21 March 2016
6
|
Viva. Abusive GP letter.
|
7
|
Role-play. Break bad
news. Primigravida.
8 weeks. Some bleeding.
Scan
= IUP. CRL = 12 mm. No fetal heart activity. Counsel.
|
8
|
Role-play. Woman attends
for pre-pregnancy counselling as she plans her 1st. pregnancy. Her
sister recently had a baby with Down’s syndrome.
|
9
|
Viva station.
You
are a year 4 SpR and have been asked by your consultant to assess Mrs Mimi
Dresden on the orthopaedic ward.
She
is 85 years old and has been admitted from the nursing home where she lives
with a hip fracture after a fall. She has Alzheimer’s disease. The nursing
staff have noted blood on her underwear.
The
examiner will ask you a series of questions:
what history will you take?
what examination will you perform and your
reasoning?
what investigations will you arrange?
what management will you propose?
|
6. Viva. Abusive GP letter.
Candidate’s instruction.
You are the SpR in the gynaecology clinic.
List the things that are wrong with this letter.
What action(s) would you take after seeing the patient
with regard to the letter?
GP letter.
The Medical Centre,
Green Lane,
Broadforth-on-Sea.
Your ref: BRI 07/54843.
Re. Jennifer Houseside,
45 The Maltings,
Broadforth-on-Sea.
Dear John,
It was wonderful to see you and Mary again on Saturday
and so kind of you to invite us. The meal was up to Mary’s high standards and
the company convivial. We may be getting older, but Mary’s fragrant beauty does
not diminish.
Please see this woman who complains of unacceptably heavy
periods. She is huge, malodorous and is more like a whale than a human being.
One can see how the family name originated! I do not envy you the task if you
feel that you have to examine her.
She is as stupid as she is fat. I doubt that she has more
than one brain cell. If she has, they are not inter-connected. She talks
incessantly and brings complete sense of the old adage “empty vessels make most
sound”. Despite the vacuum in her cranium she is awash with idiotic ideas, most
of which she gets from her monumentally stupid mother. She is too thick for
logical reasoning to have any impact on her ridiculous views – you might as
well attempt a philosophical discussion with your dog.
The father is a dirty, unpleasant sort and I would not be
surprised if incest had contributed to their low IQs. If the human race has
advanced though evolution and natural selection, what on earth were their
ancestors like?
They are social parasites. None of the family has ever
worked and they live off Social Security payments. I have had the misfortune to
have to do the occasional home visit to various members of the family. They
live in disgusting squalor. If they were pigs their living conditions would
give the species a bad name. Theirs are houses in which you wipe your feet on
the mat as you leave and not as you enter and pray that you never have to visit
again. I am sure the Court of Human Rights would regard a second visit as a
cruel and unnatural punishment. They always ask you to sit, but I would not
wish to ruin my clothes. Their hospitality also extends to offering cups of
tea. Perish the thought! I would rather take my chance with neat hemlock.
Despite living on Social Security payments, they have the
latest widescreen TVs and associated DVD equipment. The husband looks to me as
though he indulges in low-level crime, probably shoplifting. He is a shifty
character whom you would not trust and I strongly advise you to make sure that
all valuables are locked up and out of sight when he or any of her family is
around. One brother is in prison for theft to feed a heroin habit, which
typifies the contribution this family makes to the greater good. Her sister is
said to be a prostitute and I would think it true. Certainly she has a lot of
children and I doubt that any of them have the same father or that she would be
able to enlighten them as to who their fathers might be. She (the sister) is a
regular visitor to the Sexually Transmitted Diseases clinic where she displays
a surprising range of conditions needing treatment. She is a one-woman update
course for the staff ensuring they are abreast of all aspects of STDs. I was
going to say she was a one-woman refresher course, but there is nothing
refreshing about her. The sister is as fat and ugly as my patient, making one
marvel at the mentality of her clients. I cannot imagine how anyone would want
to come within smelling distance of her, far less have sexual relations and pay
for the privilege. Some exotic form of masochism, I guess.
I wish you well in your dealings with her and apologise
for sending such an unpleasant lump to your clinic. This is a family that makes
you wish the Abortion Act could be made retrospective!
Please do your best not to send her back to see me.
Yours sincerely,
7. Role-play. Breaking bad news.
Candidate's Instructions.
This is a role-play station. The role-player will act as
the patient. An examiner will be present.
You are the SpR in the ante-natal clinic. The Consultant
who was in clinic has been asked to assist her Consultant colleague in the
labour ward theatre. She is unlikely to return for some time as the case is one
of massive PPH and hysterectomy may be necessary.
One of the midwives asks you to see a patient who has
just had a scan in the EPU.
She is primigravid and the gestation is 8 weeks. She has
had some bleeding.
An ultrasound scan = IUP. CRL = 12 mm. No fetal heart
activity. No adnexal masses.
8. Role-play. Pre-pregnancy
counselling.
Candidate’s instructions.
You are the
SpR in the gynaecology clinic. You have been asked to see Jenny Williams, who
has come for pre-pregnancy counselling.
Letter from the General Practitioner.
5 High
Street,
Deersworthy,
Kent.
DO9 1JY.
Re Mrs. J.
Williams,
Manor
Place,
Deersworthy.
Dear Dr.,
Please see
this woman who is planning pregnancy. I understand that her sister has had a
baby with Down’s syndrome.
Regards, Dr. Jolly.
9. Viva.
Viva station.
You
are a year 4 SpR and have been asked by your consultant to assess Mrs Mimi
Dresden on the orthopaedic ward.
She
is 85 years old and has been admitted with a hip fracture after a fall from the
nursing home where she lives. She has Alzheimer’s disease. The nursing staff
have noted blood on her underwear.
The
examiner will ask you a series of 4 questions.
6. Viva. Abusive GP letter.
Candidate’s instruction.
You are the SpR in the gynaecology clinic.
List the things that are wrong with this letter.
What action(s) would you take after seeing the patient
with regard to the letter?
GP letter.
The Medical Centre,
Green Lane,
Broadforth-on-Sea.
Your ref: BRI 07/54843.
Re. Jennifer Houseside,
45 The Maltings,
Broadforth-on-Sea.
Dear John,
It was wonderful to see you and Mary again on Saturday
and so kind of you to invite us. The meal was up to Mary’s high standards and
the company convivial. We may be getting older, but Mary’s fragrant beauty does
not diminish.
Please see this woman who complains of unacceptably heavy
periods. She is huge, malodorous and is more like a whale than a human being.
One can see how the family name originated! I do not envy you the task if you
feel that you have to examine her.
She is as stupid as she is fat. I doubt that she has more
than one brain cell. If she has, they are not inter-connected. She talks
incessantly and brings complete sense of the old adage “empty vessels make most
sound”. Despite the vacuum in her cranium she is awash with idiotic ideas, most
of which she gets from her monumentally stupid mother. She is too thick for
logical reasoning to have any impact on her ridiculous views – you might as
well attempt a philosophical discussion with your dog.
The father is a dirty, unpleasant sort and I would not be
surprised if incest had contributed to their low IQs. If the human race has
advanced though evolution and natural selection, what on earth were their
ancestors like?
They are social parasites. None of the family has ever
worked and they live off Social Security payments. I have had the misfortune to
have to do the occasional home visit to various members of the family. They
live in disgusting squalor. If they were pigs their living conditions would
give the species a bad name. Theirs are houses in which you wipe your feet on
the mat as you leave and not as you enter and pray that you never have to visit
again. I am sure the Court of Human Rights would regard a second visit as a
cruel and unnatural punishment. They always ask you to sit, but I would not
wish to ruin my clothes. Their hospitality also extends to offering cups of
tea. Perish the thought! I would rather take my chance with neat hemlock.
Despite living on Social Security payments, they have the
latest widescreen TVs and associated DVD equipment. The husband looks to me as
though he indulges in low-level crime, probably shoplifting. He is a shifty
character whom you would not trust and I strongly advise you to make sure that
all valuables are locked up and out of sight when he or any of her family is
around. One brother is in prison for theft to feed a heroin habit, which
typifies the contribution this family makes to the greater good. Her sister is
said to be a prostitute and I would think it true. Certainly she has a lot of
children and I doubt that any of them have the same father or that she would be
able to enlighten them as to who their fathers might be. She (the sister) is a
regular visitor to the Sexually Transmitted Diseases clinic where she displays
a surprising range of conditions needing treatment. She is a one-woman update
course for the staff ensuring they are abreast of all aspects of STDs. I was
going to say she was a one-woman refresher course, but there is nothing
refreshing about her. The sister is as fat and ugly as my patient, making one
marvel at the mentality of her clients. I cannot imagine how anyone would want
to come within smelling distance of her, far less have sexual relations and pay
for the privilege. Some exotic form of masochism, I guess.
I wish you well in your dealings with her and apologise
for sending such an unpleasant lump to your clinic. This is a family that makes
you wish the Abortion Act could be made retrospective!
Please do your best not to send her back to see me.
Yours sincerely,
7. Role-play. Breaking bad news.
Candidate's Instructions.
This is a role-play station. The role-player will act as
the patient. An examiner will be present.
You are the SpR in the ante-natal clinic. The Consultant
who was in clinic has been asked to assist her Consultant colleague in the
labour ward theatre. She is unlikely to return for some time as the case is one
of massive PPH and hysterectomy may be necessary.
One of the midwives asks you to see a patient who has
just had a scan in the EPU.
She is primigravid and the gestation is 8 weeks. She has
had some bleeding.
An ultrasound scan = IUP. CRL = 12 mm. No fetal heart
activity. No adnexal masses.
8. Role-play. Pre-pregnancy
counselling.
Candidate’s instructions.
You are the
SpR in the gynaecology clinic. You have been asked to see Jenny Williams, who
has come for pre-pregnancy counselling.
Letter from the General Practitioner.
5 High
Street,
Deersworthy,
Kent.
DO9 1JY.
Re Mrs. J.
Williams,
Manor
Place,
Deersworthy.
Dear Dr.,
Please see
this woman who is planning pregnancy. I understand that her sister has had a
baby with Down’s syndrome.
Regards, Dr. Jolly.
9. Viva.
Viva station.
You
are a year 4 SpR and have been asked by your consultant to assess Mrs Mimi
Dresden on the orthopaedic ward.
She
is 85 years old and has been admitted with a hip fracture after a fall from the
nursing home where she lives. She has Alzheimer’s disease. The nursing staff
have noted blood on her underwear.
The
examiner will ask you a series of 4 questions.