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I think it is going right now. I think people are gonna keep coming in so you guys can just make a start now if you want whoever's going first. Cool. Yeah, hi. So, um, this is just a lecture to introduce you to year three. year three is quite different to, uh, 1st and 2nd year. Um, can you go to the next slide? Sure. Thank you. So, it's broken up into three, terms. Um, and each time you'll be on a different placement. Um, I think in first time it's really important to get used to placement because it's quite different to the lecture based learning you have in 1st and 2nd year. So you're gonna have to commute and get used to what it's like to be on a ward. Um, so that's quite a change. Um, but I do think time one is really important to maintain back. So join any extracurriculars. Um, it's also important that you start practicing your histories and examinations. Um, because if you start in term one, by the time you get to your exams at the end of the year, they'll kind of become like, uh, second nature. Um, and it's also really useful to get as many sign offs as possible, um, as early on, uh, just because it will relieve any stress you have later on in the year. Um, and then in term two, I think in term two, you should aim to complete all of your sign offs. Um, if it's possible. So if you have surgery in term three, then it's not gonna be possible to get all of your sign offs done. Um, but if you can in term two, then that's a good idea. Um And also, I think in term two, you should start doing practice questions, um, just using passed or ResMed, which are just some question banks you can use, um, cos it's just a good way to ease into testing yourself, um about the knowledge that you learn in year three. And you should also start practicing your clinical skills, um, a bit more in term two and you'll also have clinical skills sessions when you're on placement. So that will be useful um, way to guide you into what you need to know. Um And then in term three, you should start proper exam prep because unlike in 1st and 2nd year, you don't get a long Easter break in year three. So, but you can't really rely on that break to try and do lots of revision because you'll still be on placement. Um So you need to be a bit more consistent with your work throughout the year. Um And I think in T three, it's really useful to start using the question banks every day. Um Just so that you keep on top of it. Um So when you have your exam, it's not too stressful. Um And you should also start doing weekly osteopro. So there will be an opportunity to sign up um, to have a shooter. But if you can't, um, or if you don't get allocated an OS T tutor, you can practice quite easily with your friends. Um And if you do that once a week, then, um it just means that you'll be much more prepared um for your OS T exams. Um And then obviously in term three, you want to start your practice papers. Um So, but I wouldn't say you should really do the past papers until about 1 to 2 weeks um, before the exam because there aren't lots of them. Um So they're pretty useful to do just in the run up to the exams. Um, and you'll also have your mock Huskies, um, which are a useful way to test yourself. Hi, guys, my name is Tanya the fourth here. Um So I'm gonna talk to you a bit about the different, I'm gonna talk to you about your GP block and your medicine block. So the GP block is called Mica or medicine in the Community apprenticeship. So what actually I'm gonna talk about like what the day to day is like, and what you actually do on the GP. So the GP block is really good for getting good at history taking. I know, because you've had a long summer and you've come from second year, it's all kind of like blurring your head. So, but, um, don't worry, it comes out quite fast and at least in the first few introduction weeks they give you about like 10 lectures about how to take history. It gets really, really repetitive. But when you go on GP, you'll have a chance to really practice and don't worry if you're not greater in the beginning because you'll get better and better. The more and more you do, you also get to do examination practice. Now we talk about these things that you get to do, but it really varies depending on your placement. So some GPS will be really good at this and they'll like, dedicate time every week for you guys to do like examinations and skills, other GP practices. Your GPS might not be so active and you might not have this. So it really depends on the place, but you should ideally be given time to practice. You'll also be doing patient centered consulting. And what that means is you'll be allocated your own clinic or your own patients um, every week, maybe one or two sessions a week, depending on your practice. So you and your GP partner because you'll be with somebody else you'll get to go and consult patients independently. So that means it's just you both in the room with the patient. You take the full history, you're allowed to write in the S notes. And then once you've taken a history, you'll present that back to your GP and then discuss management. Obviously, you can't tell the patient anything about their management or prescribe because you're a medical student. But you do get to ask the questions and then you discuss the management and tell the patient that with your GP supervisor. So these are some of the sign offs, you can get done in GP. So um some examinations again, that's really depending on your GP practice and how many you're allowed to do peak flow is a good one. You can sometimes sit in with allied health care professionals, for example, as an asthma specialist nurse or an HC A who comes and does these readings and you can ask them to do it. Um MDI. So like that's like the kind of blue inhaler you take for asthma pulse oximetry. You may or may not be able to do this, ask your GP um doing swabs. So that's like the COVID swabs that you're aware about and ophthalmoscopy and otoscopy. These two I'd say are like very GP specific. This is the place you should really, really try to get this done because you can get it done in the hospital. But it, it will just be so much harder for you. So try to do this. There, definitely make it clear to your GP that this is something you're thinking of getting signed off in the eight weeks that you'll be there. So what's really the day to day like life when you're at GP? So like I said before, you'll have your own clinics where you consult people and discussions with your GP. So the way it works is on Monday, Tuesday and Friday, you normally go to the GP Practice. And then on Wednesday and Thursday, every Wednesday is central teaching, which means the faculty teaches you. So all of the people in medicine, surgery, GP, all come together on Wednesdays in the morning and they do something called capsule cases or sometimes they do like other things basically. And then on Thursday mornings, this is only GP specific, you'll get a GP teaching. So the GP team will give you lectures about things. Um And then in the afternoon you'll have clinical skills where you'll go to a hospital site to do that. So, um this GP teaching after the first few weeks, it turns into like a chosen elective. So it's called a Student Selective Component. So for three weeks, on Thursday morning, you're allowed to choose kind of what you get lectures about or what you do and there's loads of modules, there's like art, there's like um teaching like medical education, there's like an M SK exam. Basically, you be able to choose um for three weeks what you do on Thursday morning. So these are some common conditions or presentations you might see when you're in the GP. So that's like back to the list of conditions in Sophia. So the titi externa media, the flu rashes and strep pharyngitis. See if the asthma, I mean, the cyst isn't exhaustive, you might see loads more things, but it's just an example of what you might encounter. And this is just a screenshot I took from um med which shows you like the different sign offs that you need in each placement. So this is the M one and you're going to need to get three sign offs for the GP one. Is that it, it is something called like induction to placement. So you sign off in the first or second week and that's like, have you got settled? Is everything ok? And your GP will sign that then they have a mid place placement review which you do around week four or week five. Again, it's just like, is everything going well? Like is your cat project coming along? And I'll talk about that more later and then the last submission is the end of placement. So remember to get these three forms because when I saw GPI didn't even realize there was a like induction sign off, like I didn't know there was one in the first week. So, um that's just something to bear in mind. OK. So now this is a project you'll have to do when you're on GP placement called AC A project that stands a community in action project. So the aim of the project is just a health priority in your local GP practice. So it's basically what does the practice need or like what does the, the patients in the area around the practice? What's kind of lacking in their healthcare? So I'd say the best way to go about this is obviously because you're all going to be assigned in a, a different GP practice. Um The of your area will vary on in Sunday, they have a bunch of pages with the social demographics of each different borough, but the best ways to look at other people's projects. So, um I think they give you a lecture in GP and even in the consolidation weeks of like different projects that came before and the winner of the cap for an hour year and then you can understand like kind of what the project entails. So in terms of what you do, mostly GPS will give you one session a week dedicated to the cap. So that means like one afternoon on one Tuesday or Friday or one morning, you'll be allowed with your partner to work on this project. So you won't have to do like a clinic session. But again, it varies from GP to GP. They might not all give you this. Um And things work differently. So what personally, for my c it was about alcohol abuse um in the Wans area. So we visited um an alcoholics anonymous charity and we went there for like two days and like sat in on consultations, but you can also contact other charities and organizations for the project. So this is just another sentence I wrote. So I know that not everyone is super interested in putting a lot of effort into PAP because you might have other things. It might be T three you might need to study. So you can pass this like quite quickly. It doesn't have to be something you're going crazy about for the whole eight weeks. Obviously, if you choose to put more into it, you'll get more out of it. You're more likely to maybe win accommodation or even win the whole PAP project. But um if it's something you're not so concerned with about, don't worry about. Um if you're leaving it a bit too to the last minute, make sure you send some emails to people though. So um you can show that you've like engaged with the community. OK? This is the picture of a city I put just like community and action basically. OK? So now moving on to the medicine block. So these are kind of the aims what you might do in medicine and the sign off you could get. So medicine the way it's very different depending on what specialty you've got, what hospital you've got again, what you realize in third year is placement varies so much depending on who you're with, where you are and who your supervisors are and the people you meet. So it can vary a lot, but you will get to practice your examinations a lot. Hopefully, in medicine, you have this thing called bedside teaching, which is different to clinical skills where they're meant to what they're meant to do is one of the teaching fellows in your hospital is meant to come and take you and your kind of placement, firm group to the wards and they'll select patients for you and you'll be able to go through the whole examination with a real patient and present it. So they should do this every week really. But um in my first placement, they did it maybe twice and they took like six people at the same time. So not everyone could examine. But in my last placement, we had it every week without fail and we each what to do an exam. So if there were three people in the group, we'd see three patients and each of us would examine one. So it's really variable, but this can be really good. So sinus, you can get examinations, you could get cannula urine sample, a subcutaneous injection, that's really good. If you're on like an endo replacement, giving insulin is really easy. Or also if you're on like a post surgical ward, you can give like heparin IV drugs, you might be able to do taking bloods, you could go with the phlebotomist and 12 the ECG. So this is an example I took at hospital. I was just showing you a picture of the ward. So your day to day might be look like going to the ward round, going to the teaching fellow, teaching sessions. Um I think the big difference between 2nd and 3rd year placements is at least for me is um you don't really know the teaching fellows when you're in 1st and 2nd year, but when it comes to third year, because you're there for eight weeks, the teaching fellows organize a lot of things for you do a lot of teaching sessions, they do the bedside teaching. Um and you kind of have a lot more contact with them than you would in first or second year. But again, not all the teaching fellows are very good. It depends on your hospital and your placement. So depending on how strict your families are or how often your consultant does the ward round, you'll also be able to go to other departments and practice your skills. So for things like taking blood and cannula say, you know, like the next day your consultant is not doing the ward round. So you won't have to be on the ward round. You could go to A&E and say hi, I'm a medical student. Um I'd like to practice blood or I'd like to practice Cannula and then you could get those sign ups there. So it's a lot about kind of thinking about where you can get things signed off and going there. So normally you'd be able to leave around lunch time or after the ward round. But again, it really depends on your family. So this is something to think about when you come closer to exam. So because instead of leaving, just because you, you want to leave, you have to actually leave so that you're able to study um which is quite a difference to 1st and 2nd year. So just think about how you plan your time. So the thing that you have to do in the medicine placement is called the patient case presentation. So that's basically you build a rapport with one patient on your ward or kind of on your firm and then you follow their treatment as a stay throughout the hospital. So you go through that presenting complaint, like basically the structure of a history you think about their management and then you look at, you can look at their discharge summary as well. So the way that I went through doing this is I use the SA notes. So you'll have smart cards and you'll be able to access the patient's notes. So obviously, yes, talk to the patient, take their history, but then you can go back and read the notes and see um what's written in them. What's been done what the plan is and then you make a powerpoint presentation about this. So the way it works is your powerpoint says like this is the patient, this is the thing, this is the treatment, the presenting complaint, the man and then the disease or like the condition the patient has. Then you make a few slides like about that condition, just like what it is, how you treat it in general. So that's the way patient case presentation works. Um Also just to add some firms, some consultants can be really strict about this and they'll like want you to do it in a specific way. But again, some people are very chill. For example, when I was on medicine, our patient case presentation was just with the teaching fellows. It wasn't even to our family. So it really just depends where you go and then you get to celebrate uh afterwards. That's what we did. But me and my placement partner got Black Street if you guys are fun of that. Um And yeah, I'll give it back to SIM, he's talking about surgery now. Um Yeah, so the main aims of surgery are sort of to learn about um theater etiquette. Um If you're interested in surgery, it's a really good opportunity to scrub in. Um And that way you get partake in surgery, you'll also learn about anesthetics for the first time. So you'll get teaching on anesthetics and you'll also get a two week block, um, on an anesthetics placement. Um, you'll also have to get a separate sign off for the anesthetics placement. Um, and you'll learn to take a discharge summary. Um, I really enjoyed my surgery placement. Um, I had colorectal surgery in Norfolk Park. Um, but I thought it was really like engaging and interactive. Um, you can get all of your sign offs and surgery if you have it in your first, um, placement block. Um, and the potential sign offs at a more specific surgery would be your three lead ECG um, scrubbing in setting up, uh an infusion. Um And uh, yeah, um, and then, so it's quite relaxed depending on your firm lead. Um, you do have early starts in the surgery. So typically, um, if you're in theater, you have to start at 8 a.m. which means you probably have to be in the hospital for about 745. Um, the ward rounds in the morning are quite short compared to medicine. Um And if you're interested in surgery, it's a good opportunity to scrub in. So don't be afraid to ask the surgeons most of the time. Um, if you're quite interested, they will want to teach you. So they'll let you scrub in. Um, and they might let you also help them. Um, and it's also a useful time to explore other specialties. So even though I had a colorectal placement, I was able to see orthopedics and obs and gynae surgeries, especially when you're on anesthetics. Um, because the main part of anesthetics is at the beginning of the surgery and at the end. So during the surgery, you can actually also surgery when you're on your anesthetics placement. Um, which is quite interesting. Um, I'd say surgery can be quite tiring but it's really interesting. Um, and you can get lots of sign offs and you become exposed to lots of things which you won't really have learned about or seen in 1st and 2nd year. Um So it's really interesting. Um Could you move to the next slide, please? Thank you. Um And then in surgery, we'll have to do your s um So the aim of this is you need to identify a need within the clinic that you're in um that needs improving. So this could be to improve patient safety or patient experience. It doesn't have to be something huge like our, the example, the, the one that I did was basically, we noticed that a lot of people were wearing lots of jewelry in theater and you're only supposed to wear studs. Um So we based our projects on that and then you basically have to design and implement an improvement strategy. So this could be something like a poster or um a quiz. Um And then if you're struggling with ideas, you can always ask the firm leads or the clinical teaching fellows. Um They're usually quite helpful and they can guide you, if they think that your project um might be too difficult to implement in the short amount of time that you have. Um And you don't ask, you have to implement your project. So if you plan that idea, that's still good enough. Um The way the equip differs to the C A is that you actually, you get scored. So, um you'll present your equip to everyone else who's also on your surgery replacement. Um And then it will get scored by a panel. Um So you do get marks for this. Um, um So the written paper. So this is a three hour exam. You'd sit at the beginning of June. Um It's got 100 and 50 SBA S 45. Um, of them are medicine, 45 surgery, 45 are based on Mica and then you get 15 ethics and law. Uh, personally, I didn't really look to whether they were medicine surgery or Mica when I was revising, I focused my revision mostly on the conditions and the presentations. Um, but it is quite a big exam. Um And it can be quite daunting at the beginning because you don't really have many lectures this year. So it's quite dependent on your own self learning. Um, which is something that's quite new, I guess when you start third year compared to 1st and 2nd year. Um Yeah. So what I would say is that in term one, you want to start covering the conditions. So you can get lists of conditions either on the Note Bank, um or you can go through Sophia yourself and compile all the conditions that you need to learn about. Um And I think if you start reading about the condition, so the key things you need to know for each condition is how they present. Um So like the signs and symptom, how to investigate them. So you'll have a first line investigation, second line and then how you manage them. And again, you'll have like a first line management, second line management and you can use. So I use the Coumarin Clark Clinical Medicine textbook um mostly to make my own notes. Um But if you're someone who doesn't like to make notes, they have lots of resources already available on the Note Bank um which are quite useful. And also in term one, I think the capsule cases which um they release once a week um in year three are quite useful. Um just to prac to start practicing questions. Um And also the explanations are quite good to reinforce your knowledge. Um So that's what I mainly started off in term one doing. Um In time two, I think you should aim to kind of finish um have finished going through all of the conditions and then start looking through the presentations and I've attached um a link. Um Those are the presentation that's like the list of presentations that I made. Um And if you start looking through those in time two and a lot of the content for the presentations overlaps with conditions. Um So it's quite useful to like relearn conditions as well. Um And you should also start practice questions. So, um I only had past med but I think if you have ques meed and past med, then maybe start ques meed first cos I think it's supposed to be slightly easier. So, um it might be more useful to start off with ResMed. Um in term two and then in term three, this is when you want to start doing proper exam prep. So you kind of want to do, practice the questions every day. I'd say a good target to have is to have gone through all of the relevant questions on pass med or ques meed by the time you get to the exams. Um just because then even if you're getting things wrong, they give explanations. So you will have seen it once before. Um I just think that's something useful to have done and then there's lots of resources you can use. So there's passed ResMed, the Kumar and Clark Clinical Medicine Textbook. Um The thing I'd say you have to be careful with textbooks is that they do give you a lot of information. So I at the beginning of third year, try to learn like the path of physiology of every condition and it's just a waste of time because in your and they don't, they don't ask you anything about the pathophysiology like they did in 1st and 2nd year. It's just really mostly about how they present and how to treat it and how to diagnose it. Um So I wouldn't spend too much time trying to understand like the root cause of the disease. Um And then the Oxford Clinical Cases Textbook is also quite useful um way of learning and then geeky medics is quite good to help you with the presentations. Um And then notion, if you're someone who like making your own notes can be quite time consuming. So if you prefer to use other people's notes, then you can find lots of um premade ones on notion. And the bri the British Medical Journal is quite useful for um guidelines. So, you know, um like what is the first line or what's the gold standard for each um condition? Um So this is just an example. So in year three, my first placement, I had medicine and I started off with cardio. So um what I would do during cardio is that I wrote down the list of the cardiovascular conditions. So um that was my list and then for each one. So for example, this is just arterial ulcers. Um you can just see there. So I would just go through what it was the clinical features. And I think what's really important is you don't need to know just what the disease is but also how the disease looks in a pho on like on a photo cos in your exam, they might use photos or um like medical imaging. So being able to recognize things on like x-rays or an ECG. Um So you need to familiarize yourself with lots of different like modalities of conditions and then all of the signs like any Hallmark features and then how it's diagnosed. Um And there might be lots of different ways you can diagnose something, but you need to know the first line, the second line. Um because in your exam, they'll ask quite specifically um for that. And the often like, even though it's multiple choice, a lot of the options could be correct, but it's the best answer. So it has to be like the first line of the gold standard. Um and then go through the management for each condition. Um It can be quite overwhelming cos there are a lot of conditions. But if you are consistent from the beginning of the year, um you can easily get through it by the time you get to your exams. Um So I think what's really important is to understand the conditions first. So those are like the four key things you need to know about them, the signs and symptoms, how you diagnose it and the treatment. Um And then for each presentation, if you explore key differentials, and if you're someone who doesn't like to learn through notes, then I know a lot of people did just use passed and ResMed. They would just go through those questions from the beginning of the year. They just started off. Um And then they would repeat that instead of trying to read about the conditions, they would just use a question in banks as a way to revise. Um I think use them to test your knowledge but not as an exam guide. Cos I found that the actual exam is quite different to how they pose questions, especially on past med. Cos on past med they give you lots of um additional information which you don't get in your exam. So they'll give you a lot more information about their bloods or just background information, which is quite different to how the Imperial exam is. Um So you don't wanna fall into the trap of getting used to a pattern when you're using the question banks and then in the written exam, it's a bit different. Um But yeah, those are my key tips. Ok. So I'm gonna talk about the OS. So in bad, you only really have two big exams. So one is written and the next is a, so the OSK is a two hour exam and it comprises of 12 stations and you don't get a rest break in between. So these are the stations. So there'll be four examination stations and these are kind of like the big four. So cardio after rasp and neuro and neurology can either be the upper limb, the lower limb or the cranial nerve exams. Then you'll have three histories. So three stations where you have to take a history from a patient and present your findings and you'll have one P VB station as well and then four skills or slash extra examinations. So these skills I'll give you a list of what they can be and what I mean by extra examinations later. So the one thing I'd like to say for us to just keep in mind is the patients you have in the osk are actors. They are not real patients. So they have no real disease pathology. So you need, so you have to be kind of smart about what somebody can act. So what can a healthy person act out and what can they not act out? So when you're doing the examination and you're meant to present your findings, there are certain things that are just not going to be true. So you can just know that you don't need to say that. So for example, you can't make up like as a healthy person, you can't make up having a heart murmur. I can't force myself to have a heart murmur. So when you like examine someone, the likelihood is they're not gonna have a heart murmur, heaves or throats, you can't have signs. So you're not, their nails are not gonna be clogged or have any like s contraction or like harm erythema or anything like that. Raise JVP again, you can't this central pallor, I mean, maybe the actor could be slightly anemic, but then again, probably not likely any abdominal signs, for example, medusa distension, jaundice, things like that you just can't fix. So when you're presenting, if you're thinking, you heard something, just try, just listen again and think if that's really true because I know a couple of my friends who did the OSK were very certain, like one of the actors had a heart murmur. But um it wasn't, it wasn't true. So just try to be smart about what you say. So the things you can act out are, for example, you can act out pain, you can act out weakness, you can say you have numbness and tingling. Those are the kind of things an actor could fake. So that's the kind of thing that actors will try to say and that's what you'll have to diagnose. So things like this probably not. But other things, yeah, they can fake them. So this is just an example of um some of the like red flag symptoms that come with each of the history stations. I just put that in there if any of you guys want to refer to it later, but I'll go into that more detail afterwards. So the main thing about the OS that I just really want to reiterate because I didn't know this until right at the end of the year and I was really freaking out. There are no failing actions and ask you. I know loads of people tell you, oh, if you don't wash your hands, you're gonna fail the station. Um If you leave the tournament con on for like more than 60 seconds, you're gonna fail the blood taking se ok? Yeah. In, in future years you probably would fail if you missed out something important. But for third year, there are no failing actions. You cannot do something and then fail the whole session. Just use the mark. And I got that from the slide that faculty actually sent us. Um and they gave a talk about it and I'm sure they gave you the same talk to. So don't worry. So, for example, yeah, if you don't wash your hands, you're just gonna lose the mark for not washing your hands and the examiner will probably tell you please. Could you wash your hands? So don't think. Oh my God. Oh no, I forgot this. That's it. Um There's no point in me doing the rest of the session. The osk and bad is really more like a tick box exercise. It's really just like a checklist and you just make sure that you've gone through all the steps. If you forget something, don't worry, you can go back at the end and they still should give you the mark. It's better to go back at the end if you've forgotten something then disrupt the flow of your exam because you also get marks for how you present yourself, how confident you are and how the patient um feels about you. So do they have confidence in you? Did they feel like you have good bedside manner? So just go back at the end if you know you've forgotten something. So follow the faculty checklist on in so on in send under like clinical skills and like um bedside teaching, you'll have guides for each examination that could come up and they have like a list of things that you should do in that exam. These, the faculty keeps saying are not mark schemes. So they're not the exact mark scheme you have in your sy, but at least I use them and everyone else I know who practice with oss also use them. This is kind of like your gold standard of all the things you should cover. It's not an exhaustive list, but it will give you a pretty good idea. So bedside teaching is very useful. Um That's what I mentioned earlier on in this talk about your teaching. Fellows should take you to patients on wards to do the exams on but not all hospitals do this well. So I'd say it's don't expect it to be good, but if it is um make sure that you go to them because they're really worth it. Um Practice. Yeah, for the Os as I was saying before, if you start at the beginning of the year and you do it consistently, honestly, there will be no problems at the end. Um So the way that it works is that you need to pass six out of the 12 stations and you need your overall average to be higher than the pass mark to say you fell four stations. But your, your overall average is still 70% and that's above the pass mark, then you will pass. But even if your overall mark is 70% but you failed seven stations, then you'll fail because you haven't passed the minimum like requirement of stations. So really, if you feel like you've done terribly in one station, it's not the end of the world, you're allowed to fail a few stations. So try not to freak out and just um go towards the next thing. So this is the like kind of um faculty checklist that I'm talking about. So this is just an example of the lower limb arterial exam and the kind of points that they like you to do again, like paper, like um introduction inspection and palpation precaution auscultation. That's not exactly like the structure here because it's a special examination. This is just an example of what the checklists look like. Um And what you'll be using kind of to base your revision on. Of course, there's other resources that I'll go through. But um this is kind of what I found to be the gold standard for faculty. So this is what I mean by the stations and the exams. So the skill stations I said they could be skills or also examinations in the skills. So the four the exams are cardio neuro abdomen breast. But in your four skill stations, you can also be asked to do some special exams and those are like breast exams, examination of the lump, the neck and the thyroid, the vascular arterial vascular venous ophthalmoscopy and otoscopy. These are the exams that can come up in your skill stations or you can have actual skills which you will have too. And those include peak flows, inhalers, abgs, venipuncture, urine, dip, CBG, ECG, all of these other things. Basically, you can read the list um and the way that it works in the exam. So the osk run over three days and you'll each be assigned to a day either in the morning or the afternoon. So say on the first day, the skills that came up were um doing blood. So like venna puncture and doing cannulation. That means that on the second day and the third day will be the skills as well. So you are at a slight disadvantage if you go on the first day and this has been in practice for a long time. So every single year, you might, they always tell you that it's changed and what changes is kind of like the, the like the thing, the patient says or something like that or like the diagnosis. So for example, in our year, we had ECG so ECG was on the first day, the second day and the third day, but then the diagnosis will change. So for example, on the first day, the ECG diagnosis could have been like atrial fibrillation. And on the second day, it was like um sinus tachycardia or something, but the actual skill will stay the same. So if you're on the second or the third day, you will already know what skills are gonna come up or what these special examinations are, you won't know the diagnosis, you won't know like what the patient has, but you'll know what you're doing at least. So the other station you have, apart from the big four, the skills and the histories is the coms or the P VB station. So this station is really weird. They only introduced it like one or two years ago. And I think this is the station that has the lowest average every single year because it's really weird. Um And no one really knows what exactly they're looking for, but it's normally around a minor procedure. So they'll take one of these. So for example, in our year, they used um they used like teaching inhaler technique, doing a urine dip and like vaccination as the minor skills. And then they'll also ask you to do like APV component to explain the procedure, gain consent. Like you do for everything, do the procedure. But then you have a discussion with the PV patient afterwards and that could be about something they're worried about. So, for example, on my day, I was on the second day of the oy um this year and I had urine dip. Um and my patient was really worried that he had done um some, he'd had substance abuse with cocaine and he was really worried um about what would show up in the urine dip. And I had to address his concerns and questions. So that was like the other half of the station. So although I said the skills stay the same every day, the P VB change P VB station always changes. So if the first day, the P VB is urine dep, it will not be urine dep. On the second day, the skills are the same, the P VB always changes. So these are the history stations. So um like I said, they are history stations. Um And you take the history from the actor. So here like the actor can say whatever they want really. It's not like signs, they can fake or act out anything really. So you have seven minutes to take the actual history and then the examiner will stop you and say, could you please present your findings and then they'll kind of quiz you and stuff. So they'll ask you what your differentials are, what investigations you would do. Um What other things like examinations, tests you would like to do and then how you would manage it and they'll guide you through the questions. So they're the hardest stations to get full marks even just to do well in um try to get the diagnosis when you're doing these. But remember again, even if you don't get the diagnosis, right? If you don't ask the question, you're only gonna lose one mark. You won't fail the station. Always remember to ice because when you're in the stress of exams, it's something everyone forgets and learn the red flag questions. So uh a couple of sides back, I put this sorry. Yeah, these are the red flag questions basically. So for each like system cardio rest neuro, these are like the red flags. So you should be asking these questions to each patient. For example, if they have a headache or have you ever lost consciousness or have you ever um vomited? Have you ever had like neck pain, things like that? Or have you ever felt like faint or dizzy? Have you had like numbness, tingling weakness? All of these are kind of like red flag symptoms that you should learn. You can make your own list the list, but they'll always have like a list of red flag questions. So um you'll know exactly like what to learn basically. So um yeah, learn the red flag questions. Try to practice with real patients. So when you're on the wards, obviously GP is the best place to do this because every patient you see you effectively be taking a history. But um obviously you can also practice with your friends using things like SMED and passed. So they have a key features on these. I think you have to pay more for ques and the Pass me ay feature is new. So it's in like a beta testing so you can sign up to it and they normally like add you to it. Gy Medics is amazing for a, I'm sure you guys have all watched their videos. Um Again, you have the faculty checklist, but Gy medics sometimes do things a bit differently. And another thing that was quite useful is simple. AKI, one of our teaching fellows showed it to us. Simple. Oy is a website that's been made by um a past Imperial graduate. So the way the website works is they have one of the checklists on, on your phone or online and they have a timer as well. So when you click, start the timer, it counts down 10 minutes and then while your friend is doing the exam and you're watching them, you can like take off all the stuff that they've got or what they've missed and then it gives you like a mark at the end. So simple, ay is really good, but in the end it's really just about practicing again and again. So examination station. So these are like back to the big four. Again, you'll be asked to provide a summary of what you've done, what you would do to complete the examination. And again, they can ask you things about diagnosis, investigations and signs. So don't worry about this because by the time you get to the osk, you're already revised for the written exam and you have done your written exam already. So all of these kind of investigations and diagnostic signs and things like that, you should already kind of know because of that. So the big four exams are the easiest stations. You can actually get full marks in, like you can get 100% in your o exam because these are the ones that you can just practice again and again and again and you should get, you should aim to get really good at them. So practice as much as you can in placement. But realistically the truth. Well, least for me. Yeah, you're meant to do it regularly throughout the year, but sometimes you're just not as organized or maybe your placement doesn't give you as much chance to do it. The truth is in the last few weeks before you ask you, you're gonna do really intense practice. I mean, I know like lots of people like to revise regularly but some people like we are less organized or prefer to do things kind of last minute cramming at the end and you can cram but it will be pretty intense So I'd say try to practice at least in time for each start. But what, where you do your main kind of body of like, I'm doing exams every single day would be between your written exam and the ay that would be like you do it all the time. Practice on your friends because remember your friends are healthy people, they also don't have the signs. So practicing on them is very similar to practicing like on the actors and just do these again and again and again, like I remember the last three or four days before my ay, I would go through all these at least these ones, the big four because you know that they're gonna come up, I would do all of these um like every single day on someone or on like a teddy bear or on your bed or just go through it in your head. So you just really got it done because you wanna look fluent and everyone does the exams or like in their own style, there are certain things you need to take off, but the order in which you do it is completely up to you as long as you have a structure to it. So just perfect your own structure. So this, I took from the introduction to year three slide from our year. And this just gives you an example of like all the different stations that came up in previous years. So it dates all the way back to like 22,009 or something. So this shows you like everything. So as you can see the green stuff, the skills they haven't got like, they've stayed the same. So that's why you don't have like three days of showing you different things. So you can look at that in your own time as well. They'll be on the sides. So this is just to give you an idea of what came up in our year. So in 2024 so the skills for all the days were ecgs a breast exam. This wasn't on a real person. The like there was a person wearing like a model of like the fake breasts. So it wasn't on a natural person. Um ophthalmoscopy and cranial nerves exam. So this one was really strange. I think most people were quite thrown by it. So they asked us to do a skill which is the eye like examination with the ophthalmoscope. But with that, they also asked us to do some cranial nerves. So not all the cranial nerves, they were like examine cranial nerves 23 and six or something. And then they were like also do ophthalmoscopy with that. So those were the skills um the history presentations on all days. So again, they keep the presentations the same, but the diagnosis is different. So for example, if on the first day, the patient has a headache, it could be a tension headache, on the third day, the headache could be across the headache. So it would just, the diagnosis is different, but the presentation is the same. So for us, the first day was, I mean, not the first day, one of the stations was loss of consciousness. Another one was headache and one was pr bleed, but obviously there were different diagno depending on the day. So here P VB is the one that changes from day to day. So day one was inhaler technique. Day two was doing a urine dip and day three was the vaccination. So that actually changed. Um And yeah, this is another like a more updated version. So this shows you 2023 as well, which I think the previous slide didn't have. So it shows you what came up again, P VB stations, they always change. So it doesn't matter what your friend said yesterday. Um It will be new. OK? So these are just kind of like my final TIPSS of the osk. You like what I did? Um You're gonna be nervous, everyone is really nervous. Um But it will be ok because everybody is nervous or shaking or stressed about it. Um Focus on the next station. Don't worry about your pass stage, just move on because you have a chance to do well at every single station and it might not even have gone as bad as you think, even if you think you've already messed up practice with your friends as much as you can. I know the faculty always says they can tell who's been on the walls. They can tell who's put effort in placement. Yes, to some extent you can tell, but practicing with your friends will give you just as much, maybe not just as much but a pretty good advantage as well. So, OK, if you go on the wards, you to be comfortable with talking to patients who have built up throughout the year. And obviously I would recommend doing that, but say that you've got to T three and you feel like you haven't had as much exposure or you feel like maybe you were tired and you didn't go to places as much as you should have. It's not the end of the world. If you practice with each other, you can still like salvage it. It's not like, oh, I didn't do this on the ward every single day. I didn't clock five patients a week. That means I'm gonna fail. No, it doesn't mean that you can do it on each other and you can practice yourself and still do practice on the wards. But like I said, it's not the end of the world. I know. Um, Amir Sam and Korean Mir and they're really, they really pushed you to clog lots of patients, which is obviously very useful and very good, but just in case you haven't, it doesn't mean you're gonna fail the ay, remember nearly the whole year passes, I think in the year below us, only one person failed the whole ay. So it is literally possible that your whole year will pass. It's not like they have to fail a certain number of people. It doesn't work like that. Everybody can pass. Um, and in general, most of the people pass, of course, if you have problems mitigating circumstances, that's different. But, um, in general, everyone is able to pass and get your own rhythm and routine. So the big four, I'd say those are the ones you have the most control over. That's the one you should perfect. Make sure you're really fluid, you can structure it, do it how you want. Um And you also have a site specific mock. So depending on where you're placed in third term, your kind of hospital or GP clinical skills, they'll organize an Os mock. It won't be 12 stations. It will be like three or four or something. But you know, um the su so like most of the me MD E AMA, they will run a mock. So if you remember for your A CPA, you had like a faculty, not a faculty student, l mock, you'll have your own student osk mock as well. And that is like the most useful mock that like compares to the actual exam because the Os Kla D student mock will have 12 stations and they'll give you proper feedback and you'll get the chance to do everything. Um And I haven't written down here, but I think what's really important about the OS as well is clinical skills. So I know you might not always go to placement. Um Maybe your friends aren't going, maybe you don't wanna go or your consultant is not in, but one thing I'd say is always go to clinical skills. That's not something you wanna miss. Not just because they take attendance or whatever, just because clinical skills is the chance where you can practice like the bloods, the ABG the cannula and you can do it on the fake arms and that's how your exam is gonna be. So obviously doing on patients is a big advantage, but clinical skills is so important, especially in that time. So if you're gonna not come in on a day, just make sure it's not a day where you have clinical skills, really try your best to go to those. And also don't freak out. I know at the beginning of the year, it seems like a lot, everything seems so much like all the conditions to you and you just don't really know how it's gonna come together. But by the time you get to kind of third time, everything seems to kind of come together. Even if you didn't attempt placement that much, the times that you go in, you're exposed to things you see things you see patients, you see people you've done like the mocks you've seen exams and you have lectures about these like, exams and things and then by the end it kind of all just comes together. So, just trust the person go through the year. I know you don't get an Easter holiday. It's really long, but just keep on going and you'll make it in the end. I promise. So, thanks for listening. It's just like a woodsman and I study and holiday for good luck. I don't know if they all look kind of cute. But, um, yeah, good luck. You guys, you'll do fine and just try and enjoy the year, do what you like and do your best. But thank you so much for listening to both of us and we hope that we were kind of useful. Obviously, you have any questions just put in the chat or try and ask us. I don't know if you have anything to say no.