What is the content of the assessment ?
The stations are designed to assess the following areas :
Focussed history-taking, including history-taking in difficult circumstances
History-taking is a core skill for F1 doctors. You will be expected to take a short history, focussing on the relevant problem, and you will be expected to establish the most likely diagnosis. Towards the end, you may be asked to tell the examiner your provisional diagnosis and explain your reasons. The examiner will be assessing how well you communicate with the patient as well as your problem-solving abilities. The difficult circumstances may include, for example, a patient with a hearing impairment, a patient who has speech or language problems, or a patient who has mental health problems.
Examination of patients with stable chronic disease
As an F1 doctor you must be confident and competent in examining the major body systems and recognising abnormalities. You will be expected to examine a real patient who has abnormal physical signs. You will be asked to examine the relevant system thoroughly, then to present your findings to the examiner. As well as your examination skills, your professional behaviour will also be assessed. We may ask you to examine the heart, chest, abdomen, skin, neck (including the ear, nose and throat), joints and all aspects of the nervous system.
As an F1 doctor, it is important to be able to recognise acute and serious illness and take urgent appropriate action. In these stations, you will either take a history from or examine a simulated patient who is simulating a medical, surgical or psychiatric emergency. If appropriate, the examiner will give you any abnormal findings. Radiological images, if shown, will be displayed on a computer monitor with no need for any manipulation. You will be expected to explain your management to the patient and/or examiner as appropriate. You will be assessed both on your problem-solving and communication skills.
Recognition and management of acute illness
As an F1 doctor, it is important to be able to recognise acute and serious illness and take urgent appropriate action. In these stations, you will either take a history from or examine a simulated patient who is simulating a medical, surgical or psychiatric emergency. If appropriate, the examiner will give you any abnormal findings. You will be expected to explain your management to the patient and/or examiner as appropriate. You will be assessed both on your problem-solving and communication skills.
Surgical and peri-operative care
As an F1 doctor, you will spend a significant proportion of time preparing patients for operations and caring for them afterwards. Patients may wish to ask questions about their operation, the anaesthetic, pain management and post-operative recovery. These stations will assess both your communication and management skills.
As an F1 doctor, you will have an important role in helping to ensure that patients can be safely discharged back into the community. Patients may have questions about their ongoing treatment or they may have social issues which need to be addressed. These stations will assess both your communication and management skills.
You will have to communicate with other members of the hospital team, in order to arrange further investigations or hand over care. This can include use of the telephone. These stations will assess your ability to communicate appropriately with other team members, but will also consider the accuracy of the information you give.
As an F1 doctor, you may have to break bad news to a patient, handle complaints from patients or relatives or negotiate patient management decisions. These stations will assess your ability to communicate sensitively with the patients, but will also consider the accuracy of the information you give.
Ethical and Legal Issues
As an F1 doctor you will face ethical dilemmas and challenges on a regular basis. You must practise medicine in accordance with appropriate ethical frameworks and the British legal system. In these stations you will be required to communicate sensitively with a simulated patient in order to appropriately manage an ethical challenge. More information is available from the General Medical Councilís Good Medical Practice (www.gmc-uk.org).
Health promotion and patient education
As an F1 doctor, you will need to offer lifestyle advice and address risk factors for disease. Examples include smoking, excessive alcohol consumption, obesity etc. You must be familiar with how people in the UK may behave. You should not discriminate against patients because of their beliefs. More information is available from the General Medical Councilís Good Medical Practice (www.gmc-uk.org).
You will be expected to perform practical procedures, usually on an anatomical model connected to a simulated patient. These stations will assess both your practical skills and your professional behaviour towards the patient.
Practical procedures may include :
- performing venepuncture and interpreting the results of blood tests
- performing arterial puncture and interpreting the results
- giving intravenous, intramuscular and subcutaneous injections
- inserting a cannula into a peripheral vein
- setting up an intravenous infusion
- performing an electrocardiogram (ECG) and interpreting the results
- basic cardio-pulmonary resuscitation
- demonstrating the safe use of a defibrillator
- performing basic respiratory function tests
- administering a nebuliser
- administering oxygen therapy
- performing suturing
- performing urinary catheterisation
- performing a rectal examination
- examination of the breasts
- examination of the testes
Please note that some stations will assess more than one area. Stations will predominantly focus on conditions that are either common in the UK population or important and serious.
The topics covered will be taken from the major body systems :