Ask any questions below that you have on the exams! Also leave your tips on the year, for students to come and answer other people's questions.
A full list of useful textbooks used can be found at the bottom of this post. I recommend borrowing them over purchasing them. That said, I get money if you use purchase them through the Amazon links below (which helps fund the website/apps/books). Thanks guys!
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Questions change year on year, however important topics stay the same. I will give the best advice I can having done the exams in 2015.
Most important to remember is that the number of weeks you spent on a specialty is equal to the number of questions on it. Thus, for example, learn 2-3x as much detail on Obs & Gynae as Orthopaedics! For most things, Oxford handbook of clinical specialties (a.k.a. salt & vinegar) will cover you but it isn't sufficient detail for a lot of the topics! Lectures are also helpful as they are the people making the questions and they also guide you as to which topics are most important.
Obs & Gynae: cannot stress enough how important it is to read the Green Top RCOG guidelines as questions will be based on these guidelines! Just read the bits in bold as questions could be as detailed as asking whether to try assisted delivery or C-section given a certain clinical issue with the baby. Impey offers great explanations but often the information is wrong as it doesn't contain the up to date guidelines.
Sexual health: questions can be difficult, but reading the BASHH guidelines will be lots of help! Know the indications and contraindications for contraception and the way different STIs present: which bacteria, the colour of the discharge and extra features such as foul fishy smell.
Breast: ABC of Breast is more than enough! Triple assessment and breast cancer should be known inside out. For other breast conditions, know how they present (age/history/signs & symptoms) and what to advise patients.
Orthopaedics and Rheumatology: Churchill book covers it in much more detail than you need to know! For orthopaedics, know the topics featured during the lectures very well. This means you should know hip fractures inside out! Also know how different fractures present and how they are managed: open reduction with internal fixation, splints or traction etc. There's a lot of overlap of orthopaedics with emergency medicine and anaesthetics, so expect orthopaedics to potentially feature in other sections. Rheumatology can be studied using the Oxford handbook of clinical specialties or this book and it is all about knowing how each condition presents and is managed. Antibodies should be studied.
Emergency Medicine: Read the Resus council website and the emergency section of Oxford Handbook of Clinical Medicine. Know the order (ABCDE), how to manage an issue at any stage and other common presentations in the Emergency Department such as overdoses.
Anaesthetics: The brief chapter in Oxford Handbook of Emergency Medicine (NOT Oxford Handbook of Anaesthetics, which is way too advanced!) is great. Borrow it though, not worth buying for one chapter! Knowing blocks is too much, but you should know the triad of anaesthesia, briefly about ASA grading, pain management and side effects/what to do in overdose, different anaesthetic agents (when they are used/side effects/contraindications), important parts of the pre-op assessment and finally a very brief amount on the types of induction.
Paediatrics: The Paediatric Society weekend course (and book) covers important things brilliantly e.g. common conditions in paediatrics, paediatric cardiology, paediatric dermatology.
Geriatrics: Lecture notes: Elderly Care Medicine (and Oxford Handbook of Clinical Medicine) covers everything, but you should focus your revision on common topics such as falls, stroke, parkinson's disease, dementia etc. For Child and Elderly Psychiatry Psychiatry PRN is brilliant.
Dermatology: Covered best by the Paediatrics book above but also the free resource from the British Dermatology society is very helpful and more than enough! Important topics are to identify conditions from pictures and manage them.
I recommend using my OSCE Android app which contains mark sheets for many MBBS4 stations (I'm obviously biased) as well as Masterpass for Specialties.
- Don't forget to ask a brief history to begin with
- Ask them what they know already
- Ask them every step of the way what they want to know and respond accordingly
- Be reassuring and empathetic
- Don't forget to explain things they have to know (safety netting)
- Patient.info is a brilliant website
- Most importantly be safe and seek senior help early (however you should be able to ABCDE stabilise the patient first)
- In the station you usually do have to give an oxygen mask, put on a saturation probe etc.
- For the purposes of the OSCE, it might be easier to leave your stethoscope off your ears so you can hear what you're meant to be hearing
- Do ask for Chest X ray/ABGs/ECGs - you may be given a chest x ray for example to interpret
- Use the Resus website for guidelines
- Advice for specific scenarios
- Anaphylaxis - don't forget to take away the allergen
- Asthma - remember a normal PCO2/decreasing respiratory rate may suggest that things are getting worse as the patient is tiring
- COPD - if a patient is quite hypoxic start them on high flow oxygen and titrate it down. Hypoxia kills faster than carbon dioxide retention
- Sepsis - know your sepsis 6 and do them!
- Breaking bad news
- Ask a brief history to begin with (ruling out emergencies e.g. shock)
- If they're in pain, offer painkillers
- "I'll ask a nurse to get some for you, may we continue whilst we wait?"
- Try to get an idea of what the patient is expecting/hoping for
- Break the news in one go in a succinct manner without jargon
- Silence is unbelievably golden
- Reassure the patient accordingly - we will be looking after you/giving you the best treatment
- At the end offer a follow up appointment or the ability to speak to someone
- Paediatric exams
- Take your time to actually examine children getting familiar with the difficulties it can present
For information on each book, hover over the book and read my comments!
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