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