Sitting in a hotel room in London, about to to some last minute preparation for my Clinical Skills Assessment- the final exam before I finish my training.
Provided I pass this exam ( a fake surgery with 13 actors pretending to be patients in 10minute slots), come March I’ll be a General Practitioner (GP, Family doctor, Primary Care Physician, whatever you prefer).
This is the last exam I HAVE to do, in future, any exam I sit will be because I chose to do it to add another feather in my cap.
Basically feeling like I should be able to pass this exam doing what I normally do at work, but on a day when I’m firing on all cylinders.
It might be that there is a “hidden agenda” that you have to find, or an angry patient, or breaking bad news, but the clinical stuff is generally OK.
It is tricky f you don’t pick up the non verbal cues for a hidden agenda, because then you run out of time before you can deal with it properly. Finding out your patient with anxiety symptoms at work was actually raped in the company parking garage after staying late is OK if you get that out in minute 2. It is not so good if she tells you in minute 9 after you’ve spend the whole time reassuring her that work is a safe place and her anxiety is misplaced.
In theory it should be easier than real life because they only have 1 or 2 issues, and the 10 minutes is just for history and examination and management- you don’t have to do the paperwork as well like you have to in real life.
Anyway- hope you all enjoy your festivities- I’m off to have something to eat.
Since my husband recently caused a doctor to say “I have no idea what’s wrong with you” after an exam, I’m going to give you this scenario in case they try and sneak it into your exam. I’m not a doctor at all, so may have missed some of what they were looking for, but this is basically what happened:
Patient (30, male) presents with severe abdominal pain, right lower quadrant (about level with navel, slightly lower), no fever, normal bloodwork, pain level doesn’t change between pushing and pulling back slowly or quickly. Pain started about 12 hours previous and gradually got worse, to the point where the patient had trouble standing. Bowel movement earlier in the day was normal.
What’s wrong with him?
The doctors’ first assumption was:
[spoiler] appendicitis.
The problem with that? The patient has his appendix removed when he was 8.[/spoiler]
They were wrong - hence the dumbfounded “I have no clue!” response. Turns out he had:
An omental infarction, diagnosed by CT scan
My mother-in-law is a general practitioner and when we told her the details she basically said “hmmm…interesting teaching case”, so I figured you’d appreciate it!
If I can offer words of wisdom from Gregory House, MD:
[ul]
[li]Everybody lies.[/li][li]It’s not lupus.[/li][li]Order as many expensive tests as possible and cut the patient open as much as possible before you have an aha! moment and finally figure out that the patient’s problem is something a reasonably bright third-year student could have figured out from the presenting symptoms.[/li][li]It’s OK to pit your subordinates against each other for your own amusement.[/li][/ul]
Seriously, good luck! I’m sure you’ll do just fine.
Ooh, yeah do you get to have Ducklings to follow you around to do the dirty stuff and send them to patients’ houses to find out what kind of insect repellent they use, so you can determine which country they visited in the past year and therefore which obscure tropical disease they have?
Because I think that would be a lot of work to do on your own, especially in only 10 minutes. You should insist on having Ducklings.
I’m surprised that its the last compulsory exam, surely there must the some requirements that entail keeping up to date in your profession to maintain your licence to practice.
Yes you may choose certain things, but there must be a core of knowledge that is compulsorily kept up to date?
GPs are required to keep up to date (as are most other health professionals) but that doesn’t usually involve exams. It’s called Continuing Professional Development (CPD) and most often involves keeping records of courses/study days/lectures attended, logging any private study, demonstrating things like “reflective practice” (thinking about cases to see what you could improve/do better in future). There should generally be a range of activities, rather than being all one type. These get logged at appraisals and with professional bodies. Of course any relevant exams count as well.
It was… about as good as these things could be. Got a chance to chat to other people during the supervised tea break, and that was quite nice. The actors were very good, which helped, and the floor marshalls (who are GPs and RCGP admin staff) were really friendly and helpful.
I was fine coming out of it, but the more I think, the more I worry and then I have those shoulda-coulda-woulda moments.
I think I’ll just have to wait for the result and hope for the best.
I can’t give specifics, but some of the cases were pretty tricky, and some were more about negotiating a plan with a patient who disagreed about how to move forward.
On the plus side, I got to do some xmas shopping in London (Santa filled up his sack for irishchild in Hamley’s toy shop) and I met up with my sister, drank wine and chilled out in with her on Friday and Saturday.
Back to work this morning…I saw 22 patients and had 7 phone consultations today, which is par for the course.
Sometimes I wish I had ducklings, believe me!
I have receptionists providing me with an endless supply of tea and scones, which is nearly as good though.
To think I was still at High school with a dial-up connection when I started lurking here!
A plain black, knee length dress with a striped grey/multicoloured cardigan, black opaque tights (pantyhose) and grey and black mid height heeled pumps.
I thought I looked quite nice and professional- most of the other girls had opted for something similar, or a blouse or twinset and skirt or trousers. The guys all wore suits.
One girl was wearing MBT toning trainers, black yoga bottoms and a scoop neck t-shirt though, so I guess it didn’t really matter.
Still, I feel more professional and focused when I look professional and focused, so I’m glad I went for the smart option.
It did reinforce for me that I never want to be in a job which requires extensive business travel. The hotel was OK, but eating alone in a hotel dining room filled with lonely business men and couples having affairs (one tends to inadvertently overhear more conversations when one doesn’t have someone to talk with over dinner) was grim.
Wow. You’re making me feel incredibly old. I remember when you were just starting too and I’m only 31! It seems like you’ve come so far in such a short amount of time.
