Cadmore media player playing video The New Format (Post COVID) of the Clinical Part of the FRCS Exam
Video Player
Accessibility
Using forms mode, you can utilize keyboard shortcuts to make usability more efficient.
Space bar will play and pause the video. Pressing escape will close all displays and pressing it again will jump to the end of the player.
You can press A to open the Keyboard Shortcut Dialog which also provides an audio description of the player and all of its features.
Language
1x
Play Speed
Adjust Volume
Transcript
Search
Result Count
of
Click to jump to result
Search
Re-center
Segments
Result Count
of
Click to jump to result
Search
Name:
The New Format (Post COVID) of the Clinical Part of the FRCS Exam
Description:
The New Format (Post COVID) of the Clinical Part of the FRCS Exam
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/af5e4604-0232-436a-af89-04a44c2b853d/videoscrubberimages/Scrubber_1.jpg
Duration:
T00H28M54S
Embed URL:
https://stream.cadmore.media/player/af5e4604-0232-436a-af89-04a44c2b853d
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/af5e4604-0232-436a-af89-04a44c2b853d/The new formate (Post COVID) of the Clinical part of the FRC.mp4?sv=2019-02-02&sr=c&sig=7czNdgfwIAMpf%2FDeGHeRmXv%2Bk5bTKZuCVIgNK0lupsg%3D&st=2024-11-21T17%3A34%3A02Z&se=2024-11-21T19%3A39%3A02Z&sp=r
Upload Date:
2024-05-31T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
This is a picture of the hotel that the exam will be in the next two days, at least in February and April. So I would give a quick just like two slides about the venue and the PPE preparation and stuff.
One or two slides about survivor and the rest will be about the main concentration will be about the clinicals. My colleague Joe Gordon will also present about the short cases. So the as I said, it's the Crowne Plaza in Glasgow, the clinical and the survivor. They will be in the same venue. One of the changes that they divided the candidates into two main groups, and that will allow everybody to stay for 1 and 1/2 day maximum two days in Glasgow and that they will ask you to travel straight away.
So the red and the blue groups the red group will say Sunday do the Viva all day finish the Viva and the Monday morning they will finish the clinical and they will leave by lunchtime. The other part Monday afternoon doing the clinicals and then the Tuesday would be holiday. When you come, there will be a temperature check and then they will do your registration if your temperature is high, obviously they will ask you to leave.
And it's a one way system. Uh, everybody should wear a mask all the time, they have got plenty of masks everywhere, so you don't need to bring your own mask. I find it a bit difficult to talk while you're stressed in a noisy like hallway. Everybody's talking, especially if English is not your first language and you have an accent. It might be difficult for the examiner because they might normally rely on reading your lips and they can't do that.
So I would suggest for candidates preparing for the exam to try and practice a varus while they're wearing masks, that might help. So it would be a big conference Hall. The tables are arranged with social distancing. But I will not there will be no screen or any visors or anything. You will sit with two examiners. It's the same venue for both the clinical and survivor where you will be.
It's quite relieving because you'll be used to. It is not a new place. You will do the Viva, for example, the first day and then the second day will come for the clinic at exactly the same place. This is a picture actually of the actual place where you should be going in this poll, you will be waiting and then the whole town will be just to the right. This is a whole where you will be sitting in different tables.
And in the Viva. There's not many changes happening to vyver, I noticed, because I have taken this exam before. The difference is mainly that you would definitely need to know, at least for differential diagnosis for everything. And that is to say that is the most important point. There is one thing I would ask the examiners take home message.
It would be this one because I will explain this later. But if you don't know the differential for everything, then you would struggle to score marks because there would be questions on these differentials on each of them, and they will show you x X-ray of each of them. Ah, so you might be for an x-ray, for all of the possible differentials and ask to how you would approach everyone.
If you miss one of the main differentials, you miss a lot of marks and this most of that differential will be automatically lost. I'll just give you an example to explain this, because this is a very important point. It is in the vyver, but also I noticed this in the Creighton's. So see that patient, you would say. I can see that it's a left side wasting on the Super and politics and has the prominence of the spineless caterpillar.
That's a level 6 question answer. But if you are preparing well for this exam, you would avoid being asked about all the differentials from by commencing your first comment and avoiding prompting you would. You would. I mentioned all the essentials from there. So you would say I will be looking at the deltoid if it's wasting or not, the deltoid is not wasted.
I'm thinking this is not brachial plexus or personal attorney. I'm suspecting this most likely rotator cuff approach. Look at the winging also, and that would also give you an impression, whether it is a brain injury or. Out of this property and also commenting on the other side, it's unilateral or bilateral. We'll give you we give the impression that you're talking about the fishers capital humoral dystrophy, which is also one of the differentials, and they would like to look at the face, look for Horner's syndrome and look for transverse smile and asks the patient to whistle.
By saying that from the beginning, you would stop the examiner asking you about the differentials, which are now you mentioned all the differentials. And the examiner cannot fairly. So these are like very similar to one of the questions I had. And the case was maybe. Talking about one of them, but I notice the examiners have shown me an X-ray or a picture for all of the three of the patients.
So they might not ask you about all these things. The wild thing is the history finding and how would you differentiate between these? The view is how would you differentiate an examination, the investigation findings in yellow and the treatment in black? OK, so, person, I turn a young patient, it's painful. They know trauma. You differentiate that in the history from rotator cuff, where the patient is older, it's unilateral.
The shoulder pain. Most likely this patient had a fall or dislocation before. Or maybe there is no trauma. Vicious typekit dystrophy is there's a family history. It's painless. And you go like that, they might ask you everything, but they will make sure that you can differentiate between the important differential for every single case.
And then they would come back and concentrate on the main diagnosis, that's most likely the diagnosis of the case, and they will ask you a bit more question about the causes like. If this person I ask you, what do you think the cause is, is that you talk about breaking the varieties where there's violence or other causes. So for the intermediates, you expect it to demonstrate clinical test without prompting, and that was said to us in the briefing.
When they said, you try to demonstrate the clinical test in yourself. And because you will not be allowed to touch the examiners or there is no basis. You need to think of reaching the diagnosis before you get into the X-ray. You can have also because this is all virtual now, you can have a lot of rare cases that normally they wouldn't come to the exam.
You can have also pediatric cases. as I said, you at some point, I felt that I had to stand up and take a few steps away from the examiners because they asked me to demonstrate how I would do the movement of the shoulder and test the rotator cuff in myself. And I looked around. I found most of the candidates standing up and doing yoga.
Are taking history. There is some changes here really important to focus on, there's two ways of taking history in the intermediate. One will be a traditional conventional way where they examine one of the examiners with will be the patient in the name and you will go to another patient who will answer the patient and he will give you a very nice history.
Five minutes more than to through the difficult scenario is when the asking examiner is the same one who gives you the history and this happened to me and happened to you as well. And one of the intermediates where the examiners will say, well, you have a patient of this disease, what do you want to ask in history? And then everything you said, you will say, why are you asking about this? And they will just kill you every question.
I notice in that station, the other examiner will just be writing and sitting there. You will not open his mouth to the end of the intermediate case, so you will be taken by one examiner through the whole 15 minute. That is very important in that situation to not rush because this is the same person. He will give you the positive findings. So if you say in the history, I would like to ask about handedness, about occupation and about the presenting complaint in the same sentence, then he might not give you all that.
So you have to go and wait for him to answer your question. If you don't ask about anything, he will just ignore it and you will count it as you don't, you don't ask, you didn't tick the box for that one. As I said, you need to justify why you're asking every question, so you need to be really careful of not asking questions that is not relevant. They will look at you as not as a master's candidate rather than Yes.
And for example, don't ask about family history in a patient with post-traumatic known osteoarthritis of the knee, for example. They will not fight this. I always remember the safety questions, and this will be very important. I noticed the examiner if you don't, they will prompt you to ask about it, especially in Spanish cases.
You need to really make sure that you're asking about this. So just remember, these scenarios are. I made very carefully, we noticed that the old, the examiners and in the briefing, they're very worried about how we're going to respond to this. And about the feedback. And they told us they have tested this several times between themselves. So if this scenario is carefully put and any positives they give you, the history that is not for fun, that will be a question, a positive finding.
They will expect you to respond to it and to show your higher order thinking. For example, if they say in the past medical history. They have asthma, you have to say either in the same time to the patient or if you have good short term memory, give it to the discussion, but you have to mention about you suspect care about steroids because this patient takes steroids. You ask her about her pains because they might have even talking to the anesthetist because these patients might need some steroids with anesthesia.
Both both look like this like what you see and the efficiency you have to ask about medications because these patients take warfarin and. You have to mention that you would stop this before the surgery. And there is that. So this is about the history and clinical examination is very important point you have to put in your money that you have to remember you are not escorted for knowledge here you are scored for skills.
So it's showing a clinical picture you will be shown by the end of the history. The camera will turn his laptop or his tablet, and he will show you a clinical picture and you need to describe it as you would examine this patient. So are looking. And then I would feel for this and I'll do this. Remember, intermediate case, because it's just talking on the examination, you can go very quick in one or two minutes, you can say all the sequence of what you were going to examine for.
But they will stop you to make sure that what you're talking about. And they will not make it easy for you. So I would think that intermediate case, you still need to go systematic by, for example, in the hip, you have to look from the front, from the back, from the side of to walk the patient to see the patient line the patient down and do the leg lengths and these things.
But you mentioned it very quickly to get to the meat because if you don't go very quickly, you will lose some marks. They will get you to that point and then they will give you the findings of what you ask before. So if you've got a leg length discrepancy, for example, which can come very frequently in the intermediates they want you to get to the. Julia egawa test.
They will not show you a symbolic test where there is a light shortened tibia. And that's it, and the rest is normal. They will show you something complicated and they will test your heart order thinking. And unfortunately, this will be your competence question. If you don't Pose that question or go beyond that, you will not pass the examination. You might not fail the whole intermediate.
So one of the signals you could have, for example, one leg shorter the patient had, when you do the claw palsy test, they will test that, you know that you're going to put the heels together and then how you get to check the tibia, how are you going to check the femur? And then your comment will be, for example, the shortening is below the knee and then, oh, I noticed also the femur on the same side is longer and they ask you why?
And then, oh, I can see some scars, especially lengthening on the same side where you had the thing. And then they would ask you that. Then it pertains to vyver. But you need to really understand the concept of every clinical test that should be learned in depth. And you need to the false negatives and false positive tests, like if the patient have fusion of the hip, then back this would be negative, although the doctors might be weak.
So how to prepare for this clinical? I would suggest for all the candidates taking the exam soon is to go to this book and Nick Harris and Fazal Ali book and trying to find all the important clinical tests and ask themselves questions about that test and know everything around it. For example, if you ask to assess the collaterals, they will ask you why you need to flex the need 30 degree.
The study the elbow to 30 degrees and you know, that's disengage the ln of the coronavirus to be able to assess the collaterals for training. But they will ask you about hip fusion if it is fused, hip or fused. How would you perform the test? As I said, you will not be straightforward blood tests. They will ask you about the possibility if he does not act, so it should be either kind for driven or, for example, stiff.
But you would confirm by doing the movement of the joint. Egawa test as well, they would like to they would not give it straight, they will give you with fugitive only Els, for example. Also, you need to check out the IP joint is bubble first. Before you do the test, you need to check for scars that there is no fusion or there's no screw on just under the nail plate. And that as well as for dial test, you need to ask yourself, why are you doing the throttle in 30 degrees?
Why are you doing the PCL in 90 degrees? Can the PCL be injured while the economy is intact? A lot of questions that will come up in the next exams about these things. So I cannot emphasize enough the importance of revising these. The discussion will be like a normal, but I don't think the discussion will be anything different from what we do already, but do not be alarmed by this.
No x-rays, because actually these things, we realize it takes a lot of time. And the examiners knew that and they did not. Most of the cases, even in the intermediate, there is no x-rays. So that's normal. If you don't see an x-ray, that's very normal. You should come up with a clear management plan that should be targeted to the patient you have seen and not just a generic management plan.
Did it to be slipped with the consent because in every intermediate case, there is some marks put for the consent, and I have been asked about it in both intermediates. So do not miss this must be very slick and trying to do drawing is a very good idea of consenting and most of the examiners will like it. I think that's the end of my part, and my colleague Joe will finish the short cases.
Thank you very much. Thank you, Mohammed, so for the short cases. Briefly, just in five minutes, I would like to just highlight the differences between the normal and this time. So this time it's the same three upper three lower. But there is more and more spine cases. There is more and more pediatric cases and more and more cases that we don't really we didn't really have on a regular basis on in every exam before.
So the scope has increased. It almost always starts with a clinical photograph of the main deformity. It's almost always there is a finding in this clinical photograph. It's not just a subtle finding, it's a major finding saying that if you can't see it, just ask the examiner. But usually it's very obvious.
And if it is, it's usually one main diagnosis with that deformity. It's not. It's not a differential if there is any important differential. OK, safe. But usually it's one diagnosis for one deformed. Next, please, Mohammed. Be slick and describing because you're not marked for just describing what you see.
OK this is actually it's just the look. You look to this. OK, so this is a clinical photograph of the scoliosis. And then you start, say, mentioning the shoulder, the waist lines, the pelvic obliquity. You have to. This is the main point, you have to say any positive and any negative points, any associated conditions.
So whether or not you can see in this case, whether or not you can see tuft of hair, whether or not you can see cafe patches, whether or not you can see any associated or causative diseases, then if there is any differentials briefly mentioned them and then. Go to the meat straightaway by not wasting time about, well, I will look to the patient, from the front, from the side, from the back, I will look from the front for shoulder level and from the back for sure.
No, just go for the meat of the exam or the test that you will do to either affect your diagnosis. Or affect your management plan. Next, please, Mohammed. And then. Describe that main test they will ask you about, for example, here. I will do Adam egawa test, so I will do Adam egawa test to Syria pump prominence and to.
And how would you do it? I will stand behind the patient and will ask the patient to do this and this and this, OK. That's how the short cases were done for the first minute. You describe for the second minute, you are describing the very important tests that will affect your management plan. Then if there is any. Think that they are.
Um, that you asked about in the short case, in the short case, like if you ask about cafe only patches just and they can show you either another picture of cafe only patches for that or they can actually Zoom in to show you, oh, there is coffee only patches which happened with me. OK, then. The brief think about the management, so for example, just a quick example, this case, OK, this is a clinical photograph of a child suffering from Cuba to various.
Then he will ask you, what is your differential here? So you can mention that the two most common differentials is either a Man United super counterfactual humorous versus a lateral condyle or fracture. The next question would be OK, so how would you differentiate that if you go for the X-ray and to calculate the Bowman angle, which like that, no, they will tell you sorry, there is no X-ray.
We don't have the X-ray and you are not supposed to ask for the X-ray before clinical examination. They want to differentiate according to the clinical differentiation, so they will ask you what tests you will do. You will say the equilateral triangle. Next, please. So the equilateral triangle, briefly, is that if the. Edges of the triangle are equal, so that means the deformity is coming from outside the triangle, that means it is a supercollider fracture.
If they are not equal, that means the affection from inside the triangle. That means it is lateral friction. Simple as that. You have to know the concept of the test, how to perform the test and why you are doing the test. Next one, please. How much? Hello Hello.
Can you hear me ok? Yeah Yes. So for the discussion, it's the last minute or two. It's a normal Viva, but don't expect X-ray, MRI scan or anything like that. It's basically a normal Viva saying that you are they expect you to know what will you find in the x ray, for example, in this uses, if it's completely neurofibromatosis, what are the significance to significant findings in that X-ray you are looking for?
So that's the main driver here. The five starts here and then the management, brief management and then the higher order thinking, OK, next one, please. So take home message about the short cases. Briefly, don't panic. If not clear. Just ask what? What can I see here or I want to see whether or not there is that sign?
Don't waste time describing the clinical photograph. You're not scored high about just waffling around, OK. This is a male. This is a female blah blah blah. If it's not significant, prepared differentials, if they are important. And then. Describe the tests, ok? Description of the tests and why you are doing the special test.
Not all the tests, not the classical format of look, feel move. You don't have a patient, you have an examiner in front of you. He's frowning to you. All the five minutes. OK and if you waste your time about, I will look at the patient around the ground, ok? He will be very annoyed.
Thank you very much, and good luck. I know there's hundreds of questions here. Very brilliant. Thank you very much. And for your insights on this exam and congratulations again for passing seem to be a lot of changes. Lots of pros and cons for the new format, but whatever it is, we just got to get on with it. And so, as you said, the probably, you know, there are no patients, so maybe a little bit better interaction with the examiner, but they now they have the freedom of bringing any case, they wish.
They're not restricted by availability of patients anymore. So we've got to accommodate for that in our preparation. So thank you very much. Ahmadinejad, again, I think we will end this teaching session with this. I'd like to thank Ruth and Hannah from all UK for sticking with us and for organizing this beautifully this session.
A lot of hard work behind the scenes to get this up and running. Thanks to my colleagues at their first media group and to those who took part in the Viva, the examiner's Nicky, David and Abdullah and the candidates as well for coming forward. And we will have a teaching session every Wednesday, and the course, is obviously upcoming.
So thank you very much, everyone, and I think everyone is must be tired now. So Thanks for attending and good night, everyone. Made by. Good night, good night. All candidates can please kindly log out.
Thank you.
Segment:0 .
This is a picture of the hotel that the exam will be in the next two days, at least in February and April. So I would give a quick just like two slides about the venue and the PPE preparation and stuff.
One or two slides about survivor and the rest will be about the main concentration will be about the clinicals. My colleague Joe Gordon will also present about the short cases. So the as I said, it's the Crowne Plaza in Glasgow, the clinical and the survivor. They will be in the same venue. One of the changes that they divided the candidates into two main groups, and that will allow everybody to stay for 1 and 1/2 day maximum two days in Glasgow and that they will ask you to travel straight away.
So the red and the blue groups the red group will say Sunday do the Viva all day finish the Viva and the Monday morning they will finish the clinical and they will leave by lunchtime. The other part Monday afternoon doing the clinicals and then the Tuesday would be holiday. When you come, there will be a temperature check and then they will do your registration if your temperature is high, obviously they will ask you to leave.
And it's a one way system. Uh, everybody should wear a mask all the time, they have got plenty of masks everywhere, so you don't need to bring your own mask. I find it a bit difficult to talk while you're stressed in a noisy like hallway. Everybody's talking, especially if English is not your first language and you have an accent. It might be difficult for the examiner because they might normally rely on reading your lips and they can't do that.
So I would suggest for candidates preparing for the exam to try and practice a varus while they're wearing masks, that might help. So it would be a big conference Hall. The tables are arranged with social distancing. But I will not there will be no screen or any visors or anything. You will sit with two examiners. It's the same venue for both the clinical and survivor where you will be.
It's quite relieving because you'll be used to. It is not a new place. You will do the Viva, for example, the first day and then the second day will come for the clinic at exactly the same place. This is a picture actually of the actual place where you should be going in this poll, you will be waiting and then the whole town will be just to the right. This is a whole where you will be sitting in different tables.
And in the Viva. There's not many changes happening to vyver, I noticed, because I have taken this exam before. The difference is mainly that you would definitely need to know, at least for differential diagnosis for everything. And that is to say that is the most important point. There is one thing I would ask the examiners take home message.
It would be this one because I will explain this later. But if you don't know the differential for everything, then you would struggle to score marks because there would be questions on these differentials on each of them, and they will show you x X-ray of each of them. Ah, so you might be for an x-ray, for all of the possible differentials and ask to how you would approach everyone.
If you miss one of the main differentials, you miss a lot of marks and this most of that differential will be automatically lost. I'll just give you an example to explain this, because this is a very important point. It is in the vyver, but also I noticed this in the Creighton's. So see that patient, you would say. I can see that it's a left side wasting on the Super and politics and has the prominence of the spineless caterpillar.
That's a level 6 question answer. But if you are preparing well for this exam, you would avoid being asked about all the differentials from by commencing your first comment and avoiding prompting you would. You would. I mentioned all the essentials from there. So you would say I will be looking at the deltoid if it's wasting or not, the deltoid is not wasted.
I'm thinking this is not brachial plexus or personal attorney. I'm suspecting this most likely rotator cuff approach. Look at the winging also, and that would also give you an impression, whether it is a brain injury or. Out of this property and also commenting on the other side, it's unilateral or bilateral. We'll give you we give the impression that you're talking about the fishers capital humoral dystrophy, which is also one of the differentials, and they would like to look at the face, look for Horner's syndrome and look for transverse smile and asks the patient to whistle.
By saying that from the beginning, you would stop the examiner asking you about the differentials, which are now you mentioned all the differentials. And the examiner cannot fairly. So these are like very similar to one of the questions I had. And the case was maybe. Talking about one of them, but I notice the examiners have shown me an X-ray or a picture for all of the three of the patients.
So they might not ask you about all these things. The wild thing is the history finding and how would you differentiate between these? The view is how would you differentiate an examination, the investigation findings in yellow and the treatment in black? OK, so, person, I turn a young patient, it's painful. They know trauma. You differentiate that in the history from rotator cuff, where the patient is older, it's unilateral.
The shoulder pain. Most likely this patient had a fall or dislocation before. Or maybe there is no trauma. Vicious typekit dystrophy is there's a family history. It's painless. And you go like that, they might ask you everything, but they will make sure that you can differentiate between the important differential for every single case.
And then they would come back and concentrate on the main diagnosis, that's most likely the diagnosis of the case, and they will ask you a bit more question about the causes like. If this person I ask you, what do you think the cause is, is that you talk about breaking the varieties where there's violence or other causes. So for the intermediates, you expect it to demonstrate clinical test without prompting, and that was said to us in the briefing.
When they said, you try to demonstrate the clinical test in yourself. And because you will not be allowed to touch the examiners or there is no basis. You need to think of reaching the diagnosis before you get into the X-ray. You can have also because this is all virtual now, you can have a lot of rare cases that normally they wouldn't come to the exam.
You can have also pediatric cases. as I said, you at some point, I felt that I had to stand up and take a few steps away from the examiners because they asked me to demonstrate how I would do the movement of the shoulder and test the rotator cuff in myself. And I looked around. I found most of the candidates standing up and doing yoga.
Are taking history. There is some changes here really important to focus on, there's two ways of taking history in the intermediate. One will be a traditional conventional way where they examine one of the examiners with will be the patient in the name and you will go to another patient who will answer the patient and he will give you a very nice history.
Five minutes more than to through the difficult scenario is when the asking examiner is the same one who gives you the history and this happened to me and happened to you as well. And one of the intermediates where the examiners will say, well, you have a patient of this disease, what do you want to ask in history? And then everything you said, you will say, why are you asking about this? And they will just kill you every question.
I notice in that station, the other examiner will just be writing and sitting there. You will not open his mouth to the end of the intermediate case, so you will be taken by one examiner through the whole 15 minute. That is very important in that situation to not rush because this is the same person. He will give you the positive findings. So if you say in the history, I would like to ask about handedness, about occupation and about the presenting complaint in the same sentence, then he might not give you all that.
So you have to go and wait for him to answer your question. If you don't ask about anything, he will just ignore it and you will count it as you don't, you don't ask, you didn't tick the box for that one. As I said, you need to justify why you're asking every question, so you need to be really careful of not asking questions that is not relevant. They will look at you as not as a master's candidate rather than Yes.
And for example, don't ask about family history in a patient with post-traumatic known osteoarthritis of the knee, for example. They will not fight this. I always remember the safety questions, and this will be very important. I noticed the examiner if you don't, they will prompt you to ask about it, especially in Spanish cases.
You need to really make sure that you're asking about this. So just remember, these scenarios are. I made very carefully, we noticed that the old, the examiners and in the briefing, they're very worried about how we're going to respond to this. And about the feedback. And they told us they have tested this several times between themselves. So if this scenario is carefully put and any positives they give you, the history that is not for fun, that will be a question, a positive finding.
They will expect you to respond to it and to show your higher order thinking. For example, if they say in the past medical history. They have asthma, you have to say either in the same time to the patient or if you have good short term memory, give it to the discussion, but you have to mention about you suspect care about steroids because this patient takes steroids. You ask her about her pains because they might have even talking to the anesthetist because these patients might need some steroids with anesthesia.
Both both look like this like what you see and the efficiency you have to ask about medications because these patients take warfarin and. You have to mention that you would stop this before the surgery. And there is that. So this is about the history and clinical examination is very important point you have to put in your money that you have to remember you are not escorted for knowledge here you are scored for skills.
So it's showing a clinical picture you will be shown by the end of the history. The camera will turn his laptop or his tablet, and he will show you a clinical picture and you need to describe it as you would examine this patient. So are looking. And then I would feel for this and I'll do this. Remember, intermediate case, because it's just talking on the examination, you can go very quick in one or two minutes, you can say all the sequence of what you were going to examine for.
But they will stop you to make sure that what you're talking about. And they will not make it easy for you. So I would think that intermediate case, you still need to go systematic by, for example, in the hip, you have to look from the front, from the back, from the side of to walk the patient to see the patient line the patient down and do the leg lengths and these things.
But you mentioned it very quickly to get to the meat because if you don't go very quickly, you will lose some marks. They will get you to that point and then they will give you the findings of what you ask before. So if you've got a leg length discrepancy, for example, which can come very frequently in the intermediates they want you to get to the. Julia egawa test.
They will not show you a symbolic test where there is a light shortened tibia. And that's it, and the rest is normal. They will show you something complicated and they will test your heart order thinking. And unfortunately, this will be your competence question. If you don't Pose that question or go beyond that, you will not pass the examination. You might not fail the whole intermediate.
So one of the signals you could have, for example, one leg shorter the patient had, when you do the claw palsy test, they will test that, you know that you're going to put the heels together and then how you get to check the tibia, how are you going to check the femur? And then your comment will be, for example, the shortening is below the knee and then, oh, I noticed also the femur on the same side is longer and they ask you why?
And then, oh, I can see some scars, especially lengthening on the same side where you had the thing. And then they would ask you that. Then it pertains to vyver. But you need to really understand the concept of every clinical test that should be learned in depth. And you need to the false negatives and false positive tests, like if the patient have fusion of the hip, then back this would be negative, although the doctors might be weak.
So how to prepare for this clinical? I would suggest for all the candidates taking the exam soon is to go to this book and Nick Harris and Fazal Ali book and trying to find all the important clinical tests and ask themselves questions about that test and know everything around it. For example, if you ask to assess the collaterals, they will ask you why you need to flex the need 30 degree.
The study the elbow to 30 degrees and you know, that's disengage the ln of the coronavirus to be able to assess the collaterals for training. But they will ask you about hip fusion if it is fused, hip or fused. How would you perform the test? As I said, you will not be straightforward blood tests. They will ask you about the possibility if he does not act, so it should be either kind for driven or, for example, stiff.
But you would confirm by doing the movement of the joint. Egawa test as well, they would like to they would not give it straight, they will give you with fugitive only Els, for example. Also, you need to check out the IP joint is bubble first. Before you do the test, you need to check for scars that there is no fusion or there's no screw on just under the nail plate. And that as well as for dial test, you need to ask yourself, why are you doing the throttle in 30 degrees?
Why are you doing the PCL in 90 degrees? Can the PCL be injured while the economy is intact? A lot of questions that will come up in the next exams about these things. So I cannot emphasize enough the importance of revising these. The discussion will be like a normal, but I don't think the discussion will be anything different from what we do already, but do not be alarmed by this.
No x-rays, because actually these things, we realize it takes a lot of time. And the examiners knew that and they did not. Most of the cases, even in the intermediate, there is no x-rays. So that's normal. If you don't see an x-ray, that's very normal. You should come up with a clear management plan that should be targeted to the patient you have seen and not just a generic management plan.
Did it to be slipped with the consent because in every intermediate case, there is some marks put for the consent, and I have been asked about it in both intermediates. So do not miss this must be very slick and trying to do drawing is a very good idea of consenting and most of the examiners will like it. I think that's the end of my part, and my colleague Joe will finish the short cases.
Thank you very much. Thank you, Mohammed, so for the short cases. Briefly, just in five minutes, I would like to just highlight the differences between the normal and this time. So this time it's the same three upper three lower. But there is more and more spine cases. There is more and more pediatric cases and more and more cases that we don't really we didn't really have on a regular basis on in every exam before.
So the scope has increased. It almost always starts with a clinical photograph of the main deformity. It's almost always there is a finding in this clinical photograph. It's not just a subtle finding, it's a major finding saying that if you can't see it, just ask the examiner. But usually it's very obvious.
And if it is, it's usually one main diagnosis with that deformity. It's not. It's not a differential if there is any important differential. OK, safe. But usually it's one diagnosis for one deformed. Next, please, Mohammed. Be slick and describing because you're not marked for just describing what you see.
OK this is actually it's just the look. You look to this. OK, so this is a clinical photograph of the scoliosis. And then you start, say, mentioning the shoulder, the waist lines, the pelvic obliquity. You have to. This is the main point, you have to say any positive and any negative points, any associated conditions.
So whether or not you can see in this case, whether or not you can see tuft of hair, whether or not you can see cafe patches, whether or not you can see any associated or causative diseases, then if there is any differentials briefly mentioned them and then. Go to the meat straightaway by not wasting time about, well, I will look to the patient, from the front, from the side, from the back, I will look from the front for shoulder level and from the back for sure.
No, just go for the meat of the exam or the test that you will do to either affect your diagnosis. Or affect your management plan. Next, please, Mohammed. And then. Describe that main test they will ask you about, for example, here. I will do Adam egawa test, so I will do Adam egawa test to Syria pump prominence and to.
And how would you do it? I will stand behind the patient and will ask the patient to do this and this and this, OK. That's how the short cases were done for the first minute. You describe for the second minute, you are describing the very important tests that will affect your management plan. Then if there is any. Think that they are.
Um, that you asked about in the short case, in the short case, like if you ask about cafe only patches just and they can show you either another picture of cafe only patches for that or they can actually Zoom in to show you, oh, there is coffee only patches which happened with me. OK, then. The brief think about the management, so for example, just a quick example, this case, OK, this is a clinical photograph of a child suffering from Cuba to various.
Then he will ask you, what is your differential here? So you can mention that the two most common differentials is either a Man United super counterfactual humorous versus a lateral condyle or fracture. The next question would be OK, so how would you differentiate that if you go for the X-ray and to calculate the Bowman angle, which like that, no, they will tell you sorry, there is no X-ray.
We don't have the X-ray and you are not supposed to ask for the X-ray before clinical examination. They want to differentiate according to the clinical differentiation, so they will ask you what tests you will do. You will say the equilateral triangle. Next, please. So the equilateral triangle, briefly, is that if the. Edges of the triangle are equal, so that means the deformity is coming from outside the triangle, that means it is a supercollider fracture.
If they are not equal, that means the affection from inside the triangle. That means it is lateral friction. Simple as that. You have to know the concept of the test, how to perform the test and why you are doing the test. Next one, please. How much? Hello Hello.
Can you hear me ok? Yeah Yes. So for the discussion, it's the last minute or two. It's a normal Viva, but don't expect X-ray, MRI scan or anything like that. It's basically a normal Viva saying that you are they expect you to know what will you find in the x ray, for example, in this uses, if it's completely neurofibromatosis, what are the significance to significant findings in that X-ray you are looking for?
So that's the main driver here. The five starts here and then the management, brief management and then the higher order thinking, OK, next one, please. So take home message about the short cases. Briefly, don't panic. If not clear. Just ask what? What can I see here or I want to see whether or not there is that sign?
Don't waste time describing the clinical photograph. You're not scored high about just waffling around, OK. This is a male. This is a female blah blah blah. If it's not significant, prepared differentials, if they are important. And then. Describe the tests, ok? Description of the tests and why you are doing the special test.
Not all the tests, not the classical format of look, feel move. You don't have a patient, you have an examiner in front of you. He's frowning to you. All the five minutes. OK and if you waste your time about, I will look at the patient around the ground, ok? He will be very annoyed.
Thank you very much, and good luck. I know there's hundreds of questions here. Very brilliant. Thank you very much. And for your insights on this exam and congratulations again for passing seem to be a lot of changes. Lots of pros and cons for the new format, but whatever it is, we just got to get on with it. And so, as you said, the probably, you know, there are no patients, so maybe a little bit better interaction with the examiner, but they now they have the freedom of bringing any case, they wish.
They're not restricted by availability of patients anymore. So we've got to accommodate for that in our preparation. So thank you very much. Ahmadinejad, again, I think we will end this teaching session with this. I'd like to thank Ruth and Hannah from all UK for sticking with us and for organizing this beautifully this session.
A lot of hard work behind the scenes to get this up and running. Thanks to my colleagues at their first media group and to those who took part in the Viva, the examiner's Nicky, David and Abdullah and the candidates as well for coming forward. And we will have a teaching session every Wednesday, and the course, is obviously upcoming.
So thank you very much, everyone, and I think everyone is must be tired now. So Thanks for attending and good night, everyone. Made by. Good night, good night. All candidates can please kindly log out.
Thank you.
Form Title Download
Transcript
Form Title Bookmark
Entire Media
Segment(s)
Custom Clip
Start At:
End At:
Form Title Share
Entire Media
Segment(s)
Custom Clip
Start At:
End At:
Form Title Accessibility and Keyboard Shortcuts
The cadmore media player is a professional video and audio player experience designed to deliver media as well as relevant transcript, segmentation, and metadata. On the screen is a traditional html video player with buttons such as play, pause, forward, captioning, language and play speed selection and more. Adjacent to the video player are generally tabs, one of which shows a scrolling transcript of the video and the other shows any segmentation of the media, sometimes referred to as chapters. At the top of the video is a menu bar containing an Explore button and Tools button. The Explore button allows you to dig deeper into the video by opening up an explore dialog which contains tabs for a visual navigation of the video using thumbnails, an about tab which contains rich metadata about the media, a segments tab which contains further information about the video, and a related tab which contains links to other media related to this media. The tools button opens a menu with options for sharing the media on social media, creating bookmarking links, creating embed codes for your website, generating citations, and more.
Keyboard Shortcuts
Keyboard shortcuts only work while you are in forms mode. By entering forms mode, you will be able to quickly access portions of the media player with single key commands.
Spacebar: Play/Pause Toggle
I: Info Menu,
O: Tools Menu
T: Transcript Tab,
S: Segments Tab
F: Forward 15,
R: Rewind 15
L: Languages,
P: Playspeed
M: Mute Toggle,
V: Volume Bar
N: Video Only Toggle,
B: Full Screen Toggle
C: Captions Toggle
Escape: Closes dialogs and menus / Exits Player
Z: Next Transcript Chapter
X: Previous Transcript Chapter
Q: Next Transcript Paragraph
W: Previous Transcript Paragraph
Entire Media
Segment(s)
Custom Clip
Start At:
End At:
Embed Size
-
You Size - Responsive
-
We Size - Responsive
-
Picture Overlay Popup
-
400 x 225
-
512 x 288
-
400 x 700
-
768 x 1024
-
1024 x 512
-
1280 x 608
Form Title Cite
No citation provided.
Info
Segments
Related
Thumbnails
Exit Clip Mode
You have requested to see a portion of the video outside of the clip.
Click OK to switch to the full video or click if you would like to stay inside the clip. You can always go back to the clip with Tools and Clip Mode