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Dev Banerjee Department of Medicine, Birmingham Heartlands Hospital, Heart of England NHS Foundation Trust and City Hospital, Birmingham
N. Sukumar Department of Medicine, Birmingham Heartlands Hospital, Heart of England NHS Foundation Trust and City Hospital, Birmingham
Robert E.J. Ryder is Consultant Physician and Clinical IT Lead at City Hospital NHS Trust, Birmingham, and Honorary Senior Lecturer in Medicine at the University of Birmingham.
Dr M. Afzal Mir is Senior Lecturer and Consultant Physician at University Hospital of Wales, Cardiff
Dr Anne Freeman is Consultant Physician at Royal Gwent Hospital, Newport, and Clinical Adviser and Chairwoman of the Welsh Stroke Alliance
Preface
Introduction
Section D
Station 2, History Taking Skills
1 Abdominal swelling
2 Ankle swelling
3 Asymptomatic hypertensive
4 Backpain
5 Breathlessness
6 Burning of the feet
7 Chest pain
8 Cold and painful fingers
9 Cause of collapse?
10 Confusion
11 Cough
12 Diabetic feet
13 Difficulty in walking
14 Dizziness and feeling faint
15 Double vision
16 Dysphagia
17 Epigastric pain and nausea
18 Facial swelling
19 Funny turns
20 Haemoptysis
21 Headache
22 Hoarse voice
23 Hypercalcaemia
24 Hyperlipidaemia
25 Jaundice
26 Joint pains
27 Loin pain
28 Loss of weight
29 Lower gastrointestinal haemorrhage
30 Macrocytic anaemia
31 Neck lump
32 Painful shins
33 Painful shoulders
34 Palpitations
35 Personality change
36 Pins and needles
37 Polyuria
38 Pruritus
39 Purpuric rash
40 Pyrexia
41 Renal colic and haematuria
42 Tiredness
43 Tremor
44 Visual disturbances
45 Vomiting
46 Vomiting and forgetfulness
47 Weakness of the right arm
48 Weight gain
49 Weight loss and chronic diarrhoea
50 Wheeze
Section E
Station 4, Communication Skills and Ethics,
Category 1: Informed Consent
1 Consent for a Lumbar puncture
2 Consent for OGD
3 Emergency surgery under principles of ‘best interests’
4 A competent patient’s refusal of treatment
Category 2: Diagnoses and management advice
5 Obesity Management
6 Side-effects of cardiac medication
7 Presentation of a first seizure
8 Rheumatoid arthritis
9 Valvular heart disease in a young woman
10 Air-travel with COPD
11 Polypharmacy
12 Blood transfusion
13 Hormone replacement therapy
14 Lifestyle adjustments after a myocardial infarction
15 Smoking cessation
16 Starting insulin therapy
17 Refusal of analgesia
Category 3: General clinical issues
18 HIV testing
19 Communication of an HIV positive result
20 New diagnosis of tuberculosis
21 Non-compliance with anti-tuberculous treatment
22 Multi-drug resistant tuberculosis
23 “Hospital Superbug” 1 (Clostridium Difficile)
24 “Hospital Superbug” 2 (MRSA)
25 Assessing suicide risk
26 Genetic counselling
27 Fitness for anaesthesia/surgery
28 Screening for prostate cancer
Category 4: Breaking Bad News
29 Malignancy in a young patient
30 A chronic illness
Category 5: Ethical and legal issues
31 A patient with a functional illness
32 Brainstem death testing and organ transplantation
33 Hospital post-mortem
34 Coroner’s post-mortem
35 Do not attempt resuscitation decisions
36 Withholding information from patients
37 Maintaining patient confidentiality
38 Advanced care decisions
39 Healthcare decisions in a patient who lacks mental capacity
40 Care of the vulnerable adult
41 Blood transfusion for a Jehovah’s witness
42 Eligibility for major surgery
43 Postponement of an investigation
44 Clinical error in drug administration
45 Fitness to drive
46 Limits of treatment in end-stage disease
47 Withdrawing treatment
48 Enrolling a patient in a clinical trial
49 Industrial benefits
50 Internet therapy
51 Unrelated live donor transplant
Category 6: Dealing with Difficult Patients/Relatives
52 A patient desperate for a diagnosis
53 A missed tumour
54 An unhappy inpatient
55 Delay in investigation
56 A patient wanting to self-discharge
Category 7: Professional Issues and Communication with Colleagues
57 Major incident exercise
58 A struggling team of doctors
59 A colleague with Hepatitis B infection
60 A colleague with a needlestick injury
61 The improper doctor
62 The incompetent doctor
63 The sick doctor
64 Consent for medical examination
65 Submitting an audit project
66 Treating a prisoner
67 A violent and abusive patient
68 Withdrawing treatment in intensive care
Section F: Experiences, Anecdotes, Tips, Quotations
Full PACES experiences in the first person
The following full PACES experiences predate the changes in Station 5 that occurred in Autumn 2009
Additional Station 2 experiences
Additional Station 4 experiences
Invigilators diaries—Station 2 and 4
Some anecdotes from our most recent surveys
Experiences,
The power and range of the candidate’s observations,
The candidate’s examination technique
The clinical competence of the candidate
Common errors
Look first
Double pathology
Tell them of the expert that told you
Apologies accepted
‘Even though I didn’t mean to say it—I did’
Invigilator’s diaries
Fly on the wall—complete accounts
Ungentlemanly clinical methods
Miscellaneous ‘pass’ experiences
You never know you’ve failed until the list is published,
Survivors of the stor
Some ‘fail’ experiences
Downward spirals,
Anecdotes
Some anecdotes in the first person
Miscellaneous
Useful tips
Quotations
Adopt good bedside manners
Practise clinical examination and presentation
Get it right
Listen, obey and do not stray
One wrong does not make one fail
If you say less they want more
Humility is more persuasive than self-righteousness
Keep cool: agitation generates aggression
Simple explanations raise simple questions
Think straight, look smart and speak convincingly
You have seen it all before
Use your eyes first and most
Doing and forgetting
Examiners are different
Additional comments and quotes from candidates
Appendices
1 Website links
2 Detailed contents of Section F
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