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and also then M two dorsal 18 and was a history of our nonaccidental in an entry. And so I think it is over the important station and the power well for and why there is some over overnight but was saying like your auto, um, history taking stations. I think there's a couple of rashes are really worth and trying to get the pediatric history that will hopefully help you pick up a few extra marks. And so, in terms of resource is for practices. And this the five mm taking a screen show open put in the slide and also cases of marks teams and I found really helpful and I would have practice with her friends and just taking a few AM specialties per week. And I'm taxed each other using this big. And they provide really detailed histories, um, along with a few for a little questions that you might get the end of your stations, and then it also gives you mark schemes. A swell and some of the history is are quite challenging, and I think that will help the and feel well, compare it. Going in drugs is well, which is important and so then moving on to like and at the history itself. Eso without a history always want to, um, introduce yourself, wash your hands and put on your pp, And it's really important to check in the AM on the date of birth that the child and I manage. I'll just check your relationship between the after you have and on the child as well. So, for example, is that the mother or the father and our grand parents an official and remember dot maybe just check that they have consent and from them to discuss and the child symptoms make you. And so people structure this and differently. This is just the way. And I thought, boy, my history taken stations. And so, firstly, and you start with your been crash ins, and what brought you to the GP or the whole school clinic today and and then take a little deeper and so sulfa trees is really useful Ackerman. And for most and histories, it just gives you few crashes to get you in and gives you a bit of time to think about. You know, the more specific rash is that you never want to ask later on, and I think there are some money and potential conditions that could come up in your and pediatric association that I can't possibly go through them all tonight. Whatever I do think that is a really good over doc between your addled under and the African street do, for example, just going back aside. And this one here that we had last year with the teachers, you know, you just be suctioned, not seeing why they structure you're out of history will happen before, during and after the seizure and the child who presented with the cold. If you be thinking of your respiratory systems there, you know, for example, your cold, and I'm defining that it's there's other student with the cold. If there's any ways except Saturday and then I just also listed and a few other symptoms that are maybe more relevant if you're a bit stuck and or other things. If you have time that might be useful to ask the port and particularly and in infants or babies as well. And so I asked about what three. They're included in their diets, what types of foods on hurry and much they're having during the day and check with their drinking. Are they meeting their oral, um requirements And as well, since when they ask if they and child is passing your I'm m if it's a baby, it right to us that would be the number of wet. Not he's on the CME for the ball in motion, the number of dirt, enough bees and then, um, as well, just asking about him. You're still for me, for example, is a leased Oh, and you might want to ask about vomiting and keeping the frequency and vomiting how much and it's coming up. And if there's any rashes and be important to ask for a location on the spread of that rash and then finally have a M has a child had any temperatures, some of the parents and actually measured about accurately and so passed, I look in history this so I think there's a few more questions that you can, And hopefully, um, asking your space stations that would get you some more marked. It is worth really practice in this, and I have listed and a number of areas m and try Teo State of things that I asked about them there are probably lose about the crash, and she could ask. And but, yeah, just really practiced with your friends and I make sure you get your time and write this well. And so it's important. Outsmart the prenatal period. And, for example, was there any concerns about the time of? Continue those kinds of what? Where those concerns you don't want to ask you about and the mother's health during pregnancy, and it sure has taken any medications. And what were those medications or conditions that she have that might impact on the child and development in the wind, then moving on to the birth history itself and it be relevant to ask for the place of our, for example, was a hospital birth or him birth and the just a shin on week, um, off the child could be irrelevant as well for some of the pediatric conditions. And then finally, the mood of delivery on if there were any complications off the time ever. And then we've been honest Indian Needle period. And so were there any convictions during that time, for example, that the baby have any fits after delivery or where they jaundiced in those early weeks apart, Um, and for me, and if they had any infections, too, especially carrying it. And this next side has some other things. Economics in your past. Medical history is well and again. You have to tell her those, depending on the age of the child, and then you get in your oxygen station. And I might be a program to ask about feeding if they were bastard, bottle fed and how much they were taking and how often and they were feeding during the day. And then again, if it's appropriate, ask a part to him in the use of the baby wind and from there, and bastard ultimate cons. So So, if it's as well you want to ask and about the growth of the child and, for example, and what we get, heights entitles. If the parents had any concerns about there and physical development and the might be worth asking if they have, and the red dots and liver and all the and health care Mr is used, um, in the early years of life, and that might give you some more information on that if it Procrit and if it was a start the older and child and in the teenage years ask what age they want. People frequently the left and then maybe going to child development and hired for his. This is, Did you have any concerns? Support And your child is mild. Student is always either so money milestone. And she told me, um, talk time in your old see Doc support 11. And And then finally, just asking if the child's after day and with their vaccinations is, uh and so I'm moving on to the next section of your history. Family history and it's a board ask, you know, are there any conditions that run in the family? And perfectly, there's a maybe a fact, Children. And if after dogs, I Oh, yeah, and there's a heart condition that runs in my family had want to do, which I'll remember and not condition of facts and what age they were dark. Notice that, and then in your pediatric histories, well, you might want to try and find out if there any and deaths in the family, particularly there was an infant. See your childhood and moving on them to the drug and history and juices you with your heart history Johnson what current medications the child is seeking and and then if they have any new allergies. And so it's important to ask what sort of reaction and they have and with that allergy to find out it's a tree allergy or not. So I'm moving on to the social history again. I think there's a few extra things she can ask you in your pediatric history, taking stations and just to get those extra marks. And so you'd want to know and which individuals are living and with the child. And, for example, if you're living with your mom on their dog or one or the other, or if it's remember the wider found me, they're living with me and you want to know if you have any sugar ranges well, and it may also be worth checking if there's any pets in the family who most and sometimes Children, conservative allergies and to those depending on what the and present each news that you're given and as well supported. Check if anyone smokes in the family who I'm going to get, and that would be relevant to some of the respiratory and conditions that present MMP actress and maybe worth asking. Does the child seem happy at home and school, or what The impact is an old bill nous of both the child on the family. Or you could ask your I am idea is concerned. Expectations questions is well at this stage, just whatever feels most not 20 years quickly and backs to go with, um, and then finally in this action. And I asked em, I'd say to Doctor, you know, just a question. We ask everybody And have you ever had the involvement of a health visitor, a social worker and as I could get me some more relevant information as well am I might just present my next them or C stations? Well, it's I can actually see the chart function still come back to crashes at the end of that's okay. And so the seconds and almost the station and choose and 2% is an 80 assessment over ticket. The only patient and I think this has come up and most, if not every year and finals, and I I think it's really important to have a good structure for it, and, you know, you might not be able to and predict what and condition is going to come up in the station. But I think it's only she had a really good structure, and I'll help you gather all the relevant information and pick up those it marks am alone away. And so, yeah, I think it's really conversation of finals. It's also, um, something that we do daily and whenever work as well. So I'm just on general tips for the assessment and, firstly, treat it as you need to sue. If you're going through Europe A B C D assessment on you find, for example, the patient has a loop of pressure. And I thought, see you, she could say new patient is hypertensive with the BP. Oh, obvious it over 60. And you could say to the Examiner at the stage, I like to and opti and have access to and sort of cannula and withdraw my blood's of the CME time. Tell them a blood she wanted could just the routine bloods and such as your fibula kind. You need allergies, so your pay, it might be something else. Too bad it almost situation. You've got about time and then, yeah, just an information Tyco tenser than you know. Say to the Examiner, I'm going to write them up for flu bullets. And do you have a chart for me to do that? Or they might ask you Then what did you want to push for Ivan? How much? And another example? Maybe the patient ties and the auction saturations. And you could say to the Examiner, You know the state champ back to give the patient and some oxygen prescribed from that oxygen and whether it's two liters via nasal cannula, 15 m and being on an MRI breather. Masks essentially treat me and in the station as well. And I know it could be starting artificial, maybe an osteopath. It's, um, one of the models they're using, And but even excuse I could use a real patient and just paralyzed what you're doing for the Examiner just to ensure that you're picking up, Um, all those marks and also the low stations check the, um, identity off the patient and protected in these stations. That can give you extra documentation and, for example, new shorts and rebound shorts and blood tasks. And I just did everything you pick up. Just make sure and you decided example. You know, I'm checking the patient's name. Their name is Mister Jims, and their data bar is the second of all this 1960 and their health care of numbered is whatever and as well on the station, some people are to take a guess. History and I I think if you're gonna do that, probably the thing to focus on is presenting complaint. And there is quite a lot in the station already. So I think, and it is really worth practicing if you can find any opportunities on basement to practice other than encourage that. And I know some of the hospitals and our queen Geez, further basement also have, um, some stimulation and Trina's actions as well. I know they are, but they'll certainly look out when I think so. If you do, you have access that really make sure you use it and you're about Asian. If you don't tell boxes equally, that's okay. Do chronic. I'm just practice with your friends and I'm getting each other and constructive feet book. So I'll take you through. The structure are used for on a B C D assessment, and there are probably it There's another thing she couldn't fish. And I think whatever you decide to get with and make sure you have a practice well and because it probably can be a bit overwhelming. And if you have too many things you're fined, remember what comes axed. And so, actually, you want just asked a race. You want to lift this and then feel to see if their rights kittens and if the patient AM or the Examiner's? Maybe I'm talking for the, um, dummy patient, and he's talking to you. Feel sentences and you can simply say, and this patient, possibly in debt rays are speaking to me and feel sentences a middle and equally there that may have, um, some Amherst allergy signs, for example. They might have a strider, and that would be an indication that the patient has partially and obstructed. All right, and I'm standing would need to treat that appropriately. So, for example, if you need to do that right in the neighbor to support that away, or do you need to think about an hour? I trumped and I haven't I could in this presentation, But I think, and in one of the recent years I can't remember The fourth year, 50 year station and one of the problems stations had a lot of different types of airway junks later. So your knees off on GL a ratio of Angela race your good aisles and on students were asked her and identify the relevant airway. And I talked about their uses to make sure. If you're on placement and you have the opportunity to look at the type of that race, make sure you do that. And I also for been stuck going to have and for the full module and on the portal included are good pictures a little different, right? Junks. It's just worth and rigorous, um, as well. And it's moving on to be for breathing and as well. Like I said, it's all right to start in these stations and try to freeze and such a way that and you're in the press and tennis to say I I'm checking their spirit. Your it's on. Hopefully then examiner will tell you, though the respect of it is 18 grass for a minute for that meal. Find that information on the news talked just started overweight, saying I would do that so I would do that as they want to see we are actually going to do in real life. And so, after checking your spiritually rate, you know, I want to check the oxygen saturations on if the patient has any current oxygen or promise, and then you might get both of these places information, maybe for my knee short at the Examiner escape in the in the station. And after that you want to check the position of the trapezius. Who is it central, or is it deviated? And on. Then you want to Diovan brief hammer staircase arm in a shin. And seemingly I listen to the lungs. If you turn him out to Jack and extension of the lungs and percussion is well, and and then going through your GI assessment as well as treating the things that you find wrong. It's also important to think about what further investigations do you want. Doctors included. AM a few that big runs him in this class station, so I think it's important to think about it as a tax actually gonna be helpful for this patient and when I'm thinking about, um, the respect, your system and so I was saying your expectation not gonna be doing any of these vaccinations. And but your faith, you say, you know, in your life I would dio just x ray then and that's appropriate hospital done And they found that will give me those and results as well. And I just think about it and patients and what you get in your state. You know, if this is really the second patient who is quite on state, look, you know, my even we were saying I'd like to order a portable X ray and so the patient cover me and all that would where we can continue and tubes are open. We've been on them to see for circulation. And so there's quite a bit in here and do the things to check again, would be the heart breaks on the BP and again you like about from your knees start. And then after that, I like to check the capillary flow and I tend to check with the personal I'm essential, completely filled with loss until your choice and then, um, have a look at the J e P and as well. And after that I then also take and the heart. So, um, so the same for first is that, um, heartsong on I/O of heart signs. And then again, some an investigation you might want to consider. And I get and I just been ripped these in the circulation just because it helps me. And remember. So I am an HCG. And look at the trace the heart and then, if appropriate, and put me on a cannula and taking your blood cells back for that, Um, and depending on the patient is ill. And you might want to consider, um IVG. And so, um, we've been on today for disability, and so there's a document for this. It's called aged. It's a for our GI, for drinkers, for I and D for drugs. And soon personally want to consider I left. The patient does. You can do that and quickly and easy using the of preschool or and you might like to say, based on what you know, in real life, if I have more time than and I go on today, my GCS scores where and actually want to check to see And if the nursing staff of Donna Clickers for you are active you can do on yourself, then all first it and I got to tell you and some key information and you want to then and examine the patient's eyes to see if they're equal and reactive to light to him bilaterally. And then lastly, um, in the stage in there, maybe, and drug products for you to reviews. Well, I'm such a stick in my mother to you just to read three doctors and and again and you think what you would do in real life. And, for example, the patient's currently hypotensive, and they're usually all and three anti hypertensive medications for the high BP. It may be a prorated to withhold booze and or they go a registry. She asked that it might be important just to look for a new job. Second and have a sedative, in fact, is I'll, um, I feel those to see if that helps and prayed the patients and condition and then last day exposure. And so the stage and you really want to do you talk to to examination of the patient and moment and and their dignity and should be looking for things like rashes, and you might also want to check temperature again. I'm not informational who maybe in the knees start for you and you don't want to go on a debrief and abdominal examination. And so this stage and I would really focus on just still in the nine Aron's or the four quadrants over the albumin. And I'm hoping news and to see if the abdomen soft or tender. And and then I listen for ball signs as well. And then finally it happened, like on a feel off the calf, and you feel they're soft or tender and and then finally check if there's any refill, edema and as well on if there is, um, a Jima not being your or ski. And I suppose if your is that it's worth comment, and on the height of that edema, super example and really it now to literally anatomy. So does it come up into the level off and knee or the ankle? Mm. And so that's me. I'll have like, it's a There's any questions him in the chart. So the first freshman age will your office fee instructions outside the stations definitely tell you to do on 80 assessment, or will it be more vehicle, usually someone who's coming with drama. And I know entirely sure to be honest, Um, I guess it it could be either. And I would hope you know their Italian if they want you to do a history or an 80 assessment. And I honestly, I can't remember what my own space station and sat outside. And I'm not sure if, however, Catherine and have any thoughts on that and the next fresh in is for body check sauce confirm consent in regard to outlive presenting with the child journal. See them super this and I just started with the usual introduction and more so my hands But no, my PPJ 16. And that was all of the final your medical students. And on then just saying kind of check and your name. So asking that doctor and on Neymar tell you, you know, don't, um have you ever Mr June's And I'm I'm just I'm okay on track and knee, um, on date of birth, off the child and they'll tell you that information on. Then I would just like they ask, you know, Is it okay? Or just check the relationship, and between you and the child today as well. And if it's a mother father that I don't think you need Teo get consent, and to do any to you could just proceed on with your history. And if it is the grandparent that I'm just asking him And did she write the parents be there? And I discussed this for you today. And what age should be these weight normally? And to be honest, I'm not entirely sure of the exact specifics. And I think after and a few months they can start to move from my milk. Teo. There's baby foods. I think, um, are like a year. They should be in finger foods. Um, I know entirely sure, to be honest, it's probably worth checking the other thing you should learn a few nights before all C's have, um, Catherine says she's almost starting your zoster before my nightie assessment. And that was, um, instructions outside the association. Thank you. And what's the talk to? To domination is it depends on the presentation. For example, if it's trauma Regina Skeletal survey. Yeah, exactly. I think it's something you would Teeler. And today I am depending on the case, you're presented with And I guess if you offer something, who did they tell you? You know, if they don't want you to do it and first I'm blind or some people also include a brief in your large. Those are nation, but I think it's really just important in the top 22 examination just while attending the patients. Taking a day you do have a look at their legs. Have a look at that time you have a look at their chest. Just take the blanket off and you have a look at those areas one by one. Once you finish covered up middle of the next area and just a check for rashes. Or a neighbor told me that you might have ms and the next question is similar to the previous. But are we likely to get a trauma later station with a C C A. B C D. Assessment with needing to assess catastrophic loss and C spine and ovaries a shin as well Or just a simple idea? Satisfied with it? And I'm not sure I can really start to be honest, and I think most of the feedback I've seen has just the focus and and on the 80 assessment. Um, I guess East. I'm embolization. If the patient within you know the cooler and with the teeth and the support, you know, it could be worth comment and all match. And here, that's all I can say. And Katharina said yes, they start within the six months that would be expected to know the details. And so our question that and did you see the side of God is isn't necessary to take a focus instrumentality assessment of your sotalol. Um, should we stand on it? And so I think everybody does it differently, and I think, you know, it's important. The reason we do notice ask, that is because you want to treat them. It's life threatening things first of all, and always say after your away and then moving and on three. So normally I just handed to go straight into the ideas. Ask meant as I knew us, and probably we're going to pick up most of your marks. I started at the end. If you did talk more time, then you could go back and take your focus. History was approached that I took and you know, for example, running through your A B c D. Assessment on maybe with investigations that you get along the way and you find out that this patient has, um, my cardio. Unfortunately, it in the CD, you asked, what type of and, um, I it is and what treatment you want to start. And if you have time after the and a station, maybe that's the best time to go back and ask patient, you know, and more about their chastity and and running through your Socrates freshens. And I said yes, no scales. They were very specific about what they did is they did not want you to do any station. And another question is, it's fine, um, about immobilization market for personal space station and I haven't seen it. Impossible sees. And But that's not to say they can't ask it. And this year, and But I maybe think they're probably on Bonds and we're likely things that they could ask. And I think that's old infections. That's great. Thank um, A. And if anyone tells, tells any questions, feel free to put them in the shop or something. Directed Ama. I'm just going to hang around for a couple room and It's just I'm Tom. So any more questions and you know, we're gonna have over to handle and Catherine, who are two f trees and and they're gonna teach whenever I difficult Vicks Tree If you guys want work away there. Thank you. Perfect. I think I was just gonna get our slides and I need to share, so hopefully you guys can see all of those. And so, yes, I am. We're both after you use it a minute. So I am Hamas working in Royal. I'm working, but I'm incredible. And so I guess, kind of our first thing size. There's a couple of caveats and I know everybody's I am always desperate task. You know what's coming up or what could come up. And then I think your best way is hand, and I'm advice for our finals to get both on. We did, you know, go through what's come up before where what's come up before is your best template and of what could come up in the future. And, you know, and you'll get yes to see that nearly every year there is an 80 year Cecil in it and you'll see the kind of things that queens like I am, and the style of, um, this stylistic shins they use and enough for a couple of things, you know, we don't know em all answers on what we're gonna do you tonight is go free and a few stations and with you. But our answers aren't the perfect answer. There will be things that you think of in your head which will pick up marks that hand and I am have left out there always lots and lots of other things that you can get marks for and on on those games. And so and, you know, we're in news my saying that ours are at 100% complete, but what we did one today and was really just too high. We would approach and some of these osteo stations and hopefully give you a kind of transferrable framework and just a sweet kind of think about what we can learn from going for you to the stations. And so if you kind of think and look back three all of a queens feedback, you'll see that there's a limited number of skills that they're trying to assess, and it always dying to they want to see. Do you have the knowledge with skills? They're required of an F one in their day to day life. You know, work. They're not wanting you to be an expert or in any way expecting, but they want you to have some basic knowledge and skills was that you can apply on. They want you to have a good knowledge of water is to see if for you today and, you know, and when you need help and so scales assessed, you know, they're gonna assess your history, taking skills, your communication skills, consulate with the examination stations, they'll put into data interpretation into lots of different stations. There might be some prescribing and then kind of us AMAs got it free. And there might be some looking at more off the emergency management. So what we're going today it is. We've taken one M X ray station and one history taking on one kind sling and to go through because I think and kind of wind in a smart am off the others we could into them. And there's obviously examination was pretty difficult studio resume, but just us, you know, you're able to you and your grips take the chance and you know, to practice with each other and just get those really, really slick. And hopefully just in the next few minutes, typical for your stations and you'll be able to have a little think about how you had approaching yourselves and just stick any questions in the chat as we go along. All right, So the other one here may Yes, I'm assuming that's good. And the first station we're gonna talk about is a radiologist. Asian, Um, we've kind of worked this with a got a little blurb on. Then we'll go through it together. But what I would say, but the radiology stations is again, This is about being a safe form. So if they're going to give you something, which is a radiograph, it's gonna be something in my phone would look at. We're able to see and think. Actually, yes, there is a problem here, and so it's most likely if they're going to give you on. It's gonna be something which is related to what life is like on the left one and on award on a day to day basis. But the other thing is to say that sometimes the quality of the things that they show you ask you does not protect you Really good. So it has to be something really obvious for everyone to go to see this on for a copy, to nominate sheet effectively. And so station we have designed is list. So you're Unefon on your care of the elderly? Irritation may have a Smith is an 83. Your woman with Parkinson disease plays rough. You her chest x ray on answer the Examiner's question. And on that, this is the image that you presented us. Okay, so you want to take a minute? You're gonna breathe. Have a look at the picture on trial. Work it through in your head. The's stations always have lots of time. You got lots of time to talk through it, like to the exam. So tickle a second and then you're going to start your presentation on you always start it in the exact same way on this is the way that pattern and I would present it. You don't have to necessarily do it in this order, but you're gonna look at the type of the film. So is this a pa or a P the chest X ray. It will be marked if it's an AP and this is a PHS. A try off may have a Smith. We checked your details. Her homecare numbers is her date of birth. It was taken old today, not whatever term time I would like to compare. This is the previous imaging, if available. I do this all the time with X ray. Sometimes you see weird things on you. Look back. Uh, sh like gasping for four years. I don't need to worry about about. And it's the one of the most useful things you can do with chest sexually. And and chances are on the oxy they won't trouble for you to comparative. But you will get marks for saying that you would like to see it. And the next thing is really like actually what is the quality of the sexually, which is something I don't think can be underestimated and in terms of the trouble that you can get if you haven't realized that actually is a really bad radiograph and so forth are think she knew like out his rotation. So everyone knows how to do this. But you look at the end of the and Topicals when you look at where the Spanish processes are on, if it's rougher, right, I wouldn't get too worried. You're going to get excited if it's really off. Uh, if it is really off, you need to figure out which way it's actually related because it alters. So everything else looks of inspiration. And I always would have kind of dying number ribs in the exam, so that should go up to the picture and kind. Don't want to take 456 onto your ribs off the diaphragm is adequate inspiration. You might also want to comment if you can see it. Online Ribs Able to Die from I think just a feeling is, actually but patients over expanded and penetration, so you should be able to see the spinal call. Oh, I threw the shadow off the heart. If you can't, it's not penetrated enough. If you're seeing through the heart too much and it's really penetrated and that kind of and then extent, this community, particularly in very large patients, were actually they might have to take more than one radiograph to get from the apex of the lungs, right, going to basic difference on if you got one which doesn't attack you To say it was a second film taken. Can I see it? And because sometimes that that's happened and on then you know you work. Three isn't like systematic. So the thing here is, if you see something which is playing on your mind is this is the big up around the earth, something you need to comment on. Sometimes that's easier to point it. Start if you want to say most obvious abnormality is this so that you can put that in the way a number correct? Systematically, I attended you just with your systematic and then somebody that they had to put. Some people like to say one a day and on again. You work through a sabbatical like you do and everything that's a so airway is trickier, riffling the middle. If it's not, think first rotation and go back and check yourself again. If it's no crease limited on, it still looks like you either. Pressure pill trying figure has actually being pushed refilled. Is there a mass somewhere? Is there something going wrong with your pressure? Just reason why it's moved and bathe for reading. So I always start again. You're on the trachea. Keep working, but I find the carina and then follow it into the lung fields. What can also be hard here is if you got you've not got anything to comment on. People run out of stuff to say so basically what you're saying, and I'm looking for symmetry and Hooper long markings extending to the edges of the fields. I don't see any evidence of a pacification keeping with consolidation or whatever else you're thinking off of the time. The next thing to think about is your heart so again is relevant. If you knew what the film that is, and even if it's in a P and you know you can't comment on the heart size, say that that's that's one of the marks on the sheet for the heart certified things. You don't expect it to be a radiologist here, you want to say, Look, it looks like the borders are clear. I don't see any bloating of the ankles. It's an appropriate size. It's not displaced and day looking at a diaphragm so right should be higher than left. She's a gastric bubble underneath the left one. You shouldn't see any air entry's right one. If you do, that's a problem. I mean, that's definitely something that they want you to pick up on. If there is, um, and then the for everything else. And this is where you can pick up lots also marks depending what there is to say. So I often start with bones first. Do you like dairy? Tricia Way around all of the ribs, on the topicals on sometimes the shoulders, just while depending home. Um, I include mediastinum here so people do under breathing. But I always just forgot what I did breathing. And so you get like a baby staying on the higher areas. Is it broadened? Is it narrow? It doesn't look like there's something funny going on, like it could be a run out and are the highest symmetrical. That's all matters if they're the same size one slightly higher than the left. You said her on the right. That's fine, don't you middle, um, softer. She mastectomies or a big thing. And on that committee confusions Well, because my doctor excelling consolidation. But it's actually just that there's been also shadow, another side, and sometimes it could be interesting. Artifacts is well on images. It could be a piercing. It could be clothing. It could be surgical clips. Um, you can get a flare from it, 20 places and things that route. And that's worth common thing on that is obscuring. You do potentially and on then the other big thing. And this category is lines. Um, that's kind of what the point of this particular station is to look at the lines. And so the line's useful and that can tell you all about the patient if they're covered in cardiac leads, Um, person is sick, and you might be able to see any teaching may be able to see a central access device be able to figure out where that's actually going and and then. The other common thing, which is very common in African, is N G chips because you're likely to be the person confirming whether you're happy with the and teach you. And some times I don't think that's protecting you out talk. But it's something that you're confident with it. It's easy on. It is definitely a scale that should be assessed the finals. It's meant to be within your competencies. So how you testing things on Angie? You're gonna look up the film going to see this year, which is passing. It should be crossing in the midline. You should buy sec the carina on, remain in the midline past that point and then end up underneath, die from on the left side. You should be able to see the tip of it under the last site, and you should technically be a will to measure 10 centimeters. Being on the gastroesophageal junction on about is the way I documented a note. So that's where you presented to the Examiner. And if it means all those criteria, then that's 92. You got to stay on the feet. And so and the source. You know, I would like to maybe working my dog obesity and then common thing on the engine. And then important thing is by the state, you probably said quite a lot. So it's important to summarize, and you say this is an erect just actually, because Smith, which reveals no acute pathology but there is an anti should present, it appears to be the correct place, and at finals, it's reasonable for the Examiner. Tea attention. They ask you questions usually mentally, clinically relatable. And so the nurse ask you that can use the anti itching. What would you say? So the answer is, I've confirmed the center tube isn't the correct position. Pretty a. Graphically, some of the anti cheap hasn't made for what's marking. I would be happy to the current seeing, and my other methods existed. Confirm. And Egypt Placement and other common method is pH of the aspart. And although thrust policies do very from place to place and that's for for you to say and and then then I ask you to explain how you would actually measure an insert and and Egypt and which is actually technically not very difficult, and you don't need to give you 30 seconds to explain it today. So by measuring from your news behind the ear, do that a gastrin to your xiphisternum. Um, and then you actually just make sure there's no contraindications decorations happy coordinate with their school, getting to set something up, the full of safe That's not contraindicated. Secure it mark, which measure to on the news on then you to confirm whether it's in the car excision. And that's all there is to it. Yeah, So in terms of extra stations in general, the important things are But being safe with an F in image on the common things that go wrong is that you don't miss identified patients or miss identified scan in terms of its timing or what it is. And so if you do that with every single one, then you don't run into trouble basically. And, um, one thing. The technical quality, most called obvious abnormality. If it jumps up to you if it doesn't heal on the system, out of work through it. So just X rays. Probably the easiest thing to do and and asking because of cost to say. Even if you can't find anything, you can go away through it. And Abdullah X rays are are forgetting. Um, there should be something fairly obvious moment, and the acronym that we've concluded here is so Abdul. And so for a So is there where it's supposed to be a certain any erection ointment debate cervic preparation somewhere, and they sort of for vials to looking at positions size again. Hi, big the our in terms of your your large pollen. You're still well and day for dense structures. And a complication owns anything that looks like stone. Potentially, they am organs. Soft tissue often might not be much to comment on. There, depending on for the forms. Look like you're reading a season like it's massive. And then any artifact on top and joints bones could play a part of part of a station. You probably can't talk about it the whole 67 minutes or whatever it is, but you kind of working through alignment. Look at the bones and sales, like a carpet like a soft tissue, and you've got the answer on end feet back to the center. What your conclusion is, even if your condition is not right, That's okay on the probably trying point your shorts right direction if you think you're quick. Okay, so I am quick run free X rays. I am No, I eat kind of thinking a little bit about a history, and I think the big thing to remember it is in finals. Maybe more compared to you for taking histories in all ski since first year and and finals compared to before you'll be expected, more to apply your knowledge to answer questions, and and they'll be something you know, a little bit more. You have to think, you know, you have more. Your finalist auspices ones are longer. And that's not because you're taking a longer history. It's because there's time for you to answer more questions at the end. And so there's a little burp here to hopefully you can have, um, a little like, uh, so and Mrs Broin am. It's a 67 year old woman who has come to the Risperdal Clinic with shortness of breath. And so you're asked to take a history from Europe on interpret the investigations provided on answered examiners questions. So, you know, you're standing outside, you've got that minute and to think about and what you're going to do. And so she's coming in with shortness of breath. So you're at the respiratory clinic. There's lots of cruise there, and so hopefully that can help and, you know, get you thinking, What are the symptoms I need to ask about? And so I guess, um, my, um, kind of approach and to this am so the first thing and you're going to do and just am onto the next like they're Hama aimed is you're going to obviously introduce yourself and you're washing your hands consent. Whatever the queen's arrangements for PP are, just make sure you follow them. It will be part of that market, the start and with all your and histories. You know, you do this in real life you do in our skis asking open question and see how much information you get. Obviously, probably depends about how cooperative your something allergic patient there are. Some of them will give much more away, and some of them you'll ask Oh, can you tell me a little bit more like that? And they'll be like, What am so? But, you know, show that you know that you should be asking an open question. It's not your fault if they don't give you much more information and then re a lot. And in real life, open questions generally work really well. And so we've thought about the fact that this is your respect. Aresu water, your respect tree, big symptoms you're wanting to hit, so you want to pass them itself, since she's come in with shortness of breath. So you know, I only want to ask her in detail about that. You want to ask when it happens for far can she walk to ever happen at rest? And don't get yourself too sidelined during the fact that this is a respiratory clinic to forget to ask about things like or foot near on PND. I don't think about cough. Are you bringing up sputum? Um, opposites, chess pee and characterize the chest. Be in briefly and you want to make sure it's a political rabbit and the cardiac three and you know, asking about lease and things like that. And you also want to ask a little bit about your systemic symptoms. I think it's good practice in every history just to have a couple of questions that you ask, which means Examiner. And it was your thinking about systemic things. So, you know, ask if you know they were pulled temperatures, night sweats and we had lost. What's your appetite and energy levels? It won't take you more than 10 seconds, but it shows that you're thinking about the big picture, and then you're gonna ask my older your offer having so you know how you to date us. Ask about their drug. An allergy history there, past medical history. Obviously you might want to ask specifically has ever had, you know, being diagnosed or something like asthma, COPD, family history again specifically, and to respiratory conditions on then in your social history, just make sure that you ask about smoking pets and, you know, dogs your stereotypical pigeons or birds. And and then obviously what they do you or what they used to do and then kind of on the next slide. I'm sorry. There's a few quite a lot of words I'm on this, but just to shoot, you know, this is the kind of answers you might get, so I'll read. All right. And you can see that we've kind of bolded and the things too, you know, they're really pointing you in one direction. So you know, your ms is Brian, a 67 year old woman. You've been affair to your spiritually clinic by your GP, and you've had some investigations. You're a bit worried about what might be wrong, but you're only going to tell them that you're worried. You know, if the s district asked you and how you're feeling about this or what you think might be going on, and, you know, she's been short of breath for a long time. It's been getting worse. Now you get short of breath when you're walking up the stairs or just the end of your driveway, which is a like 10 or 15 m, and you also been annoying drying cough. But you've never smoked, and so you don't know where this cough has come from. You know, there's no way sputum coughing up blood, no chest pain, and you don't have any temperatures. But you do tend to be tired, and and you've never been someone he puts on with it when asked what's going on the background and you say There's something you're not too sure about it to do your joints and it's called rheumatoid. When you asked about the drug history, you find out they're on something called methotrexate, and then your social history is kind of reassuring. And that's what else you can kind of say Hi, you piece together in your head on. You know the big things you know to take out of our shortness of progressive shortness of breath noise, you know, really limited exercise tolerance a dry cough in a nonsmoker with a past medical history of rheumatoid arthritis and on methotrexate. And so you're probably am still thinking about all of this. When the Examiner hands you shaped and on by, I think it's fair enough probably for them to give you a sheet and with a spirometry result, and so you can have a little like. And at this and on slight noise and on, you know, as we kind of Emma's already said, the first thing to do and is make sure that you're and confirming your patient details, and so and that's just on the next flight and you've got your results. So and this is you notice certain name matches. You're going to just check double check all of that with them, then have a little look in your exams. Whatever results are investigations they give, they should give you and you're kind of normal reference values. And I'm sorry, and that's very small, probably on your screen. And But what you can see is that there's a predicted um, and the patient result. And so the important thing is that both the F E V one under F B c are richest, and but the issue is more or less normal. And so you're kind of thinking about s and putting all and together for and so am I. Yeah, what you wanted to do to interpret it. You want to check the patient details, comment on the results. Just say what you see. So just what I've said. And you know, this is a spirometry of seven. So born and soon, so health care number less When was the spirometry done is a recent and I can see that and FEC be wantin FEC or both and normal compared to the protected that are lower comparative predicted values. But the issue is normal and and then you've got your two spirometry patterns and to think about and so this is obviously a restrictive pattern. And so that's already kind of narrowing, doing your list of what's and going on and and hopefully there's a noid enough, please, for you to start putting us and together Sudan Examiner might ask you next. Well, what imaging investigations would you like to request and which obviously does require you to have a 90 a of what's going on but start simple and she's coming in for spiritually symptoms. So we're probably almost always going to get this lady a chest X ray for first and on against were thinking about what the condition is. I'm sure you've all kind of put it together, that we're talking about pulmonary fibrosis and so water your causes of it. Well, we've got to do that. We could have a less lady. So the first being rheumatoid arthritis on the second being that methotrexate is one of your dog drug causes. And and then a third question that you could get asked in the station like this is, Well, what's the characteristic examination finding? And you'll read this and in your text fix and hopefully maybe heard on the wards. And But you get these fine and inspiratory crap Titian's so hopefully you can kind of see how I what they give you in the history should all point, you dine one direction. There shouldn't be contradictory information. It should be. You know, your simulated patients should be your characteristic presentations. And until Klay a bit Tidier than it sometimes is, and be a life and, you know, and everything that they give you should in kind of point you in the right direction and with the questions at the end of everything. The examiner's air going to and chart to you, you know, And they will help point you in the right direction if you get one of the questions wrong. You know, if you really don't know what's pulmonary fibrosis, they'll tell you, you know, right so that you can still get the mark for Well, what would you find on auscultation and things like that? So I guess. And our general top tips for history taking a R. You know, start with your open question and just ask them. You know what's brought you in today or you know what? What do you want to talk about today and then see what they bring up? You got that little minute outside, and you should get some clear as to what you're setting is or and hopefully and then think about the associate of symptoms. So what? You knew that this lady was coming in with shortness of breath to respect your clinic, so we kind of had our bundle of respiratory crashed respiratory symptoms that we'd want to ask about and and you'll know when your head and you know whether it's a G I history or a cardiac history. You know, we're in a musculoskelatal. You'll have your kind of list of symptoms that you want to talk about it, so just think about it and make sure you ask about them. And don't get so caught up in the presenting complaint that you leave yourself with no time to talk about all of the over sections. And there are There will always be marks for your family history, social history, drug history and past medical history. And make sure that you do, even if it's just one. Really, you know, quick question about each of them so that they know that you're thinking about them. And I think you know the thing to remember is that if you're really not sure what's going on with this patient, you know, just start from the hair doing Do system Astor systematic questioning and you will find something that they have in. So that's hopefully in a little bit in on history, taking on, going to go back over the handle like Okay, so our last sort of thing we want you to chat three was but communication and are all skis were pre pandemic, but there was so many of our stations were about communication on. I can only imagine that it's increased because it's actually I actually think they're really, like a decent station and that, ah, visiting my entire job was But communication, um on. It's also easier for them to be in a cool but world, and but what we're going to get a minute is talk about certain drug counseling. I've chosen a fairly complicated drug, which is probably what they would give you. They're gonna give something difficult. The other thing that's very common. It's about explaining diagnoses, and there's no real way to prepare every single diagnosis as though you're gonna cancel it. But probably the easiest thing to do for that is to kind of practice it in your hand when you actually revising for your friends or written exams and and actually think home. But I explain this in English. Do you have somebody who's nothing, right? Medicine or even somebody who does know has a liver jargon doesn't actually understand what it means. You have to take it right back to the six and on. So, yeah, we're gonna go through this drug one, and I use the exact same structure every single time. I discussed anything with anybody. Um, and it's what works for me, and you don't necessarily have to use it. And but hopefully they'll find something useful from it. And so the station is your left eye to doctor working a general part. This please cancel. It's 40. It really takes his Smith like someone replacement therapy. So again, you really get in a pattern here. We all do that. You do the exact same thing every single time on you. Start paying more marks immediately. So you would open the consultation. Don't wash your hands that people have a baby. You need all you need. Introduced a patient on. One thing I would say is if the station tells me that your enough to doctor introduce yourself is an actor, doctor, even though you're still you're not on your finals. But it kind of just is a rule place. Know that's what you just have to remember and important to Just to confirm that you're speaking to understand of birth on Think that in your head actually what age is this person when you're thinking about HRT, something hormonal. Is that relevant? Probably. Yes. And then it's always good to just explain why you're there until times to check with patients is there and realize if I do this all the time because you got people who have no idea whether from to talk to you or why you have to stop the wind, Um, on the way I like to do that is like, What were you hoping we would discuss today or stroke right and and hopefully at that point, the lipid up and start to tell you what why they're there and and and I'll see they might try and be a little bit difficult on. You might have to say, Actually, do you have any symptoms that you wanted us to talk about it or anything that's bothering you in particular? Um, on the one thing you need to make sure you cover sort of not little section tiny little bit of history of start to make sure that you're on the right track on there on the right track, and so symptoms off the medicals itself. So hot flashes energy, skin mood. Let me do it. Periods are really important. You take have to clarify When was the last time that they had a blade? Um, I was on it months ago or 10 years ago. And then is there any abnormal bleeding that's been happening? Because that needs to send you off and hold the direction entirely. That is something that's a red flag, because you need to be picked up on us if it's there. And so that's sort of your introductory making sure you're all on the same page and and then the first thing I always do is check. Actually, is this brushing ineligible for what they're after that? Is there anything that would stop from getting it? Because you might as well stop. They're basically if you find something else, stop you and so elliptical you could be expected to no reasons why people get our age 30. So you're sort of symptoms of menopause with a risk benefit balance. People who got osteoporosis you can't have a nonestrogen medication on, then people who have had already on set up with the holes and they kind of continue to, but the one I'm not even if there is It's not like simply for there bone and hunt cardiovascular and so things you need to talk about in terms of making sure there's no absolute contraindications. So a nice way to talk without is kind of just check if you have any other medical problems. Are you on any regular medications? And I think most things. But with them from that. And then there's a few things you just need to make sure, because it's amazing the things that people won't tell you it's wrong with him. Have you ever had a clot on your night, girl, you ever had a stroke? As anyone ever told you have problems with your liver or your heart? What, What cancer in your breast or your one? And do you still happy would cause actually that on that again, well, anyway, we're bleeding. I need to know what which actually needs investigated night. One final thing is, if you got somebody who's young issue think so in the medicals, they actually pregnant, and that's even something easy, real light. And and then I often use ice here on ice cream, worked really well, or Kamarck rate about light on account of hands how well it it. And do you hear people a new credit when you here and say any ideas, concerns expectations on that is not hard to do it. Um, so the way I usually do is have you ever heard about this? Do you know anything about it? Do you know why somebody would take it or do nothing by this condition that's relevant? And is there anything that we worry about? This thing you worried about? And then what do you think this will achieve for you? What are we hoping together to us? And that's a really good way to start bringing around for you to actually just start off loading information. Because ultimately, it's communication station. But you have a lot of things to get through in a very short space of time. And so is it okay if I tell you that more so, anything specifically you want just to cover because they actually will have a couple questions on the ship on sometimes to be cups in early. You can cover all up and we'll go. She work you a three or sometimes I bring them up later, at one minute to go and So I always explain things. I'm seeing that way every time. So what actually is this condition? Extra Medicals occurs when your ovaries stop producing eggs. As a result, there no Ravel's. The hormones in your body are estrogen progesterone, Um, unless continues to symptoms that you got So competition symptoms, hot flashes, living bones to dryness that you're talking about two or anything else. They mentioned a nature t It's not replacing those women's. We don't fix the underlying process, and but it helps to relieve some things in the health problems that are associated and on here conservative. I didn't destroy term benefits, so it's like symptom relief also, but long term, so protecting your bones, preventing some types of cancer. And conversely, you talk about how you actually, there are side effects on there ever since, and there's also some reported caveats sometimes, and so the risks you saw a bit serious things will calm things. Nothing else matters so serious things risk of falls. It's gonna be catastrophic, and I need to know that the blood can become, but stick your increased risk of clots and need to be aware of up and because the risk of clots. You can have increased risk of a stroke. You can have increased risk of heart problems. And then there's a very small risk of increased risk of breast cancer and meet your cancer very cancer people. Do you know what base? Because their own using them papers and things but the thing to say but that actually his risk overall, it's very small on it would only be lasting filtration that you're on HRT for doesn't really ask me on that. And and then sort of more minority. There are a few side effects. You'd be right so people can feel the, um well, no, see, I bloating and breast tenderness leg cramping on. If you feel this person's gonna end up getting secondarily starting, you tell him actually will start attention to bleed in a cycle again. And that's no nothing to worry about. And caveats to tell people in this station woman is 40 it so you need to tell her, but and it seems to be taken in contraception for two years after her last period in this particular case in it or if I went off period was kind of she still using contraception and she has a major contraception, and then you make sure she knows what she can and don't have. And that's a whole another station. And and then it's time to quit, sir. Actually, the practicalities of this because it is comes in two formulations. So usually people can offer the top fresh. If you tell they're alternative site there terms of jails and plants, patches that we can that got leader. But but maybe start with a tablet and see how you get home. And so again, you talk about what types are available. If you manage to get this information, you can. If not just people past and say what could talk about it? And so you're going to talk about It starts second combined. If it's somebody is s and your since last period will have cycle then and we'll have a bleed. And most likely that's more than one year. They got a continuous combined preparation. If you have a uterus, you can give them estrogen and and you explains them. We already got it for a couple of years and see how you get all and then we'll have a trial with this. Like the top. It's because I say I'm a risk. I almost see whether actually you're still symptomatic about point and spending on the medication. You don't quit well, alternatives. That could be really for somebody who's got medical. Sometimes there's not a lot for the turkey and on this far enough to tell them that. And but some people do like to try some purple invasive things that grow up and see how they get home. And uh huh. So overall, well, I always offer a leaflet and only distant much already for the day and and well, for one final mark. And so puzzling. Stations can be really hard because a lot of stuff to get three and sometimes you don't know actually, what they're after, you covering and chances. It's always good to know. I know what patient actually knows what they want to know. They're worried about it on what they expect about a conversation with you. That's kind of if you do, you guys really well, you can find all that right. Make sure you answered whatever questions they have. They're similar patient that probably have five questions on a shape. Have to ask you some point and unlike you, asking them if they have any questions, they will offer those teeth. Um, little bit. Lots of using books in there. Offering the leaflets is really important. Um, or simple steamed towards websites and things actually probably more practical, useful. Um, and then medical target is really, really easy to include by accident. Um, on. I think it just comes with practice figuring actually, what people do you do not understand as every day knowledge. And on that was when the reasons why I would encourage parsing this mess your family members on other people are even with the other medical students on cuts each other and you use works, patients who understand and look at much easier time. Okay, so this is our house, so I don't ski Top tips depressed. Read the blurb. Really carefully. Read it twice. Read it three times. Sometimes you really long on. Do you actually do need to look into them? Really careful. Like information will be on page. Remember your basics. Close your hands and just yourself. Car. If I had a patient, is your walking to be nice to them? You will get marks and and actually listening it's hard enough to not getting people get stressed on the think. It's a worry about what they have to do, but they don't actually listen properly on If you don't listen, you're probably gonna miss certain things in actually affordable and particularly in communication station. About the patient's worried about actually station about and having a framework is important. Um, for all of these in the osteo stations, just something to get you started on. Then you can go from there depending on what you can and can't remember or the patients that are directing the day. And I like taking over the breast for you, going rumor, breathe and Catherine developing else for that. No, I think I'm hopefully that's being yes. Well, I think the toughest part by our scales. That's the fact that you've got lots of stations and after each other or so I think it's just that's trying to once you step is that once a bell is gone and you've stopped at the station, you can't do anything more about it as difficulties that might be, and you might come out and you immediately be like, Oh, I haven't done that, but just really try what you can do. You buy something like stations that are coming next to try your best and easier said than done and to just leave that behind you. And I've got a few questions to me and you feel you got something the CME hammer. So I'll go through the ones to me first. So sometimes asking and even look at what's come up before. Where can you find the site? And so they're It's a generally on the portal, and there will be like feedback for the last few years of final stations and on there's generally a spreadsheet, which kind of goes about which has final stations for much longer. It goes on that, and I can try and have a we like if you guys don't have it and send it for you to the GP society guys and I'm sure they can forward it on and and then you can update. It was the last couple of years, and that can continue to be to passed onto next year's, and somebody's just asking about the auscultation finding and Paul referent fibrosis. So it's classically fine and and spiritually repetitions. And so those are your postcards for that? If you hear it, Really? It sounds like yeah, like, you know, doesn't sound like what you much cramps be like Exact welcome. Yeah, And somebody was asking for any history. Tick king stationary. Expected to include fills in that systematic questioning. I think in general not I would stop said when I got to the station at the end of it, Oh, I would consider doing systematic Westchester on. Generally they will tell, you know, And if you make it kind of always to look at the end, the examiner and at the same time, it can be you're still if you're really stuck and you're not sure what's going on because you're you will set hit on some symptoms and within that, then somebody, I guess, has a big question wondering about any tips for studying for Retin Finals. And so I think I'm not going to tell you anything that a lot of people haven't told you before. We're and things I falling to personally quite helpful were zero finals podcast. Um, and I know he's actually done when we were doing finals, he don't need done Madison, but I know he's no I don't like surgery. I think on DPI, a tricks and maybe some other things as well. And so and, you know, I find they they were really you're still on, just like driving to and from placement. And it was a good way and some of thumb It's really funny, you know, I associate with, like, a certain rule it I was driving on. And I think actually, a personal tip is that his stuff on and liver is great, because I think in general I didn't feel like I was taught and liver very well. But I remember his stuff not being good and and then use a question bike and on the but use it properly. The tempting thing to do is just like click through and not really care about the ones you got wrong on be like saying I'll get it right next time. But, like try and read the explanation and and see what's actually going on and so that you can actually, you know, learn and use that learning. I knew a lot of people use different things. I used to pass medicine and I used up the whole way free medical school and somebody is just asking again. What was in the, um, off the the podcast? It was, um, zero to finals. It's cold. There's a website, their studios. He's called Take. Your whole cast is almost verbatim. What's on the website on your little day? You can read it unless it at the same time. And it will go in and and then somebody asking about the top resources for osteo practice. So hang on. I quite like the Ask e stop book And in finally air on, I think there is no substitute for just finding people to practice with and, you know, find people that you know, that you trust that you're happy for them to tell you what you've done wrong. What your best I and you know, we there are a group of about four of us who did a lot in final year together and, you know, went through stations with each other, tried to think about how we had approach things. I think that was a sudden it said, you'll never prepare for every point Swing station, like we tried our best. Prepare for a lot of different six stations on in our finals we had kind of somebody on a diagnosis and Addison's disease, but I don't think we've ever fought would come up. But we developed enough of the free and work and that we have something to say. So I think just it's just practice. Get really slick it. Your examination's you will. I'm sure you'll get at least a couple of examinations still coming up there, easy stations to get marks. And so just make sure your slick and, you know, if you've people, will be able to tell if you've been on the ward's. If you've interacted with the patient before, it really is very obvious. I have another couple of questions. So it was just a question about something. Patient works. So from my knowledge of what the mark schemes look like, there's a big section at the top, just kind of working through what we think you might be getting done and your session. And then this usually and examiners group will score so hard they feel you are are in the station on. Then we'll be if it was somebody a patient, like sending patients global score so those usually go to five at the end and but before that, there's usually out of the 25 to 30 marks, depending on what you're doing in your station. Sort of four. The actual work that you've done, the clinical work that you've done. And But I mean five Marxist ill a lot a lot of the time and and you remember these new patients luxury. Do this professionally on Have seen many of you come through in a day. Um, and they do get a really good feel for people who can't. I can't talk to patients and who are are not listening and and then you do get pieces like I remember this patient and or a second of all ski. See any of the bleeding year I am from being examined excessively basically, and something you can feel that rough like that will not go in time where because I don't live in their day. And so it's It's just a bite being courteous and making sure that you're kind of actually talking to them and not just trying to get through your old your list of things. And so, yeah, on the formulary question there, And so just and the Oscar stations are likely to be eight minutes this year. I am asking whether you'd be expected. Take a history and exactly most stations. The team who organized the final year old skates, I think, changed for our year after. Is that right, Onda? We certainly, you know, it was that that was quite a big shift in terms of trying to make sure that stations doesn't fit into one side. And so whether that's a silo between and one special diet or a Sunday between different skills being assessed so often you do you end up with a mixture of things. So in the example that Kathryn did with the history on the and daughter interpretation, so this started reputation might not just started a whole station, it only could take you off minutes dated out. Interpretation part. It might be an element, which is a history on communication in the same station, and uncertainty, I'm saying are assets disease diagnosis. Still, the diagnosis bring me a tight side station with investigation results in front of us. So that was a bit of data interpretation there on then. Those communication to the patient about that diagnosis and, um so often that will be attempts about or they will try and complicate that. What could be a simple history with something social or ethical going on same time, uh, you know, just thinking. Yeah, they like to were multiple specialties like R M. We really had an obscene guy need endocrine kind selling station and which again nobody's expecting. And where we had a lady with type one diabetes who A wants to get pregnant on day. You had to cancel her on, and I actually but I think this was a station. Most of us stood outside being like, What am I going to say to her? But it actually she had, like, five or six questions which she asked, do one after each other or that was high, you know, and it went in our circuit on that. Did you knew? They will help you in the kind sling stations and know what the questions are. But in finals, it wouldn't just be like you go in on day. It's one. It's only one scale and only one specialty. They'll make it. It will be a little bit more than that because they've got a whole curriculum to cover in. Not that many stations. Yeah, And I have another question here which is against or more about MCQ use about planes or electric content. And Teo am sick use that people have been getting. And I think probably this point in the year. He probably figured out where you're going to revise by this point. Um, on. I mean, I like to like to notes that I made for myself, but they were kind of ones I built up over a couple of years and I would not recommend starting today tonight and take a long time, and then you have to go through and afterwards, So if you've got them and you like them, that's great. I wouldn't start making the night. And there are notes. Are there people have already compiled? You can use them. You can use things that podcast. And then part of things are question skills is a big thing. Because you know what? Four months it sounds gonna take. Okay, Max, Know, from what your exams? Pretty nice. We'll use the resources that buildup free. Everything is coming. No, I think it was just gonna say like in general, you know, much more than you think you do, like genuinely, and that was gone in from just like being on placement, you know, revising before and that all comes out in finals. There's lots of things about finals Oscars that wouldn't stretch, right. That would have stress. You're in first to your second year for a year for here. And, you know, I think I guess what we said start is the thing to remember. Is there not like looking for a perfect clinician? They're not looking for a consultant, um, or anything like that. They're looking for somebody is going to be a CFF long and so just kind of remember that and don't set to, you know, I, um, you know, a standard for yourself or between hard, hard and on yourself. And I guess maybe a last question was just quickly high. Similar past MedQuist means to your finals, and I think probably of the different Ah Preston banks. Like they're they're probably the most similar. And But you kind of will know what the queen's style is annoying as well. And like, there are certain people from that Mike medical skills cancel. That was a lapse tackle the Queen Jesus. There was no a lot of them to practice with. But the very good? No, not really. I had forgotten about that. There were some more questions that were like basically exactly the same was from that. So the medical skill kind soul there's like two papers. I think hopefully you guys have find online and no, actually completely thrown by that home. We definitely have some that were like exactly the same question is was on that. And yet, so if that's all the questions, Thank you so much. Teo Hannah, Catherine on Emma's Well, and if you do you have any more questions for them in the chart books noise or an email or a message GP society, and we'll pass them on to the guys to abide to you. And if you just check in the chat books there, there is, uh, um Feet box survey. And that's really you spoke for. The speakers on for us as a society for pounding the future events on what you've completed that and then you get your certificate. The recording of tonight's talk on the slides will be put up into mandalas well, and if you're looking to access the math words. But thank you so much for attending. And thanks again to the speakers. Thank you. Thank you. And I think there's still some other weekly herbologist left you guys anyway. Uh, yeah, that was great.