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Preparation for FRCS Orthopaedic Exam
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Preparation for FRCS Orthopaedic Exam
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Segment:0 .
We'll get people. OK good evening, everyone. Welcome to the FRC is teaching from the first splinter group. Um, thank you all for joining. Tonight, we have the pleasure of having two candidates who recently passed their first case successfully.
And there were members of this group who attended our teaching, and they have a lot of experience of the exam. They're going to tell us about tonight. And we have other mentors also here for Abdullah brancheau and one joining shortly. And I myself am curious, also one of the mentors.
So please, there will be mainly exam experience here. So I'm sure a lot of you will have some questions. So please raise your hand symbol next to your name. If you want to ask our presenters any question. And I will put you through. There will also be a couple of visa questions towards the end from Anshul, who is going to present a couple of cases. You want to ask you.
Viva Viva you about it and then tell you, what's the ideal answer, so please take it to the end. Again, any questions, raise the hand symbol next to your name or right in the chat box, and we'll try to help you out. So without further ado, as I said, his first ever since. Only a few days ago, but and that's the ideal person to present today because everything is fresh and, you know, you can't get any better than this.
And he's an orthopedic surgeon, obviously. So over to you, Ashish. Yes, we can see you now. We could get good. Thank you for us. First of all, to start with, I would like to definitely thank all the mentors on this group because of which I found it very helpful to pass in my first attempt.
So thank you very much for us, Sean and all the mentors on this group. I think comedians of take them. So I foresee as part two, I said, how did I do it because I would like to say that this is not the only way of doing it. And this is definitely like I'm not aware what are the standards set by the Royal College for passing the exam.
But this is the conclusion of my own experience that these are the things which helped me pass it in the first attempt. So I will say it again, this is not the only way of doing it. Everyone is different. I will have my own strengths, I will have my weaknesses so everyone will have them. So you will have to tailor it according to your needs. But this is the conclusion of what I feel.
These are all things help me get it through, right? Plus, talking about the preparation, one thing which I feel is that you should have adequate experience, preferably in the UK like this is not for people giving the international efforts years. But if you are in the UK, I feel that you need to work at a registrar level for at least three to four years in my personal experience.
People will have different views, but that much time I feel is needed to get a hang of how and it just works. What is the level expected? And also in general, it gives you a confidence of talking to people, talking to colleagues and in general, how referral system works, how a level one trauma center will take or a tumor center will take patients.
What to do with the metastatic quad compression so all those things can be found in the books. But if you have worked and you have dealt with those patients, it is much less like, much easier. So I came into UK and end of 2013. Initially, I was like, OK, I need to give the exam. But then I thought that it will be too stressful. So I waited for about 3 and 1/2 years, four years to apply for it.
And that gave me the opportunity to work in all the subspecialties in orthopedics, except pediatrics. And that was the only thing I was very scared in the exam that I should not have an intermediate case of cerebral palsy or should not have any pediatric case in my clinical exam. That's what I was hoping. So that definitely makes a difference. Like if you have not worked in a subspecialty, that will be definitely your weak point.
Like, people are often scared of spine cases. I had worked six months in Spain and like I was lucky to have a consultant who used to show me how he examines all the patient I used to just stand. Instead of saying, OK, you examined, I will tell you what is wrong. He used to examine like an exam candidate, and I used to observe him.
So towards the end, like I was so confident with Spain saying, OK, I'll be very, very happy if they gave me a spying case. So I think it makes a lot of difference, like if you have spent six months in the hospitality. So if you were to spend in all subspecialties, you do need about three, 3 and 1/2 years to be minimum. And similarly, with level one trauma center experience, if you have had that, then it is much less stressful to answer all these high velocity, pelvic traumas, chest injuries or spinal trauma than to just read it from the book and then like to just reproduce the answer.
So that's my personal opinion that if possible, then you should give adequate time for having an adequate registrar experience in the UK. You can definitely do it much better than that, but you might have to put in 3 to five times more effort for the same. That's my personal opinion. Now, once you've decided to give it, then I would say to start early, like I have given part one and part two with a long gap, like I had given part one just so that I start reading at least.
But then there was a gap of about 14, 15 months between the two parts in my case, so I took it easy. After part one, I passed it in November. 2017 didn't do anything till, I think, August of 18. But then I started reading seriously from September of 18 for my April exams. So that means like I had a good eight months in my hand for 7 for part two. So I think at least six months is minimum.
I feel from my experience that six months for part two is a must. Eight months gave me a good, good time in hand so that I could finish one reading in six months and then revise everything in the last couple of months. So must start early, and as you would have heard everyone say, find a study group, find a study group. I was lucky. I had another couple of people appearing from my same hospital, so we were able to start efforts teaching with a very senior consultant here every Tuesday.
He used to have Viva sessions for us, very experienced person. And then we were also able to sit down and discuss clinical cases or by scenarios on the weekends or in between, like in theaters. So that makes a lot of difference. So ideally three people, but if not these who is also enough. I feel like we had, like the third person was not very active.
So I think it's equally good if you have two people who are very serious about it, like you both have to have the same passion enthusiasm that you're finding after working for it to it that you can still sit and discuss for a couple of hours. So that's one thing which I found helpful. Books, again, a lot of people would have told you. I would again, this is very personal, I feel like what I felt that these were the right books which helped me pass.
This might be a bit different from other people would have told you, I just have a few slides of the books that were the main books that helped me. And of course, is what I found is that people said that, oh, I am on the waiting list for that course or I didn't get quotes because that was full. So I think good courses will go early, so you need to start early. I started like sending emails to the psychiatrist or the person who had arranged a good course last year.
As soon as I started, like September, my focus was not on the book, but to send the emails to people that oh, when is the next year course? I am appearing in April. Can you please tell me the date? So even before they were like the dates were decided or like to advertise, it is far, far away. Like they said that we have not yet decided what date we are going to conduct it.
My email was with them that please put me on the waiting list, so any good course will go much in advance, like six months very easily. So I will let you know my courses as well. But most of those courses I had booked Well in advance six months in advance for the last three courses, especially I did. So I let you know so this everyone would have seen these are the pillars of anybody preparing for the FARC.
Is this the first book? I just love it. Like this is even a slight level and just the right amount for the FARC. Like, I literally love that book. I want to literally see the author and thank him. This is the level I love that book so very concise as the right level and the way it is asked. That's very, very important.
Like they will ask you or they would have given scenario, which is the way I was asked. So I think the best and the best book was the post-graduate automatic Blue Book. And similarly, vivas book was good, but I could not get a chance to revise it. It's given nicely about Viva stations, but some of it is covered by the Bluebook itself, and I had six months, six weeks in the end to revise stuff so I could not revise it to that detail extent.
But I still remembered most of it for my first reading and Nicholas book. I think most of the people use. It's not necessary that you read through it, but I think I just use it to pass through the articles to see how it is done. And I think that again was very, very helpful. Now, a different section, but this is something which people might or might not agree.
Ramachandran, I read it for six weeks in my peak time in February. I didn't like it at all, like it is given in too much of detail and I am a kind of person. If something is in front of me, I tend to try to learn it or just keep it in mind. So there were quite a lot of stuff, which was not needed, I believe. So in the end, what happened is if you try to memorize everything, you will not remember anything.
So after spending a good six weeks, the amount I retained from Ramachandran was about 30 to 40 percent, I believe. So I decided to ditch it in the last six weeks. So I read the book has about 125 pages of basic sciences. I had not read them before, so but it was very stressful. But in last six days to my exam, I read those 125 pages and I then went to this Ramachandran book.
It has given like options in the end what whatever questions had come. So I just passed through the pages. I said, whatever question is covered by the book, I'm not going to touch that anything which was not covered in those 125 pages of meniscal, which I read through ramachandran, though I would say it is a good book as a reference. If I was to suggest it like to a friend or a brother, I would say that I would read the 125 pages of which some places it is too concise.
You don't understand what he is talking. Those places you can definitely go and read from Ramachandran. But all in all, if you are reading, you have to know what level you need. Like in everything, he has given complications in everything he has given too far of for detail, as per my opinion. Again, people can differ. But like, for example, in processes, in processes like there are different like obviously a processes will have four components what he has done is that he has given details of the suspension.
And what can be the complications and benefit of each type of suspension in the processes, which is not expected. I believe like I was asked that question, but I was just asked to name the headings of different types of suspensions like a belt type or suction type or anatomical type, not what can be the complication of a belt type or disadvantage of a certain type.
So personally, I feel that the level given is a bit too far in detail. So if I was in like in a mode of reading, in which it is given quite concisely, so I used to read miscovich and try to remember the most important points, which was I found it very difficult with ramachandran, even in six weeks. Similarly, as when I started my preparation in September, I think you should read the biggest book possible, and then I started with this postgraduate pediatric orthopedic book.
That's because, as I said, I had not done pediatric, so I thought this will make it up. But again, unless you can revise what you have read in the last six weeks, I think number one is a computer to remember everything. Whatever you will read or leave, 50% remains after a few weeks. You have to revise all the stuff in the last six weeks to the exam. So unless you can revise in the last six weeks, you would not be able to reproduce most of the stuff you have read beyond two months.
So I did read it in September for about three or four weeks, but I did not have the time to read it in the last six weeks. So again, I switched to with meniscal, which has pediatric sections, and I read only that, and fortunately, I didn't have any problems with that. In addition to these books, the resources, obviously everyone is aware or tabulates is a very, very good resource. I would use it in addition to any of the previous primary books meniscal, which if you read something in which he's not given in detail or you don't get what he's saying or you don't make any concept out of it, then you can definitely go to the bullets, have a read through or the bullets to just understand what benicio, which is trying to stay like, say, and then you won't need a back to bullets in the last six weeks.
So use it as a reference like anything which you don't understand or some trauma topics, I believe like benicio, which has not given trauma much in detail in any way. So if you feel that some trauma topics, you are finding it a bit difficult or hard, then definitely you can refer to the bullets. Images are so nice, like the Judith views and those things. It's much easier if you see an image, which auto bullet says given nicely.
And obviously, anyone who's here is aware of the FARC group on YouTube and Abdullah had suggested after his passing about physio tutors, I did use that I found it helpful to see some tests, which you don't know how to do it. Different books give it differently. So I did use physical tutors, which I found helpful. Courses, I booked these five courses. The first two courses I booked much earlier in my preparation there.
All of them were very, very good courses like the course. Very, very nice. The first day was focused on Viva stations, and they had, I believe, 16 clinical cases. And like those who have not done pedes, this is a very, very good course for them to see some actual pediatric cases. Viva again, like, it gives you a good practice for talking about peel-back cases in Viva very experienced faculty as well.
So I will say it was a very, very nice sports organized in Abelino hospital in London, Spain or Spain. Again, very, very nice course organized in Stanmore. I made up the name that was, I think Abdullah was there in both the courses. So a very nice course, very nicely organized and good clinical cases. I think towards the end I thought like, Viva, I can anytime talk, but it's the clinical cases which you need to see.
So if someone is showing you good 10, 12, 15 clinical cases, that's cause it's definitely worth giving lectures, I think. I don't know. People found like the Newcastle who sold the I think the other course was, I have not read the book what everyone reads. I can't even think of the name. There is a lack of forces done in which they just eat you, which I think no one can put this much amount of knowledge into your brain just by listening, it's who has to read.
So I found both these courses very, very good. And then the other last three courses were towards the end of my preparation. Like midway was five weeks before my exam kingswap's, three weeks before my exam, or it was two weeks before my exam. Excellent courses, all three of them. But all three, as I said, made way. I sent my email about us who organizes this course in October, saying that what are your dates for next year, march, april?
I want to appear in April, and he said, not decided yet. And then after 15 days, I was the first person to go on that course for this course. On 23rd of March. Well, six months in advance and came with things. I kissed the Secretary who organized the schools in 2018 and then changed. But the Secretary passed over my name that this person is forced.
I was second because my colleague from the same hospital, he was first. So I was the second person on the waiting list for this course to be held in April, and we were on the waiting list from October 2018 and we learned a bit more at course, like we had both applied in October 2018. So good courses will go early, so you must must face the organizers and get yourself a place six months in advance if you want to go on Good courses.
Of course, other courses will be available last minute, but obviously if they have not filled up, that means they are better courses available. Regarding the courses, I will just say one thing in some of the courses like they're all very useful, but some of the courses, I found a bit of a bias between a trainee and a non trainee in the book. But I must say that this is something which I learned from one of the coaching classes when I was appearing for my slap exam.
And this is a method of history taking. I was taught for my plan and I applied the same for the first, as was suggested by one of my friends who passed in February till February. I was I didn't have a set for formal for history taking. So I used to try to cover all the points individually for each case is like spy in case I will try to cover all points thinking, OK, what else can be important in spying and all that?
But often it used to lead that. OK, the examiners will say that. Or you didn't ask smoking. It's important in this case or you didn't ask the patient's expectations. It was important. So then my friend suggested me, why don't you use that same performer we use for plan? And that's this that's three months.
So I find it easy to remember and recall because I had done it before for my plan. If people want to use it, they can. I found it very helpful. So it stands for presenting complaints, past history, personal history and personal history. Mostly, you asked like smoking and alcohol, then it's your medical history, allergies, family history, treatment history, occupation and social.
Anything else? So family history, you will ask only when it is relevant. So if you think that the patient has some tic disorder, autosomal dominant or autosomal recessive rheumatoid arthritis, anything which you are aware can run in families, you will ask, but you will not ask a family if it's a trauma or chronic trauma case or something in which it is not relevant.
Treatment history again, like you will not offer a patient, a treatment, which is already had. So if someone has had physiotherapy or someone has had injections for their back pain, you will not like to offer them the same treatment if that has not helped. So treatment history is important to us. And in social history, I used to ask the activities of daily living like for your awkward hip score or Oxford knee score.
If like you want, you don't have the time to ask all of them, but at least you can ask, can you manage? Still, can you go up to the shops for your shopping and any other third question you can ask in social history that will work ok? You have asked how this arthritis is functionally affecting this old lady so that I used to ask in social history and last anything else I used to just ask, what is their expectations from this consultation with I was taught is very important to ask.
Intermediate cases. So last point is what is their expectation? I used to just hold it in this way. If I was to make only one thing better, what that one thing would be and they would tell me, OK, if you could take away my pain. So at least they have stressed that pain is their main concern. So I used to use it in that fear and again, like people would have seen it before in presenting complaint.
The most common symptom people will come with will be pain. The questions what pain is so great? Many books have said it before, but those who have not heard it before who critics will stand for sight on. Character not very important, I found, but radiation association climbing exaggeration, relieving factors and severity of all relevant in individual cases, like in case of a back pain and pain case, you need to cite, which is more bothersome back or leg.
And then you need to ask on set how was the onset radiation again? You need to ask, OK, if you are thinking hip pain or back pain, you need to ask whether it's going up to the knee or it crosses beyond the knee so that all the examiner that in your mind you are thinking you are making your differential diagnosis and you are ruling out one by one. What is not there?
Only association, excuse me, association again, pain. If you are thinking in the lines of infection sceptic, then you will ask for fever. If you are thinking in the lines of back pain, the article you will ask in association with weakness, numbness, bowel bladder symptoms. So obviously, by that time. You should have a differential diagnosis and the Association of all those differential diagnoses, you will ask in your history timing, I found very important for tumors and infection like you were last NIPE.
Pain it can tell you severity of osteoarthritis. If it's NIPE pain, it can tell you about tumors. It can tell you about infection. If it is like persistent non mechanical pain, even at NIPE time again, like morning time pain, rheumatoid arthritis. So if it is relevant, it's not that you have to cover all these points saying negative. Like if it is not there, you still saying that your character is like this, not like that.
It's like a sieve, which will help you ask the relevant question of the differential diagnosis. You have thought in your mind that I'm going towards this again, exaggerating relieving factors you if you have a differential, you ask specific, exasperating, relieving factors. Did this make better? If you are looking at the number stenosis sitting down, make it better going up and make it better or down, he'll make it worse.
So the differential should be in your mind and your question to the examiner that you are asking this question to rule out or you like going towards one particular diagnosis. This was another new morning for chronic cases like paragon, I read. I found it from one of my coaching in slap and only paralyzed for chronic conditions, like if someone has a long standing back pain or if someone has a lump, then you are the only better history, onset, duration and progression.
Whether it's rapidly progressive, gradually Progressive Association. Again, like if you think it's a tumor, whether it's associated with other lumps and bumps in the body, any bleeding from orifices, loss of weight, NIPE sweats. So again, your differential should be in your mind, but then association. This will just let you ask the right questions. I relieving aggravating factors against same would be better.
And these were some of the modifications like in the history taking I had prepared. Fortunately, I didn't have an intermediate pediatric case, but I taught in pediatrics. Often it will be a chronic issue for presenting history. I will ask, according to Deborah, and then past history impedes often becomes the birth history of the child. So you will ask whether the child was born into the quantum and whether there were any perinatal issues for all the parties.
We will become to in pediatrics and personal history. Obviously, a child does not smoke and drink. So instead of that personal history, children will become milestones. So depending on the age, you can ask whether they balked at what age did they walk? What age did they start talking? What age did they sit without support and without support in pediatrics would have become milestones and rest.
Everything would. I would have left the same. As I said, fortunately, I didn't have a pediatric intermediate case, but that was my preparation. Similarly, I got a scoliosis is my coaching stanmore, and I didn't ask that girls menarche for which I failed. But then I made sure that for every other case I saw of scoliosis, so presenting passed again scoliosis most common case will be an adolescent girl, 11, 12.
She's most likely not smoking and drinking, so keep the eye made for periods. So that I never miss that again and rest everything can be the same. And for a polymer case used to start always by age, handedness and occupation, so in my language, our whole means Yes. So I had prepared myself that in my intermediate case, I would always start from our home. So I will start by history patients.
Age is often given in the letter, GP letter or small note given to you. But I would always start with the Mason occupation, and that's only in one case. So when I was walking in the corridor towards my Intermediate Upper limit case, I was just saying in my mind, this is the case. I have to ask, start with hope. Nothing else, like no other case.
You need to ask an intermediate case history. So only one case. So I was just telling to myself, start with how I started with that. So there is nothing to Mason that. There are two things from my what I felt I did not prepare very well was deformity and lumps like everyone reads the Nick Harris book, prepares all the joints, prepares for spine examination, prepares for peripheral nerve examination, prepares for brachial plexus examination.
But these two things it's not given specifically how to examine in those books. So I felt this is like can be a weak point if you had not well prepared for it. So for deformity, I got it in one of the course, like a nonunion of the tibia withering. So I had for myself after that experience, I made the history again better that on set duration progression association relieving aggravating factors.
Anything else? But then for examination, I made a code of Lara. So Lara stands for length, angulation, rotation and association, so association can be stiffness in stability or neurology. So if you apply it for any deformity, it can be applied on that. But specifically, I used it for, as I will tell you later on, my intermediate lower limb case, which was a hypertrophic non union of the tibia.
So I asked, like, there is no specific examination technique, but I looked at these things is it shortened? Is it undulated? Is it rotated or is it associated with stiffness of the knee or the ankle? Is it associated with instability? Is there any distal neurovascular deficit? So I think people can make it better if they find it in a good clinical examination book, they can even make it better.
But that's what I came up with. And fortunately, this helped me pass my exam and lumps. I had not prepared this. I have prepared it for this talk. Like I was told in one of the courses that someone had got a soft tissue sarcoma of the thigh as their intermediate case. So again, if you have prepared only the joint examination, you might not be very well prepared for a lump examination.
So I looked up a good site about examination of a lump and I just again, I love to make new necks. So if you find it helpful, you can use it. If you want to use your own, you are free to do that. But I found that it can be summarized to this. That FRC has exam is basically from your street to your CCG. So x-t3 stands for site size and shape of the lump or wherever the lump is, you will tell, OK, it's in the distal femur and it's roughly of this size.
And on feeling the shape, it is either small shape or multiple ovulated or munition. But now coming to the actual economics experience, so if you want to stop. OK, Ashish.
Segment:0 .
We'll get people. OK good evening, everyone. Welcome to the FRC is teaching from the first splinter group. Um, thank you all for joining. Tonight, we have the pleasure of having two candidates who recently passed their first case successfully.
And there were members of this group who attended our teaching, and they have a lot of experience of the exam. They're going to tell us about tonight. And we have other mentors also here for Abdullah brancheau and one joining shortly. And I myself am curious, also one of the mentors.
So please, there will be mainly exam experience here. So I'm sure a lot of you will have some questions. So please raise your hand symbol next to your name. If you want to ask our presenters any question. And I will put you through. There will also be a couple of visa questions towards the end from Anshul, who is going to present a couple of cases. You want to ask you.
Viva Viva you about it and then tell you, what's the ideal answer, so please take it to the end. Again, any questions, raise the hand symbol next to your name or right in the chat box, and we'll try to help you out. So without further ado, as I said, his first ever since. Only a few days ago, but and that's the ideal person to present today because everything is fresh and, you know, you can't get any better than this.
And he's an orthopedic surgeon, obviously. So over to you, Ashish. Yes, we can see you now. We could get good. Thank you for us. First of all, to start with, I would like to definitely thank all the mentors on this group because of which I found it very helpful to pass in my first attempt.
So thank you very much for us, Sean and all the mentors on this group. I think comedians of take them. So I foresee as part two, I said, how did I do it because I would like to say that this is not the only way of doing it. And this is definitely like I'm not aware what are the standards set by the Royal College for passing the exam.
But this is the conclusion of my own experience that these are the things which helped me pass it in the first attempt. So I will say it again, this is not the only way of doing it. Everyone is different. I will have my own strengths, I will have my weaknesses so everyone will have them. So you will have to tailor it according to your needs. But this is the conclusion of what I feel.
These are all things help me get it through, right? Plus, talking about the preparation, one thing which I feel is that you should have adequate experience, preferably in the UK like this is not for people giving the international efforts years. But if you are in the UK, I feel that you need to work at a registrar level for at least three to four years in my personal experience.
People will have different views, but that much time I feel is needed to get a hang of how and it just works. What is the level expected? And also in general, it gives you a confidence of talking to people, talking to colleagues and in general, how referral system works, how a level one trauma center will take or a tumor center will take patients.
What to do with the metastatic quad compression so all those things can be found in the books. But if you have worked and you have dealt with those patients, it is much less like, much easier. So I came into UK and end of 2013. Initially, I was like, OK, I need to give the exam. But then I thought that it will be too stressful. So I waited for about 3 and 1/2 years, four years to apply for it.
And that gave me the opportunity to work in all the subspecialties in orthopedics, except pediatrics. And that was the only thing I was very scared in the exam that I should not have an intermediate case of cerebral palsy or should not have any pediatric case in my clinical exam. That's what I was hoping. So that definitely makes a difference. Like if you have not worked in a subspecialty, that will be definitely your weak point.
Like, people are often scared of spine cases. I had worked six months in Spain and like I was lucky to have a consultant who used to show me how he examines all the patient I used to just stand. Instead of saying, OK, you examined, I will tell you what is wrong. He used to examine like an exam candidate, and I used to observe him.
So towards the end, like I was so confident with Spain saying, OK, I'll be very, very happy if they gave me a spying case. So I think it makes a lot of difference, like if you have spent six months in the hospitality. So if you were to spend in all subspecialties, you do need about three, 3 and 1/2 years to be minimum. And similarly, with level one trauma center experience, if you have had that, then it is much less stressful to answer all these high velocity, pelvic traumas, chest injuries or spinal trauma than to just read it from the book and then like to just reproduce the answer.
So that's my personal opinion that if possible, then you should give adequate time for having an adequate registrar experience in the UK. You can definitely do it much better than that, but you might have to put in 3 to five times more effort for the same. That's my personal opinion. Now, once you've decided to give it, then I would say to start early, like I have given part one and part two with a long gap, like I had given part one just so that I start reading at least.
But then there was a gap of about 14, 15 months between the two parts in my case, so I took it easy. After part one, I passed it in November. 2017 didn't do anything till, I think, August of 18. But then I started reading seriously from September of 18 for my April exams. So that means like I had a good eight months in my hand for 7 for part two. So I think at least six months is minimum.
I feel from my experience that six months for part two is a must. Eight months gave me a good, good time in hand so that I could finish one reading in six months and then revise everything in the last couple of months. So must start early, and as you would have heard everyone say, find a study group, find a study group. I was lucky. I had another couple of people appearing from my same hospital, so we were able to start efforts teaching with a very senior consultant here every Tuesday.
He used to have Viva sessions for us, very experienced person. And then we were also able to sit down and discuss clinical cases or by scenarios on the weekends or in between, like in theaters. So that makes a lot of difference. So ideally three people, but if not these who is also enough. I feel like we had, like the third person was not very active.
So I think it's equally good if you have two people who are very serious about it, like you both have to have the same passion enthusiasm that you're finding after working for it to it that you can still sit and discuss for a couple of hours. So that's one thing which I found helpful. Books, again, a lot of people would have told you. I would again, this is very personal, I feel like what I felt that these were the right books which helped me pass.
This might be a bit different from other people would have told you, I just have a few slides of the books that were the main books that helped me. And of course, is what I found is that people said that, oh, I am on the waiting list for that course or I didn't get quotes because that was full. So I think good courses will go early, so you need to start early. I started like sending emails to the psychiatrist or the person who had arranged a good course last year.
As soon as I started, like September, my focus was not on the book, but to send the emails to people that oh, when is the next year course? I am appearing in April. Can you please tell me the date? So even before they were like the dates were decided or like to advertise, it is far, far away. Like they said that we have not yet decided what date we are going to conduct it.
My email was with them that please put me on the waiting list, so any good course will go much in advance, like six months very easily. So I will let you know my courses as well. But most of those courses I had booked Well in advance six months in advance for the last three courses, especially I did. So I let you know so this everyone would have seen these are the pillars of anybody preparing for the FARC.
Is this the first book? I just love it. Like this is even a slight level and just the right amount for the FARC. Like, I literally love that book. I want to literally see the author and thank him. This is the level I love that book so very concise as the right level and the way it is asked. That's very, very important.
Like they will ask you or they would have given scenario, which is the way I was asked. So I think the best and the best book was the post-graduate automatic Blue Book. And similarly, vivas book was good, but I could not get a chance to revise it. It's given nicely about Viva stations, but some of it is covered by the Bluebook itself, and I had six months, six weeks in the end to revise stuff so I could not revise it to that detail extent.
But I still remembered most of it for my first reading and Nicholas book. I think most of the people use. It's not necessary that you read through it, but I think I just use it to pass through the articles to see how it is done. And I think that again was very, very helpful. Now, a different section, but this is something which people might or might not agree.
Ramachandran, I read it for six weeks in my peak time in February. I didn't like it at all, like it is given in too much of detail and I am a kind of person. If something is in front of me, I tend to try to learn it or just keep it in mind. So there were quite a lot of stuff, which was not needed, I believe. So in the end, what happened is if you try to memorize everything, you will not remember anything.
So after spending a good six weeks, the amount I retained from Ramachandran was about 30 to 40 percent, I believe. So I decided to ditch it in the last six weeks. So I read the book has about 125 pages of basic sciences. I had not read them before, so but it was very stressful. But in last six days to my exam, I read those 125 pages and I then went to this Ramachandran book.
It has given like options in the end what whatever questions had come. So I just passed through the pages. I said, whatever question is covered by the book, I'm not going to touch that anything which was not covered in those 125 pages of meniscal, which I read through ramachandran, though I would say it is a good book as a reference. If I was to suggest it like to a friend or a brother, I would say that I would read the 125 pages of which some places it is too concise.
You don't understand what he is talking. Those places you can definitely go and read from Ramachandran. But all in all, if you are reading, you have to know what level you need. Like in everything, he has given complications in everything he has given too far of for detail, as per my opinion. Again, people can differ. But like, for example, in processes, in processes like there are different like obviously a processes will have four components what he has done is that he has given details of the suspension.
And what can be the complications and benefit of each type of suspension in the processes, which is not expected. I believe like I was asked that question, but I was just asked to name the headings of different types of suspensions like a belt type or suction type or anatomical type, not what can be the complication of a belt type or disadvantage of a certain type.
So personally, I feel that the level given is a bit too far in detail. So if I was in like in a mode of reading, in which it is given quite concisely, so I used to read miscovich and try to remember the most important points, which was I found it very difficult with ramachandran, even in six weeks. Similarly, as when I started my preparation in September, I think you should read the biggest book possible, and then I started with this postgraduate pediatric orthopedic book.
That's because, as I said, I had not done pediatric, so I thought this will make it up. But again, unless you can revise what you have read in the last six weeks, I think number one is a computer to remember everything. Whatever you will read or leave, 50% remains after a few weeks. You have to revise all the stuff in the last six weeks to the exam. So unless you can revise in the last six weeks, you would not be able to reproduce most of the stuff you have read beyond two months.
So I did read it in September for about three or four weeks, but I did not have the time to read it in the last six weeks. So again, I switched to with meniscal, which has pediatric sections, and I read only that, and fortunately, I didn't have any problems with that. In addition to these books, the resources, obviously everyone is aware or tabulates is a very, very good resource. I would use it in addition to any of the previous primary books meniscal, which if you read something in which he's not given in detail or you don't get what he's saying or you don't make any concept out of it, then you can definitely go to the bullets, have a read through or the bullets to just understand what benicio, which is trying to stay like, say, and then you won't need a back to bullets in the last six weeks.
So use it as a reference like anything which you don't understand or some trauma topics, I believe like benicio, which has not given trauma much in detail in any way. So if you feel that some trauma topics, you are finding it a bit difficult or hard, then definitely you can refer to the bullets. Images are so nice, like the Judith views and those things. It's much easier if you see an image, which auto bullet says given nicely.
And obviously, anyone who's here is aware of the FARC group on YouTube and Abdullah had suggested after his passing about physio tutors, I did use that I found it helpful to see some tests, which you don't know how to do it. Different books give it differently. So I did use physical tutors, which I found helpful. Courses, I booked these five courses. The first two courses I booked much earlier in my preparation there.
All of them were very, very good courses like the course. Very, very nice. The first day was focused on Viva stations, and they had, I believe, 16 clinical cases. And like those who have not done pedes, this is a very, very good course for them to see some actual pediatric cases. Viva again, like, it gives you a good practice for talking about peel-back cases in Viva very experienced faculty as well.
So I will say it was a very, very nice sports organized in Abelino hospital in London, Spain or Spain. Again, very, very nice course organized in Stanmore. I made up the name that was, I think Abdullah was there in both the courses. So a very nice course, very nicely organized and good clinical cases. I think towards the end I thought like, Viva, I can anytime talk, but it's the clinical cases which you need to see.
So if someone is showing you good 10, 12, 15 clinical cases, that's cause it's definitely worth giving lectures, I think. I don't know. People found like the Newcastle who sold the I think the other course was, I have not read the book what everyone reads. I can't even think of the name. There is a lack of forces done in which they just eat you, which I think no one can put this much amount of knowledge into your brain just by listening, it's who has to read.
So I found both these courses very, very good. And then the other last three courses were towards the end of my preparation. Like midway was five weeks before my exam kingswap's, three weeks before my exam, or it was two weeks before my exam. Excellent courses, all three of them. But all three, as I said, made way. I sent my email about us who organizes this course in October, saying that what are your dates for next year, march, april?
I want to appear in April, and he said, not decided yet. And then after 15 days, I was the first person to go on that course for this course. On 23rd of March. Well, six months in advance and came with things. I kissed the Secretary who organized the schools in 2018 and then changed. But the Secretary passed over my name that this person is forced.
I was second because my colleague from the same hospital, he was first. So I was the second person on the waiting list for this course to be held in April, and we were on the waiting list from October 2018 and we learned a bit more at course, like we had both applied in October 2018. So good courses will go early, so you must must face the organizers and get yourself a place six months in advance if you want to go on Good courses.
Of course, other courses will be available last minute, but obviously if they have not filled up, that means they are better courses available. Regarding the courses, I will just say one thing in some of the courses like they're all very useful, but some of the courses, I found a bit of a bias between a trainee and a non trainee in the book. But I must say that this is something which I learned from one of the coaching classes when I was appearing for my slap exam.
And this is a method of history taking. I was taught for my plan and I applied the same for the first, as was suggested by one of my friends who passed in February till February. I was I didn't have a set for formal for history taking. So I used to try to cover all the points individually for each case is like spy in case I will try to cover all points thinking, OK, what else can be important in spying and all that?
But often it used to lead that. OK, the examiners will say that. Or you didn't ask smoking. It's important in this case or you didn't ask the patient's expectations. It was important. So then my friend suggested me, why don't you use that same performer we use for plan? And that's this that's three months.
So I find it easy to remember and recall because I had done it before for my plan. If people want to use it, they can. I found it very helpful. So it stands for presenting complaints, past history, personal history and personal history. Mostly, you asked like smoking and alcohol, then it's your medical history, allergies, family history, treatment history, occupation and social.
Anything else? So family history, you will ask only when it is relevant. So if you think that the patient has some tic disorder, autosomal dominant or autosomal recessive rheumatoid arthritis, anything which you are aware can run in families, you will ask, but you will not ask a family if it's a trauma or chronic trauma case or something in which it is not relevant.
Treatment history again, like you will not offer a patient, a treatment, which is already had. So if someone has had physiotherapy or someone has had injections for their back pain, you will not like to offer them the same treatment if that has not helped. So treatment history is important to us. And in social history, I used to ask the activities of daily living like for your awkward hip score or Oxford knee score.
If like you want, you don't have the time to ask all of them, but at least you can ask, can you manage? Still, can you go up to the shops for your shopping and any other third question you can ask in social history that will work ok? You have asked how this arthritis is functionally affecting this old lady so that I used to ask in social history and last anything else I used to just ask, what is their expectations from this consultation with I was taught is very important to ask.
Intermediate cases. So last point is what is their expectation? I used to just hold it in this way. If I was to make only one thing better, what that one thing would be and they would tell me, OK, if you could take away my pain. So at least they have stressed that pain is their main concern. So I used to use it in that fear and again, like people would have seen it before in presenting complaint.
The most common symptom people will come with will be pain. The questions what pain is so great? Many books have said it before, but those who have not heard it before who critics will stand for sight on. Character not very important, I found, but radiation association climbing exaggeration, relieving factors and severity of all relevant in individual cases, like in case of a back pain and pain case, you need to cite, which is more bothersome back or leg.
And then you need to ask on set how was the onset radiation again? You need to ask, OK, if you are thinking hip pain or back pain, you need to ask whether it's going up to the knee or it crosses beyond the knee so that all the examiner that in your mind you are thinking you are making your differential diagnosis and you are ruling out one by one. What is not there?
Only association, excuse me, association again, pain. If you are thinking in the lines of infection sceptic, then you will ask for fever. If you are thinking in the lines of back pain, the article you will ask in association with weakness, numbness, bowel bladder symptoms. So obviously, by that time. You should have a differential diagnosis and the Association of all those differential diagnoses, you will ask in your history timing, I found very important for tumors and infection like you were last NIPE.
Pain it can tell you severity of osteoarthritis. If it's NIPE pain, it can tell you about tumors. It can tell you about infection. If it is like persistent non mechanical pain, even at NIPE time again, like morning time pain, rheumatoid arthritis. So if it is relevant, it's not that you have to cover all these points saying negative. Like if it is not there, you still saying that your character is like this, not like that.
It's like a sieve, which will help you ask the relevant question of the differential diagnosis. You have thought in your mind that I'm going towards this again, exaggerating relieving factors you if you have a differential, you ask specific, exasperating, relieving factors. Did this make better? If you are looking at the number stenosis sitting down, make it better going up and make it better or down, he'll make it worse.
So the differential should be in your mind and your question to the examiner that you are asking this question to rule out or you like going towards one particular diagnosis. This was another new morning for chronic cases like paragon, I read. I found it from one of my coaching in slap and only paralyzed for chronic conditions, like if someone has a long standing back pain or if someone has a lump, then you are the only better history, onset, duration and progression.
Whether it's rapidly progressive, gradually Progressive Association. Again, like if you think it's a tumor, whether it's associated with other lumps and bumps in the body, any bleeding from orifices, loss of weight, NIPE sweats. So again, your differential should be in your mind, but then association. This will just let you ask the right questions. I relieving aggravating factors against same would be better.
And these were some of the modifications like in the history taking I had prepared. Fortunately, I didn't have an intermediate pediatric case, but I taught in pediatrics. Often it will be a chronic issue for presenting history. I will ask, according to Deborah, and then past history impedes often becomes the birth history of the child. So you will ask whether the child was born into the quantum and whether there were any perinatal issues for all the parties.
We will become to in pediatrics and personal history. Obviously, a child does not smoke and drink. So instead of that personal history, children will become milestones. So depending on the age, you can ask whether they balked at what age did they walk? What age did they start talking? What age did they sit without support and without support in pediatrics would have become milestones and rest.
Everything would. I would have left the same. As I said, fortunately, I didn't have a pediatric intermediate case, but that was my preparation. Similarly, I got a scoliosis is my coaching stanmore, and I didn't ask that girls menarche for which I failed. But then I made sure that for every other case I saw of scoliosis, so presenting passed again scoliosis most common case will be an adolescent girl, 11, 12.
She's most likely not smoking and drinking, so keep the eye made for periods. So that I never miss that again and rest everything can be the same. And for a polymer case used to start always by age, handedness and occupation, so in my language, our whole means Yes. So I had prepared myself that in my intermediate case, I would always start from our home. So I will start by history patients.
Age is often given in the letter, GP letter or small note given to you. But I would always start with the Mason occupation, and that's only in one case. So when I was walking in the corridor towards my Intermediate Upper limit case, I was just saying in my mind, this is the case. I have to ask, start with hope. Nothing else, like no other case.
You need to ask an intermediate case history. So only one case. So I was just telling to myself, start with how I started with that. So there is nothing to Mason that. There are two things from my what I felt I did not prepare very well was deformity and lumps like everyone reads the Nick Harris book, prepares all the joints, prepares for spine examination, prepares for peripheral nerve examination, prepares for brachial plexus examination.
But these two things it's not given specifically how to examine in those books. So I felt this is like can be a weak point if you had not well prepared for it. So for deformity, I got it in one of the course, like a nonunion of the tibia withering. So I had for myself after that experience, I made the history again better that on set duration progression association relieving aggravating factors.
Anything else? But then for examination, I made a code of Lara. So Lara stands for length, angulation, rotation and association, so association can be stiffness in stability or neurology. So if you apply it for any deformity, it can be applied on that. But specifically, I used it for, as I will tell you later on, my intermediate lower limb case, which was a hypertrophic non union of the tibia.
So I asked, like, there is no specific examination technique, but I looked at these things is it shortened? Is it undulated? Is it rotated or is it associated with stiffness of the knee or the ankle? Is it associated with instability? Is there any distal neurovascular deficit? So I think people can make it better if they find it in a good clinical examination book, they can even make it better.
But that's what I came up with. And fortunately, this helped me pass my exam and lumps. I had not prepared this. I have prepared it for this talk. Like I was told in one of the courses that someone had got a soft tissue sarcoma of the thigh as their intermediate case. So again, if you have prepared only the joint examination, you might not be very well prepared for a lump examination.
So I looked up a good site about examination of a lump and I just again, I love to make new necks. So if you find it helpful, you can use it. If you want to use your own, you are free to do that. But I found that it can be summarized to this. That FRC has exam is basically from your street to your CCG. So x-t3 stands for site size and shape of the lump or wherever the lump is, you will tell, OK, it's in the distal femur and it's roughly of this size.
And on feeling the shape, it is either small shape or multiple ovulated or munition. But now coming to the actual economics experience, so if you want to stop. OK, Ashish.
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