16985-53 - 01 Approach to the long case To the physician...

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± TO THE PHYSICIAN TRAINEE The ‘long case’ is the main focus of interest in the physician’s examination. Candidates at the FRACP examination are given two long cases. It is very important to perform well in the long cases, to secure a comfortable overall pass at the examination. This book introduces the long case to the novice in the field and attempts to correct some flaws in more experienced players. These instructions are aimed mainly at candidates taking postgraduate clinical examinations. However, there is also useful advice and informa- tion for medical students preparing for the clinical component of their examinations and for students participating in their clinical rotations. The case discussions in the lat- ter section of this book are also aimed at providing useful guidance to medical students involved in problem-based learning (PBL) and case-based learning (CBL) modules. The long case is an art that needs mastering. Long case mastery will not only help candidates to pass the examination but will also equip the trainee with the skills and expertise to handle any complicated medical case. These skills are vital to the can- didate’s future life as a physician. While preparing for the clinical examination, the candidate is expected to acquire as much expertise as possible within a very short time. Such intense learning will not happen at any other time in your career. Therefore, it is important to approach this time of preparation knowing what to do and how to go about doing it. The preparatory period should be well planned and executed, with utmost commitment to your goal. It is important to plan this preparation systemati- cally, so that no aspect of clinical medicine is missed or omitted. It is also important to achieve your peak level of performance at the right time. Peaking too early can lead to exhaustion and a lacklustre performance by the time of the examination, and peaking too late may mean ‘missing the boat’. An ideal way to start preparing is to fully understand what the preparation is for. It is therefore important to become familiar with the examination and what exactly will take place on the day. At the examination the candidate is usually given 1 hour to spend with the patient unobserved by the examiners or the ‘bulldog’ (the bulldog is a basic trainee registrar from the host hospital assigned to attend to the candidate on the day of the examination). During this period, a detailed history needs to be obtained, and a thorough physical examination performed, focusing particularly on the main system involved. The candidate is usually given a warning 10 minutes be- fore the end of his or her time with the patient. Then another 10 minutes is given 01 Approach to the long case
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MASTERING THE MEDICAL LONG CASE ² as preparation time before the candidate is introduced to the examiners. There are usually two examiners for each candidate on the long case, one being a member of the National Examining Panel (college representative or censor). Occasionally there may be a third member present, acting as an observer. This member of the examin-
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  • Spring '13
  • xyz
  • Physical examination, long case

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