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Not yet. Hi. Um, can people hear us? Oh, they will. Hi. Um, if he can hear us, give you probably a message in the chat. Oh, yeah, they can, I think. Amazing. Thank you. So, um hi. Um, welcome to our first session. Um, one second. So, um, hi, my name is Rosa. Um, I'm with the grade team from Cardiff and we are recent graduates slash medic final year medical student who passed se and we just a quick intro. We've just started the series so we can help you guys uh pass your because we know how, um stressful to get. Um, just to start off quick, we'll do a quick introduction to the team, um, quick intro to the actual series and we're, we're hoping to do this year. Um Ronan will go through how these work and how to stop practicing for it and then we'll do a quick, um, TPS and advising what to do for your CBD and how to approach it. And finally we'll end with AQ and A and we've got the whole team for, for any questions so we can turn to the team. We, uh, he's gonna for that Yeah. Do you want to do an inter? Yeah. Hi, everyone. My name is Ron and I'm one of the, um, f ones based at Wrexham. Um, I graduated from Cardiff last year. Um, and we had the, is the year before that, so we already ran the, um, is series that you're kind of seeing now last year. Um, and myself and Riser ran it with the fourth year medical students at that time while we were final years and we found a lot of students found it very, um, very helpful and it was a lot smaller at that point. And uh not as many sessions as we've put on for, for you guys, kind of as the series for this year and we've got a much bigger and um more coherent team. So we're hoping to run the series even better for this year. Um, kind of springboard off that to help you all um with your s um So yeah, we're looking forward to seeing some of you at the mock is skis or the regular sessions. Um And the more sessions that you turn up to, the more useful you'll find it. So, yeah, looking forward to seeing you at the, at the series and then there's me. So I'm an F one recently, I'm an F one in Wales. Um, and I can't see the slides. I don't know if other people can, right? Can, can people not see? I can't see it. Yeah. I need to change. You're on the, um, medal. You're not on the, the powerpoint. Yes, sir. Now we can just see ourselves. Wait, wait, wait, technical issues. Oh, we learned from it. Oh, yeah. Yeah, it was presenting like, um, only like five minutes ago on the right one. So, while you're doing that, should I introduce myself? Yeah, we'll go around and everyone can sort of introduce themselves and their roles. Yeah. So, um, I'll, I'll go. So, um, oh, sorry, Roma, I'll be back. Cool. Arnie. Um, hi, everyone. I'm, um, I'm Cath, I'm one of the f one doctors. I'm currently in Princess of Wales. Um, I'm good friends with, um, Ro Ro and everyone else here actually, but Ro Ro and I, um, uh, are all the ones here. Uh, we did our skis a couple of years ago now, so we know exactly, um, what it's like. Um, and so actually, so you did your skis as well? Same time as us. Um, so, yeah, we're all here to help you. Uh, we're kind of c, in the evenings giving up our time to, we want to help you. I'm personally more than happy for people to contact me if they need any help with anything or if they just want to chat or whatever. Um, we're all going to be doing, um, our own sessions on various things. So, I'm doing a couple, um, coming up in the series. So, yeah, hopefully it will be useful for you. But we know more than anyone how stressful is can be. But, um, hopefully we'll be here to help you. Um, yeah, so that's me. Ok. Yeah, hi, everyone. I'm Ruth. Um, I'm currently 1/5 year. Um, so I did the last year and, um, the reason I joined is because I attended all of rain and business teaching last year and I found it really helpful. So I decided to join them and help out this year. Um So yeah, I looking forward to helping you all the prep. So you, hello everyone. I'm Sarah and I'm a final year medical student at the moment. Um Working in GP in Cardiff. Um I did my keys with the F one lot. So Rodan Roma and c um consciously extended my medical education by a whole year. So I'm still a student. Um Yeah, hopefully the over the weekend comes in handy and the, the series is quite helpful. Justin you next? Hi. Um I'm Jocelyn. I'm also a final year medical student. So um see, same as Ruth. I did um join the Q 101 like last year and find it really helpful. So um I really benefit a lot from it. So hopefully, um with the sessions we organized this year, like you guys will find it helpful as well and I'm happy for you to like contact me as well if you need any help, like CBD or like extra practice sessions. Yeah. Hi, ma'am. Jack. You're the last one up. So is Jack? I think Jack might have be having some net network issues. Jack either. Um, so Jack, Jack, er, Wellington, he's one of the F one doctors based, uh, in one of the hospitals in England. I'm not specifically sure where exactly, but he, he's working as the research lead for the ski teaching series. So, um, just going to be seeing where we can improve and you taking any of this data to us and we'll go over it and see what we can improve on for future teaching sessions to tailor it around you guys and also for the market, see where there might be gaps in the knowledge. Um uh He'll also be doing a couple of teaching sessions as well. Um So if I just go through everyone's roles, so myself and Visa with the um Cole. So we're the ones who sort of do the uh the background sort of leading of the teams. Um Ruth and Sara there, the mock leads. So they'll be kind of looking at organizing your mock and trying to orientate how you guys will slot in and examiners. So they do all the admin as well as preparing the stations for you. So they're really good at that and then they'll also be doing some teaching sessions for you. Um C she's the administrator. So she does all the organizing of kind of the argument of where you guys will have your teaching sessions and she's very keen on doing some teaching for you guys. Um And then Joscelyn, she's the social media rep. So we'll be basically kind of sending you updates about what teaching sessions we have going on. Um And also has some good teaching sessions planned for you as well. So that's the team in of itself. I don't think Wisma is back. So, what I'll do is I'll kind of get the ball rolling at least. And then once we've got the kind of background of the slides up and running, we can, we can obviously go through the slides from there. Um So what's the actual is series for? So it's basically a series which is going to allow you guys to develop your consultation skills. Ok. Pertaining to the is a, so mainly focusing on those key components of taking a history, um, building rapport with your patients, how to maintain like a professional, professional relationship with the patient, building your differentials and your management and investigations of patients presenting kind of an acute situation and also uh kind of chronic management of medical conditions as well. We'll be tailoring it based on what we would expect you as students to be capable of doing at the level of the is, um, as that's what will be expected of you on the day in terms of you pass the is a, um, and because we all have kind of that experience. Some of our members being very recently passing the is, um, oh, your b any l with these? No, not at the moment. I'll just keep going while this is trying to. Um, yeah, I'll, I'll, I'll give it a, ok. Hold on. Can I go see that? Yeah. Yeah. Ok. Right. So we'll just go from here then. So we'll just go through the itinerary really quick. So to the team, you've already kind of got to know everyone on the team and we'll all introduce ourselves is good. Um We'll then be going through a breakdown of the is, which is the Iski series and what we can offer, which is what I was just discussing with you guys now and we'll be going through specifically how the Iski are structured and the stations that are orientated around that, um how to start practicing. So, tips and tricks of what we would recommend you guys to go away and do by yourselves independently. And also, you know, attending the IC series will be useful for your learning as well and we'll then be doing AQ and A that's before the CBD station and then afterwards we will go through kind of the specifics about the CBD station. We have another session which goes into it in more detail, further down the line. But it's more just to give you guys a guidance of what cases to possibly look for and what things to think about it's good to try and look for these cases of why you're on placement at the moment. Because then if you find something, which you think would be good, you can already start preparing it in advance. And I would say for that one, the preparation in advance is key. Um you know, and feeling prepared for that station. Um as it's a very good station that you can predict what you're going to, where you mostly can predict what you're going to get asked. Um And you can prepare for beforehand and know what the examiner will likely test you on. So you've already kind of got to know myself and Lisa. Um there's K Jocelyn and Jack and then sour and wh as well. So going through the series, as I said, it's um yeah, yeah, you can. Yeah. So hi guys, sorry, sorry for the tech technical problems. Um I was just saying, I'm, I'm working in North Wales at the moment, um recently graduated this year from Cardiff as well. Um And the whole, the whole point of this series um is that we help you with preparation for your uh pre preparation for your si mean. And it's only because we have been through the whole same process and we know how stressful it could get or how scary it could be and we wanna be there. So there is someone you can ask help for. Um and we'll try our best to help you guys. Um We're hoping to have a mock ski this weekend and we will be emailing you the slot. So we've given you guys like 40 minutes to one hour slot each. Um at the end of the, at the end of the session today, um We'll, one of us will explain a bit more about what's gonna happen over the weekend. Um But we'll run a mock ski and then starting next week onwards. same, same time as today, we'll start regular Wednesday sessions, 630 on metal where we'll go, we'll go through topics such as like um how to, how to do a proper, good a how to approach uh the red flag symptoms and acute stations. And the whole point of is that you have a structure, an organ, uh an organized way to a protein station. And that's the only, that's how you pass an esky uh because structure is so important in an esky. Um We'll also here and there give you tips that we have learned ourselves while uh preparing and um hopefully that will enhance your preparation as well. Um Yeah. So we'll have the teaching sessions every Wednesday up until the beginning. April and then we'll do another m closer to your actual session. And hopefully you'll have seven of us here. If you ever need anything, any help, any questions, any advice uh regarding Iski? Yeah. Yeah. And just to add, so we're obviously going to tell you all in advance. We're going to be using a lot of the data from these mock E skis and also teaching sessions to, to gauge what you guys might be struggling with components that need extra levels of support. Um And it, it does also inform us for next year when the series continues. Um knowing how to tailor service where if there's a particular aspect that students really struggle with, then focusing more sessions on that to benefit you guys. So we are doing this still to benefit you guys fairly down the line. We'll still be looking at the data regularly, but it will also help us for the future years as well. Ok. So this is the timetable of the um is series. Um I won't kind of bore you with all the names of the different sessions we're doing, but you guys can have a read of that. So, you know, the basic itinerary um we have the intro session which is today and then the mo he will be well, the first mous he will be running this weekend. We have um basically organized the teaching sessions based off what we think of the most important things and most likely stations that you would get in a um and have kind of assimilated that down so we can fit all of it in nicely. So we're not going to run a very niche teaching session on something like uh spinal like lumbar spinal X rays. If I don't think that it's something that's likely to come up on the day, but definitely having an ECG presented to you or given an ABG is a highly likely thing much the same as your standard stations like presenting patients and doing good sbar handovers. Um And then at the end of the series, we have a session which is to be confirmed and that might be more of like a free fall session for you guys, either to ask you questions, ask you queries and answer them or if there's a particular aspect that we kind of realize students need some help with from your feedback, then we can obviously focus a session specifically on that on that final, final session. And then right to the end, we have a mock gate and that will basically be just to see how you guys have improved. Um And if there's anything else that we can support you guys with. Um So yeah, and by the way, all the slides will be up for you guys. So you can obviously look at these slides and write down the specific timings of these dates. So, you know, and I would recommend trying to attend the sessions regularly um as some of the sessions kind of piggyback off the previous ones. So, um you know, it is very useful in a lot of these sessions. You know, they'll be done by like f ones that have, you know, fifth year medical students or f ones who have had experience with these stations or with these particular topics in the actual exam. So they might have really good tips that you might not initially get if you just look at the slides or something and I will talk to the, um, sessions and the schedule. So you, you all should be having it on your emails. Ok. So how the ISS are structured? So there's eight stations that you get in the is ok, two are clinical examination stations. So that's like getting your um you know, cardio history, gastro history or whatever. Um You always get at least a a cardiac or gastro or rest or some kind of neuro exam that's a given. And then the other one is kind of in that licorice, all sorts of other examinations you can get. Um and that can even range to things like having the thyroid exam or uh being asked to do a lower limb pneumological exam for instance. So the other one is kind of up to the medical school, but the first, the first one is a bit more predictable that you'll at least get one of those which I mentioned. Um you have two com skill stations. So these are your seven minutes to take a history. Um You can be asked to present your findings and you might be asked how to manage that condition or what investigation you'd like to do and they often will give you some kind of like clinical data to interpret and then they might have some other questions to, to quiz you on. Um Occasionally they might give you some diagram that they want you to label, which has some anatomy on it or something, which is a bit more out of the box. But usually it's the more predictable present your findings. How do you want to manage this and so on, you have an professional com com skill station. So this is a four minute acute history. So when we say acute, you know, it's something that you can take a quick history, you don't have to spend too long and just get the basics of what's going on with the patient. So your chest pain, your shortness of breath patient or you know, your gi bleed patient like those kind of presentations. Um The examiner will then give you some time to kind of summarize the case and then they'll ask you to do like an SBAR presentation. Um Often they'll give you some information before this. So they might give you some obs of the patient or an ECG ask you to interpret and then do the SBAR presentation. So it might not just be the history alone you're presenting, but also some aspects of the case, which you're presenting with it. Um And then again, 11 minutes, they, they can ask you, how do you want to manage this or you know, what do you want to do? In terms of investigations and so on. And you have a clinical pharmacology station. So this can be taking a normal history and then identifying medication side effects or interactions of some new medications that have recently been started. It will present like a normal history, but it's your job to identify the medications as being an issue. So, um, what I would advise in these, in all of your stations is, um, one Cardiff really put weight in on your, um, ice. So I would always include that in your history. So your ideas concerns expectations. Two of my stations, I saved myself because I asked the ice and it allowed me to identify really key red flags. And often than not, the reason why students don't pass pass stations isn't because they don't have the vast arrays of knowledge that you need because you already demonstrate that in your, um, kind of written exams, it's that there's some safety risk or some red flag that you've missed. And there are ok. Um, because you want to show that as a doctor rather than you, you know, being able to manage some really niche condition that, you know, a reg or a consultant can manage. They don't necessarily want you to do that because you're, you're still preparing to be an F one. They want to see that you're safe. They want to see can you manage someone in the acute situation and make sure that patient basically is stable by the time the consultant comes to review them or a senior comes to review them as that's almost the chain of command that you're there to make sure patients are safe. Um So yeah, your acute assessment station is your four minute history. So an acute history again, and then again, you will be asked like kind of differentials in management and you do get two clinical procedures that you'll get asked and I wouldn't get caught up in knowing the really, really niche procedures like obviously know them, but also make sure that you're competent and doing your basic uh clinical procedure. So, you know, taking your blood glucose or um doing like spirometry of a patient because those are just as likely to be assessed as you being asked to put a catheter in and remind you there's only 15 minutes for a station. They won't ask you to do the whole catheter in the time that you need for clinical procedure because it just isn't feasible. So they might break it up into components. So set up the equipment for the catheter or the equipment is already set up, insert the catheter. So it would be like that. Um And then your final station is your CBD station. So you get seven minutes to present a case that you've seen. Um, and uh also had an element of involvement in the care. OK. And I'll go forward of this later on and then your three kind of topics of questioning that the examiner will go around is an investigation that was done on the case, the management or in some cases, if they didn't do something, why they didn't do something and an ethical element. And this can either be social or interpersonal communication. It, it's what do you think is an ethical dilemma or unit around the case. So this is the kind of breakdown of how they separate what they're examining in the different stations. I won't go through that all. But as you can see, it's a lot of kind of clinical examination, but the things that they assess in every single station is your diagnostics and reasoning. OK. Are you logical in your thought process? Basically clinical care and patient safety. As I said, they want to see that you're safe that you're going to keep that person alive until a senior comes to a view or if it's your chronic case where they're not unstable, are you at least identifying the key components that are your sort of red flags like exploring the patient's concerns or expectations regarding me? A yeah. And then the professionalism. So are you presenting yourself in, you know, the professional decorum that they would uh expect of you as a, as an F one doctor? OK. And this is a good thing to actually at least have a look at. So this is how they'll actually mark you. So they might have a couple of boxes which asks them what they want to write specifically about how you were in the station. So, you know, clear questions, good manner, more specific and so on. But the actual bit which the examiner fills it and OK, they say simulated patient feedback. But um it's also the examiner has a section like this and it will be then basically flawed, categorizing your performance into where you very good. Were you like acceptable proficient or was it insufficient? Like, I don't know the names of the specific way they do it, but you want to make sure that basically your, um, general performance on the day is enough of those for them to say, as your overall performance for that station. Yeah, I'd say they're proficient, I'd say they're safe. Yeah. Another kind of safety bracket for you. You don't need to pass six out of the eight stations. So this is why it's really important to kind of have your shuttles on. Once you finish the station, you go on to the next, you don't think about what happened before because in fact, sometimes they're not, you think that the station has gone poorly and actually you might have passed it. You don't want it to affect your future stations that are relevant to those six out of the eight stations you actually need to pass. And if you bottle one, then you've still got another two that you could fluff before you actually looking at failing So, you know, you've got plenty of opportunity to show your stuff and they won't fail you if you didn't get some diagnosis or something, if you made sure. So if you had a patient coming in and it was shortness of breath and you thought it was a pa from the history and actually it was an MR, if you still said in your investigations. Oh, I'd like to do an ECG. I'd like to do this, this, this and then they showed you the ECG and it has some ST elevation. Well, if you identify that, then still you've shown competency in ruling out something very significant. They're not gonna say, oh, you, you don't pass because you didn't get it first time. So it's looking at the whole context of the situation. Yeah. Ok. So do you wanna take away from this one? Yeah. So, um, just from our experiences. Um, I, I'm pretty sure other people have other experiences that, um, quick, quick tips as to how you can stop repairing. Um, so when I get my A ski, um, yeah, when I did my EK I found a group of people who I know I can work with and I would highly recommend you find a group as well. So two is a good number or I would say three is a good number. Two actually, cause then one of you can be the exact, um, actor, one if you can be the, um, student and one, if you can be the examiner or give feedback basically, and this taking it in turns, um that's obviously gonna help you. Um The main key way of learning uh preparing for is practice, practice, practice, cannot emphasize that enough. Um So what I would suggest and how we did it um is to have set the day aside in your week, do something every week. So, um I know I practice with Rodan and cat and we had, I think every Sunday 3 p.m. to 5 p.m. just literally for the whole year. Um And yeah, uh literally, that's, that's the only way you can actually practice. Um So if you don't have a group yet find a group and you are in a platform right now where you can actually find other people who are equally interested in preparing for. So if you want feel free to use the chat function to find your um group, um you can do that too, not hurting and out. Um And the other thing is common is common. So don't and II remember I used to make the exact same mistake back in the day. Um is is there to make sure that you're a good doctor who can actually recognize when, when things are going wrong and there are certain conditions that are common. So if you were to, that will get you to pass your ski. So you're learning about like, I don't know, antiphospholipid syndrome is slightly unlikely to come on. So I would highly recommend just focusing a main topic. So causes of chest pain or, um, cause of, uh, pr bleeding PV, bleeding, all of that. There, there is a set which hopefully will go through over the next couple of weeks. Um, and I'm sure you all know already, Gy Max is the we, uh, website to go to, um, use it, use it before your group session, group practice session and then make sure you do your independent revision as well. And the other thing I was gonna say, I don't know if you can see my, see my video, but this book is super handy. Um And I think this will, this was basically our es Bible at the time. So um yeah, those are some resources to use, happy for you guys to have a chat with us at the end and we can answer your questions. We also use the um book with the uh a stations. But again, I'm aware that now geeky medics and past med and that medicine, all of them have a stations as well. So you don't really need to work on the bit. You can, as long as you have some stations to practice with the other way to practice would be if you make stations that's actually helping you use the knowledge and apply it to make the station and that is a good way to practice as well. So you being an examiner will actually help you in your escape by applying the knowledge that you've learned. Yeah. And you can split costs with these things that reduce it significantly. If you find your particular group, only one of you needs to get the book. I would say there's the osk stop one. OK. From my own personal use of it, I found it a great investment and I would say that as a personal investment into you passing your finals, I would, from my experience recommend it as I would have been lost without using it. I find it very useful by all means we are not advertising particular. No, no, it's more like we're not sponsored by these people or anything. It's more for our own personal use of them that I found it very helpful. Yeah. Um and we'd want to guide you to what are the best kind of resources, I guess that we can recommend from our own experience, but most importantly, and I cannot emphasize this enough. It, I it is a, it, it's one of those exams that you need to prepare on long term, long scale, long term scale rather than quick sprinting. It's a marathon rather than a sprint. And it also means you need to actually make look after yourself, um exercise, good diet, good sleep. Um because losing that is not really gonna be efficient because you, you need to stay calm. Um And it's so it's so common. I think, I think the biggest worry for the ST would be panicking or getting nervous and then blanking out on the day. But the way to avoid that would literally be to start early, start preparing early. So you, by the time ST comes, you'll actually feel like you've started early enough that you won't feel like it last minute. Ok. And also if you actually stay calm, that will actually help you use whatever knowledge that you already have. Um But also we look after each other because sometimes we do forget that. Yeah, any questions so far, we'll just love it. Move for a bit if anyone wants to put a message on the chat, is that anything you've mentioned? Except CBD? Because we're still gonna go through that and there'll still be time for questions at the end. It's just a quick stop off if somebody isn't been about something, although we're just gonna do a quick injury to CBD just to cover everything. But um, we will have a ses proper session on CBD as well at some point. Um, um, the other thing to emphasize difference between year four and year two, in my opinion would be year four has a lot of communication stuff including history, taking, explaining stuff, medication, medication, review, data analysis, a lot of speaking rather than the actual examination because only 22 of your age stations will have examinations, one of which would be your basic ones like cardio Gastro Rest neuro. So, hence why, that's the other reason we're gonna do our session or zoom mainly also to cover both banker C 21 North. Um, and Cardiff. You, so, yeah. Have you got a list of topics or plan to go through? Um, if you mean from what IG from the, from your question, um, in terms of the plan, it's obviously the itinerary that we've listed out in terms of what the sessions moving forward are going to be in terms of the list of topics. Ah, what I would suggest is from our own sessions that we're running. It's going to be the broad things of what we think are absolute must that you need to know for the escape, um, kind of your call fundamentals. Um, and that includes your differentials how to go through your investigations and management and all that. Um, and then if there's niche stuff beyond that, then we leave that with you guys to somewhat look into further. Um, we didn't think it was useful running a whole session on how to manage exacerbation of AC O PD patient because you can find that information in like the ofs stock book. For instance, I know there's a great section in that which goes through it. Um, there are certain things which I guess we found, you know, we can cover with you because we think it's absolutely important we do and then those extra bits you obviously can find within the book. How you doing? Right. We'll go quickly onto the CBD station then. Ok. So the CBD station basically it's just finding a case from your placements. OK. And it can even be something that you saw the year before. But I would say that I only do this if you know the actual background because you'll see why when I go into it in more detail. Um The only thing that you can't use is anything used on like your patient pathway oncology projects, you can't use those. Ok? But anything else is fair game. Try to find something that's interesting, interesting to you. But then like interesting to you because an examiner can tell whether you actually found this case engaging and you know, stimulating to your own learning. So pick something that you're intrigued about and you want to uh discuss in more detail with the clinician because it's a good talking point. Um Make sure that you actually have enough details and this is why I say it's important that you have a case that you know, really well and you know the background, which is why it might be more difficult if you pick a case that you did from third year that you never predicted you were going to use for your because you need the details of investigations they had management because when you're writing it up, you might actually start asking yourself, oh, why did they do that test or what was the value of that? Oh I don't know what other differentials they would have had in mind at the time. So all those things start to come to light. So if you have a case like now, which you find, which you're already going into it, knowing those are the kind of things you need. You are much more in depth looking about the background and document more of this for when you write the case up. Another important thing that they say that you should have is a case that you've been involved in. And this can be any element and try and even mention it without actually like physically saying literally, I did this um try and make it like seamless in the actual text that you're doing. So, um you know, a particular investigation, they have like a blood test or something which, you know, you took the bloods for or something. You know, it's a way that you can show that you're involved in the care. Um and then picking a case that has the ethical element to it. So, you know, it would be like a smoking during your pregnancy or patient who might lack capacity or polypharmacy and knowing whether someone's presenting with something related to a side effect or you started a new medication, they poorly responded like, you know, those are kind of your ethical psychosocial concepts in a sense. So this is a breakdown of what they give you in your actual booklet on the internet. Um because as I said, they kind of highlight you keep it so a case that you've been involved in their care and that can be from any aspect of the spectrum you doing, you know, just seeing them in ed to, you know, doing the full work up investigations for them. Um And then it breaks down the three aspects of the questioning that you get. So your investigations, the management and your ethical social science aspect. So this is why I say it's really important with the directing of the case. So you're lighting up the case. So knowing, um what the examiner is likely to ask you on is somewhat more predictable. In my case, mine was on a lady which had smoking during pregnancy and although she had an array of investigations and her whole admission, I included ones that were pertinent to her work up. So this lady presented with um, uh it was preeclampsia and then became eclampsia. Um She developed like hell syndrome and all those things. So I found that really interesting, I included things that were pertinent to her case. So I didn't write up her whole FBC panel and U and E and LFT S and everything, but I definitely included the important tests that she had done. So one which was a new test that they had recently brought into practice for most females presenting like this was placental growth factor level So writing this in my piece, I almost kind of knew that was where the examiner was likely going to ask me questions on because it was interesting. It was a new practice and I could tell them about the guidelines that supported that. And in the ethics, there was kind of multiple ethical factors, but you can narrow it down to a couple of things that an examiner is likely to ask you on and then just having things in the wings knowing what to say for these cases. So I'm just gonna quickly go through like the questioning bit because the writing of the case is fine. I would recommend when you write your piece. Um, there's certain criteria of how many words that you're meant to have and the font size and everything. So the cardiff technically goes through that already and try not make it like a seamless paragraphs of text, but organize it appropriately. So it's easy for the examiner to read because the last thing the examiner wants is just bunch of text. So bullet points is fine. Um, boxing things is fine. Um And that helps when the examiner is reading through it because they'll be seeing loads like, like, you know, loads of these each day. So yeah, try to make it easy for them. Um, c the first kind of set of questions that they can ask you on is on your investigations. So this is the wording that they actually give the examiners to us. So say with respect to X investigations. So in mind, the placental growth factor level test, why is that particular test undertaken and try in your answer to almost piggyback off what they're probably going to ask you further if um if you didn't say these things. So when I put here, I have guidelines to support this. In my answer, I would at least say why they did a test, how it informed their care and have the guidelines to back that up. Um And these guidelines when I say have them ready to hand, I don't mean verbatim, say them, but to a degree what I mean by that is, um, in my case, I would have probably said, well, the obstetric and gynecology, uh kind of college of Ob and Gynecology guidelines from 2020 suggest that for females presenting with um, uh, symptoms consistent with preeclampsia, we must do these levels for every female that comes in. It would be something like that. Um So at least you can back up why they did a particular investigation. That's all they're looking for. Ok. And then when you were suggesting how it informed their care, well, if the levels are significantly high enough, it might mean they need to be admitted. Whereas if they're low, it means the clinical suspicion of this condition is less likely. And as such, they would need to do more investigations to figure out what was wrong that would be fine for an examiner. They'd be happy with that in terms of management. It's, this is kind of verbatim what they'll, they'll ask. So, regarding the patient's management, what do you think the risks and benefits? So, risks and benefits, uh, everything which we do in healthcare, even down to the paracetamol we give will have risks and benefits. Some will be very, very minimal. So you might be scraping the bowel for the wrist like the paracetamol. And but usually if you've picked a fairly complex, interesting case, there's going to be something in that management where there is a good dichotomy of things that you can discuss and that and then same thing again, they might ask you for some guidelines to support that. So in my lady's case, she was given magnesium sulfate, ok, magnesium sulfate. Obviously, you know, in pregnancy, any medication we can give, you know, can affect mother can affect the mother, but also can affect the baby. So you don't need to overcomplicate it. You can just say there's the risk of, you know, the baby having thoracogenic effects. It's unlikely. But you know, any medication we give can can affect the baby, you can list some of the side effects of the medication. Um And then you can obviously also mention benefits. If we don't give it, they could develop full blown eclampsia, this could cause enough seizures, mum's life and baby's life can be at risk. And so on and then the ethical aspects. So this is very related to it. It's broad in the sense that it can be practically anything from a case. You can even pick the most bold standard admission for someone. And you probably will be able to find some kind of ethical aspect to that case, whether you feel it's good enough to present it at an is different, but anything is technically fair game, as I say, pick something that you find is an interesting case because the reason why you've likely found it interesting is because it has a good ethical element to it which you know, peaked your interest. Um So with mine is a woman who smoked during pregnancy, had previous issues in a pregnancy related to the smoking and yet she was smoking during this pregnancy. So I found that quite interesting because it obviously showed the addictive natures of smoking and this is quite related to the ethical bit. They'll ask, are there any ethical frameworks, guidelines or principles that support that you encountered in the case? Most principles or kind of your broad one which you probably heard at medical interviews? You know, you can talk about the pillars of es that's always a big one. And try and look up on Google something, some ethical frameworks around the case. So in mine, I just did a quick Google search. It was the first time search, smoking during pregnancy, ethical framework slash guidelines and I found a really interesting article where they were talking about, uh, pregnant women and the addictive nature of smoking and how they were incentivizing women to stop smoking and the different psychosocial elements to smoking. Um, and I talked a bit about that in my case as I found that quite an interesting read. And normally if you find it interesting, you find it easy to remember it. What I say is, site cases always have some interesting aspect to them obs and gy cases. In some cases, you can find some really interesting ethical bits like the one I had, which was smoking. Um And then some of you guys will also be on uh kind of like your general wards. There's always going to be a patient kind of on those wards who has a capacity issue or, you know, they might be making a complaint about something that's been said or, you know, some aspect where, you know, it makes it makes it an interesting case. So those are kind of like your three categories of questioning that you get after you've presented your case and this would be kind of our general advice. So for my advice, I'd say find a case early. So start looking now, don't make your life difficult and over complicated a case if you're going to phone and say that there's an investigation done, but it didn't really relate to the case. They had like a full Ct Abdel S and it kind of showed all these interesting findings but it wasn't pertinent to what they were eventually diagnosed with. It is just kind of open the floodgates for them asking well, why was this investigation done? And then you kind of turn around and say, well, it didn't actually really inform the diagnosis. So you have to start rooting around a bit more to try and make your life a bit easy in that sense. Um And then another thing is for the mock esky, you can't reuse a case that you've used in that mock ey for the actual ESCA so don't use your best case for that one. It sounds like obvious advice, but you'd be surprised people do it and then they realize that they use their best case. So for my here, I put together a case that I've seen a week before because I wasn't going to use the one which I'd actually been preparing. Um and just accepted that if I got asked on the CBD station, then I wouldn't really have much to say. Um But I didn't actually get that in my station as they only give you a set number in your actual, I would actually say sorry, sorry, taking over from now um practice as many, as many times as you can so literally draft it, um draft whatever, you know, so far and then just keep practicing with any doctors you can find. Um I remember I did I did mine in pediatrics and I remember going to the consultant in the ward during the ward round or something. I literally asked him, said I have a CBD and they all know what CBD S are because it's part of the training and they've gone through the same thing. So everyone knows what CBD is, but just say you need to test constipation um that is being tested and your rescue as well. Um So literally pres keep presenting that patient to whatever doctors you can find whoever offers help, whoever's available. Cause um at the end of the day, the more questions they ask you, the more that will open up your mind and the more ideas you'll get about the case and things to read up on. Um And I did pop it on the chat earlier when Ronan was speaking, but I think you normally tend to find good cases in psychiatry or in pediatrics. Um And even geriatrics actually, um obviously you can use any department, but these tend to be the ones where you have either safeguarding issues or social issues. But also you have a good management plan, you have all sorts of things coming around. So um just try keep an eye out for any interesting patient whilst you're on placement, just write it down and you can always go back, you can always ask people about it later on. Um Just to just write down anything you see on board um, and before you end your placement block, just make sure you actually look at the investigations as well. So you know what, what's going on or you have a contact with the doctor or something like that where you have someone to go back and ask questions to closer to your EK if you need. Do you guys have any questions? We will be around, um, if you have any questions, I'm also gonna pop the feedback form on the chat and please, and you can use this time to ask any questions you have about fourth year about med school, about a ski.