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History T aking Pass the UKFPO Clinical Assessment D. Jamal RossIntroduction Our T eam %S▯▯3PTT▯ %S▯▯/ZBNF▯ %S▯▯+FPOH▯ '▯▯%PDUPS▯▯ '▯▯%PDUPS▯▯ '▯▯%PDUPS▯▯ 4PVUI▯5IBNFT▯%FBOFSZ▯ 8FTTFY▯%FBOFSZ▯ 4PVUI▯5IBNFT▯%FBOFSZ▯ )"46▯ 3FTQJSBUPSZ▯.FEJDJOF▯ 1TZDIJBUSZ▯ 1BTTFE▯$"▯MBTU▯ZFBS▯ 1BTTFE▯$"▯MBTU▯ZFBS▯ -PDBM▯6,▯HSBEVBUFCourse Overview Standard Course Overview Tailored 眢 .PSF▯*OUFOTJWF▯▯ 眢 5BJMPSFE▯TUVEZ▯QSPHSBNNF▯▯ 眢 ▯▯UP▯▯▯5FBDIJOH▯ 3BQJE▯ 3FWJFXT ▯▯ 眢 ▯▯Y▯0OMJOF▯NPDL▯FYBNT▯XJUI▯ GFFECBDL▯ 眢 1FSTPOBMJTFE▯GFFECBDL▯▯ 眢 -JNJUFE▯TQBDFT ▯FNBJM▯ JOGP!DMJOJDBMBTTFTT▯DPN▯Why we started this course .FEJDBM▯&EVDBUJPO▯ 眢 眢 'FX▯3FTPVSDFT▯ 眢 )JHI▯4UBLFT▯ 眢 8F▯VOEFSTUBOE▯JU▯XFMM▯ 眢 )FMQ▯PUIFS▯*.(T▯ 4BGFUZ▯/FU▯1SPHSBNNF ▯ 眢 -JGFMPOH▯MFBSOJOH▯QPJOUT▯Overview ▯▯ #BDLHSPVOE▯PG▯$"▯ ▯▯ ,FZ▯$PNNVOJDBUJPO▯5JQT▯GPS▯$MJOJDBM▯"TTFTTNFOU▯ ▯▯▯$PNQPOFOUT▯PG▯UIF▯)JTUPSZ▯ ▯▯▯$BTFT▯▯ ▯▯▯1TZDIJBUSJD▯IJTUPSJFT▯DPWFSFE▯JO▯*OUFOTJWF▯DPVSTFClinical AssessmentWhy is this happening ? 眢 .PSF▯QFPQMF▯BQQMZJOH▯GPS▯UIF▯'PVOEBUJPO▯QSPHSBNNF▯ UISPVHI▯UIF▯FMJHJCJMJUZ▯QBUIXBZ▯▯ 眢 "▯MBDL▯PG▯GVOEJOH▯UP▯DSFBUF▯OFX▯USBJOJOH▯QPTUT▯ 眢 "▯TVSHF▯JO▯JOUFSFTU▯BT▯QFPQMF▯XBOU▯UP▯FWBEF▯TJUUJOH▯UIF▯ 6,.-"▯ 眢 .PSF▯NFEJDBM▯TDIPPMT▯JO▯UIF▯6,▯ F▯H▯,..4New Medical SchoolsWhat does this mean for you? 眢 .PSF▯DPNQFUJUJWF▯▯ 6OQSFEJDUBCMF▯▯ 眢 眢 )JHI▯TUBLFT▯FYBN▯▯ 眢 5IFZ▯XBOU▯UIF▯GJOJTIFE▯BSUJDMF▯▯ 眢 4UVEZ▯4NBSU▯GMC vs UKFPO 眢 5XP▯WFSZ▯EJGGFSFOU▯FOUJUJFT▯▯ 眢 (.$▯EPFT▯OPU▯PWFSTFF▯USBJOJOH▯PG▯GPVOEBUJPO▯EPDUPST▯▯ 眢 /0▯PUIFS▯DPVOUSZ▯FNQMPZT▯UIJT▯TZTUFN▯ -JDFOTF▯JT▯OPU▯ FWJEFODF▯PG▯GJUOFTT▯UP▯QSBDUJDF ▯ 眢 5XP▯WFSZ▯EJGGFSFOU▯FYBNT▯XJUI▯EJGGFSFOU▯QVSQPTFT▯The Clinical Assessment They Don’t Know Whoou Are The Clinical Assessment They Don’t Know Who Y ou Are 1. Ado a phD in stem cell therapytook time out to The Clinical Assessment They Don’t Know Who Y ou Are 1. After medical school, Natalie2. After medical school, Jane has been do a phD in stem cell theratrying to gain a license to practice for 5 years The Clinical Assessment They Don’t Know Who Y ou Are 1. After medical school, Natalie took time out to do a phD in stem cell therapy trying to gain a license to practice for 5 years 3. Charlotte is a new graduate but has not done a post graduate medical internship The Clinical Assessment They Don’t Know Who Y ou Are 1. After medical school, Natalie took time out to do a phD in stem cell therapy 2. After medical school, Jane has been trying to gayearslicense to practice for 5 3. Charlotte is a new graduate but has not done ais a local UK graduate who was post graduate medical internship on the foundation programme but left as she started a business and now wishes to return to complete her training. The Clinical Assessment They Don’t Know Who Y ou Are • Body Language • Clinical Knowledge • Clinical Reasoning 1. After medical school, Natalie t2. After medical school, Jane has been do a phD in stem cell therapytrying to gain a license to pra•tice for 5 Skills years • Rapport • Interpersonal skills • Confidence 3. Chpost graduate medical internshipthe foundation programme but left as she started a business and now wishes to return to complete her training.Introduction 7 minutes for your OSCE Station • The clinical history forms the basis of everything • A good structure will serve you well • Likeable • Build a rapport • Be observant. Non verbal cues • Signposting • Show Empathy • You may need to do a very focused history if it is a combined stationCommunication In 'Good medical practice' (2013), paragraph 32 adviseouthat, 'Y must give patients the information they want or need to know in a way they can understand.' 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Be Meticulous 眢 $SFBUF▯B▯UJNFMJOF▯PG▯FWFOUT▯▯ 眢 "TL▯UIF▯QBUJFOU▯GPS▯TQFDJGJDT ▯XIBU▯NPOUI ▯XIBU▯EBZ ▯XIBU▯UJNF▯▯ 眢 *WF▯CFFO▯HPJOH▯UP▯UIF▯MPP▯NPSF▯PGUFO▯▯)PX▯NBOZ▯UJNFT ▯-FTT▯UIBO▯▯▯ ▯.PSF▯UIBO▯▯ ▯▯ 眢 #F▯NFUJDVMPVT▯▯ 眢 .BLF▯ZPVS▯QBUJFOU▯DPNNJU▯UP▯BO▯BOTXFS▯▯ 眢 4PNFUJNFT▯FYQMBJOJOH▯UIF▯SFBTPO▯XIZ▯JUT▯JNQPSUBOU▯XJMM▯NBLF▯ZPVS▯QBUJFOU▯NPSF▯ DPNQMJBOU▯▯▯SAFE One of the main keys to this exam • S olve problems A ssess & Apply • • F ollow up (patients, results) • E scalate (When necessary)Approaching the patient • Greeting your patient • “ Hi, Good morning.. are you Sarah Jones? Hi, I’m John”…one of the junior doctors. 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To back →Aortic dissection •Sputum Abdomen •Abdominal Pain •Diarrhoea •No bowel movement/ No flatus •Bowel habit Neurological •Headache •Vision Problems •Weakness •Syncope/ Seizure •Confusion Systemic •Fever •Nausea & VomitingExamination 7JUBMT▯ (1&▯ 4ZTUFN▯0SHBO▯TQFDJGJD▯FYBNJOBUJPO▯▯ ▯Investigations 3PVUJOF▯#MPPET '#$ 6▯& ▯$31 ▯&43 ▯-'5 $MPUUJOH ▯HMVDPTF ▯-JQJET 4QFDJBM▯5FTUT▯ "VUPBOUJCPEJFT ▯5VNPVS▯NBSLFST ▯WBTDVMJUJD▯TDSFFO ▯5SPQPOJOT ▯%▯%JNFS▯ +PJOU▯BTQJSBUJPO▯BOE▯DVMUVSF *NBHJOH $5 ▯$5▯1" ▯$5▯" ▯.3* ▯$93 ▯64 ▯%PQQMFS ▯Management AIRSONSS "*340/4▯ "ENJU▯ *OGPSN▯4FOJPST▯ 3FGFS▯ 4ZNQUPNBUJD▯▯▯4VQQPSUJWF▯5Y▯ '017" ▯ 0GGFS▯-FBGMFU▯ /FYU▯'PMMPX▯VQ▯ 4QFDJGJD▯5Y▯ 4BGFUZ▯/FUUJOH▯The Tie Up 眢 #SJOH▯CBDL▯BOE▯BEESFTT▯ZPVS▯*$&▯ 眢 'PDVT▯PO▯UIF▯QBUJFOUT▯DPODFSOT▯ 眢 6TF▯UIF▯JOGPSNBUJPO▯ZPV▯HBUIFSFE▯UP▯JOGPSN▯ZPVS▯QSPQPTFE▯ NBOBHFNFOU▯ F▯H▯4NPLJOH▯DFTTBUJPO ▯%4/ ▯#FSFBWFNFOU▯ $PVOTFMMJOH ▯▯Case 1 Time allowed: 10 minutes You are a junior doctor working in the Accident and Emergency department. * Miss Josephine Thomas has come into the department complaining of chest pain and looks out of breath. She has been brought in by her neighbour, who is waiting outside in the car park. Please take a focused history from her and formulate a management plan.Case 2 Time allowed: 10 minutes You are a junior doctor working in the Medical Assessment Unit (MAU).Smith , an elderly woman, has just been admitted to your ward with headaches. Please take a focused history from her and suggest a differential diagnosis. The examiner will stop you at 7 minutes to ask you a few questions.Case 3 STATION 5 Time allowed: 10 minutes You are a junior doctor working in the Accident and Emergency department. Mr Gopala Kaur, a middle-aged man, has attended the department complaining of feeling unwell, is short of breath and coughing up blood. He looks drawn out and tired but says he needs to be investigated strai. t away Please take a focused history from him and formulate a differential diagnosis.Feedback & Certificates Required for access to prescribing lecture