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Okie Dokey. Hello everyone. Can you hear me? All right. Someone wouldn't mind just putting that in chart just to double check. You can. Brilliant. Awesome. Um So, um thanks for coming to this is you talk, we're gonna make a few more minutes just while people are still filtering in. Um But I have to start off with, I have a little poll, um which I imagine uh people aren't gonna like very much, but the poll is just asking how confident you're feeling for the Mock Iski. Um So I just wanna get a, an overall gauge of what so very confident somebody is feeling. Um So just want to get overall gauge by how people are feeling ahead of that, Iski. Um So we got that coming up. I think this should continue to pop up for other people. Um As they join, usually at the beginning of these events, we tend to ask what year are you in? What university are you from? But I imagine you're all year fours at Cardiff. Um cos that's who this is gonna be the most tailored for. And if you're not that uh we'll see how useful this will be for you. Um Yes. So we've got that poll running at the moment. If you've just joined, then you're welcome to um join in with it. Just to gauge how confident people are feeling to start with, to the people who are here. Have you already had any talks by the university about the ey, any useful ones? We'll just leave this for a couple more minutes whilst people are answering the poll and still filtering in. Ok. So you've got a decent amount of responses from that poll now and also you've got a, a few people who have joined. Um So it seems like o on the whole, somewhat, not confident, not really that confident, which I think is entirely fair given that you're still relatively early on in your risky preparation. I don't know if it feels like that because I know it seems that the mock EK is looming around the corner. But since you're engaging with um Iki preparation and revision materials already, you're, you're ahead of the majority of people given that we've got about 30 people in here now. And remember, you've got 100 people in a year, so doing better than 70 at least. Um So our aim for today is to sort of give an overview of the ie hopefully in a fairly useful way, it should reiterate what you've been told by the university already. Um And then talk through some general revision preparation tips and then go through how to write a CBD. I've got mine as an example to work through. Um And also, then we'll have a time for questions at the end cos I imagine that you have a lot of them. Um I'll leave the poll up for people who are joining just to keep adding in if they would like to. Um All right. Uh So we'll get started then. So my Ams Devo, I'm 1/5 year at the moment. Um I'm also uh the, the SQS team also has a foundation doctor. Um Megan Ward, no relation. Uh She changed her last name halfway through where I met her and I think it was flitting at the time. Um But she has also helped prepare these resources and she'll be helping to deliver some of them going forwards. Um But given the timetable of a foundation, your doctor, she was unable to make the one today. Um So we'll be lucky to if she's able to host any of them for us. So, the overview of our session today, um we're going to like I've said, looking at the overview of the issue itself, how to prepare for it, including a timeline of something that would be good to do and then how to write a CBD. If you have any questions at any point during the presentation, put them in the chart, I can see them at the same time so I can answer some of them as we go along if it's related to the slide. But if you've got general questions, then I might just leave them to the end. We'll see how it goes. Um Right, if there's any problems with the pre presentation or anything and you can't see it, do let me know. Um So to start off with it, key information about the SG exam. So IG is meant to be a measure of your clinical competence. It's supposed to be the culmination of your time at medical school and it's supposed to show that you understand the knowledge itself. Um And also that you have a good patient demeanor. In reality, you're presented with an ay two years after starting the crux of actual medicine after you started doing the clinical stuff. Um And a lot of people feel like it comes a little bit earlier than they would like, but it does mean that your fifth year is much more chill. So, although it might suck for now, next year's gonna be lovely. Um So hopefully these dates on the board line up with the dates that you are aware of at the moment that you have your mock in on the 15th and the 16th of February and then the actual eki on the eighth and the ninth of May. Um So with them, there being two days, you'll be assigned to either a morning or an afternoon or on either the 15th or the 16th or the eighth or the ninth and you'll get told that closer to the time. Um, a lot of students will try and say, oh, well, the first morning is the worst one or the last afternoon is the worst or anything like that. In reality, they're all fairly similar. Um, there's not much of a, a difference that happens between the sessions. So, whatever you have just be happy that you were assigned one and one missed out. Like we had a few people missed out last year in order to pass the AKI, you have to do six out of the eight stations and a, uh, a more than 50% of the set adjusted mark, which means that if it's an easy exam, the pass mark will be higher. If it's a hard exam pass mark will be lower and that's set per station as well. And I've written here plenty of time to prepare. But like I said, it probably does not feel like that at the moment, but it definitely is. So during your risky, you have alarms that will sound at zero minutes, which is the start of the station and it has an aggressive voice that tells you start station. Now you will have been the year that hopefully would have had an ex a mock ey exam already in year two. I was in the year that didn't. So this was all completely new information to me, but this should be fairly familiar to you what might be new is the four minute timer they've added that in because it signals the end of the short acute history. Seven minutes is the end of your history and your examination stations at 11 minutes. Usually around the end of either the data interpretation questions or any of the viva questions that they've asked you. And 15 minutes being the end of the station I've written underneath use this in your practice. So you're used to keeping to time. So when you go through and you practice, um, doing your histories and doing your examinations, try and make sure that you're timing them to seven minutes. And if you're trying to push yourself to practice for an acute history, again, time it for four minutes in terms of the se format. So the one that will be in May, you've got eight stations, 15 minutes each. You've got two acute assessments, two clinical examinations, one com skills, one sbar, one CBD and one pharmacology and therapeutics, which tends to be the one that people are the most worried about in year four because you've not really had much exposure to, um, actually explaining stuff about medications. And it tends to be a weak spot for people compared that to the ISKI format. When you have six stations, which one are you gonna get rid of? Or we get rid of the ones that are repeated. So six stations, 15 minutes per station, but you only have one acute assessment, one clinical examination in these uh in the mock is format, um you'll, you'll be asked to give feedback on a front and nobody is really prepared for the mock Iski and you are not given a brilliant amount of er information that's super useful to you. Um Is that on this slide here? Oh, let's going through this bit here. So in democracy, um you'll be on, you'll, you'll be given a feedback sheet that you'll write feedback for um your colleague. Um And you'll also get feedback from the examiner themselves. Like I said, the feedback that you actually gain in that moment is not super useful, but it's a really nice uh way of assessing how you do in the moment. Um How do you deal with the exam pressure? How do you deal with presenting it to somebody else and dealing with an actor in that situation at a higher level than your year? Two ones. So in terms of a bit more detail about the stations themselves, you've got the acute assessments which are four minute histories and then the examiner will provide clinical findings and a and usually a new school and then you have to answer questions on your differentials and management plan. You're then asked to perform a clinical skill. Remember that in your exams, you have two clinical skill stations, cos there are two acute assessments, one of them has to be a shops. So sharps remember being anything that's gonna involve a needle, you your subcu and im injections, insulin injections, cannulas, um venipuncture, blood cultures, ABG S suturing. Try and think what remember because this the scale lasts from four minutes to 11 minutes. So seven minutes in total, what would you feasibly be able to do in seven minutes? And although it might seem like a wound assessment station or a catheter station is really hard to do in seven minutes. The clinical skills department have uploaded videos of how they expect you to be able to do all of their skills and all of them are under seven minutes with no cuts. So that's how you know, that you can do them in seven minutes. But what I'd highly recommend and I'll go into it in a bit later in terms of resources, watch those videos. They're exactly what they want you to do. They show the layout of the Iski station because they have all of the stuff in front of them. The only downside is is that they don't have a voiceover. And so it's just in silence, some guy doing a clinical skill. So you do need to be familiar with what the clinical skill is first and then try and practice it in time with them. Your acute assessments are likely to be your emergency scenarios because in emergency scenarios, you don't have a lot of time to take a history. The one that I had in my ski, which is probably the hardest acute history I think that you could really give was a patient presenting with mania. And the reason that I think that's a hard acute history is that you have to do all of the psychiatric risk assessment with a patient who is talking quite a lot, um which is quite a challenge to do. Um It's unlikely that they'll do it two years in a row. However, I would make sure that I would be on top of learning the techniques of redirecting a patient with mania so that you can ask the questions, the clinical examination stations, seven minutes for your examination, then you summarize your findings and then you answer questions on the care of a patient. Some of these patients are actors, some of these patients are patients. Um It's quite hard to do. I mean, I I've done this examination and II can't even tell you whether I did or didn't have patients or actors in it. Um The main thing is if you're unsure if you heard something or you unsure if you observed something, mention it, but say that you were unsure. I was unsure. I'd like to check this with a senior. Remember that the examiners aren't trying to make you make sure that you're the perfect doctor. They're trying to make sure that you're a safe doctor. So if you listen to a lung and you think it sounded like I heard crackles, but I can't hear them anymore I'm gonna get a senior to come in and review that because I'm not sure if that patient has crackles or not. I'm not just gonna treat them for pneumonia and off they go so be a safe doctor. And that's a really key thing to remember. As you go through, be safe communication skills station, there's only one of these now seven minute history and then summarize your findings and then interpret data and the data will be related to um related to the the history that you've just taken. And then you answer questions on the care of a patient. An example of what I had in this scenario here was um a history um about worsening breathlessness over a period of time, I presented it to the examiner. They handed me a chest X ray. I looked at it said it looks normal and they said this patient has an infective exacerbation of CO PD. How do you manage that? And I looked at the x-ray and I was like, oh yeah, this patient has a barrel chest, this is a hyper expanded lung fails, but that's fine. Um And so I had to answer them questions on it. The key thing being I got the diagnosis wrong. Uh oh I got the diagnosis correct. Er But the my interpretation of the data was wrong but they led in with this patient has an infective exacerbation of CO PD. How would you manage that? So if you have no idea what the diagnosis is for a patient. Or if you give a really wild diagnosis, if I said, oh, this patient has aspergillosis, they're not gonna ask you what's the management for aspergillosis? They're gonna ask you the management for the patient that's in front of you. So just bear that in mind. Acute assessment, clinical examination, communication skills. And then the next ones we have, what have I done next? Why it's not working? There we go. Sbar Station is our four minute acute histories. And then they give you a summary sbar sheet, use the sheet, it says SBA R. You think that you'll be able to remember it in your head, you won't be able to remember it in your head, write down everything that's important. They will hand you a news chart, write down the stuff from the news chart because you don't wanna have to be trying to interpret a news chart as the registrar is asking you questions, you wanna have it in front of you and then you'll be asked questions about patient care. This is often from the perspective of the person you are calling. So for example, if you've called somebody and you said, oh, I'm concerned this person is having a STEMI, they'll often ask you, what do you, what can you start now? And that means that you need to interpret that in that time period er, within your capacity. The CBD is a seven minute presentation on a preprepared case is what we'll be going through today and then you have to answer questions on your presentation. We'll talk about that a little bit more later. So, go ahead and spend time on it now. And lastly, the Pharmacology and Therapeutics, this is a seven minute history. It's either a focused medication review or it's focused on a side effect of a medication or it's explaining a new medication. All three of those I think sound like hell. They sound really awful when it comes to actually doing an Iski station on this. Um Maybe you're super confident with pharmacology, but I certainly am not. Um There are really good lists. Um We, we have a, we have a session on Pharmacology and Therapeutic station because I think it's quite a challenging one. And we'll signpost you some resources about which medications are worth reviewing. Um off the top of my head. Main ones to, to look at, look at the antipsychotics, look at your OLANZapine cloZAPine lithium Cos they, they come up quite a lot and they require explanation and look up Warfarin. Like I said, I will go into a more detailed explanation of that when we do the Pharmacology Station. Um But that's what I would make sure that I would be happy with you. Then summarize your findings of what you've discussed in the history and you answer questions on patient care. The example that I was given in my Iski was a patient who had just started a few medications and now is experiencing worsening muscle pain. One of the medications they'd started with a, was a statin and it seemed like they had developed statin induced myopathy. They gave me, uh, I presented that to them and I discussed with the patient that it might be that this is causing some of your mu muscles to become irritated. They handed me some electrolytes, potassium and your C KS through the roof. It's a rhabdo picture instead. Um But I in the same way the, the management is still the same. Um Yeah, so that's the example that I had rhabdo is quite a common one and that will come up, right? Um I've not seen any questions in the chat so far, but if you do have them, just pop them in as speaker, um is marking criteria is in your handbook, the IY handbook that you have. Um I just thought I'd put this on the screen just to show what the marking looks like for both the examination and for the history. So on the left, we've got the exam one, the right history, main thing I just want to point out um um is what it actually says about the examination here. Um The process is important. Also, did the student identify all of the correct signs? This is literally only relevant if you have a, a patient like um er who actually experiences the signs themselves but you need to show you proving that they're not there, even if the patient doesn't have them compare that to the, er, the history one. It's much more about the way you take the history. That's more important. I'm not gonna go through this in detail. Cos it's a huge, huge document that you can check and you can look at them for all of the individual stations. Again, we're gonna go through a few of the stations as sessions anywhere, right? Red flags. This is something that everyone seems to worry about going into an exam. Um They're fairly hard to get. I will be entirely honest with you. This is the list of the common stuff and I've put them as quote, simple stuff. Don't fail a station because you are rude to a patient and I would like to think you don't go out insulting your patients, but people have failed them before for that reason. Ok. Um Inappropriate attire means both what you wear to the ki and we did have people get a red flag for that in the mock last year. Don't come in short and slides. Um, make sure you're wearing appropriate stuff but also not putting on um, gloves, not putting on an apron attire. So what you're wearing, not hand washing, you can't get marked down for hand washing too much. So if at any point you're thinking, should I handwash it? Handwash poor or dangerous examination technique Um Again, this is just a case of hopefully, if you revise for the exam, then you're not going to have dangerous examination technique. I would hope um poor communication skills. It says poor math skills on here. That's in talking about dose calculations, dose calculations only already come up for those injection stations, your subcut im and your insulin. So just make sure that you're really on top of it with your subcut im and insulin calculations. There are examples of what you can do that in the clinical skills. Um poor clinical skills and the main reasons that people um fall down for that is not disposing of sharks correctly. Um doing basic life support incorrectly and not carrying out aseptic technique properly. We don't do all skills using aseptic technique and we don't use all of our skills using shops. But again, if you have any doubt whether a skill needs to be carried out is aseptically or if something is classed as a sharp, put it in the sharps spin, you don't get marked down by putting a plastic cap into a shops spin because it's better safe than sorry, but you will fail a station for putting a sharp into a bag, not understanding the mental Capacity Act. I don't think there's many people who understand the mental capacity Act in year for even after you've done your psychiatry block, um we will go over this cos we have the Psychiatry, we have a Psychiatry um, lecture plans. Um, but, uh, just make sure overall that, you know, the numbers, how long and by who? So the names of them, how long do you, are you detaining them? And for what assessment or for management? Um, yeah. And if you've got those three things then you're pretty much all solid for it. I'd lost any drug allergies, not asking if they have a drug allergy and then asking if they have a drug allergy. But then giving them the thing that they're allergic to anyway. And this middle one not checking for an allergy bracelet. Some people, when you do an examination, you're supposed to look around the room, just check that they've not brought anything with them that should include a check of the wrist and also of any necklaces just to ensure that they don't have something that says I'm allergic to penicillin. Really big on the, on the arm. Another bracelet that is important to check is if they have one that says that they're on anticoagulants. It's another thing if you find anything like that, you need to say, I've observed that they have this bracelet that says they're on anticoagulants. Ok. Honestly, I wouldn't worry too much about these, the red flags themselves. If you're, if you're practicing the way that you'd practice on the wards, the majority of the time you'll be fine with this. It's probably bold. I'm not sure how good your maths is, but the majority of these things you're probably fine with, um, just don't get caught out, don't in the heat at the moment, accidentally dispose of a shark the wrong way. Ok. So I'm gonna move on to how to prepare for the exams themselves and then we'll do the CBD stuff. Does anybody have any questions about what I've just said about the, is for, we'll have time for questions at the end if you've not, if you don't ask them now, I'm hoping that what we've said is the majority of stuff that you've already been told. Although I know that sometimes the, the information we get given is a little bit iffy. Ok, I'm gonna assume that that means we're all ok then. All right. So in terms of preparing for your examinations, I think there's a few things that it's worth, um, paying attention to. One is starting early. You're here, you are starting early. Um, the preparation is similar to how you prepare for progress tests, but it does take a little bit of a frameshift. So it takes a little while to get into it. Once you're in a rhythm with it, you'll be fine. What I did personally was I took a Saturday, er, I Saturday, I took a Saturday afternoon and that's what I focused on for Iski prep and I started December in preparation for the mock, which meant I had two months for the mock. Um, and then I'm not very good with maths. But however long that is to me every Saturday and they increased in frequency as I approached the EK itself, get a group of three, so three people. Um, you have to bear in mind that I'm, I'm teaching you this coming. Uh I'm autistic, anxious and depressed. I don't have good friends, but I needed a group of three people because you need, you need the teacher, you need the person doing the exam and you need somebody uh, sorry teacher, the examiner person doing the exam and the person to be examined, you can probably get away with you probably. But in an ideal world you have three. I got my group of three at an event like this. I put in the chat. Hello? Does anyone want want to be in a group of three with me and three people joined in? So if there is anybody at the moment who is thinking, oh God, I don't have a three people that I can revise with, put that in the chat. Now, see if there's anybody else that can help you out, the group of three would be the ideal as you approach the exams. You want to meet both online and in person if you meet or if you're in the same house, that doesn't matter, obviously. But if you um interact online, you can practice your histories and your CBD S really nicely and just any general like teaching that you want to do the reason I say about teaching is you've, you're doing your specialty modules at the moment and in the ee itself, there will be questions on specialties, including your mock that you've not done. Guarantee it. I didn't do obs and Gynae w women Children and family was my last block. Of course, women, child and family was the station I get given in the mock issue. Um But what was useful was that I had people in my group who had women Children and family as the first block. So they did some teaching for us about how to take a history or how to do an examination on um a pregnant person. And that helped me and then I gave a presentation has to give it, take a psychiatric history so you can help each other in that respect. And everyone's stressed about the fact that they've not done one of the one of the blocks or not finished the block as well. So everyone will be in the same boat, get a toy. So um in terms of doing the examinations, it's best to do it on people. Um But when you can't rope somebody else into doing it and you just want to practice, maybe you don't want to embarrass yourself, showing your poor examination technique on somebody else. You want to be able to do this by yourself. II bought this toy. There is a little frog, what I'm aiming for when you're getting, I'm hoping you see my picture when you're getting one is you want one that has arms and legs and a body and a head because that's what a human normally has. When you're doing these examinations, I need to be able to say that I'm looking at the hands. So it's a good thing that they have hands that I can demonstrate that I'm looking at in world, they'd also have joints, but I just bent them here. So I'd highly recommend this cos this means that you don't, you can do this at any point. You can do it at night time, you can do it at 3 a.m. in the morning if you really want to. Um and you can practice your exams about people. I also have this tiny one which I used for newborn examinations, which I think my scale is slightly off of what a newborn is. But again, it's got arms, it's got legs, it's got a head. Um which means that you can practice in the absence of friends said here, continue your progress test, revision, progress test helps build your general understanding of conditions and their management. And that's basically what the EK is. I've said continue progress test revision. It's more probably like your iski preparation will become your progress test revision, but it will be slightly more tailored. If you're gonna make flashcards, for example, on Iski topics, it's most likely going to be signs and symptoms of A CS management of a CS much more reductive than actually doing the questions, but the questions will still help you. Um So do continue that also bear in mind, you obviously have progress tests. Um And last year, I think you do as well. We had a progress test after the ISKI. If it makes you feel any better at all. My understanding for that progress test that came after my ISKI was so good. I got my highest progress test score that I'd ever got. And it was literally just because the way the the level of understanding that I developed for the Iski was so much better and that helped me in the progress test as well. So they they feed into each other, get an investigation for low. And what I mean by this is you often they will ask you what is your differential diagnosis? How would you investigate this patient? And so you need to have an idea of what would you say and in what order just to make sure that you stay on track now, it will depend on what resource you use. Maybe you already have a structure for it already. The one that I use is I do bedside bloods imaging special tests, which is BBI S. Some people use boxes, I think bedside observations, uh x-rays for images and um yeah, use the wheel to whichever one works for you. Bedside bloods imaging special test is what I use. So bedside being, what can you do at the bedside, I'm thinking, can I do my BP? Uh, obviously the examination itself, but that's not an investigation. Can I do? I can do BP at the, at the bedside, I can do pr at the bedside, blood glucose is at the bedside bedside. Now your bloods, so any bloods I would include ABG S at this point here. Um, er, and also get into the list of which bloods are you going to use? The majority of the time you're gonna be just say F BCU and E LFT ST FT S. But it's a good idea to at the end of that sentence, you say FBC LFT S ES looking for markers of inflammation. We'll talk about that in more detail when we go through the specific specialties because I'll bring up which investigations I would mention for each of them. But as a general just have to think what blood tests would you do and why would you do them? Imaging? Ultrasounds, x-rays CT S MRI S special test is anything that's specific to this patient. For example, a lumbar puncture I would put in special test. It's not technically, it's not blood, it's not imaging, but it's something that I would probably do. Let's get an investigation for it and familiarize yourself with the management. This one should probably go without saying um but a lot of people aren't super confident with the management of a lot of conditions is the the hardest part because you tend to build up the basic science, which helps you support what the symptoms look like the management. You, you only really start learning in year three. If then um so familiarize yourself with the management. Like I said, I have, I had flashcards of symp signs and symptoms. And then another flashcard for management of all of the conditions that I could think of engage with any practice is issues. Um A lot of different societies will hold practice is issues. Go to as many of them as you can. The more you go to, the more confident you'll feel we'll run 1 to 1 sessions um later down the line, um which again, hopefully should be useful just in tailoring your history and examination technique. Um And there's also the ones on the clinical skills. They're the ones that look like uh Google Street view those in themselves I think are really useful when I looked at them for my mock iski, one of the stations came up, I looked at them again for my actual iski. Another one of the stations came up. It just makes me start to think that the examiners getting a bit lazy and just reusing the stations that are out there. So definitely do have a look at and engage with those because they might come up and you will be better off for having seen it. And lastly obligatory self care message you will perform your best when you are feeling your best. Um It is not worth trying to remember what the signs and symptoms are of ITP 3 a.m. before the Mock Iski despite the fact that ITP came up in my is ok. Um Remember like I said earlier, the most important thing is that you are safe, they are looking to make sure that you are a safe clinic and a safe clinic is not one that knows everything. A safe clinician is one that knows when they don't know. So you just need to be super, super happy with saying I'm not sure what the diagnosis in this case. I'm thinking that it might be something lung related like pneumonia or fibrosis. However, I'm not sure. So I'd like to consult this with a senior before I progressed any further. I've just told the examiner, I have no idea what this is and I don't know what the management is because I don't know what the diagnosis is, but I've shown I know where my knowledge, my knowledge gaps are and I've been safe and I hope that is what you would do as medical students. Now, if you had a conversation with a patient and the doctor said, oh, go g go and take bloods from them, but you didn't know which bloods you were meant to take. I like to think that you'd ask them rather than just taking all of the bottles and off you go so be safe. Um And that's way more important. Self care is way more important than learning some wild off condition. So those are the main things that I would recommend for preparing for you is is start early, get a group of three and revise with them early on. Get a toy. If you can't find any friends, continue your progress test, revision to make sure your knowledge is topped up. Get a nice flow of investigation, bedside bloods, imaging, special tests, familiarize yourself with the management of different conditions, engage with any practice issues that anyone gives you and make sure that you're putting yourself um o in your best foot because that's when you perform your best. So resources that I think are quite good, the clinical skills um the videos like I said, they show you how to do it in four or seven minutes. And so if they, if they can do it in four minutes, then you can do it in four minutes. Yeah, the clinical skills department will get booked up and it will get booked up early. Uh You might be having that already. I'm not sure. Towards the end they over a two week period, they allowed us one clinical skill session two weeks before my exam, one session. Now, that's not, that's not enough, right? So best thing to do would be to take one day every week, every two weeks, starting around. Now, if you can do it on a day where you're already allowed off placement. Great. If not hope that your educational supervisor is nice. Take it to revise big issue that we had last year with this sort of stuff. Um Was people just took time off placement without asking or telling the people that we were going? Um And if you do that, then people get angry and they will speak to the university and then the university won't let you book SDL sessions, right? The best thing to do is to just be honest with the person you're on placement with and say I'm trying to prepare for my, is at the moment, is it ok if I take Wednesday afternoon off or can I take Friday morning off to go and do some clinical skills or can, can I take Friday off to do some revision? Um And every time that I've just been entirely honest, I said this is what I need to do. They have always said yes. So just be honest with you people, then you definitely know that you're not gonna get told off for it. And you also know that like you've got a supervisor or your f one or the reg whoever you're shadowing, who's supportive of your learning and is likely to let you have time off to revise for your exams. But you're never gonna know that unless you ask. Yeah, um Clinical skills department, obviously, all of the stuff are really, really good in, uh, giving you advice and tips for is s as well. They give you specific things um, that people messed up on last year and that's sort of like a gold mine of information because we're all taught in the same way. So if I've messed up and I've put the wrong sharps in the wrong sharps bin, it's likely that you were taught in a similar way and might make the same mistake. So it's useful to know what our issues are as a cohort geek mis it's brilliant in terms of the skills videos, I'm sure that you've all seen them for both skills and for the examinations. The thing I'd like to point your attention towards is that they, they oy resource. Now, the resource itself is great. It's got um a bunch of practice cases on there and it also has a way of doing the stations. Uh So it sets them up. So you have an examiner patient and the examinee. Um Now this is a paid resource. However, if you have one version of it, multiple people can use it. So if you're in that group of three, like I said, really good. Um For revision, you only need to buy it once and then you can split it three ways. I'm sure if you were a little bit more savvy with it, you could do that with a bigger group, but I didn't need to do that. So I'm not super sure how it works. Um But yes, that resource really good. It has full explanations of what the correct answers are and why downside to it though is that it is an ay resource and it's an ay resource that's tailored specifically towards like London Universities. So the questions are sometimes in way more detail and not the sort of thing that we get asked at all in our history and our examination questions, we get asked, what's the differential diagnosis? How would you investigate this patient? How do you manage this patient? There may be some minutia to it, like, how would you manage this patient in the short term or in the long term or how would you prevent the development of this, this condition? Sometimes in the geeky metics questions, they'll ask things that are more like, oh describe the pathophysiology of atherosclerosis and you're like, what? And we just don't get asked that sort of question. So just take it with a pinch of salt when you're coming across a question that you think? Gosh, that seems a bit unusual compared to what I've seen previously. It's probably because you don't need to know it for our riskies. Um Us, um We're aiming to do this weekly. I'll show you what our plan is for the next uh up until your exams in a, in a, in a second and it is tailored to the ISKI, it's tailored to Cardiff University iss so any of the downsides of other iski resources we just don't have because we're doing it specifically for our cohort, a vision guide books. These are the two, um that everyone talks about Osk revision guides, gives you a list of conditions. Um, what the hell they present and what sort of investigations and management that you'd like to do. Oy cases with Mark schemes is like it says in the title, it's the stations both are good. Um Sort of depends on what way that you want to approach it. I think that it's a good idea to have the blue one, the Os revision guide. Um because I think that helps build your foundation of your understanding. The Aussie cases is then something that you can use to apply what you've learned, but you can also do that same thing using the geeky medics resource again, paid. So just it's just where you wanna spend your money, right? Um Yeah. Um So yeah, these, these are both very good, very good resources. They are, are some uni libraries, they will get uh taken out on loan immediately and then there will be like three people who are cycling it between each other. Um which is just really annoying for all of you involved. So I would love to say I'll go and use it from your library, but the reality is you've got over 100 people in your year and they only have six copies of this book. Ok. And lastly A II think is really useful. Um, again, specifically if you're alone or if you're looking for more stations, but you don't have enough, you can choose a specific focus. Um, so for example, if you want to focus on doing a cardiology er station, but you've run out of geeky medics or the ay case stations, then you can do that there, you can do it alone and you can get instant feedback and I'll show you what I mean. Um You don't have to do this. It's just something that I found as I was doing that was really useful and no one else talked about it. So here it is, this is on chat GPT. This is the prompt that I've given it. I know it's a detailed prompt. Um But remember these are the, the A I language system is not what they're built for, but you have to make sure that you're giving a really clear overview. So I've said Cardiff University doing my ac examinations, eight sessions. I explained it. I said I need to interpret data relating to the condition. Um and then formulate a management plan. The examination will ask some questions about the condition that was tested such as pathophysiology or risk factors. Can you act as the examiner? And then it goes sure Fang. Um And it gave me a basic scenario. Now this is ii can you can phrase it differently and you can say, let me ask you questions as if you were a patient, I've done it so I can do the interpretation bits. Cos I was fairly ok with my ability to take a history but if you're trying to put something together, er, to test your ability to do the investigations management, this is a really good way to do it after this. I then type to them. Um, what I think the diagnosis is, um, so I, what I always did was I said to summarize this patient case because you have to summarize the end of your history. And I summarized it. Um And I say my differential diagnoses are blah, blah, blah to investigate this patient. I would like to do XY and Z and then I would say, can you give me feedback on this answer and it will give you feedback on this answer. Just make sure you double check stuff if some, if it comes out with something and you're like, that doesn't sound quite right. Just double check it. It's not, it's not medicine based and they don't cite their sources. So do just double check if anything's like a little bit off, double check it. OK? I just found this as a really useful use resource if you don't like it. Move on there. But I thought it was really useful. I just wanted to let you guys know about it, right? Our series then this is what we are going to be doing. We've got our introduction to CBD S this week. Next week we're gonna be going through the sbar and important conditions to know. Um, Fourth of December, we're going to go through the Pharmacology one. So how to explain which medications to go through. Um, then we're gonna go through peds and then obs and Gynae, we've done those ones before the winter break because, um, I think although sbar, you're probably be ok with how to do that. The important conditions that I think is more important for you guys to know pharmacology, peds and Obs and Gynae. These are ones that people tend to find difficult and we're trying to front load them before your mock exams. Then we've got the one on the first of January data interpretation for A B FBC S LFT S TFC S, not necessarily super hard. You will have seen these sort of things before, but you will definitely be asked it multiple times in your mock Iski. And I just wanna make sure that you're all happy with having seen it, right? Um So those ones, that's the chunk that we'll do before you mock after that, the remaining specialty, neuropsych and then imaging and then we'll do a summary on the common and important presentations. Although I imagine by that point, you'll all have figured out the way that you guys like to revise and probably won't come. That's what we're gonna do. The reason that it is rough dates at the moment is, like I said, we're trying to find dates that Doctor Ward can do at the moment. But the foundation program isn't, isn't brilliant. So we'll try and make sure that you have the, um, uh, the, the times and the dates for them. We're trying to keep them internally consistent. If it's just me, it's likely to be on a, a seven o'clock on a Wednesday sort of thing if that time doesn't work, do just let us know, looking at the times, looking at the responses you gave us to original questionnaire was good. So that's what we're gonna do. And hopefully this is what the, the order in which I would have wanted to do it for the mock ei um and hopefully it covers enough of the specialties so that those of you who haven't had woman, child and family yet will have had some experience because their, their rogue histories, they're all over the place. Um Right. So we're gonna go on to doing the CBD S. Now, does anybody have any questions about what we've talked about in terms of preparation? Again, there will be time for questions at the end. I'm not seeing any questions. I'm hoping that means that nobody's typed any questions this whole time. Um But II don't really know, I've seen somebody message and chat so I know that I'm seeing the right thing. Um OK, not seeing anything. This makes me think that we're all fine. So far. Ok. So how do we actually write the CBD? Um So you've done the case based discussions as S ES before. This is slightly different CBD station. You need to find a case whilst you're on placement and present it for seven minutes. It can, it's a very good point in chat with the management and conditions. Where do we start? There are so many conditions. I 100% agree with you. We all get to that point where we realize that you'll never be done with medicine. You'll never be satisfied with the amount of revision you've done for PT and you definitely won't be happy for it. For is either, um, what I would recommend to start with is write out all the specialties that you can think of for me personally, I don't believe in surgery. So I simply don't do surgery. Um I wouldn't recommend that approach, but I don't like surgery. So I don't, I don't do it. But for example, you put on your cardiology and your respiratory. I would aim to get three common and three dangerous or important conditions. Each so common conditions. Um For, oh, sorry, yeah, common condition for your cardiovascular. I thinking things like stable stuff, so stable heart failure. A CS, that sort of stuff, your acute stuff. And then thinking we're going down the route of an M I and thinking uh like pulmonary embolism, that sort of stuff. Three common, three important it will be hard to find them for the majority of specialties. Um, but go through it and if you aim for three of those, then you'll be pretty solid. And like I said, I got ITP in my pediatric history, pediatric history. I'm already not super confident with already. And then they throw me an I TPI don't know how to manage itp. Um, I said it was idiopathic. I think they've changed it now to immune and um they did say to me immune and if I'd listened to that, I probably would have thought steroids. Um, but my main thing being is I had no clue how to manage itp. I passed that station, I passed that station with like 85% which is pretty good and I didn't get a red flag or anything for not knowing it because I went into it and I said, I don't know what the management of ITP is in this situation. I would like to speak with my senior, which is likely the medical reg or the pediatric registrar. Um, so we can discuss, discuss the management together. And then I said, given the low platelets, I would imagine that this would involve a platelet transfusion, but I'm not sure. Again, I'd just like to double check this with my senior. Um I then did some stuff where I talked about psychological welfare of the patient because she was, she was concerned about blood cancer. Um, in that situation, I got a big tick, despite the fact I had no clue what was going on. So, really do try and be confident in the fact that you can, you can not know and you won't be able to cover everything that is fine. Focus on those three common and three important or life threatening conditions for as many of the specialties as you can think of and you'll be pretty solid as long as for the rest of the time. If you don't know, you are just honest and you demonstrate an, er, a good escalation plan. So, like I said, whoever your registerr is, whoever's in charge, I hope that makes sense. And that answers your questions when we go through the special, the specialties. Um, yes, it definitely is overwhelming when we go through the specialty ones. Um, I'm not gonna give you, oh, I'll aim for three common and three important, but I'll also give a list of any of the other ones that might be worth coming up and I'll do that for all of the ones or we'll do that for all of the ones that we come across. Um, but you will be best off with those three common, three important. Um, yeah, again, if you have any more questions, just put them in the chart. Um, so yeah, case and patient seven minutes can be one of your s les. So if you presented it as a CBD, if you presented it as a long case or a mini CEX all 100% fine. But can't be anything that you submitted in a, in a written assessment. And I think that's usually quite a confusing statement because your S les are assessments, but it means you can't do it for your patient pathway. You can't have done it for your oncology project, any of that stuff where you've written something and submitted it. Really? Geeing. Don't use your best case for the mock. Everyone does it. They're like, wow, I spent ages working on this one and then they can't find a case for the next one in an ideal world. You'd make both of them now, like or now or over the next couple of weeks. Um cos then you can pick the best one and the best one you keep for the IY and you will be familiar with it. You'll be super familiar with it by the time your risky is in, in May, the only downside to that is you've not been on placement for very long. So you might not have two cases. And it's a really good idea to practice this with doctors. I would usually, um I, I'll talk about this in a bit in a sec, but usually people recommend that you present it to the doctor who saw the patient. I wouldn't recommend that. I mean, it would be useful because it means that they can, if you've missed anything in your presentation, they can let you know I'd recommend presenting to doctors that don't know the patient. The reason for that being is that they will ask you the clarifying questions that will really test your knowledge of the patient because they don't know the patient. And that is what you'll have in the CBD station. I hope that makes sense. So, exam information, this is what will be provided to you in your document already. Just make sure that you've followed it. Um So if it says one side of a four cri font side 12, don't, don't do an aerial font side 18, right? You you it's just it's just a fail, right? So make sure that you've got this, it sets clear structure with headings for the history and I'll show you what mine looked like. Um But this is good. It helps lead your eye through it and the examiner in the exam two copies get printed one for you, one for the examiner. They can follow you along. You can just read from the sheet, although it is a presentation and you are marked for how well you present it. So it is best that you are familiar with it and you can look and engage with the examiner but also like jot your eyes down. So you don't need to remember it off by heart. So yeah, read through this in detail. Um like only P DFS. So don't severe a word document. So when it comes to the end, they have to ask you and guide you on your answers to three questions, they give you the questions beforehand. So for this station really, you should be really, really solid in your answers to these questions. One is about the investigation, one is about the management and one is about your ethical idi I of social science questions. Now I know what you're thinking. You're looking at thinking. Well, they're not set questions because it says with respect to investigation, why was this test undertaken? Importantly here, they will ask you about the investigations that you put on the piece of paper. So you can tailor, you can direct the examiner towards the investigations you want them to ask about, depending on what you've put on there. If you don't put investigations on there thinking, ah, ha I'll be smart about this. They'll ask you, why didn't they carry out this investigation? Those questions are harder to answer. So just try to try and include your investigations. Don't try and skive out of work cos they'll just be mean about it. Um, but just make sure the investigations that you're putting on there have to be the investigations that are important for the patient. Again, I'll show you mine which hopefully it will give it as an example. And then it says, how did it inform their subsequent care? Why did you do an ABG on a patient who presented with Topa if they presented with Topane, you did an AP ABG and it didn't inform management. What were you hoping to find on the ABG? And how would it have guided management if it had changed? And the answer is, is that we kind of like ABG Topane, not super relevant. That's an unnecessary investigation. I probably wouldn't put it on there. Then again, here regarding the p regarding the patient's management with blah, blah, blah, what do you think the risks and benefits are for this approach? What this says? And it says on the next bit as well is just for you to be aware of the guideline of the management of the condition that you're talking about. I recommend knowing the number. So you can go according to nice guideline NG mine was 56. So you can say that um and it's worth being aware of the alternatives. So you know why they didn't do it again? This seems like this is a lot to do but you have from now until the until may to prepare the answers to this question. And what are the key impact impacts of this management plan? That one there is usually if you've done something like a surgical intervention, if you've had a patient who went into labor and ended up having an emergency hysterectomy, what are the key impacts of the management plan from the, from the patient's perspective? That's been quite, quite an impactful. Um If not, it's, you can say the benefit of this approach is that it was a simple medication rather than a surgical intervention, that sort of thing. And lastly, this bit here means you have to have a case with an ethical EDI or social science issue. Um which again, and then it asks you for specific guidelines or principles. So just be happy with your pillars of ethics. And if there are specific guidelines about the situation, obviously know those guidelines. Um Yeah, and I'll, and I'll show you what mine was in a second. I have just remembered. Now, you know, I said, don't use your best case for the mock ey, you're gonna do them in pairs. One of you does the examination, one of you watches, half of you will write and prepare a CBD that will not see the light of day, they will just not do it. OK? So I got to practice mine, my partner did not get to practice this. That is really frustrating. So really when I say don't use your best one, really don't use your best one because if you did your best case and then you don't end up even practicing it, it's gonna be really annoying. So, yeah, just bear that in mind, ok? Um These are the things that I would aim to include uh go for an interesting case. Um Remember examiner has been sitting there for eight people listening to you waffle on about a case, right? Try and make it somewhat interesting if you can't, it's fine. That's one that you can ignore. But in an ideal world, the more the examiner likes you in the station, the better you're gonna get on. Go for a case that you were involved in. Because any other questions, any surrounding questions you will hopefully be able to answer. This isn't always the case. You weren't always involved in a case from start to finish in an ideal world. That's the sort of case you'd use. But in a ward that I was on that, that did not exist, these were not things that I encountered at all. Um But a case that you know about one with ethical or psychosocial concepts, they will ask you a question about this. So you have to have an answer to a question about this. You need to again next two months, you need to have both enough details to suggest a differential diagnosis and also details on the investigation and management. Specifically things like doses, blood test result, ra numbers and ranges. And lastly, there's two ways you can go about it. You can go for a concept that you find really easy and therefore you can explain well or a concept, you find hard and therefore it's worth revising for me. II like suffering. So I picked one that I suck at, II hate obs and go with a passion. It's not for me. And so I went for an op and gy case Um And that was because I then had to go and learn about the condition. So I learnt about it for the Iski itself. I learned about it for PT just because I had it for a case based discussion. It's just, it's just one of those ways. But if you wanna have it to be a nice easy station for yourself, I mean, it did become a nice easy station for myself cos I had to learn it. Um But yeah, those are the two routes that you can go down. Remember one of them sort of betters yourself as a learner. The other one just keeps you in a nice safe happy place. And there's sort of a few and far between when it comes to um key points, you only get one side available. So you're gonna make sure that you're using narrow margins, right? And text boxes because that maximizes the space lead, the examination examiner towards the questions you want to ask by including selectively the information. And I would recommend the following headings, overview, examination, differential diagnoses, investigation management. And then what I the way that I phrase it was case update. You can also do ethical issues, psychosocial aspect and I'll show you I'll show you now my, my examination, that's what I went for. That's my case. I've got a Zoomed in version of it in a second key things that I just wanna point out. Um my or my, my student number was in the top corner of that. You should have your student number in the top corner. Um, your name. I've written the fact it was a case based as I probably didn't need that. You can see that I've used text boxes. I was able to make the most use of the space at the bottom of the investigations of management by using text boxes rather than using columns or just the normal text formatting. Um, I've tried to highlight some important things, the highlights, the things that I've pointed is I'm trying to steer them towards the questions I want them to ask. I've put in meows rather than news. And then I've defined what meows is because the person that I'm looking at is likely not, er, an obstetrician and therefore I'm trying to point them towards that. I've also tried to point them towards asking you about a speculum examination. Um, now, why is that? Well, the, the case that I'm talking about here shouldn't do a speculum examination on this patient. So it's an interesting thing to talk about. Um, I've got a box that's for differential diagnosis and I've put stuff in bold where I think it's important in my investigation thing. I have not only the, the value itself but I also have the reference range in brackets. Honestly. That's more for me because I don't know the reference ranges for Laing. Um, and I've also included the fact that one of them was different for the case that I was looking at. I've included the units as well so that when I present it, I can make sure I'm including all the important stuff you can see in the bottom left case update, eg case update I talked about was capacity and capacity is one that you can talk about with a lot of patients. A lot of you spend a lot of time on care of the elderly wards, even if your patient has capacity. If there's a question of, does my patient have capacity? You can use that as your ethical issue. Um This one here. Um I've also put in that, I've, I've mentioned about two different guidelines that just helped prompt it for me that II sh II know that the guidelines are there. I can mention it. I'm ticking those boxes early on about the guidelines. Um Yeah, that's what it looks like. II have the next stage little animation of me covering my student numbers are embarrassing. Um Here it is here. Um In a bit more detail, I've only put this here just because I think it's useful for people to have an example. And if you wanna read that, that's a, that's an example of a CBD. The CBD went. OK. Um And so you can sort of use the structure as you want and I just think it was a bit small on the other page. Um Yeah, so um what's that? Why is it that animation? So I'm gonna wrap that up there. Um So any questions about what we've talked about, we've gone through the Iski examination in itself and what it is. And we've talked through best ways to prepare some things that you can start by doing now as including an overview of what we will be covering and what therefore, I think is important for you to cover ahead of your mock Iski. And then we've talked through how to do a case based discussion with an example. Um So you can have a look. So how are we all getting on? Just look into the chart to see if there is anything? What kind of topics would you prefer with the CBD acute chronic conditions? Thing that you a rash specialist? It's a very good, they're very good question. Um I would say it's, it's probably up to you. Um The main thing that I would be thinking when I encounter a patient is how much can I feasibly get about in terms of detail? Um, chronic conditions if the investigations were done a while ago, do I have access to them acute conditions? I probably do have access to them. But how much of a history can I feasibly get from the patient and also with acute stuff? Am I gonna see them throughout the course of their care? Am I gonna be able to fill out a case based discussion? So it honestly does depend on the patient. Um I think acute things work better for a case based discussion. I think they're more interesting for your examiner. Um, but I also think because things are happening, sort of as you're there, you get more involved in it and so you can see and access them more quickly. Um, whereas with a, with a case based, uh with a, um, a chronic condition, you probably have better psychosocial aspects. Remember, you've probably got a lot of patients in the wards who are medically fit for discharge but unable to go home. That's a psychosocial issue that you can talk about. Um, although it may not be necessarily quote unquote, interesting, um, to, to sort of discuss it. Um, if you're talking about a chronic condition, it's probably best to go through what, like, why are they in and what investigations are determining their management now. So again, just focus on the patient in, in itself. Um, cos I hope that answers your question. It, it really is up to it and the majority of people, um, are a bit, they fluff it a little bit. Ok. Um, they might not always be 100% true patients. Um, and that means that you can make up some of the aspects of it, um, just be reasonable and make sure that you understand the guidelines for the hospital that you were in because my, uh, my examiner was one of the consultants at the hospital that I was at. So they would have known whether my, my management was completely wacky or not. Uh, we sign up for future sessions. I will send an email out, um, with them with the registration link. But if you, um, if you follow the organization you'll also get, um, get pinged every time that we set up a new, um, event where I'm speaking to the, er, the doctor as well, um, tomorrow. Um, so we should be able to have a good idea about when the next session will be at that point there. Um, but yeah, if you, if you follow the organization itself it'll pop up. Um, it'll be recorded. I hope so. Um, I think so. Uh, and it should be uploaded to here afterwards. Um, and also I can send the slides out as well. I think they will be available as catch up recordings, but you can only access that stuff if you fill in the feedback form. Now, I think the feedback form will automatically ping up to you when you leave. Um, I'll, you know, I'll put it in chat now just to make sure that it's not. Um, but if you send me an email afterwards, if you've not got said follow up stuff and, and the slides and everything ping me an email you've got me on, uh, hopefully I've sent you emails already. Um, so just, just ping me for it. Um, there are six stations in the mock. Um And there are eight stations in the actual Iski, I'll just squoosh back to show you the two at the beginning. Um Why do they include so many animations? It's really annoying. Uh There we go. Um Actual exam two acute two clinical examination mock is ski exam one acute one clinical. Remember you're only gonna do half of these in, in your mock. So you'll do three of them and I think some are easier than others. Um But yes, you have to obviously be prepared for all of them. The timing this year is the same 15 minutes. Uh You have a slightly longer break between sessions though, in between stations. Sorry, I hope that answers your question. Um Do they need to know which patient you're in the hospital in? Nope. Uh We don't need to include any identifiable patient information. Um And you can also make sure that you're um try to keep things as vague as possible. Um You can say something like um oh, this was an 86 year old woman. Um But you, you can also say this was a patient in their eighties just to be a little bit more general about it. If you think that the case is specifically identifiable for some reason. If you've got like a case that could be written up for a case report, I probably wouldn't be trying to include loads of patient id identifiable information. So things like location. No, um you do just read it off the page. They let you do your entire presentation, seven minutes start to finish and then they ask you all of your questions. So just make sure that not only you've got all of the information on the page in front of you, so you can talk about it for seven minutes, but also that it lasts you seven minutes at the end. I've told you about those three main questions that they have to ask. If you are less than seven minutes, they'll ask you those three main questions that they have to ask. But then you also risk that they ask you other questions in sort of like a small talkie way um about the case and then you have to answer more about it. Uh But yeah, you do just read off it seven minutes. No worries any more questions. I hope it's been useful. Um I I'm gonna hang out. I hope it's been useful for everyone. Um Honestly, you, you will, you'll do, ok? Um Just make, just make sure that you, you're happy with what you think that you need to know and don't set your expectations too high when it comes to learning all conditions or anything. Like I said, go for three common 33 life threatening conditions um for the specialties and you'll get on, ok, just be safe. Um Obviously there's no actual patients in this scenario but be safe. I'll hang around but if people want to leave, then I say thank you for staying around. Um and good luck with the rest of your preparation. Oh, brilliant. I'm glad I'm glad that it was useful. Maybe see you next week for the sbar and the other important conditions to know. All right, thanks everyone. Oh, it's quite nice. Thanks guys. Hope placement isn't treating you too nasty. Thanks everyone. Again, I'm just hanging around in case anyone has any more questions and then I'll, I'll end it. If not. Thanks everyone. Ok, I think we may be at the point of being at the end and people have walked away. So why did someone rejoin? My goodness. Very keen. Uh Right. I'm gonna end this now then. All right. Hopefully, if, if somebody's mid typing, like a really big question, please press enter now, even if it's not finished. So I just so I don't shut it, I think. Or. Ok. All right.