Tips & Tricks for Year 3

1. Tips & Tricks for Year 3 Sally Barker Yvonne Tsitsiou Mahmoud El-Khatib Laz Ranasinghe Michael Jiang Amer Al-Balah

2. Welcome to MedED! Your team: Dedicated Year 3 Coordinators: Michael Jiang mj1216@ic.ac.uk Amer Al-Balah amer.al-balah16@imperial.ac.uk Chairs of MedED: Sally Barker Sally.barker15@imperial.ac.uk Yvonne Tsitsiou yvonne.tsitsiou15@imperial.ac.uk

3. First things first DISCLAIMER: MedED does not represent the ICSM Faculty or Student Union. The lecture series and advice within this talk has been designed and produced by students. We have made every effort to ensure that the information contained is accurate and in line with Learning Objectives featured on SOFIA, however this guide should not be used to replace formal ICSM teaching and educational materials.

4. Talk Overview “I heard that 3rd year counts?” Support offered by MedED Timeline Ethics OSCEs Written Exams

5. ‘I heard that 3rd year counts?’ • FPAS = nationalised scoring system that determines where you are placed for F1/2 • Final Year – rank your deaneries by preference • Allocations depends on your overall FPAS score FPAS = 100 points • 50 Medical School Points • 34 points = everyone • 1 point = every decile (i.e. 1st decile = 9 extra points, 9th decile = 1 extra point) • 4 points = BSc (1st = 4, 2:1 = 3, 2:2 = 1 etc.) • 5 points = PhD • Up to 2 points = publications with PMID or presentations at conferences • 50 SJT Points • Exam sat in final year • Based on situational judgment • Hard to prepare for Medical School Decile = Year 3 Ethics (10%) + Year 3 Written (15%) + Year 3 OSCE (15%) + Year 5 (60%)

6. What MedED can do for YOU: OSCE Tutoring Lecture Series Mock OSCE

7. MedED Year 3 OSCE Mentoring Scheme • Dates: December – May • Sign-up forms released shortly after this talk • Groups of people matched to 1 or 2 tutors from older years • Weekly or fortnightly meetings • OSCE resource pack given to tutors • Excellent way of learning and practicing examinations and clinical skills in an exam-focused style!

8. MedED Year 3 Lecture Series • Dates: January – March • Weekly lectures on Tuesday/Thursday evenings in Charing Cross • Covers all the main topics on SOFIA via interactive, case-based lectures • Also covers lots of practice SBAs • Lectures form an excellent platform for structuring revision • Mock written exam near the end of the series • FEEDBACKis needed before we can release the slides

9. MedED Year 3 Mock OSCE • Dates: May • Centralised system where everyone is allocated at least 1 mock • Sign-up form released closer to the time • Full 12-station practice OSCE • Assessed by older years and 1 to 1 feedback given at the end

10. Timeline: Term 1

11. Timeline: Term 2

12. Timeline: Term 3

13. A few details The ETHICS EXAM

14. The Ethics Exam  • What are you talking about? • FOCP exam, January • 1 paper, 2hr 45mins • MEQs on pre-released case • 20 A4 pages notes • 30 Law SBAs • 2) I hate writing essays..... • MEQs are very similar to SAQs • Ethics-by-numbers • Sticking to time is the most important thing.

15. The Ethics Exam • After the case is released?  • Go to a prep lecture • Groupwork: make questions and answers • 3) How do I prepare... • now? • Do the Ethics and Law E-modules on Blackboard • And again • And again 

16. The structure and how to smash it  THE OSCE

17. OSCEs: structure Exam consists of 12 stations in a circuit • 10 minutes per station • Stations are NOT released beforehand Tick box marking scheme

18. OSCEs: Examinations

19. Basic structure? The sequence of steps in a classic examination of that system. Should be taught to you in beside teaching and/or OSCE tutors. Also useful: • Don't forget those easy marks! • Introduction and consent • Washing your hands • Explaining each step to the patient • HR, BP, JVP

20. OSCEs: Examinations

21. Pain? At the beginning: “Before I start, do you have any pain anywhere?” • Yes – “Has anyone offered you pain relief yet?” • No- offer pain relief During: show me again where the pain is • Ask patient’s consent to examine that area • Yes – examine carefully • No – move on After: remember to include the pain location in your presenting findings, even if the patient refused proper examination.

22. OSCEs: Examinations 7 minutes Presenting 3 minutes

23. Presenting? “I have performed a cardiac examination on Mr X, a 55 year-old male who presented to A+E one hour ago with breathlessness. There was no obvious stigmata of chronic cardiac disease.HR was 100 bpm, pulse weak and irregular, RR 26, BP was 160/100 and capillary refill was <2 seconds.  Jugular venous pressure was 3cm above the sternal angle and the character of the carotid pulse was strong and regular.  Upon inspection of the chest, there was no chest wall abnormalities, the apex beat was not palpable in the 5th ICS in the MCL and there were no heaves or thrills.  On auscultation, hearts sounds one and two were present with no added sounds.   There was no evidence of pulmonary or peripheral oedema.   In summary Mr X has an irregular tachycardia, tachypnoea and a raised blood pressure.   To complete my examination I would take a full history, perform a full peripheral vascular exam, check for an abdominal aortic aneurysm, check oxygen saturation and temperature, do a urine dip and fundoscopy and perform a  12 lead electrocardiogram. ”

24. OSCEs: Examinations Presenting

25. The extra stuff

26. OSCEs: Examinations 7 minutes Presenting 3 minutes

27. OSCEs: Histories 7 minutes 3 minutes

28. OSCEs: Histories Basic structure 

29. "The new combo station" • WHAT IS IT? • Previously specific 'explain' station part of clinical skills • Now this clinical communication is being integrated into other stations • E.G "Patient comes for annual BP check, advise the patient accordingly" • WHAT TO DO? • TRAP – STILL A HISTORY STATION • Remain calm  • Don’t get caught up in having aimless conversation • Still marks for: PMHx, PSHx, SHx, etc • Try to identify the RFs for the patient's KNOWN condition instead of figuring out WHAT the patient has!  

30. OSCEs: Clin Skills Clinical skills:  •Catheterisation •Explaining peak flow and inhalers •Suturing and wound care •Taking blood •Cannulation •Performing ECG DOPS: Urine dipstick  Basic Obs Fluid administration  Special Exams Thyroid, Breast, DRE

31. Imperial rumours: True or False? Forgetting to wash hands Automatic fails  Swearing Vivas Must pass all stations You can't do well on both OSCE and Written  You need to be Patch Adams to do well  People who do well in pre-clinical tend to NOT do well in clinical year and vice-versa 

32. OSCEs: what to do now and later

33. Written Paper – Advice Overview What to make of DPD SOFIA – useful or misleading? Best resources to use! Rough timeline for the year

34. DPD • 3-week lecture series just before Christmas • Amir Sam Lectures are ESSENTIAL – many exam questions are based on his lectures • The other lectures are not essential but may be useful if you learn well from lectures

35. SOFIA • Massively overhyped • ‘Completing’ SOFIA is time-consuming, dull and not a particularly effective learning exercise • Useful list of conditions and presentations that you should know by the end of Year 3 • Use older years’ notes to save time • IMPORTANT: SBAs in Year 3 exams are CASE-BASED, so they require a wider understanding of topics rather than knowing discrete details

36. SOFIA Tachycardia Fever Furred tongue Lying still Coughing hurts Foetor with/without flushing Shallow breaths

37. SOFIA Type of question that SOFIA prepares you for that you wont be asked: ‘Which of the following is NOT a typical sign of appendicitis?’ Type of question you are likely to get: ‘An 18-year-old girl is rushed into A&E with severe right iliac fossa pain. She also has a temperature of 39.2ºC and marked abdominal tenderness. What is the most likely diagnosis?’

38. RESOURCES: Oxford Clinical Cases • BEST BOOK FOR YEAR 3 • Talks through presentations from head to toe – easy to follow • Useful for history taking and data interpretation • ADVICE: read up on the presentations that you are most likely to see on your firm (e.g. Urology – poor urinary output)

39. RESOURCES: Rapid Medicine • Written by Amir Sam • Same layout as SOFIA • If you are really intent on completing SOFIA, this book is useful • Otherwise, quite dry and only occasionally useful as a reference book • ‘Rapid Surgery’

40. RESOURCES: Question Books • EXCELLENTway of learning and consolidating knowledge • Much more interactive than simply reading a textbook • GetAhead books have excellent explanations – HIGHLY recommended • Some questions will be targeted at Final Year students, so try and identify which questions are relevant

41. RESOURCES: Brainscape • Download app and search ‘Year 3 Medicine’ (Author: Joe Vincent) • Contains all 1023 blackboard questions • Can rate difficulty of the question from 1-5 • Not especially representative of the exam (some questions are outdated) • Useful when travelling to firms/got time to kill

42. Rough Plan for 3rd Year Oxford Clinical Cases Amir Sam Lectures Questions HAVE FUN! Flick Through Sofia More Questions EXAM

43. Thank You! FEEDBACK: https://forms.gle/AggH3czxhTM1ApMHA Questions? @ic_meded