10 August 2023.
|
20 |
Role-play. Anencephaly |
|
21 |
Role-play. Teach FY1 about complaint
procedures |
|
22 |
EMQ. Medical Examiner |
|
23 |
EMQ. Coroner |
20. Role-play.
The topic will be emailed just before the tutorial so
that you don’t have time to prepare.
21. Role-play. Complaint procedures.
The exam has had stations with a patient who wishes to complain. There
are lots of possible scenarios, including the patient who wishes to complain
about you! You need to learn techniques to deal with the various scenarios, but
you won’t get far if you don’t know the facts, which I have put on my website: http://www.drcog-mrcog.info/Complaint%20procedures.htm. Read this
through and you will be able to display your mastery in the role-play.
Candidate’s instructions.
You are a 5th. year SpR. It is a quiet day on
the labour ward. The consultant on duty happens to be responsible for risk
management and has asked you to teach a new O&G trainee about complaints.
22. EMQ. Medical Examiner.
Abbreviations.
MCCD: medical
certificate of the cause of death.
ME: medical
examiner.
Do I really need to know
this stuff? This
is ‘hot’: MEs were an innovation in 2018.
Question
1.
Which, if any, of
the following are included in the role of the ME?
Option list.
|
A |
scrutiny of all death certificates from the NHS Trust |
|
B |
scrutiny of all death certificates from the local area |
|
C |
scrutiny of non-coronial death certificates from the
local area |
|
D |
deciding if postmortem examination is appropriate |
|
E |
supervision of postmortem examination |
|
F |
deciding on and arranging further investigations to
establish the cause of death |
|
G |
liaison with the coroner |
|
H |
discussing the cause of death with the family of the
deceased |
|
I |
directing police investigations in cases of suspicious
death |
Question
2.
What
qualifications must a ME have?
Option list.
|
A |
be registered with the GMC |
|
B |
be licensed to practise or be < 5 years into
retirement |
|
C |
be a member or fellow of a Royal Medical College |
|
D |
be a member or fellow of the Royal College of Pathologists |
|
E |
none of the above. |
Question
3.
Which, if any, of
the following are included in the role of the medical examiner?
Option list.
|
A |
discussing the case with the doctor who provided care
during the final illness |
|
B |
reviewing the medical records |
|
C |
deciding the cause of death to be put on the
certificate of death |
|
D |
discussing the cause of death with next of kin |
|
E |
identifying any concerns the next of kin may have about
the care |
|
F |
providing medical advice to the coroner |
|
G |
identifying deaths that should trigger a mortality case
record review |
Question
4.
Which, if any, of
the following are included in the role of the National ME?
Option list.
|
A |
being a member of the medical team responsible for the
King’s health |
|
B |
appointing Trust MEs |
|
C |
disciplining errant MEs |
|
D |
producing reports |
|
E |
arbitrating in disputes between MEs and coroners about
the cause of death |
|
F |
dealing with appeals by families who are dissatisfied
with the MCCD or the care |
23. EMQ. Coroner.
This topic has featured in the exam and makes for
easy marks if you know the basics.
CC: Chief Coroner.
CJA9: Coroners and Justice Act 2009.
MCCD: medical
certificate of the cause of death.
NOD: notification
of deaths.
SB: stillbirth
Option list 1.
A.
an independent judicial officer
B.
a barrister acting for the Local Police Authority
C.
the regional representative of the Home Office
D.
the regional representative of the Queen.
E.
an employee of the High Court.
F.
the Local Authority
G.
the Local Police Authority
H.
the Home Office
I.
the High Court
J.
the Queen
Use option list 1 for scenarios
1 - 3.
Scenario 1.
What is the best description of the status of the Coroner?
Scenario
2.
Who appoints the Coroner?
Scenario
3.
Who pays for the Coroner and the coronial service?
Scenario
4.
Which, if any, are current titles for coroners?
Option
list.
|
A |
area
coroner |
|
B |
assistant
coroner |
|
C |
district
coroner |
|
D |
deputy
coroner |
|
E |
lead
coroner |
|
F |
national
coroner |
Scenario
5.
Which, if any, of the following are functions of the Chief
Coroner?
Option list.
|
A |
to
appoint coroners |
|
B |
to
approve coronial appointments |
|
C |
to
negotiate coroners’ salaries |
|
D |
to
negotiate coroners’ terms and conditions |
|
E |
to
oversee the disciplinary procedures for coroners |
|
F |
to
keep an eye on coronial investigations that have taken too long |
|
G |
to
organise advice from coroners about how deaths may be prevented |
Option list 2. Use for
scenarios 6-8.
A. must have had experience as a detective
in the police force with the rank of Inspector or above
B. must be a barrister, lawyer or
doctor with at least 5 years’ experience
C. must be a legally qualified
individual with at least 5 years’ experience
D. must be a trained bereavement
counsellor
E. must be able to play the
bagpipes
F. Monday - Friday; 09.00 - 17.00
hours, including bank holidays
G. Monday - Friday; 09.00 - 17.00
hours excluding bank holiday
H. All the time
I. to arrest people suspected of
unlawful killing
J. to manage traffic in the
vicinity of the Coroner’s court
K. to make enquiries on behalf of
the Coroner
L. to make enquiries on behalf of
the Coroner and provide administrative support
Scenario
6.
What qualifications must the Coroner have?
Scenario
7.
What are the hours of availability of the Coroner?
Scenario
8.
What
are the roles of the Coroner’s Officers?
Scenario
9.
Who or what is responsible for appointing medical examiners?
Option
list.
|
A |
Local
authorities |
|
B |
the
Chief Coroner |
|
C |
the
Chief Medical Examiner |
|
D |
the
local Senior Coroner |
|
E |
the
Lord Chancellor |
|
F |
NHS
Trusts |
|
G |
the
Queen |
Scenario
10.
Which, if any, of the following are applicable to the role of
medical examiner?
Option
list.
|
A |
to
decide if a post-mortem is required |
|
B |
notification
of deaths to the coroner |
|
C |
supervision
of the quality of MCCDs |
|
D |
attendance
at post-mortems |
|
E |
performance
of post-mortems |
Scenario
11.
When was the 1st. Chief Medical Examiner for England
& Wales appointed?
Option
list.
|
A |
2005 |
|
B |
2010 |
|
C |
2015 |
|
D |
2017 |
|
E |
2019 |
|
F |
the
post does not exist |
|
G |
none
of the above |
Scenario
12.
What was the specialty of the 1st. appointee to the post
of the lead medical examiner for England & Wales?
Option
list.
|
A |
accident
and emergency medicine |
|
B |
forensic
medicine |
|
C |
forensic
pathology |
|
D |
forensic
psychiatry |
|
E |
obstetrics
& gynaecology |
|
F |
pathology |
Scenario
13.
Which, if any, of the following are requirements for those wishing
to become a medical examiner?
Option
list.
|
A |
full
registration with the General Medical Council |
|
B |
consultant
status |
|
C |
>
10 years’ experience as a fully-registered doctor |
|
D |
to
have the Diploma of the Faculty of Medical Examiners |
|
E |
to
have membership of the RCP |
|
F |
none
of the above |
Option list 3. Use for the
remaining scenarios, unless they have an option list.
A. the death must be reported to
the Coroner
B. the death does not need to be
reported to the Coroner
C. the Coroner must order the
return of the body for an inquest
D. the Coroner must order a
post-mortem examination
E. the Coroner must hold an
inquest
F. the Coroner should arrange for
the death to be investigated by the Home Office
G. the death must be reported to
the authorities of the country in which it took place in order that a
certificate of death can be issued
H. a certificate of live birth
I. a certificate of stillbirth
J. a certificate of miscarriage
K. yes
L. no
M. none of the above
Scenario
14.
A
resident of Manchester dies suddenly while visiting the town of his birth in
Scotland. His family decides that he will be buried in the town of his birth.
His body is held at the premises of a local funeral director to arrange the
funeral and burial. What actions should be taken with regard to the Manchester
coroner?
Scenario
15.
A
resident of London dies suddenly while visiting Manchester, where he was born.
His family decides that he will be buried in Manchester. His body is held at
the premises of a Manchester funeral director who will arrange the funeral and
burial. What actions should be taken with regard to the Manchester coroner?
Scenario
16.
A resident of Manchester dies on holiday in his native Greece. The
family decide that he will be buried in Greece. What steps must be taken to
obtain a valid death certificate?
Scenario
17.
A man of 65 dies of terminal lung cancer. The GP who had visited
daily up to three weeks before the death has been on holiday for three weeks.
He has now returned and says that he will sign a death certificate, but needs
to visit the funeral director to see the body first. Will this be a valid death certificate?
Scenario
18.
A man of 65 dies of terminal lung cancer. The GP, who has visited
daily up to the day of his death and attended to confirm the death, is on holiday.
However, he says that he will sign a death certificate and put it in the post,
so that it will arrive in the morning. Will this be a valid death certificate?
Scenario
19.
A man of 65 dies of terminal lung cancer. The GP who has visited
daily up to the day before his death has been on holiday since. However, he
says that he will sign a death certificate and put it in the post, so that it
will arrive in the morning. Will this be a valid death certificate?
Scenario
20.
A 65-year-old man dies suddenly 12 hours after admission to the
local coronary care unit with chest pain, despite apparently satisfactory
insertion of a coronary artery stent after a diagnosis of coronary artery
thrombosis. What action should be taken with regard to the Coroner?
Scenario
21.
A
16-year-old girl is admitted at 36 weeks’ gestation in her first pregnancy with
placental abruption. She is given the best possible care but develops DIC and
hypovolaemic shock and dies after 48 hours. What action should be taken with
regard to the coroner?
Scenario
22.
A 28-year-old woman is admitted with placental abruption at 36
weeks. She has bruising on the abdominal wall and the admitting midwife
suspects that she has been the victim of domestic violence, though the woman
denies it. Despite best possible care she dies as a consequence of bleeding. What
action should be taken with regard to the coroner?
Scenario
23.
A 30-year-old woman delivers normally at home attended by her
husband, but has a PPH. The husband practises herbal medicine. He applies
various potions but her condition deteriorates. She is admitted to hospital by
emergency ambulance. She is given best possible care and is admitted to the
ICU. She dies 7 days later of multi-organ failure and ARDS attributed to
hypovolaemic shock. What action should be taken with regard to the coroner?
Scenario
24.
A woman is admitted at 23 weeks in premature labour. There is
evidence of fetal heart activity throughout the labour, with the last record
being 5 minutes before the baby delivers. The baby shows no evidence of life at
birth. The mother requests a death certificate so that she can register the
birth and arrange a funeral. What form of certificate should be issued?
Scenario
25.
A woman is admitted at 26 weeks’ gestation in premature labour
after being kicked in the abdomen by her partner. The presentation is footling
breech. At 8 cm. cervical dilatation the trunk is delivered and the cord
prolapses. There is good evidence of fetal life with fetal movements and
pulsation of the cord. The head is trapped and it takes 5 minutes to deliver
it. The baby is pulseless, apnoeic and without visible movement at birth.
Intubation and CPR are carried out for 20 minutes when the baby is declared
dead. What action should be taken with regard to the coroner?
Scenario
26.
A woman is admitted at 26 weeks’ gestation in premature labour
after being kicked in the abdomen by her partner. She says that he did not want
the pregnancy to continue.
Pick
the best option from the option list.
Option
list.
A. dial 999
B. get advice from the BMA
C. get advice from the Department of Health
D. get advice from the legal department
E. get advice from the police
F. none of the above.
Option list.
|
A |
provide access to the
records by the Coroner in person |
|
B |
provide unrestricted access
to the medical records by the coroner’s officers |
|
C |
provide a copy of the
hospital records to the coroner or her officers |
|
D |
provide a medical report,
but no access to the medical records |
|
E |
provide a copy of the letter
to the GP about the recent admission |
|
F |
none of the above |
Scenario
28.
You have been swimming in the sea at Broad Beach, Rhosneigr. As you walk back to the
shore your foot hits something in the sand. You explore and find a number of
gold coins that look ancient. What should you do?
Option
list.
|
A |
put
them back as they may have been an offering to the Gods |
|
B |
put
them in a safe place with a view to having them valued and sold |
|
C |
take
them to the local museum for identification and advice about informing the coroner |
|
D |
take
them to the nearest police station for advice |
|
E |
take
them to your favourite pub and trade them for a meal and round of drinks |
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