introduction to final year 24 th september 2012. welcome to meded! three schemes: – tutoring –...

Introduction to Final Year

24th September 2012

Welcome to Meded!

• Three schemes:– Tutoring

– Speciality Days

– Cases for Finals

Cases for Finals

• Interactive, non-didactic teaching. Clinical, directly relevant to PACES. Delivered by F1s

• Dates: 1st Oct – Session 1 – Neurology8th Oct – Session 2 – Respiratory15th Oct – Session 3 – Cardiology22nd Oct – Session 4 - Abdo SurgeryAll subsequent sessions on mondays

Intro to Final year

• 3 Ex-ICSM F1’s in NWT– Anika Kaura, Ola Markiewicz, Pranev Sharma

• There will be some overlap to represent different learning styles

• Questions session at end of talk

• Slides will be up soon on Meded website

• Any questions/feedback please email:

– medical.education@imperial.ac.uk

Introduction to ICSM Finals

Introduction• Foundation year doctors:

• ANIKA KAURA

• OLA MARKIEWICZ

Structure of Finals• Written Exams

Practical Prescribing Paper 1 & Paper 2

Medicine/Surgery/Pharmacology SBA & EMQ

• PACESMedicineSurgery

PACES • 6 (7) stations: - 1 x 20 minute history- 5 x 10 minute stations- 1 x 10 minute rest station

• Medicine: History Taking, Abdominal, Cardiovascular, Nervous System, Respiratory, Short Cases (Skin/Eyes/Rheum/Endo etc.)

• Surgery: History Taking, Abdomen, Vascular, Musculoskeletal, Images/Instruments, Short Cases (bed cases or seated)

PACES• Mostly well outpatients. Although can get inpatients…

• More subjective – not so much ‘tick-boxing’

• Broad Domains- Clinical Skills (History and Examination)Competent, systematic, safe - Formulation of Clinical Issues Summary, interpretation, diagnosis, appreciate psychosocial- Discussion of ManagementJustify investigations, multiprofessional approach, EBM, basic clinical sciences- Professional and Patient Centred ApproachProfessional communication, patient safety, legal and ethical principles, empathic behaviour

• Overall Mark• Examiners Meeting

REVISION COURSES

• BARRY’S SURGERY COURSE•MIRZA’S MEDICINE COURSE•MEERAN’S MEDICINE WEEKEND• FINALS PACES WEEKEND @ WEST MID• DR CLARKE MEDICINE & SURGERY• BROMPTON PACES

BOOKS

MEDICINE

SURGERY

WEBSITES

PACES StationsFORMAT• EFFICIENT Examination i.e. QUICK whilst picking

up the SIGNS• CONCISE presentation – all the signs and other

features like cushingoid etc• Offer single DIAGNOSIS and differential • Investigations for THOSE diagnoses- know what

you would look for in each i.e. ECHO for aortic stenosis to look at area of valve orifice

• Management of the condition – MDT and holisitic- so for AS offer conservative- cardiac risk factor modification, medical- controlling hypertension and treating cardiac failure, surgical- options of valve repair/replacement

MEDICINE- Short Cases• No set numbers of cases• Focussed examination

• Rheumatology: Rheumatoid hands, Scleroderma, Ankylosing Spondylitis

• Endocrinology: Goitre, Acromegaly, Cushing’s

• Ophthalmology: DM, Optic Atrophy, Retinitis Pigmentosa

• Dermatology: Rashes….• OA, Gynaecomastia, Carpal Tunnel, HHT,

Bell’s Palsy, IIIrd nerve palsy…

SURGERY- Short Cases• Global assessment• Browse’s Introduction to S & S of Surgical Disease

• Groin & Scrotal lumps• Head and Neck Lumps• Skin: Lipomas, Ganglion, Neurofibromatosis• Minor Musculoskeletal: Dupuytren’s, RA Hands,

Hallux Valgus• Minor Vascular: Varicose Veins, Ulcers, AV Fistula

(dialysis)• Scars (including breast) & Stomas• Nerve palsies• Random others

MOCK STATION

• Thank you!

• Please email akaura0@gmail.com if any queries

My Final Year

Dr Ola Markiewicz FY1 Hillingdon Hospital

Introduction to Final Year

Why I wanted to do this lecture

Why I wanted to do this lecture

Not going to tell you: What you need to do to pass final year Which books are available Which courses to go/not go on How to get a distinction

I will tell you What I (ME!) did to pass final year What I wish I’d done differently

Plan

My timeline Tutors Courses Writtens

Medicine Surgery CPT & Practical Prescribing Epidemiology

PACES

My Final Year

Aim - finish it!Sept Oct Nov Dec Jan Feb March April May June

Start typing up medical and surgical notes on core subjects a little at a time

Tutors sorted Little bit of reading

CPT/PP

Surgical tutoring

Medical tutoring

Group work

Mock exam

QuestionsRe-read notes PACES

practice

Tutors

Tutors

MEDICAL TUTOR Who Professor

Group size 2

Where Hammersmith Hospital

When Once per week starting from January

How Found patients ourselves then examined in front of him

Good points Experienced and knowledgeableRestored our confidence Signs

Bad points Sometimes cancelled /late as very busy Very pragmatic – good doctors v.s. good PACES (?good thing)Hammersmith Hospital!

Tutors

SURGICAL TUTOR

Who Surgical CT2

Group size 4

Where Her house/Wexham Park

How Tutorial based sessionsVivasHistory and examination practice

Good points

Very exam focussedKnowledgeable (post MRCS)Flexible Comfortable environment

Bad points

No real patients – only one trip to Wexham Park

Courses

Courses

Finals PACES

What FebruaryCourse focussed on how to present Saturday – MedicineSunday – Surgery (included instruments and images)

Good IntenseGives you idea of what you need to knowThe only place I learned how to present for finals Done by Imperial alumniGreat guide book

Bad Focussed on producing a “show”Expensive - £80

Courses

Professor Meeran’s Weekend Course

What MarchSaturday – Medicine: Prof MeeranSunday – Surgery: Prof Meeran’s friend from CardiffQuestion book you fill in and answers explained as you go

Good £52 each if booked as a group of 5Can do just Saturday or SundayReally engagingGood summary of core subjects I needed to cover

Bad Intense Probably didn’t go into as much detail as I did aloneNot essential

Courses

Barry’s course: why I didn’t do it Location – time it would take me to get

there Duration – I can’t stay awake non-stop in

a lecture for 3-4 hours Timing – right around my dinner time Time commitment – had to be free every

Tuesday for 10 weeks, couldn’t afford to miss a session (Valentine’s day, Circle Line)

Courses

“Para-skivers”: Met once a week at the Reynolds in a

group (same time as his course happened)

Went through his guide viva-ing each other (can buy his guide for £25)

Great viva practice Retained to memory Still got to see friends!

Writtens

Writtens

Medicine

Writtens

Surgery

+ Barry’s Guide

?

Writtens

Questions for Medicine & Surgery

Online: + Web CT!

Writtens

CPT

Lectures +

Questions Schachter’s book Schachter’s questions Web CT Past questions – repetition!

Writtens

Practical Prescribing

Lectures + + online BNF

Practice!•Under time pressure •Do past questions then compare answers•Calculations •Be familiar with the BNF

Writtens

Epidemiology

Lectures! Learn the definitions – DON’T learn

numbers Practice some calculations –

Onexamination Positive/negative predictive value Incidence Etc....

PACES

PACES

Made a list of things that could come up in each station

Ask Dr Clarke – amazing and FREE!

PACES

Medicine Tutoring or seeing patients. Saw 2-4 patients per session Don’t overdo it – a liver is a liver. Balance – patients v.s. bookwork Make the most of firms and avoid the

rush

PACES

Medicine

PACES

Surgery Anatomy! Google and wikipedia Presentation Complications – structure!

Immediate Early Late

PACES

Surgery

The Exam Itself

Medicine NWP Very unhelpful Expected to get moved on – didn’t Thought I’d failed because I didn’t

get to talk about management for 4/6 stations

Don’t worry about weird stations or getting the diagnosis right

Just act like you’re the doctor

The Exam Itself

Surgery NWP Very friendly Barely touched anyone Don’t forget peri-op care and trauma Complications! Nothing unexpected

Summary

Be honest with yourself Do what you need to do Don’t follow the crowd Make sure you know your basics

inside out A little bit at once Everyone else is in the same boat

Any Questions?

Good Luck!

Welcome to Final Year

Pranev SharmaFY1 Cardiology, Northwick Park Hospital

Don’t believe the rumours!◦ “Finals are impossible to pass”◦ “The examiners are trying to fail you”◦ “The examiners will coldly stare at you if you’re

stuck”

General Advice

Don’t believe the rumours!◦ “Finals are impossible to pass”◦ “The examiners are trying to fail you”◦ “The examiners will coldly stare at you if you’re

stuck”

Organise your tutors

General Advice

Don’t believe the rumours!◦ “Finals are impossible to pass”◦ “The examiners are trying to fail you”◦ “The examiners will coldly stare at you if you’re

stuck”

Organise your tutors

Organise your time wisely

General Advice

Know the rules!◦ Don’t argue with the examiner

PACES is a game

Know the rules!◦ Don’t argue with the examiner

◦ Learn how to talk

PACES is a game

Know the rules!◦ Don’t argue with the examiner

◦ Learn how to talk

◦ Use appropriate language

PACES is a game

Know the rules!◦ Don’t argue with the examiner

◦ Learn how to talk

◦ Use appropriate language

◦ Learn how to present yourself – and dress appropriately!

PACES is a game

Know the rules!◦ Don’t argue with the examiner

◦ Learn how to talk

◦ Use appropriate language

◦ Learn how to present yourself – and dress appropriately!

◦ Be polite

PACES is a game

Medicine◦ Books◦ Courses◦ PACES structure

Surgery◦ Books◦ Courses◦ PACES structure

Outline

Books

Medicine

Courses

Medicine

PACES structure◦ Cardio, Neuro, Resp, Abdo: 7 mins examination / 3

mins viva. Aim for 6/4.

Medicine

PACES structure◦ Cardio, Neuro, Resp, Abdo: 7 mins examination / 3

mins viva. Aim for 6/4.

◦ History: 10 mins history/ 10 mins viva. Aim for 8/12.

Medicine

PACES structure◦ Cardio, Neuro, Resp, Abdo: 7 mins examination / 3

mins viva. Aim for 6/4.

◦ History: 10 mins history/ 10 mins viva. Aim for 8/12.

◦ Shorts: anything goes.

Medicine

PACES structure◦ Cardio, Neuro, Resp, Abdo: 7 mins examination / 3

mins viva. Aim for 6/4.

◦ History: 10 mins history/ 10 mins viva. Aim for 8/12.

◦ Shorts: anything goes.

◦ Rest: maybe/maybe not.

Medicine

PACES structure◦ Cardio, Neuro, Resp, Abdo: 7 mins examination / 3

mins viva. Aim for 6/4.

◦ History: 10 mins history/ 10 mins viva. Aim for 8/12.

◦ Shorts: anything goes.

◦ Rest: maybe/maybe not.

◦ Ask Dr Clarke Imperial Finals Archive

Medicine

Books

Surgery

Courses

Surgery

PACES structure◦ Abdo, Ortho, Vascular: 10 mins – examination and viva

simultaneously!

Surgery

PACES structure◦ Abdo, Ortho, Vascular: 10 mins – examination and viva

simultaneously!

◦ History: 10 min hx / 10 min viva. Aim 8/12.

Surgery

PACES structure◦ Abdo, Ortho, Vascular: 10 mins – examination and viva

simultaneously!

◦ History: 10 min hx / 10 min viva. Aim 8/12.

◦ Shorts: anything goes

Surgery

PACES structure◦ Abdo, Ortho, Vascular: 10 mins – examination and viva

simultaneously!

◦ History: 10 min hx / 10 min viva. Aim 8/12.

◦ Shorts: anything goes

◦ Images & instruments: anything goes

Surgery

PACES structure◦ Abdo, Ortho, Vascular: 10 mins – examination and viva

simultaneously!

◦ History: 10 min hx / 10 min viva. Aim 8/12.

◦ Shorts: anything goes

◦ Images & instruments: anything goes

◦ Rest: maybe/maybe not

Surgery

PACES structure◦ Abdo, Ortho, Vascular: 10 mins – examination and viva

simultaneously!

◦ History: 10 min hx / 10 min viva. Aim 8/12.

◦ Shorts: anything goes

◦ Images & instruments: anything goes

◦ Rest: maybe/maybe not

◦ Ask Dr Clarke Imperial Finals Archive

Surgery

Any questions?

ps1006@imperial.ac.ukJenner Ward (Cardiology) – 9th Floor, NPH

Thank you