This comprehensive course crafted by a team of Foundation Year 1 Doctors is aimed at final year medical students, providing a guide for common OSCE finals stations. The course, which has been designed loosely around the University of Leicester final OSCEs, features 11 sessions with peer-reviewed cases and video guides relevant to all participants, and is also intended as preparation for future FY1 responsibilities. Offering an interactive learning experience, the course includes a focus on pre-operative care, including medical history discussion, risk and benefit evaluation, medication changes, on-day preparation, recovery measures and required investigations. Attendees will have the opportunity to put their learning to the test with practical examples and a Q&A session, ensuring thorough comprehension and application of the material. The creators of the course encourage feedback and maintain an open-door policy for participants to address any concerns or queries.
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OsceExpress Session HollyGarcia(FY1)Disclaimer This course has been designed to help final year students with practical OSCE exams and is an unofficial resource that covers themes present in the University of Leicester Final OSCEs. We have nonetheless made this course as applicable to other final year OSCEs as possible, but there may be discrepancies in your University’s expectations. OSCE Express sessions are peer-reviewed by junior doctors, but we take no responsibility in the accuracy of the content, and additionally our sessions do not represent medical advice. Please use our sessions as a learning aid, and if you note any errors, do not hesitate to message us at osce.express@gmail.com Kind regards, Dr Nidhi AgarwalFY1 Sumedh SridharYr5 MedicalStudent OSCEExpressco-creators Meet the Team Nidhi Agarwal Sumedh Sridhar SaraSabur NikitaChoudhary Shaili Kadambande Osce Express Co-Founder5Osce Express and FY1 Doctor FY1 Doctor FY1 Doctor OsceAce Co-founder LNRTrust LON Trust LNRTrust Holly Garcia BethanyTurner Nevash Maraj VanessaDatta FatimaAhmedi FY1 Doctor FY1 Doctor FY1 Doctor FY1 Doctor FY1 Doctor LNRTrust SY Trust NWTrust LNRTrust LNRTrustCourseOverview Osce Express 1. 11 session guide to common OSCE finals stations 2. Delivered by Foundation Year 1 Doctors 3. Peer-Reviewed Cases + Video Guides provided to all participants (published on MedAll, osceace.com) 4. Preparation for OSCEs… 5. …And also preparation to be a safe FY1 InToday’sSession… 01 02 03 Pre-OperativeExampleCase Q&A Care 01 Pre-Operative Care Layout 01 - Simulated Patient in pre-op assessment clinic - 10 minutes to: Pre-operative 02 - Talk to patient about operation Care (Indication, risks, benefits) - Pre-op history and investigations they require explaining why 03 - Medication pre-op management - Post-op recovery (work, driving, follow ups)Approach - Why Clinic? - What Operation are they having? - Discuss Risks and Benefits - PMHx, DHx (allergies), SHx, FHx, previous surgeries (anaesthetic use, complications?) - Medication changes - On the day - Recovery - InvestigationsApproach Common Procedures (Just a few) - Ortho (hip replacement, knee replacement, joint arthroscopy, ACL repair) - Gen surg (Cholecystectomy, hernia repair, colectomy, splenectomy) - Gynae (hysterectomy, prolapse repair) - Urology (TURP, Prostatectomy) Risks (How we will minimize) - Bleeding - Infection - Pain – we will control - Damage to nearby structures - Lap to Open - Anesthetic risk – throat, breathing problems… - DVT - Surgery-specific risks (e.g. bile leak) Approach-Medications COCP/HRT – 4 Weeks Clopidogrel – 7 Days Warfarin – 5 Days – bridge LMWH DOAC – 48 hours LMWH – 24 hours ACEi/ARB – 24 hours Steroids – sick days START – LMWH, TED stockings, antibiotic prophylaxis Diabetic - likely switched to VRIII if missing more than one meal •Continue glitazones, gliptins and exenetide •Stop gliclazide, gliflozin on day of surgery (if abnormal renal function stop metformin too) •Once daily insulin - reduce doses day of and day before •Twice daily - reduce dose day of •Basal Bolus - omit short acting; continue long actingApproach–Ontheday - Arrival - What to bring - Anesthetist and surgical team – lap/open - NBM (6 hours and 2 hours), Bowel prep - Recovery – staying over, day case - Support at home - Driving - Return to workApproach-Investigations - Be able to justify - FBC – Anaemia? - U&E – Renal function – fluids/analgesia - LFT’s and coag – Liver clotting? - HBA1C/TFT’s – specific - Group and save cross match – Transfusion? Cardiac history – ECG/ECHO Respiratory – Spirometry/CXR MRSA swab Urinalysis – urology surgery / Pregnancy test Cardiopulmonary testing – major surgery, high riskWHOPre-OpChecklistTopTips - Childbearing age – Ask if risk of pregnancy! - Don’t just talk about risks – talk about benefits - Briefly go through risks – explain anaesthetist and surgeon will come on day can talk through procedure and answer any questions - Make it personal – bring book, slippers, comfy clothes, waiting around… - Check in as you go along – any questions after each section you cover - When in doubt say you can look things up or find a leaflet ☺ - It’s a lot to cover, try and be slickPractiseWithUs–CaseOne You are the FY1 you are meeting Charlotte a 23-year-old female who is attending pre-op assessment clinic prior to her tonsillectomy.Approach - Why Clinic? - What Operation are they having? - Discuss Risks and Benefits - PMHx, DHx (allergies), SHx, FHx, previous surgeries (anaesthetic use, complications?) - Medication changes - On the day - Recovery - InvestigationsPractiseWithUs–CaseTwo You are the FY1 you are meeting Susie Ann a 52-year-old female who is attending pre-op assessment clinic prior to her hysterectomy.Approach - Why Clinic? - What Operation are they having? - Discuss Risks and Benefits - PMHx, DHx (allergies), SHx, FHx, previous surgeries (anaesthetic use, complications?) - Medication changes - On the day - Recovery - InvestigationsPractiseWithUs–CaseThree You are the FY1 you are meeting Darren a 63-year-old male who is attending pre-op assessment clinic prior to his knee replacement.Approach - Why Clinic? - What Operation are they having? - Discuss Risks and Benefits - PMHx, DHx (allergies), SHx, FHx, previous surgeries (anaesthetic use, complications?) - Medication changes - On the day - Recovery - InvestigationsQuestions?NextSession… Feedback https://app.medall.org/feedback/feedback- flow?keyword=28c9baeedb1bdb96b39db43c&organisat ion=osceexpress Thanks ! 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