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Monday 11 June 2012

Family Medicine Posting

Family Medicine Examination will be in OSCE format (where I came from).

usually comprises of 2 stations, which could include
  • history taking
  • physical examination
  • patient counselling
  • explanation of investigation results to patients
  • most often a combination of the above components
the OSCE will be an emulation of Patient-Doctor interactions, basically.
It is very difficult to predict what will come out in the exam, but we can assume you will not face something that is completely unfamiliar. A recurring example of OSCE questions are as follows;

  • History taking and patient counselling (which includes explanation of test results and lifestyle modifications) of a patient with chest pain
  • History taking and patient counselling of patient presenting with anemia
  • Physical Examination and History taking of patient with Hand numbness
  • Asthma clerking and patient counselling

A very vague-yet-relevant tip I could suggest in preparing for the Family Medicine Exam is to be present at the teaching session in the clinics, and try to observe what the FMS is doing (not everything they do are correct - try to see if there is anything you can do better), observe what the patients needs to know, try to clerk as many case as possible in front of the FMS (who will give you tips as you go along), try to discuss cases as often as possible, and be present and involved in the TBLs.

another important thing to remember during exam is time management.
OSCE exams prove challenging to some students because of the time constraints. try to hone your skills of speed-clerking and speed-physical exam during your posting. 
this comes with experience, but I can just suggest that during the exam - starting with an open-ended question, following up with a close-ended questions to support your diagnoses, and slip in some empathy comments ("it must be very diffcult for you...", "I understand your concern", "please let us help you" etc etc) - because the examiners do lookout for your professionalism and soft skills.

one last thing - pay attention to the small details.
OSCE exams in general will sometimes try to trick you - a good example being, when the patient produces a blood investigation slip, for example - you should check with the name, and date. if the test was done 2 days ago and 2 years ago, it does make a world of difference, no?
also, the OSCE patients are told to act - so think everything the patient does has meaning. if the patient is couging, you should by right ask when they started coughing. if the patient look agitated, ask her if she is agitated. If the patient just so happens to be doing something out of the script, the examiner would (should) tell you.


After the exam, you'll probably feel pretty shitty - mainly due to carelessness and lack of time management. This is NORMAL. chillax and go have some tea and sleep. if you make a mistake now, just remember not to do so next time.



1 comment:

  1. thank you so much for the explanation on how the family medicine examination osce stations can be nailed..thank you once again

    ReplyDelete

hi. any kinds of comments are welcome! thank you...