January Exams

January Examinations are over.

75 SBAs - Tuesday 5th January

75 questions on our entire medical clinical year curriculum so far. Some of the questions were really tough and even after a post-mortem discussion with housemates, didn't really seem much clearer.

I do feel I have recognised a couple areas of weakness - liver and kidneys. As much as I prided myself on learning haematology and endocrinology to weird and wonderful complexity, this exam was really focused on common management considerations.

2 OSCEs - Tuesday 12th January

After all the preparation on patient histories and examinations, it was two communication stations. One largely preparable on 'risks and benefits of AAAs' and the other a 'diabetic medication review.'

AAA station went largely to plan. Misheard the patient during one explanation but clarified it with a dose of ICE. Newcastle and proud. Viva questioning featured one curve-ball of 'how do we assess frailty?'

DM station was tougher. The temptation to avoid a full medical history was avoided by a mixture of supportive life discussion and elements of motivational interviewing before a brief discussion on medical therapies. I did not quite manage to complete succinctly within time. Viva questioning featured 

On reflection, empathy and good bedside manner probably helped but I could have definitely could have structured my consultations based on ICE and then focusing my lines of questioning, instead of trying to fulfill the written OSCE objective first. I also could have ended both consultations by asking the patients to repeat back to me what they'd to make sure it had been understood.

Overall a great learning experience in fulfilling the objective and tickboxes required of you in this station - structured ICE, clear chunk and checking and knowing relevant statistics. There are no simpler ways to demonstrating competence than by showing an understanding of taught communication basics.