Name:
Tips & Tricks for Orthopaedic Postgraduate Exams
Description:
Tips & Tricks for Orthopaedic Postgraduate Exams
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Upload Date:
2024-05-31T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
So most of the guys know me here. The topic, what I'm going to talk about is not about any teaching today. All my friends relax, ok? Just I want to share some experience. It's not about tricks or tips. OK, just what I gathered from my own experience and from the senior examiners who was being done this example last 10 years.
OK I'm not going to vote this day on day two, so these examples are two days in the middle and suitcases, two nickels and four egawa tables on the day to. Write the main thing is the game changer is the day one. 60% to 70% of your results. The decision is made on day one. I'm just repeating this day one is very, very important and the day to can confirm the decision taken on day one.
And you can change a bit if you do very well in your favor. Right now, we want to say first impression is the best impression. OK when are you going for any cases? You to nail the first case? I'm telling you any examiners, if you go inside the first case, if you nail them confidently, once it. Relax the examiners because they don't have to be skeptical. And you are a confident man.
You can sail through that very well. So whenever you go in the clinical bay, the first case, just nail it. You can nail it. Your score is going to be about 70 to take it from me, if not at least create the impression for a second case. If not, just forget the situation. Focus on the next one. Right, socks, sort cases, I will rather say this is Portis.
It is only sports. You how to get the diagnosis as early as possible. OK, you diagnosis the key for success. So if you mention it first, as soon as you go in, then the diagnosis, then they will go to. You don't have to examine, for example, in my cases are pulling. I got rheumatoid. Had I got gout hand, I didn't mean any harm.
Tell the diagnosis. Then four minutes you will be discussed. You will be going into literature and you'll score very well. This is especially for such cases. Focus on obvious findings. If there is any study findings, please mention it. Don't ignore the subtle findings, but focus on all these findings, particularly play to get the x-rays in 3 minutes.
That means you're going to score well. OK treatment plan approach if you're going to the approach for the cases that you're going to score more than six. Literature, again, literature, especially for me personally, my exam was saved only by literature. Every OK because that compensate wherever you go. One of the stations someone will some examiners will play with you to compensate that.
Please, please take it from me. Literature is all the base of this example. Some most of the guys will say, oh, literature, nobody asks me the literature. Nobody will ask you the literature. But if you do very well, they will ask you when to present the literature. That's a lot of questions. Even I had a doubt when to present the literature.
Literature is like a desert. You have to do it at the right time after nailing all the basic questions. Implemented in the first place, then it'll backfire on you and then you lose the game. Right, especially start cases, when the examiners ask you, can you ask a couple of questions? I had this doubt. What was you to ask?
What goes? These are the questions. Basic questions. If any case, you have come across. Just keep this focus in your mind. What's your problem? How is it affecting you? What treatment you had so far? And what is your expectation?
These are the questions I had in my mind, and that help for almost all sword cases. The case is completely different, so you don't have to have a very good detailed history for. These are the suitcases just within the basics of. OK, shoulder, elbow and I can tell you, you can everyone, if you know, but if you have this diagnosis of these cases, at least two of the cases will come for your exam.
It is just a snapshot. You can just take this. These are the basic or whether the exam is going to be in Sheffield University Hospital or whether it is going to be in this Regional Hospital. These are the basic epicondyle to test for the upper limit, particularly for such cases. Remember, c-spine, always think about this point.
How cases follow Allen, these are the suitcases again. Any exam these will be the suitcases, at least to you will get it. And particularly, I want to focus on the food examination. This plane is don't always. Commit yourself about people's dysfunction. The most common cause for the best is global crisis. Please make sure you examine the patient and then commit yourself, whether it's be or ulnar claw.
Again, for peacekeepers, we have the tendency to say empty all the time, but it could be CMT or it could be other causes, such as lesser tuberosity. So unless you examine, don't commit yourself because I know most of the guys who just straight away can make people's dysfunction and get crap and find difficult to come out of it. So keep these things in your mind, especially for some cases, right?
And talk a lot about spying, particularly for lower limb. Always that could be spying cases. Scoliosis being about. And then syndromic, these are the seven or eight syndrome cases that they have to test for. That doesn't mean that you have to find a diagnosis that you have to labral the syndrome. They may ask you for symptoms, they may ask you to examine the need.
Put this Marfan syndrome. They may ask me to examine the spine. Shoulder They can examine the shoulder. So you don't have to mention the syndrome. Still, you can pass, but keep the basics right. Whatever the case, whatever the symptoms, don't get flustered. Just do the basic examination, what the examiner ask you to examine and then you'll come out easily.
OK, now come to intimidate case, the people who started with the demented case, they are very lucky because they have time to breathe. They can go and see the patient and they can ask history. So they are lucky. One court case is going to start straightaway into the game, especially for an anteromedialization case. Read the letter, which is given to your hands most of the time. We don't read it fully because we go in and see the patient, see the examiner and start straight away to the patient.
Tell you the letter. Have a clue about the diagnosis and what the examiner is expecting for me. That is very, very important. So as soon as the letter has been given to you, please read the letter fully. Why? well, it's very, very difficult. But I pray to God that you have a complex case to have a complex case examiners and for good points who posit.
If it's a simple case. Then want you to be very slicker at the same time, they look for finer details, they can easily frame it. But complex cases are the one which saved my life, particularly for the intimate case in the middle of history. Focus on primary complaint. Sometimes the patient may not have been the patient may not have deformity.
They may compensate for some other reason. So try to get what is the primary reason they come. So what is the problem? What is the problem? It would be a central problem or a peripheral problem. Always think about spine that can go in the intermediate. When you're taking history, focus, whether it is a spinal problem or it's a particular problem. That will win the case if you forget completely about spying and you keep on dragging the history.
It be very, very difficult to come back. And then also make sure you will. Is a congenital problem or acute problem? Third question and is there any history of trauma? These are the four casinos, which will give you the diagnosis by going to surgical city very quickly. So that you don't lose time as well. Next, we're taking history, you need to know about this Oxford school, particularly for the lower limbs.
It's very difficult for me to remember all these things. I'm a simple man. I keep it simple, so I ask all these questions by one single question and you walk upstairs and have a shower. Some don't put your shoes. Can you go for shopping in your car? That's it. This is for Oxford school daily activity of limits.
You keep this one sentence. And that finishes axilo school and then when you ask me three, make sure in the first What treatment you have, it could be operative or non-operated treatment or the patient could be waiting for surgical. So you need to ask this question. And final question is, what do you want me to do for you? That will answer all the questions for the examiner, who is really jumping to trap you, if you ask this question, sometimes the patient will say, I'm happy with this, I don't want anything.
And that should be the answer as well. And then they can poke on you, whether you need surgical treatment or else you will do that goes with another medication. So I keep all the medical when you ask, can you see? Ask about medication history. When you ask for medication history, you ask our history, particularly for orthopedics. You ask for steroids, history and anticoagulants as well.
OK, particularly mention them. Are you taking steroids or are you taking warfarin? Ask them particularly OK. And then for smoking, as you know, social history ulnar claw. As been mentioned in the wall, because that's where you're useful, you know, you can just finish the history in four minutes time, but you can always tell the patient like anything you want to ask and you can summarize to the patient.
At least you have a chance that if you want to add anything, the patient will tell back to you. You miss this, then you can add it to that. And then you can present to the examiner if you missed any important key. For example, if you miss one history, that's it. You won't other. Then he will be skeptical throughout. By the clinical exam, Peterson will keep the history and we keep the history very tight and clean.
Will pass the exam next. By the end of the day one, everyone will be in the same room. It's a very difficult time, especially at the end of day one. We never know what is whether we have done wrong or right, but this will be the status for almost all 70% to 90% of the candidates. All right.
Yeah thank you to the patient. I think it's finishing your history and history succinctly and summarize directly to the patient, say, could I just summarize what we've discussed today? You are blah blah blah. You are a 75-year-old person with right shoulder pain who's presenting after three months. We've tried physiotherapy and injection, and you're on warfarin and you're asthmatic.
Your you have had no previous surgery and your today you'd like us to just deal with your pain. Have I missed anything? Yes, I agree with you, but I think that last bit, I practiced to ask that question to the patient as his practice to ask them, is there anything else at the end? Is there anything else you'd like to tell me about? I think if you have a nice practice in that knee that you want to do a replacement on or warfarin, which I can't talk at all for because I had these a bit, you know, it's always worth asking that question at the end.
Exactly that me just said. Ask the question about what equipment to take to the exam. I would say actually, don't take very much because they'll provide you with most things. If you have to take anything, take the things that you need to do the hand exam and function exam. So coin a key something for fine touch. Don't worry about a hammer or on the ometer.
Everyone gets obsessed with those. They will provide those if they're needed for the station. Exactly that's the key. I took a key and a coin and a pen. That's what I mean. Yeah, but they should provide you with everything. So it's not essential. Even if you incorporate exam, they tell you don't need to you anything with you.
But no one will stop you, obviously. But make sure you don't carry a mobile phone or medical dictionary. Rather, I have the.