of foundation, one of integration and two of clinical practice. You are examined on the wards as well as on paper. Then comes a twelve month intern year, three months of it in medicine and three in surgery.

What follows is the shape of the thing, taken from the schools' own pages and the Medical Council's own documents. Your programme will differ in the details, so read your own handbook next to this.

How do you get in, and which route are you on?

The two routes barely overlap, and they are decided before you write a single line of anatomy. The general rules on modules, credits and repeats still apply to you, and those are set out in how Irish university exams work.

• The undergraduate route runs on the HPAT. ACER describes HPAT-Ireland as a 2.5 hour online multiple choice assessment of 114 questions in three sections: Logical Reasoning and Problem Solving, Interpersonal Understanding, and Non-Verbal Reasoning. It is held in February, and ACER lists six Irish institutions that use it for undergraduate medicine, University of Galway, RCSI, Trinity, UCC, UCD and the University of Limerick, with UL also using it for its master's programmes in occupational therapy and speech and language therapy.
• The score is added, not averaged. University of Galway requires a minimum of 480 points and the programme's minimum entry requirements in the same sitting of the Leaving Certificate, and then the HPAT-Ireland score "will be added to the Leaving Certificate points to create a total point's score for admission".
• The graduate route runs on the GAMSAT. ACER's page for Irish admissions lists five programmes that use it: medicine at RCSI, UCC, UCD and the University of Limerick, and veterinary medicine at UCD. The page sends you to the CAO and to the institutions for eligibility, because the schools set their own degree requirements.
• Fees are real money. As of September 2026 the HPAT page shows a standard registration fee of 164 euro and a late fee of 75 euro, with a 22 euro Written English component for University of Limerick occupational therapy and speech and language therapy applicants only.

Both routes go through the CAO, and both end in the same place. Nothing about the test predicts how you will find third year.

What do the first two years actually look like?

The early years are the part most people picture when they think of medical school, and they are the part that changes least between schools. RCSI groups them as Foundation of Practice, years one and two, where students work through the anatomical and biochemical basis of disease in integrated modules, and states that case based learning is a core teaching and learning approach in those two years. A six year track adds a Foundation Year before that, covering biomedical sciences, professionalism and IT skills across two semesters.

Case based learning changes what a good week looks like. You are not being handed a syllabus to memorise in order. You are given a case and expected to arrive having read around it, which means the reading is the work and the class is the check. That is closer to a tutorial than a lecture, and the note you take in it is a different kind of note. The four rooms of an Irish degree, and what to write in each, are covered in notes for lectures, tutorials, seminars and labs.

The volume is the other thing nobody tells you honestly. Two years of preclinical material is more than you can hold by reading it twice, which is why almost everyone ends up on some kind of repeated retrieval system by the end of first year. More on whether that works below.

What changes when you reach the clinical years?

The timetable stops being a timetable. RCSI calls year three Integration into Practice: students take hospital based clinical placements at an RCSI affiliated teaching hospital and complete a student selected research or audit project alongside them. Year four is Preparation for Practice, and RCSI describes students as anchored full time within a clinical team, working in medicine, obstetrics and gynaecology, psychiatry, surgery, paediatrics, child health and general practice. Year five carries an eight week clinical elective and a twelve week clinical clerkship in medicine and surgery.

Three things follow from that, and they catch people out every year.

You move. A rotation ends and the consultant, the hospital, the specialty and the commute all change at once. Any study system that depends on a fixed desk and a fixed hour breaks in week one of the clinical years.

Your learning is opportunistic. What you see on a Tuesday depends on who is admitted. Two students on the same rotation finish with different cases, which is why the log matters and why comparing yourself to the person beside you is not useful.

The assessment follows the clinical work rather than the reading list. Which brings us to how you are actually marked.

How are you examined?

Written papers do not disappear, but they stop being the whole story. Two published examples show the shape.

UCD's Advanced Clinical Skills module splits the mark in two. Forty percent is an OSCE, an objective structured clinical examination, used for history taking, physical examination and communication skills. Sixty percent is a clinical assessment in a UCD affiliated hospital, covering history taking and physical examination, the ability to present clinical information and the ability to generate differential diagnoses. That second component is marked must pass. Students also submit four formative case write-ups from their clinical attachments and get tutor feedback on them.

RCSI takes a different line on the end of year. It describes its assessment as programmatic, with a grade point average scale, and says this reduces the emphasis on high stakes end of year examinations. Some schools also run longitudinal knowledge tests across the whole degree, but the Irish schools do not publish the detail of those the way they publish module descriptors, so ask your own year coordinator rather than assuming.

The hour with your module descriptors

Whatever your school calls it, the same hour in week one pays for itself:

1. Open the descriptor for every module you are registered to.
2. Write down each assessment component and its weighting.
3. Mark anything that is must pass, because a strong OSCE cannot rescue it.
4. Write down which components are formative, so you know where you can afford to be bad in public.
5. Note the clinical assessment dates, which usually sit inside a rotation rather than in an exam hall.

A must-pass clinical assessment is the single most useful line on that page. It tells you that time on the ward is not optional revision, it is the exam.

What are you allowed to write down on placement?

This is the part where the rules are not a matter of taste. The Medical Council's Guide to Professional Conduct and Ethics opens its confidentiality chapter by saying confidentiality is central to the doctor patient relationship, that it supports trust and confidence, and that it reassures patients they can safely reveal what a doctor needs to know. Everything else follows from that sentence.

Three of its paragraphs matter to you directly.

• You need permission before you interview or examine anyone. Paragraph 58.5.3 says students must get permission from patients before they interview or examine them, and the paragraphs around it require students to identify themselves by name and not represent themselves as doctors.
• Recordings need consent to be made and consent to be shared. Paragraph 31.2 says that where a recording of a patient is necessary and appropriate for patient care or beneficial for education and training, you must explain it to the patient and obtain their consent to both the making and any proposed sharing of it.
• Education use means not identifiable. Paragraph 31.3 says recordings are kept confidential as part of the patient's record, and if they are used for education or training beyond the patient's healthcare team, the patient must be neither identified nor identifiable unless they have consented to being identified.

Read together, those rules give you one simple working answer: never record a patient for your own study. A private recording of a ward round or a consultation is not patient care and it is not a teaching resource the patient agreed to. It is a copy of someone's medical history on your phone. The general position on recording in Irish institutions, and what a lecturer's permission does and does not cover, is set out in recording lectures in Ireland. None of that extends to a bedside.

Your notes work the same way. Write the clinical reasoning, not the person. No names, no dates of birth, no hospital number, nothing that would let a reader work out who it was.

What goes in a clinical log?

A log is not a diary and it is not a transcript. It is a record of what you have seen and done, and it exists so that somebody can sign it off.

The intern year shows you the target. The Medical Council's National Intern Training Programme says the ePortfolio includes an eLogbook element "where interns will record clinical procedures completed and experience gained during the intern year", and that at the end of each clinical attachment an Intern Assessment Form is completed by the supervising consultant and co-signed by the intern. That is the format your student log is rehearsing.

What one entry should hold

• The presentation, not the patient. Sixty year old with two days of pleuritic chest pain, not a name.
• What you did yourself. Took the history, examined the chest, watched the drain, assisted, observed. The verb is the point.
• The finding you would not have predicted. This is the line you will actually reread.
• The question you could not answer. One per patient is plenty, and it is the best source of flashcards you will ever have.
• Who supervised it, because the sign-off depends on it.

Keep it to four or five lines per patient and write it the same day. A log written up from memory at the end of a rotation is a work of fiction, and it teaches you nothing.

Does spaced repetition actually work in medicine?

Mostly yes, with less certainty than the internet suggests. Two studies you can read for yourself set the range.

A randomised self-matched trial published in PLOS ONE in 2017 took teaching points from weekly lectures at one academic medical centre, randomly reinforced some of them by email and left others in the standard weekly email, then quizzed residents monthly on both. Across all residents the effect was not statistically significant, a risk ratio of 0.90 for a wrong answer on reinforced material with a p value of 0.14, and among the second and third year residents there was no benefit at all, at 1.01. Among interns, the least experienced group, incorrect answers on reinforced material fell significantly, with a risk ratio of 0.83 and a p value of 0.04. The authors' reading is that the benefit depends on the learner's stage: interns had more to gain from the material and less email fatigue than their seniors.

A retrospective cohort study in the International Journal of Medical Students in 2023 compared 35 Anki users with 268 non-users in one graduating class. Licensing exam scores were slightly higher for the Anki group and the failure rate was lower, but the difference in scores was not statistically significant, and the non-Anki students actually had higher grade point averages.

So the honest version is this. Retrieval at spaced intervals is the best studied way to hold a large body of facts, and medicine is a large body of facts. It is not a substitute for clinical exposure, and a big deck is not evidence of anything. The mechanics of setting the intervals are in a spaced repetition schedule that works, and why testing yourself beats rereading is in active recall.

What a question bank costs

Question banks are the other half of most people's revision, and the prices are not small. As of September 2026 AMBOSS prices in US dollars: 19.99 dollars a month billed monthly for students and residents, or 12.50 dollars a month billed yearly, with clinician plans at 29.99 dollars a month. Anki itself is free on Windows, macOS, Linux and Android; the iPhone and iPad app is paid, and the price is set in the App Store rather than on Anki's own page. Check what your school's library already licenses before you pay for anything, because several Irish schools buy access centrally.

What does a week in a clinical year look like?

Nobody can hand you a real timetable, because yours depends on the rotation and the hospital. What you can plan is the study that sits around it. The pattern below assumes a year four student on a full time clinical team, in the shape RCSI describes, with a must-pass clinical assessment somewhere in the rotation.

Two things about that table. The nightly work is small on purpose, because a clinical week ends when it ends. And nothing on it is first contact with a topic. First contact happens on the ward, in the teaching session or in the reading you did for the case. The evening is for holding on to it.

Build the rotation around the assessment date, not the other way round. If the must-pass clinical assessment falls in week six, the presentations you have never seen by week four are the ones to go looking for.

Where Notibo fits

The weak point in a clinical year is not the ward. It is the teaching session at 8am that you half heard, and the lecture in second year you never wrote down properly. Notibo records a lecture, or takes an audio file you upload, and gives you back a transcript, structured notes and flashcards with spaced repetition, so the questions you review in a later rotation come from what was actually said. It also turns PDF, PPTX and DOCX files into notes and cards, which is most of what a module hands you. Pro is free for the first 14 days, with 240 minutes of recording and no card. After the trial the free plan covers 30 minutes of recording a month, and Pro is 9.99 euro a month. Uploads are capped at 50 MB per file.

On data, so you can decide: files are stored in the EU, on Supabase in Frankfurt, and transcription and the AI notes run on US processors under standard contractual clauses. That is fine for a lecture you had permission to record. It is not fine for anything involving a patient, and neither is any other tool. Recording people needs their permission, and the Medical Council's rules on patients are not a setting you can change.