Specialist Foundation Programme Interview Preparation - Introduction and Clinical Station
Summary
This special on-demand teaching session is designed to help medical professionals prepare for the ever-stressful Specialist Foundation Programme interview. During the session, the instructor will provide actionable tips on how to approach the academic and clinical elements of the interview, with an emphasis on navigating the online interview. They will also provide insight into what to expect on the day, including the abstract and clinical scenarios. Participants will learn valuable strategies on what to look out for, how to prioritize and justify management decisions, and even tips on how to make the best of their time if they have a long wait before their interview. It is essential for anyone who is hoping to ace the clinical interview!
Learning objectives
Learning Objectives:
- Identify the interview format for Specialist Foundation Programme interviews
- Demonstrate an understanding of prior authorization and patient safety guidelines in clinical scenarios.
- Recognize key components of clinical scenario patients, such as observations and clinical history, and effectively take notes on them.
- Effectively prioritize clinical scenario patients for safe patient care.
- Describe investigation strategies for clinical scenario patients and accurately calculate time management strategies for interviewing.
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The following transcript was generated automatically from the content and has not been checked or corrected manually.
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So welcome, everyone to our special information program. Interview Press. Uh, clinical in particular will get tips on outside of London. Uh, but I first congratulations. You're in order. Because if you are watching this, that means that you've done incredibly well already to be considered for offered an interview, which in itself demonstrates that you're fantastic. Candidates, profession you're taking instruction. Yeah, uh, she goes to the thing and introduce so appointment for the pitch of bitches that sounded before. So I'm unjust. Um, but I think it will care in about, uh, going through this process last year. Uh huh. So when I'm done, I'm on a PPI in clinical neuroscience that Kim's apparently say just we're going to do is very briefly going to talk through kind of the interview format. And then we'll move on to the main kind of the majority of what we want to talk about today with the clinical scenarios you have to go about, um, a few tips and tricks from our experiences, and then we're happy time pending to answer questions at the end. Yes, I said before to county out, we'll focus on London just because the interview for that tends to remain same year on year on. You can apply a lot of learning London to our son in London wearing it's much harder to be the opposite. Uh, if you do have any specific questions for outside of London, but keeping being, and if we cannot wait, certainly find someone looked for you. Uh, way bean for this. We're going to give you information that we've been trended down the need experience. But we are affiliated with anyone delivering the interviews. No, inside knowledge. This is just the word of mouth. Please. They ever been? If you want to take into account what we tell you that fantastic. But what did he think? It's a load of rubbish that you may well be right. So interpreted that That's okay, All right. Say, ah, that's was into yet Way it works. Out of the day is huge. Log in. It's online on this knee. Gently this corporation out about 15 minutes. Once you've done the documents and add with right D checks and everything on during that time, we abstract all this stuff that stuff this week. Next week, if you haven't abstract time to kind of look through those things, you know, given any of the clinical station information in advance on. But you've done that based on our experiences. Last year it was quite a significant time. Lap time gap delays between doing your interview or doing your preparation into you and actually having your interview. Um, so that's something to be aware, and we'll talk a bit more about that in a bit on. Then academic patient personal questions first, followed by the clinical station. So the clinical station really happens right at the end. It's the last thing when you're probably the most tired and worn out in your mouth is very dry. That point, um, on the panel for both of the stations academic in clinical is that you have two conditions on additional server. One of them takes sort of the lead on the academic station and the other one takes Aleve, I suppose for the clinical station to just Yes. Yeah, okay. The way through. So the most stressful part of the entire into the short the only bad check. You know, check in here you are on. Get away from the range from anything between five minutes for me or quite literally several hours to Dan. Um, unfortunately, you're at the back end of the day. I imagine the like you waiting for a while. It's going to be more on. Then you get 15 minutes and that's not called. You get in both the abstract, which will be next week. On the clinical scenario, Will Robertson are more likely? No, no. It'll be filled with no blind and writing down much information as you can with you can catch around. Probably best if you use this trolling the head of the interview, Uh, also rather nerve wracking the morning. Well, being a waiting room with seven of people, then you'll be able to see what they're doing at the same time. I advise, of course, would be not to see how much writing throughout, uh, you see, some people don't spend the whole time traveling down much information you can. Or, if you're more towards that, maybe if you find out it's ready trying to see where you work really? Well, Um, yeah, but that's that's much going to say here. So our hit the back fine so perfectly for the first minute. If you're anything like me and he really wanted this job, he'll be quite stress on. You weren't really able to order your courts do much, so I I would be to read through the entirety of the abstract. That will be, you know, a typical abstract a few 100 words. If you see any of the major journals on clinical scenario, which can range from one or two patients is really up to five or six on. For that, you'll get probably a couple of lines of information, whether that be clinical history observations or specific times. You've been asked to do it. Definitely reflect an aunt about doing that for non cool roll. Your experience from from the Place is really comes in handy. Uh, I think with clinical scenario in particular, it's focused on several things. So, firstly, Prior Authorization, which of the patients you want to see first, we'll have an activity and found it to you back in a little better, focusing on patient safety. Think about the key things that might need to be done for each patient. And again, we'll talk about that. For example, if you're patient with, I'm thinking I'm tough Year than 80 is something that you would need anyone, anyone, that patient cannulated that's making scribble down to remind yourself. I think that some people like to do is highlight. Fix your observations or if it's a general question, which you're getting something like a pleasant complain of checks, a have sticking down, keep differentials that you don't want to miss around your eight years for the presentation. If you spend the whole time writing all of your thoughts, in my opinion, you won't be able to order that for headed head of your presentation. And also because of the speed of the interview itself, there will be no time to look for your notes, really about the interview. You could afford it, but I didn't find no feeling, uh, you think that we weren't aware. But when we went into our interview is the fact that you might get in the 15 minutes but prepare and then then would be a long ways before you interviewed for out, which would be provided the clinical scenarios again. So if you do, like, write down some brief information about the patients themselves on your own piece of paper, because you might not be getting back, Um, I like the trial finding is to make things simple. 83 with supper So any patient with the airway problem should probably be seen, but any hurt patient was a new oxygen requirement. Probably need to be seen. Studies allergic disease than someone with abdominal pain. However, there are obvious caveats about someone had a massive jiverly on they are severely hypotensive. And you have another patient to me today, your cannula option requirements that saturating well and actually been much distress. Then obviously, you need to break these rooms, but it's a good idea to have a line, um, and always will save it for when patient safety first. So if you ever concerned about well being implication, uh, particularly hugely, the manage your birth priority on this is where the interview is. Somewhat folks, in that you will be the one or call, however innocents. You see the sickest patients first, you won't be distracted. Go see that patient? You, uh, in terms of don't. Like I said, writing for the whole time really won't allow you much time to order your thoughts that just my personal opinion about that might be different. You know, we'll leave the academic stuff after, but also don't feel like you need to split your 50 50 between academic in clinical. Actually, I thought formal comfortable going into you in the clinic receptionist dot in the academic north, a little my new shine that you can get her in the academic section that might take a little short. So you don't feel like you need a 50 50 thing. What we do, Whatever you feel sick. But also that's where your practice 100. So practical, really exam conditions or interview condition on very how much time you spend in agency, which, which way, work anything hurt there down to my family. And, um, not really. I think the things that I remember doing that stood out is I made a note for the clinical station, a list of maybe I think it was five or six things I definitely wouldn't hold because I thought they were important bits of management or investigations that I thought would demonstrate that I was being safe. So I made a list of those is key things to say, um and then basically, Jackets said, I think the main difficulty with the time you have is thinking about how to prioritize, um, and how you justify that and then moving into investigations and stuff if you're lucky, like me and you have a really big gap. So I had about 2.5 hours between seeing my prep stuff and actually being interviewed. I made enough of a hole through my T approach for the different patients in that time. So I suppose the upside going in very quickly is it's all fresh in the head. But if you do have a weight, you obviously have to optimize and make kind of best use that that time on you can do if you make notes new prepared in a way, you might have a way. Okay, say I actually am thinking back. But what kind of is But I know that didn't read living well in the interviews. But that day for each one, I wrote down every single, well, officially common, life threatening condition. I thought that presentation it reflects made my heart fabricated me to really address them or throw them out. And similarly, for the patients on, you know, it's unlikely are going to see have a least one action. I ensured that they were going to be safe even though I didn't see them. Uh, for example, it with the patient had a New York and I couldn't see them was at least going to after another member of my keys season or state clear information to the nursing team about what needs to be done. So, for example, if the patient be continues to defect rate well from the cannula. Please escalate to with that simple face or anything he didn't rebreathe. And if you are concerned about metal, and in that way, I stay inside in the patients that I wasn't going to see, and I can say that intense that in the millions of you to demonstrate that I'm going to use that one, that one's pressure. But my All right, let's see. Okay, so we kind of like that. That in itself is 10 minutes of being academic in clinical. On the clinical could be anything from one patient with one instruction to several patients for several scenarios that requires you to manage the priority list that basically be from speaking to previous previous interview me. There will be a teaspoon one distraction on that might be an only family member that would interrupt you or a patient went into self discharge or nothing. He won the award, particularly about managing a patient, they stated, and being aggressive towards thumb or even in the more today, a cardiac arrest. And the point of this is to demonstrate that you can think when you speak and adjust your primary motivation dynamics, which will be on to do out there quite in the perfection. Uh, typically, I probably make it better to test you that around in practice, you'll be asked at least one legal question. Whether that be related to the patient, we've done your to be on or another situation in which you are to apply the guidelines for our medical school and also exercise your judgment that we've got it of it out by a little bit. Um, I would the only other thing to say. Some people say they interviewed interact very much well, the clinical scenario, tricky office building vacations or response to your inventions. Investigations are giving you. Other people have said that the interviews sit there and blow up from the face. As far as we know, there's absolutely no infection. What they didn't well, we'll do it. But don't be a nerve if someone sits there and look at your bottom, please, throughout that no reflection of what you're doing, that's just their style. My advice is it is very much opinion. I wouldn't I by interacted with the interview from, so I specifically don't want to be in the three that I put on 15 liters. How I noticed a change in saturation responded about and you didn't want a day. You know, I know there's been no change from when we go. Actually, may not respond. I think you got Yeah, I don't really. I think I think everything to realize Is that the basic, similar or previous interviews? This one too, Or maybe even three patients Something about as well as expecting that you're gonna have maybe some questions as well. So if you spend a lot of your time and you practice to spend the whole 10 minute period talking to 1 80 approach, even if you could get match marks on that person, you won't fully kind of cover all the bases for a while. The different things we're looking for in the clinical station. So I would be looking at bringing down the time you spend on 18. Get nice and smooth and slick. So you have plenty of time into you to interact with the interview and to answer any questions they might have without them pressuring you to stop and then move on to the next a great night. I was like caveat up by saying that you, like you said earlier, Absolutely fantastic candidates find. Probably get your interview section. You would be amazing. A Sinus thing. In a way, the difference between someone that's good interview and sexual in you is the ability to adapt your into me and what you folks on based on patient presentation and interpret whatever informational given with any context of pressure into a baseline of where you should be unique before your interview is for you to rest for a day or two in a minute, uncomfortably exposed with the caveat that you will be given, several patients were like, Most likely there's no expectation that he should see one of them doing a three and a lot of them. One comprehensive, in my opinion, is far more beneficial than doing really pouring to use point medications way. Yeah, I think one of the ways over making sure you're covering all the bases and being safe, which is I can't take anything you're trying to demonstrate in the station is making sure that you can adequately prioritize with patients. And to do that you want an S from the the Office of Emissions on in a natural tendency, you might get given a a BP of 102. But then you say, Is that a big change? That's a known that have been like that? A lot. So So you're immediately little bit less worried about that. If you were given a BP that was 102 but they're normally 160 for instance. Um, you can safety net everyone you don't see, and you can make that. How you asking, for instance, that immediate concerns, you know, get back in touch with any change. Also using more disrepair, Team, say nursing team to say, I'm going to see them now, But can you do the investigation? I would ask for the investigations to be done in my absence, like an E c G, for instance, or to place a cannula to take some blood or to repeat observations on that. Well, that means you can't go to see that person. Right now, you are making sure that you're doing something in your absence, and if they become more on well, you, there's a mechanism of the finding out being at read, prioritize anything you wanna check. No apartment the anything is that absolutely no benefit benefit in Utah and demonstrate that you can do everything when your own that that's just not realistic with real life. And I think based on seeing each other than look at my own lawn cetera that they really are testing your ability to understand how been happening really life, you know what you're going to be in real life. And in that sense, there were so many things that we don't really touch for the medical school that you understand. And you start the job, for example, be better. So they start on the ward. When you're out about to do things in your instance for dump with, you need the investigations. It's quite beneficial for us about on the way to seeing the patient where they were like It'll make you just a much more effective doctor. So, for example, I traveled to find a ward here where that would be a few years doctor. Far better of leading patients with me far better cannulated patients with me. Like I said, I don't know if you've been handed over patient with a P um of 6.5 Oh, you're going to are things immediately so any GI could be done before you're there that patients should be cannulated before you're there. And then, eventually your job is to accept them and decide. You know, I'm going to use to mention in debt. I'm going to get a couple weeks knowing that things need to be done away from the empty. Do you have a medical school that damn where you're just going to practice fuckin with the drugs? And she happened immediately, making far more. It's more in my situation place the final point on on that flight there. It's really important bravado. The next one is a dangerous, dangerous quality. If anything, stating that you want the senior to review the patient or a medical for a period school or if you're in a DJ, have actual to do it immediately is a good thing is not too bad. Then on that will come across where, in your interview. So if you have a patient before you want it in the end, be saturating. What are the next one going to do in 10 minutes? Time to resolve that situation? I already be asking for a letter for that I think you can do that in in to demonstrate. Well, so escalator only as you would in real life demonstrated that your state That one that you're going to get today if you where you have fun clinical exposure, Uh, being lazy boy, that section person me, um I like anything is for all of it. It's going to be basically a script. So assuming you get into into the you can say I after next Monday. But I got the population, but trends. I got a bit of background history enough. Some would be the blood me by the site while I'm traveling a lot of these things on the plane. My restaurant, my my whole 14. The UN don't see the patient and to ask if they want me to continue the patient. Feel it. You can say well about a 32nd and you've got some really good information and demonstrated to the Examiner that you know what counter protests it. Relation. Cancer. Prior medications. Um, yeah, I think Yeah. Someone just asked him the comments. How How would I go about asking chance by end of it? And I think you literally just need to state that you would ask for an SSRI, and then you don't need to break those those things down necessarily. You'll be given. You were given the lining of your information. You say you so with the patient, but and this is really useful information but really inadequate from you to prioritize these patients. Sure. Patient using seven is great. He might be given that information about clinical background about them in the trend. The operation. You don't know if someone has been stable a week in time of the medical team. Happy about someone that started from the news one to renew the 7 50. And then really, you need to You need to do something about that. So I put a lot of them Just say I don't forget the hand a day on these trends, not training information close to single night information so that I I approached it. Uh, it good. I'm saying so any any time there is concerned, you're probably should be around patient safety. So, like I said, if you're worried about patient, verbalized what you do in real life, you know, for, you know, after the big doctors to come and help you out or put him in a medical emergency thing. Cool. Uh, prior authorizations for doing this much like really like distracted will come in in your interview, and that will be you might be on by chance of this patient. You really need a t o. They just test tomorrow or this one. You know, every year ius or this patient is very agitated. That doesn't trump urine. Well, patient on the point that the questions you don't strain that you can probably based on patient safety. And you could say, you know, I'm really sorry, but my priority by a flare because of these reasons. So that's one thing I keep in my mind. I always say it's about patient safety, and they want to know that your safe practice one again. Considering that you are you doing the 50 you have left for nickel time? Because if your academic block So maybe next Friday. The black? Yes. Uh huh. I think we We don't have spoken about this a little bit. You can even expedite information. You can also stuff to be anybody. That's fine. If you think stations gonna require a kind of like you go out to be about that size we spoke about. That cools. I say the base Regarding that, you could say I don't get the patient doesn't communicate with you about chemo and my senior registrar to let you know what I'm doing. If they want me to do anything differently, uh, escalation basis should be something that we'll do a long well, patients with gardening. And I think it demonstrates actually, in your institute that you spend time on placement of the postage just authentic. Use it very much. No, I've heard that he but he would look quite city If you be on a million devoted to register patient that has a whole day 11 care and it'll come in the air pathway. I think it doesn't strengthen Been awareness of things happen in real life. Wake about the NDTV really important. When we spoke about your level of confidence, my advice would be the in your interview. You should know, say anything that you wouldn't really do with that for for example, on at the extreme, if a patient require intubation, you are not going to be achieving a patient uncle, I think, demonstrating that you are aware of it and you're in. You can only come across well. So you know, I'm really unload patient of mine is actually I feel somewhat out with my dad. I'm going to implement these measures off the Safeway, but really on your Penis by my bedside. And that's one good metaphor. Do you agree? Done. Yeah, completely agree. A huge I mean, definitely this interpretation. But actually life is it. A few days later, it is recognized escalating them on DNA low about coming out. This incredible House esque diagnosis made things by myself. It's definitely about it's forcing people. It's like going and seeing them checking, telling my senior escalating care if needed. That's basically the job is. And that's with the station structure. Yeah, absolutely. No being in this being a one on cool, I think it's actually very good preparation for what you're going to experience. Um, yeah. Say that you really love eggs. Say it going a bit of audience interaction and the QR cade will take you Teo NT website on dust. Want you to all read through these descriptions is a little political vignettes, um, off patients. These a very representative off the sort of thing you might be given on day. Just going to them in to meet her on by prioritizing if the patient do you want to see first, right? Give you a couple of minutes. Okay. Onda was to you guys doing that? I'm gonna answer. I'm gonna just talk for it quickly about some comments that people post nasal. So someone off. Could you explain more about treatment? Escalation status? So that treat Ms Kelation status is a bit more of an extension to DNA CPR. So DNA CPR is basically a little somebody's either gonna have CPR. Well, then no. Have CPR. There's treatment escalation status recently white used concept, which is not just about whether someone would be for resuscitation or not, but for whether someone is suitable for treatment in intensive care. Whether someone is suitable for IV antibiotics in those things or at the lowest escalation status would be for this war based care. Some treatments, like oral medicines or then what is the next step down from that is a palliative, comfort based, um, pathway looking to treat this person symptomatically angry on did someone else's house. If patient comes in ascetics shop, would you put out on medical straight away, we'll give flu virus Association first thing That really depends on on how long will that person is. So if someone was, I thought someone was septic and that a bit of a low BP that I would think about giving him a flu. A challenge if someone If I had one of these conditions and they had a systolic of 50 wouldn't even think about touching fluids. I would be calling for Met call or periscope to get, you know, more qualified, more experience people to the bedside first, and then in what's they're coming to me to come and help me. Then I can worry about things like that, but I wouldn't do that. Someone was stable. Um Well, uh, I think it this kind of new and said that determined I rented you this Jack dresses noncemented. Okay, you know, Well, I think we'll company called it that you want to show you read down. He read it out. I don't know how. So we got fine or quite clean your patients. We bought 30 seven's right to get me a patient. They got none from frustrated family member on. We've got known for our certification. I think my usual, actually, if someone again audience interruptions saved my sanity someone that patient to do you want to pop in the chat? Why you chose stations to influence it gives a good way of approaching this. And then we control for how did you do it? Telling anyone Say it has always put most of Cuban well, patient, which I like, But I want to know why. Why do you why they miss to keep you on rotation, in your opinion. Cool. Okay, say answers I've got I don't know, you can see them, but I've got some anything that I've got some I've got low sats Despite to what? 10. You're saying it's a be issued desaturating on 22 kidney declining DCs liner in Greece is once. It's a big problem, which is a priority here on yesterday and next. 7 10 least option. What do you think That Yeah, friends that you identified to keep young well, patients. And I've been getting into the reasons you talked about. So we've already know that we're giving this patient tend these simple things months, which is I don't know, Why my privilege? That by something like Norplant Fine on there. Still not reading meat leaching target situations Someone scale want Well, basically unknown. Hae the captain patient. Um, we know that talking colony well, so basically nothing acutely young well, patient on that patient. I'd already be thinking about being out of school. Third patient sure is is unwell. You know, the potential risks there for a rhythm. You, for example, that actually, all of their observations are relatively stable. We're, you know, 111. What? A single sharing asking by you and then with no other concerns. Although, for example, if we were to get it over with, say this patient of his extension palpitations, chest pain, that might change. What? Um, in terms of patients drink ongoing abdominal pain short might be an indication of an acute pathology that we're concerned about. Need to do something about that. Actually, the pain to have turn into therapy. Their observations are all within normal range, and it's very hard. There's different rating can remember they're going back to our patients safety prior authorization. That doesn't trump the fact that we have to attention on well, Asian patients all right in there for several reasons. Really No unlikely that you would get it would be given a aggressive, delirious patient, and that would be hard to manage. Well, well, well, for management of that for our medical school. In terms is good nursing measures reversing the reversible causes of memory. Um, on that last a lot of attention, potentially eating symbolically therapy. However, it's important to consider that delirium itself may be a symptom of an underlying pathology on, I think demonstrating that lateral thinking in your in your interview demonstrates that you're aware of all the things I've actually patient to patient one probably patient for, um, inpatient three, but then thinking. But I think we're going to essentially do it later, depending on time. But thinking about how I say start these patients. So for patient one actually previously smoke about there several things that I need there in addition to communicate with my team. So that is definitely under. If they don't have one already, um, no probably will have a repeat of that trust you and knowing how about be done fasting. But I always get the BG will come back quicker than a man money on based on your trust, you more than likely, this patient is going to need an EKG. Those three things that I can ask from Ward Star that does not require my president. However, things like commuted you will require a doctor to go see that. But we've got something in the interim on. I know they say, I'll communicate that with my seniors in the short of that patient seen or something patient, too. In terms of patients pool, he's been off for several things as well. The observations would be definitive patient, although it might be hard considering they are thrown in the old stuff you can give advice about general Much is really rewarding. Take the patient, for example. Um, until you know, if you are concerned, please call me back. It has three again. If I remember transit observations, you try and get to it in the interim. If there's any people within your team with three, then that also the history here is very, very important, and we don't have much. We can ask for a bit more history, for example, is a postoperative patient had new or going out on the pain or for example, get this patient because they might be delirious. Have they? Just not taking the Imodium the day you could be going to get that information but saying a couple of things. A lot of those how you learn to safeguard, um, it doesn't really get in your in here on board. So I live in a point here. You can do that in about 20. Uh, but yet that's no surprise that you you got that right. It might be more than you want in your in your in the point we're trying to make it. You just need to justify why you're doing what you are on. That your insurance. Every patient is saying, if you can't see them immediately, my space station to the only additional holding medicines, I can say it. Please put that patient on 15 Normally breathe. Sure, they might be retaining over. We can do without. In the interim, they are caught it at the moment. Uh, anything Is that trade further? Then please put that medical necessity being cool. It's huge usual to yourself. There anything that you can tell on the way to ensure that the patient being safe. But they must be anything understand? Um uh, not really, No. I think I like describing things Is a problem or an airway problem or breathing? Forgetting or circulation And prioritizing that. I think we all talk 80 that people will be well versed with that a swell. So it's a university. I could use it to advantage, and it will clearly help you prioritize. And just if I walk without having to use lots of words on someone has asked if you could ask nurses to carry out examination. I would say, essentially, the bottom line is know the role of a junior doctor is you're gonna go and do the examinations with a few caveat. So I suppose you could ask them to do a bladder scan, which is one Western examination. You're scaring that bladder. See that foot? It's full of urine. It's not really an examination on dure. Gonna ask them to kind of check for attention or constipation of the PR exam or anything like that. I would know just to stay on the safe side, I would know any nurses do 80 any exams, Um, on on any patients in this kind of just the blurred lines not necessarily show. You know what your role is going to be. Yeah. No, actually, I kind of trigger another. Put my hands now like that Possible. Will have a critical care outreach team on it before your interview. Please look up for all of these teams. Need and do that demonstrates, you know, hospital work for patients to Certainly they meet criteria for physical care. Outreach seem referral. Taking the the patient on the far as managing them. Then you know, with the next one on, they predominately be run by canyons is plus minus. Registrar consultants. Uh, they didn't do something. Then they said they are that are having. Yeah, but other, you know, with the exception that know when you can escalate to see foot on bourbon like that in the interview, because they are fantastic. Resource one for initial management, but two or so if this patient is going to go to you, they have direct line of communication with you, and we'll be communicating with the idea of already knowing what they do and how to use the market. That's really well. And then second follow up. Question. Can you ask the street without assessing in the context of 02 of oxygen. If someone is decide to treating, you need a junior doctor to come over and say yes, that definitely desaturating. It's almost the saturating noticed Give the most in the best treatment. Actually, typically, I don't know what you were on with thinking. They're fantastic. They were probably already done so by the time they contact you. But if you just described often, it isn't as well. Just do it. Yeah, um, on then, any scenario is that any sorry that would recommend doing more than one for 80 assessment? I think it's it's not so much. I mean, in real life, you would do it for late to the assessment on these people. But the time to time limit. You have the 10 minutes you have to think about what you're gonna be able to realistically do. You're probably going to be able to say that you're gonna do a few things before you see people do one thorough 82 she you know you have to cross the ts and dot the i's and then you're going to do probably a follow up of a couple of others your other patients who you can see and say a few key things you would do for them. And at that point, they'll stop you on. Did ask you some questions and stuff. That's how we think about it. In reality will see patients I didn't take. I got 10 minutes after my shift. So I'm going to quickly to be on this person and got to document they get for that, too. Every time, every presidency, um, anything. You might interrupt it out, and that's fine. And then you need to be fire type. But my invited be practically low. And you'll soon realize that doing more than 18 week really be challenging and 30 Probably reconsider how long you have anyone in What do you consider me? All right, um, if you have the question is what you answer these at the top at the end. I'm just aware that we have a time of ourselves. One say, Let's make them okay. So I think we've covered these things, but just definitely clarifying. Don't expect to see everyone won't stay intact independently or without support with senior Don't don't say you do anything that younger continents you know being a hero in the station, you're trying to demonstrate your don't leave a patient are safe. Nothing. Don't prescribe anything for patient who you don't know their medical history, allergies and current medications. If you say you're gonna give penicillin to someone or amoxicillin whatever and then the interviews give you a nasty way to say, Well, but they're penicillin allergic. That's gonna really throw you off and throw you off your flows on, but not gonna look great. So make sure you know a little bit about these things before doing them. But the vast majority of the station is about the assessment of the bedside and what you're gonna do in steps and stuff. Some steps. So if you're getting onto the fifth line management of of asthma, you probably doing it wrong. You know it's not about that. It's about talking about how you prioritize how you be safe with the investigation is ordered the 1st 1st simple, effective, important medications you're gonna give immediately. And then you have a very big jump. I have a great I mean, there are exceptions every rule that we say. So if a patient has obviously having anaphylaxis then I am adrenaline. This probably find a patient is acutely de saturating that you can probably get some oxygen on them and blue it with a question mark because obviously that might be related. Leading all down point about the flying fifth line management. This isn't mg. So I'm very much dot We will be expected to know management so that down the line, But actually a lot of good candidates will know dosages for a murder you the medicines which will be useful and my invited always being that if you think in real life, you know, have time to look it up, which is actually a very small amount of drugs, Then you should probably know those those going and, um, you apart from that, everything's about this. In my personal opinion, I'm not something that I can see assay. So just a exception between the different between London interview and outside of London interview I had, Which is it's Cambridge. Was they expected me to know days, I guess, uh, on, But, uh, you're right. Two degree. The dosage is very between trust for some drugs, but they definitely don't vary for things like adrenaline. Everyone gets this name dose of adrenaline on the planet everyone gets in baseball. So things like adrenaline, like nebulizers on stuff like that. Just know that does, because it would be useful for your interview. But also you'll be expected to know this is a yes. We got things like anything on a guideline does not really very nebulizer. For example, you might have a difference in South Beach. Um, all it sometimes makes it may. It would be a really harsh in fewer that was a market down because, you know that's just not going to happen. But Bull Park is certainly important. And if it's on an urgency guideline such a a less then does your does your dosages ideally just know them? Okay, lets me forwards. Um, way talked about all of these things. Think kind of, say the idea. Or this time you said earlier, that you should probably know we mentioned one of my second court is so that, like, important like presentations, there's general presentations on the way that we approach. The interview was basically think about all of the common presentation, what you see in hospital, whether that be shortness of breath and just a a one of those think a bowl of the life threatening causes. I'm saying that one life is being You know, the most common cause is not the very much one in a million one in a million causes. So we wanted, you know, one for this time. What was it central pain onto that We should probably get you to do basic instigate, basic investigation and management of them out of hours. So if you could all that moment, he's working. So scan, do you think you are on then just in there. A corn presentation for a problem. Life That was the month of hours. Just kind of a stork exercise that may or may not work. And again, we'll get a populated. Wait a minute or so, Uh, let me get back and answer. Um, would I prescribe? So someone said, Just ask for fear The question if someone said, Would you seeing in pain or into the examination? So I will say, What's it is very tempting to just, you know, prescribe the allergies. They're they're good to go. I think it's important to ask why it's someone in pain. Has the pain changed And the only thing you're gonna you're gonna shrink was reading through the night, going and seeing them damaging them and then describing So, you know, you might They might already have them already have paracetamol in their drug chance. If you say, Oh, that I would just give them some procedure and then this and then they say over genetic. Oh, you You know, there's no parasites mobile that again is going to throw you off kind of your smooth flow safe. I would think about not doing things to people you know, seen or don't know Everyone. Everyone in theory gets rude. Their notes. You don't clinically examine them are some questions and prescribe the things I need, um, on insulin us. Do you think it marks you down to now? A Days is I think it's better to say that. I mean, if you get that the worst case scenario is you get the dose wrong. When you get that, it's dangerously wrong. That's good. If you say I don't know, but I checking the b nfor check with the class guidelines. Think that is a safe middle ground area. No one to mark you down for admitting you. You know where your confidence level is on that you were doing the safest thing, but obviously the best of October market saying this is the dose. But if I wanted to double check it, I take here most guidelines saying, Yeah, exactly the days is I don't know how to double check it, Andre. Yeah. Um, show me. Oh, I don't think I can show it. Easy way. So under. I think it will come up on that one anyway. So chest pain, he That's this. About a million shortness of breath near interchangeably. See you. So hopefully you'll see this. It's not really Oh, that may take a quick screen shot. We can share it later. Yeah, essentially what? This demonstrated that you will probably know the common causes or potentially life threatening illness in the hospital hour by for after way we approach to going. The interview is for a lot of these. I need to know the most dangerous, dangerous causes, and I need to know how to result. Uh, only a first line. Maybe a second one if you're particularly comfortable. And if you do that, you're really not going to be our very knee started NutriSystem management. Then you're into because that's not the point. The point is that you're safe, but managing what people see so good, we'll just bump. Here are your conduct the medicine section or the sexual about whatever it is, you should probably know it, uh, probably sort of share nature of how we approach it on for a lot of them, the way we approach for the investigation. So for your age, you weigh it by the bedside, do it first. Flood and gas is probably cover bit later, but actually they happen for the eight me when you put a cannula in on all of the imaging and complex investigations, comma, if you want anything to do that. And I say that's buying by saying that understanding that you will burble eyes in the section that you might want to check X ray. However, asking for the results of that chest X rays immediately demonstrate that you probably are aware of things really start. Actually, you realize that the priority about my changed, um, well, so if it makes you just acutely high part of the test, that's raising going on actually taking time to come in early if you want a through the port. A patient had some time in our body and they have, you know, pretty normally he doesn't talk. Are for myocardial profusion in your interview walk demonstrating that you have some kind of background cardiology knowledge actually demonstrate that you aren't really aware of what will happen on about probably will approach patients because it just wouldn't have been, uh, so I think that's the key. The key difference between the end you that you get in your medical finals on by the FDA and see where you're expected to know how things work and actually don't. So I think when I was practicing through for my interview think about how this is going to happen in real life to come. I truly going to respond on it might be a bit late. Do this. But if you are on placement at the moment, actually shadowing one of the one director is that about it's really, really useful to see you know what really happens. Um and we've We've spoken about the with the rest of us think anything. No, nothing, Mr. Yeah. People to really ethical legal areas on expect the lot of things to come up. So you want to make sure that you've definitely had to read through them, but also the fresh in your head. So things like capacity consent get competence. How would you deal with violence in aggression? Jehovah's Witnesses. Blood transfusion. What blood products can does witnesses sometimes have, or what would a potentially agree to important turn? This is our that. How would you navigate that mental health fact? So the adverse event definition of liberty safeguards? Um, you're obviously not going to expect it to know that you know, granulated detail of each of these different areas, but knowing where your competency lies, you know, in a lot of these cases that you're not going to be the person to make a decision. But, you know, the the person to make that decision is, you know, have to provide support to patients. And you know how you would find out more information on get more simple a lot of this. So, uh, I think that's one thing, but I think the time no completely. I'll answer some of these questions after I really again, very briefly hair. So Oxford had a lot of clinical medicine in that back section or the pages of read read through all of them. Make sure they didn't, I would say almost inside. Now, apart from the kind of weird knish you know, add Italian crisis things. I think you should know all of the really common ones. And it's got some really good ways about looking at different chores for things like shortness of breath, Hamburger Foundation program on a hamburger. Emergency medicine, also fantastic as well s and racist comes with guidance national society guides. So, you know, individual society. So like knowing the acute past summer guidelines for treatment as by the British Drastic society is definitely something worth looking at because it would just talk to you how to manage on acute asthma exacerbation. And then the TMC has lots of really useful documents on how to navigate ethical scenarios and problems with patients and then a space. The other thing is that you need to practice practice, practice until you're sick of doing it. It does get very boring. You need to vary a practicing do practice with other people, but don't just practice for the same of the person because if you are missing things out or you do have a kind of habits and things on this sort of the most helpful, just reinforce them. If you any practice with the same person, be harsh critics. I mean, Jacque practice with each other, and we were extremely, I think, towards the end, very picky and very pedantic over how we were presenting things and what we would do and how could be you, because out by an interview by giving that answer actually meant that when we got to interview, I did about Jack. But I felt that the interviews gave me an easier time that Jack had done like the day before, so it felt a much easier, more comfortable place to be than you know the other way around. Don't practice in, complement each other and have a really hard into the game on. Then this, Jack said, actually shadowing if one's left two hours to see how these things work. Even if you can't verbalize exactly that, it does come across in interview when someone has seen on his experience what emergency looks like compared to someone who's just read about it and in touch, okay, No, I think that literally are like that. So I took those three sources I created fresh hard on For what, seven months before I made it. My my duty to basically learned that, right. Um and then yeah, way had agreed to separate of us when they rotated practice. But I would say very much, very your practice. So practice in a situation where you would you would give you nothing on Just sit there and just deal with that uncomfortableness interrupt each other sometimes provide his old around sometimes doing so that when you come to your day when you're inevitably very well prepared. But the anxiety very much chicks in most of it is just you. You've done it so many times. It's natural, and you can free of the brain. Basically interpret the information will give him If you're having to think about your age, you weigh on the components of a native me on interview. By the time you've given the information, I very much doubt that you have an interpreter information and it can adapt you approach. So that would be my recommendation. That has a billion. Enough practice you can do. Cleaning is on, I promise you. So you won't get a CT is absolutely no wasted time. Almost every one of you will get a medic alert in your final that you have to deal with you. Load on call. And it was probably the best practice I did in the hole. It finally it makes me that one out. Uh, so it's not a wasted time until so Yeah, my beaches to do it. Okay. Yeah. So we can want to be reckoned climbing life. Think you did it. You did it way. Get you to one. Uh, I knew I could be taking a prioritization. She will get me to do one a to me, and then we'll stop. Grab some point, and you can do whatever, but I spoke to you. Take those Weighed Yes. They actually said before we've already fired. Be patient. You spoken out. So if I suppose it didn't you say something like so here we are, four competing priority two of which I know are acutely medically unwell for their lab value on in case you want to just go on the ablation in two plus minus two other competing priority, which might suggest medically on well, patients. So there are things I don't do the same with the patients while choosing to see patient limited number 100 the afternoon. And can extenuate a couple already can make any GI of this patient and anyone on the war days into believe the patient getting a BBg morning, This repeat blood something really easy to know about that? Uh, no, but it was a clear based medicine patient becomes symptomatic with having palpitations or chest pain for them to immediately pull back. And it's that concerned that little people paramedical are communicating like easy to find someone to see this patient in the interim patients really apologizing family member or getting the after remember done dealing with medical manage that one's one point. Be able to see them again explicitly facing the nursing staff. If that concerned about my patients call back, um, patient, I'd like to be that patient that might be indicative of underlying pathology work. However, that's not my party. 11. Based upon the information I'm given on advice and generally realistic over yours reorient taking the patient on a good note next technique on the optimal approach and then potentially if that doesn't work, would be ruled out before. Didn't you might think about a patient from the waist patient. I cannot think this is going to cannulate in blood on gas equipment to be by the bedside, I'd like for people of Asian and actually, I'd like ongoing monitoring. So please leave the practice. Cycling. Keep the heart rate and factory running really, depending on where they are. I don't know. After know being with me on that side of quickly Someone to be aware of a street water be kind of a time with me plus minus with patient, depending on where I am patient by introduce myself on that one doctor in doing so What? He's looking at the patient to see if that will be a solid, straight distressful generally unwell. I guess it's been communicating with me. Let me check with their airway stated with any additions. Sign in giving. Going to be Have a brief of veggies. Yes. Uh, yeah. Please interrupt me if you have any information to give the done. But when I get a shooting, everything like they like finding so I don't know it is the way away because of the patients. Actually, I'd like to put them on 15 liters. Normally. Breathe immediately and I'll be considering the risk of quite Catholic spiritually failure. But the moment I put here is the greatest life threatening calls in the patient or life threatening problem in this patient that we're going with question and we try to metric. It's Central on with consent chest Think I'll be looking for for my It's a Nordic with our with our will be the inspector chest on the signs of a 30 distress I'll look to see the chest is rising by actually on. Invitation is evidently working hard, obviously are also looking for any signs of peripherals intrasinus At the same time, I got to take the testis. Well, actually, uh, we already be needed at this age. I'm really saturations to see if that had changed it all the responsibility, invention, life. But I regulation the birthplace dictation because of the fact that they have such a high up to requirement, they will require again. So I'll be looking for the beam about me. Anyone could potentially do in a BG. And if I don't have the equipment because we know that I'm going to need that. Uh, I'm already worried about the patient that they were fitting. Heater's on these Activating. So, actually, at this stage, I haven't delivered immediately. I've been using it for my medical medical team or my feet propped up, depending on what kind of cost. So I am to get more support with me. I've already left my extra note on seeing the patients that hopefully thing is the boys coming? Uh, so I think that might be section covered. For now. You've gone to see, I'd be looking at the BP and heart rate again. I've already asked Cannulation equipment. So again I will be on board. But anyone contrary late with me, and it's going to work or cannula in each case yet, and in doing so, we can take off blood. I understand, but you get used any. I'm worried about a p on making your diamond. Being aware of the issues about, I thought, you know, I could get the capsules. Well, uh, if I'm concerned about which but we needed the same time, I can take off the syringe and didn't think about it afterwards. When I get more support uh, the BP. Actually, I'm happy with this at the moment, so you know, every day. Although they are tracking comic on the jet peripheral in central, compare a recent time which might guide me in my in the family with whether the patient is shot and also the laxative I get that will give me some more information. But I'm not going to initiate any issues at this stage because that card it and considering the resource is on the team would have around me. I may be considering any GI or the one thing that this is point results and then we'll get one immediately after also cartas well, And like I said, if we're the monitor today really would be really useful stage. But again, thinking about reputation is that might not be possible that the little maybe one day I use it after you are a blue coast for the patient. But again, I will be able to get that from my DDG. And it depends on what staffing I have around me and then was able to get the MRI first. I'd like a temperature as well, which might die me towards differential of it's age. Don't offend patient past year. And what extent part here today that's going to whether there's anything of concern going on there really expose the patient for any obvious bleeding, bruising or any other pathology that might indicate there cause of bet you deterioration. After doing so, I reviewed the drug trial on patient history on Reassessment a twin, which I won't. You know brevity because initiated initial management plan will be affected this time. It's also now providing gym, you know, hopefully more my team with running where I can ensure NBG is done on initiation investigations. Touch has a chest X ray, for example, and I continue. I think we stopped there. I see. So that is a lot of an 80 approach, a prioritized beforehand and, as you can see, so that took about after six minutes. They probably by the end of talking three, maybe bit of discussed examiner into the embassy. One patient, they may be time to talk about one or two, maybe a t s your things. As you can see, it is odd and deeply very well with what you're talking about, and you want to be a to talk smooth, normal. It's like you're trying to remember that next, and also being able to give a copy at nuances shows that you're not just good. You're thinking about the patient in front of you and how you're how you're changing your management to fit that perfect. So this move on. So that's that's example one in like in Unfair. So that's what we said. Oh, many is that during million you have very much how I blow. However, I was went on our for the investigational results, given more information, for example, since you put the 15 liters on basis, saturations of now improved to 96. So, like I said earlier, if you want well, the nature we were speaking it which I'm not that much of the moment that he's speaking, it can be very hard to interpret that information within the context of your quality. We also didn't even get into the central differential there just important to find Parker information. Yeah, so this is so this example is actually something that you can find in one of the documents they give you for the interview. Since part of a pea or as a foundation program before before this year. But this is a natural example of weight this available now. I still have 33 foundation program, but this is a sort of thing you're expected to shock through and navigate A. So you can see there are quite a few things here medically on that can legally, you're you're going to need to be, oh, never get to talk through. I'm just acutely aware of the time. So I think we've given some changes for questions, but just in kind of closing in the last few minutes with a more any other questions or things that just like us to talk through, I got you. Here it comes. Interviews are easy and ABG. I think if I prepared as they can, they're having at that. If they are going to give you one of the Navy D results are going to take up a lot of your time, and they're not going to be able to accurately assess you. However, they may quickly say that you know patients. P 02 is which died your management, so it's very much prepared. If they can any in depth infected Gatien, they won't give you expect that they give you changes and observations on the immediate thing that you can get. So, for example, if you had a patient with reduced level of consciousness, it would. It should be expected that in your unit least give you with Blue Coast because that takes two seconds, and it completely changes how you depressed that patient. I believe, Um, I don't give you anything to that time. I guess they get a little thing that you're learning your medical final anyway. So I wouldn't really stressed about learning the my new shiny because you've already learned it for our medical school. And this isn't about learning. New information is just about flying the information. Um, so would you say your differential is during your rate? Would you say afterwards, I would say that probably person. So that's a good question because it demonstrates. Actually, although we're learning almost rowed learning a process, it's really important to keep on new on. We know that there's not a one size fits. If I was given a clinical vignette, I thought demonstrated kind of relaxes. I they write the beginning. I think this is out of flax is what I'm concerned about anaphylaxis. And I know the things that I need to do immediately are but how? Crash. Cool. Make sure the bedside make sure you know the question is, uh get a patient of bed and run, and then I'm gonna run through maintain. But I talk about that at the beginning. If you thought it was something that was less, you know, immediately Life threatening, like bit left listening in someone who may may be minimal mail. They don't have it, you know, it's not clear with the current trouble. I talk through my weight. We approach first, and then at the end of it, much information as possible. You know what? My impression is that given you have a fever. They're breathless, low BP. Um, you know enough. And I've noticed I'm not support a sonohyst crepitation Zen the, you know, on the right hand side of the chest, I think this could be a community acquired pneumonia. So, as I said, I gotta have my my body chest X ray coming and I can look for that. But other differential be thinking about are and then maybe later on for a few of them. But I think it's really little. Remember, the whole point of this station is demonstrating safety on actually making sure you're doing all the steps investigations so that when a senior comes, they have all the information that they need help make further decisions, and it I really is, more importantly, new. Nailing the diagnosis is on playing all the bits of information, all the bits of management, you know, you're supposed to say actually, 80 isn't like that. And on call in hospital, I can tell you it's not like that at all. It's very much I'm treating. You don't necessarily know. You just need to do things first. Yes, I agree back that they know that the immediate you should know all of the immediately flexible things that you've seen in your eighth away in the next, um, but very prepared to get to the end of eight away. And no, no, a diagnosis. That doesn't mean you've done badly. It's just actually mean you're keeping your diet really find it is good on the informational given can help you reorder your differentials. But ultimately you probably won't have trying different, like certainly didn't during my job. My station. Okay, uh, life, Mourners. It's the one about the kind of just wait, get a prior authorization way we get I'm almost there. You will be given an ethical conundrum, but it will probably be like a small on it relates to what you what you've seen you won't be expected to you from down from talk about your reasoning behind everybody Very much like I treat this person with motility And even though they don't have a consent, I will do that. However, seen your doctor with some caveats. For example, if they are in adults on, they have a neurogenic Jehovah's Witness with directed saying they don't want blood. That might actually so so and say, this is what's really important to know your EKG. I don't even talk to medical school so you can interpret it quickly, but also very more in that one. The only actually ethical eagle decisions you're going to be making are the ones that cannot wait for one of the doctors. I'm alone. Help you so in the night that you're my age three. Um okay, that she shouldn't need. Want to explain where they deal with other questions. So So what? We're gonna do is see you tonight. You had a quick one through the clinical station, doctor taking us through the majority of that next week. Or you're gonna look at it more for the academic station on how you go about doing that, The experience of it and maybe that. And then 123 people have what's just with the metal thing. That way you have to fast for we will be. If you email sfp, we will we will reply with a spreadsheet. We'll get a switch E Outworld Google for related. They're fact that you use especially which is put in the chat as well on, um waited into another AFP so find many people they are interested. Tonight is the time to put your name on that that's going to be dying. How many people that we can get And if you have questions they don't have the chance. Is the taste that great? But we can apply on there please do fill out. It's really, really helpful for us just so that we know what we're gonna write it wrong on if he's gonna help for and use for on do you next week ending of Sad Uh huh. Between a minute they take pictures of the back way, throat or fours apart, trying to dry. Big Leak. Last game. Do you know, do the saving of the recording? I think it's all done through the metal. True. Cool, Right? That may, uh, cool. Thanks so much, guys from your stream now. And he says, I think that's you know, I guess.