Introduction to Final Year
24th September 2012
Welcome to Meded!
• Three schemes:
– Tutoring
– Speciality Days
– Cases for Finals
Cases for Finals
• Interactive, non-didactic teaching. Clinical, directly
relevant to PACES. Delivered by F1s
• Dates:
1st Oct – Session 1 – Neurology
8th Oct – Session 2 – Respiratory
15th Oct – Session 3 – Cardiology
22nd Oct – Session 4 - Abdo Surgery
All subsequent sessions on mondays
Intro to Final year
• 3 Ex-ICSM F1’s in NWT
– Anika Kaura, Ola Markiewicz, Pranev Sharma
• There will be some overlap to represent different
learning styles
• Questions session at end of talk
• Slides will be up soon on Meded website
• Any questions/feedback please email:
– medical.education@imperial.ac.uk
• Foundation year doctors:
• ANIKA KAURA
• OLA MARKIEWICZ
• Written Exams
Practical Prescribing
Paper 1 & Paper 2
Medicine/Surgery/Pharmacology SBA & EMQ
• PACES
Medicine
Surgery
• 6 (7) stations:
- 1 x 20 minute history
- 5 x 10 minute stations
- 1 x 10 minute rest station
• Medicine: History Taking, Abdominal, Cardiovascular,
Nervous System, Respiratory, Short Cases
(Skin/Eyes/Rheum/Endo etc.)
• Surgery: History Taking, Abdomen, Vascular,
Musculoskeletal, Images/Instruments, Short Cases (bed
cases or seated)
• Mostly well outpatients. Although can get inpatients…
• More subjective – not so much ‘tick-boxing’
• Broad Domains
- Clinical Skills (History and Examination)
Competent, systematic, safe
- Formulation of Clinical Issues
Summary, interpretation, diagnosis, appreciate psychosocial
- Discussion of Management
Justify investigations, multiprofessional approach, EBM, basic clinical sciences
- Professional and Patient Centred Approach
Professional communication, patient safety, legal and ethical principles, empathic
behaviour
• Overall Mark
• Examiners Meeting
• BARRY’S SURGERY COURSE
• MIRZA’S MEDICINE COURSE
• MEERAN’S MEDICINE WEEKEND
• FINALS PACES WEEKEND @ WEST MID
• DR CLARKE MEDICINE & SURGERY
• BROMPTON PACES
• EFFICIENT Examination i.e. QUICK whilst picking up the SIGNS
• CONCISE presentation – all the signs and other features like
cushingoid etc
• Offer single DIAGNOSIS and differential
• Investigations for THOSE diagnoses- know what you would look
for in each i.e. ECHO for aortic stenosis to look at area of valve
orifice
• Management of the condition – MDT and holisitic- so for AS
offer conservative- cardiac risk factor modification, medicalcontrolling hypertension and treating cardiac failure, surgicaloptions of valve repair/replacement
• No set numbers of cases
• Focussed examination
• Rheumatology: Rheumatoid hands, Scleroderma,
Ankylosing Spondylitis
• Endocrinology: Goitre, Acromegaly, Cushing’s
• Ophthalmology: DM, Optic Atrophy, Retinitis
Pigmentosa
• Dermatology: Rashes….
• OA, Gynaecomastia, Carpal Tunnel, HHT, Bell’s Palsy,
IIIrd nerve palsy…
• Global assessment
• Browse’s Introduction to S & S of Surgical Disease
•
•
•
•
•
•
•
•
Groin & Scrotal lumps
Head and Neck Lumps
Skin: Lipomas, Ganglion, Neurofibromatosis
Minor Musculoskeletal: Dupuytren’s, RA Hands, Hallux Valgus
Minor Vascular: Varicose Veins, Ulcers, AV Fistula (dialysis)
Scars (including breast) & Stomas
Nerve palsies
Random others
• Thank you!
• Please email akaura0@gmail.com if
any queries
Introduction to Final Year
Dr Ola Markiewicz
FY1 Hillingdon Hospital

Not going to tell you:
 What you need to do to pass final year
 Which books are available
 Which courses to go/not go on
 How to get a distinction

I will tell you
 What I (ME!) did to pass final year
 What I wish I’d done differently




My timeline
Tutors
Courses
Writtens
 Medicine
 Surgery
 CPT & Practical Prescribing
 Epidemiology

PACES
Aim - finish it!
Sept
Oct
Nov
Tutors sorted
Little bit of reading
Dec
Jan
Feb
Medical tutoring
March
April
May
June
CPT/PP
Mock exam
Surgical tutoring
Start typing up medical
and surgical notes on core
subjects a little at a time
Group work
Questions
Re-read notes
PACES practice
MEDICAL TUTOR
Who
Group size
Professor
2
Where
Hammersmith Hospital
When
Once per week starting from January
How
Found patients ourselves then examined in front of him
Good points
Bad points
Experienced and knowledgeable
Restored our confidence
Signs
Sometimes cancelled /late as very busy
Very pragmatic – good doctors v.s. good PACES (?good thing)
Hammersmith Hospital!
SURGICAL TUTOR
Who
Group size
Where
How
Surgical CT2
4
Her house/Wexham Park
Tutorial based sessions
Vivas
History and examination practice
Good points Very exam focussed
Knowledgeable (post MRCS)
Flexible
Comfortable environment
Bad points
No real patients – only one trip to Wexham Park
Finals PACES
What
February
Course focussed on how to present
Saturday – Medicine
Sunday – Surgery (included instruments and images)
Good
Intense
Gives you idea of what you need to know
The only place I learned how to present for finals
Done by Imperial alumni
Great guide book
Bad
Focussed on producing a “show”
Expensive - £80
Professor Meeran’s Weekend Course
What
March
Saturday – Medicine: Prof Meeran
Sunday – Surgery: Prof Meeran’s friend from Cardiff
Question book you fill in and answers explained as you go
Good
£52 each if booked as a group of 5
Can do just Saturday or Sunday
Really engaging
Good summary of core subjects I needed to cover
Bad
Intense
Probably didn’t go into as much detail as I did alone
Not essential
Barry’s course: why I didn’t do it
 Location – time it would take me to get there
 Duration – I can’t stay awake non-stop in a
lecture for 3-4 hours
 Timing – right around my dinner time
 Time commitment – had to be free every
Tuesday for 10 weeks, couldn’t afford to miss
a session (Valentine’s day, Circle Line)
“Para-skivers”:
 Met once a week at the Reynolds in a group
(same time as his course happened)
 Went through his guide viva-ing each other
(can buy his guide for £25)
 Great viva practice
 Retained to memory
 Still got to see friends!
Medicine
Surgery
+ Barry’s Guide
?
Questions for Medicine & Surgery
Online:
+ Web CT!
CPT
Lectures +
Questions
 Schachter’s book
 Schachter’s questions
 Web CT
 Past questions – repetition!
Practical Prescribing
Lectures +
+ online BNF
Practice!
•Under time pressure
•Do past questions then compare answers
•Calculations
•Be familiar with the BNF
Epidemiology
Lectures!
 Learn the definitions – DON’T learn numbers
 Practice some calculations – Onexamination
 Positive/negative predictive value
 Incidence
 Etc....


Made a list of things that could come up in
each station
Ask Dr Clarke – amazing and FREE!
Medicine
 Tutoring or seeing patients.
 Saw 2-4 patients per session
 Don’t overdo it – a liver is a liver.
 Balance – patients v.s. bookwork
 Make the most of firms and avoid the rush
Medicine
Surgery
 Anatomy!
 Google and wikipedia
 Presentation
 Complications – structure!
 Immediate
 Early
 Late
Surgery
Medicine
 NWP
 Very unhelpful
 Expected to get moved on – didn’t
 Thought I’d failed because I didn’t get to talk
about management for 4/6 stations
 Don’t worry about weird stations or getting
the diagnosis right
 Just act like you’re the doctor
Surgery
 NWP
 Very friendly
 Barely touched anyone
 Don’t forget peri-op care and trauma
 Complications!
 Nothing unexpected

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Be honest with yourself
Do what you need to do
Don’t follow the crowd
Make sure you know your basics inside out
A little bit at once
Everyone else is in the same boat
Pranev Sharma
FY1 Cardiology, Northwick Park Hospital

Don’t believe the rumours!
◦ “Finals are impossible to pass”
◦ “The examiners are trying to fail you”
◦ “The examiners will coldly stare at you if you’re
stuck”

Don’t believe the rumours!
◦ “Finals are impossible to pass”
◦ “The examiners are trying to fail you”
◦ “The examiners will coldly stare at you if you’re
stuck”

Organise your tutors

Don’t believe the rumours!
◦ “Finals are impossible to pass”
◦ “The examiners are trying to fail you”
◦ “The examiners will coldly stare at you if you’re
stuck”

Organise your tutors

Organise your time wisely

Know the rules!
◦ Don’t argue with the examiner

Know the rules!
◦ Don’t argue with the examiner
◦ Learn how to talk

Know the rules!
◦ Don’t argue with the examiner
◦ Learn how to talk
◦ Use appropriate language

Know the rules!
◦ Don’t argue with the examiner
◦ Learn how to talk
◦ Use appropriate language
◦ Learn how to present yourself – and dress
appropriately!

Know the rules!
◦ Don’t argue with the examiner
◦ Learn how to talk
◦ Use appropriate language
◦ Learn how to present yourself – and dress
appropriately!
◦ Be polite

Medicine
◦ Books
◦ Courses
◦ PACES structure

Surgery
◦ Books
◦ Courses
◦ PACES structure

Books

Courses

PACES structure
◦ Cardio, Neuro, Resp, Abdo: 7 mins examination / 3
mins viva. Aim for 6/4.

PACES structure
◦ Cardio, Neuro, Resp, Abdo: 7 mins examination / 3
mins viva. Aim for 6/4.
◦ History: 10 mins history/ 10 mins viva. Aim for
8/12.

PACES structure
◦ Cardio, Neuro, Resp, Abdo: 7 mins examination / 3
mins viva. Aim for 6/4.
◦ History: 10 mins history/ 10 mins viva. Aim for
8/12.
◦ Shorts: anything goes.

PACES structure
◦ Cardio, Neuro, Resp, Abdo: 7 mins examination / 3
mins viva. Aim for 6/4.
◦ History: 10 mins history/ 10 mins viva. Aim for
8/12.
◦ Shorts: anything goes.
◦ Rest: maybe/maybe not.

PACES structure
◦ Cardio, Neuro, Resp, Abdo: 7 mins examination / 3
mins viva. Aim for 6/4.
◦ History: 10 mins history/ 10 mins viva. Aim for
8/12.
◦ Shorts: anything goes.
◦ Rest: maybe/maybe not.
◦ Ask Dr Clarke Imperial Finals Archive

Books

Courses

PACES structure
◦ Abdo, Ortho, Vascular: 10 mins – examination and viva
simultaneously!

PACES structure
◦ Abdo, Ortho, Vascular: 10 mins – examination and viva
simultaneously!
◦ History: 10 min hx / 10 min viva. Aim 8/12.

PACES structure
◦ Abdo, Ortho, Vascular: 10 mins – examination and viva
simultaneously!
◦ History: 10 min hx / 10 min viva. Aim 8/12.
◦ Shorts: anything goes

PACES structure
◦ Abdo, Ortho, Vascular: 10 mins – examination and viva
simultaneously!
◦ History: 10 min hx / 10 min viva. Aim 8/12.
◦ Shorts: anything goes
◦ Images & instruments: anything goes

PACES structure
◦ Abdo, Ortho, Vascular: 10 mins – examination and viva
simultaneously!
◦ History: 10 min hx / 10 min viva. Aim 8/12.
◦ Shorts: anything goes
◦ Images & instruments: anything goes
◦ Rest: maybe/maybe not

PACES structure
◦ Abdo, Ortho, Vascular: 10 mins – examination and viva
simultaneously!
◦ History: 10 min hx / 10 min viva. Aim 8/12.
◦ Shorts: anything goes
◦ Images & instruments: anything goes
◦ Rest: maybe/maybe not
◦ Ask Dr Clarke Imperial Finals Archive

Any questions?
ps1006@imperial.ac.uk
Jenner Ward (Cardiology) – 9th Floor, NPH