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Clinical Medicine for the MRCP PACESVolume 1: Core Clinical Skills$
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Gautam Mehta and Bilal Iqbal

Print publication date: 2010

Print ISBN-13: 9780199542550

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780199542550.001.0001

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Brief Clinical Consultations: General Approach to Brief Clinical Consultations

Brief Clinical Consultations: General Approach to Brief Clinical Consultations

Station 5 Brief Clinical Consultations: General Approach to Brief Clinical Consultations
Clinical Medicine for the MRCP PACES

Gautam Mehta

Bilal Iqbal

Oxford University Press

The new Station 5, Integrative Clinical Assessment involves two 10-minute encounters, each known as a ‘Brief Clinical Consultation’. Following an introductory referral, the candidate has 8 minutes to undertake a focused history and examination to solve a clinical problem, answer any questions the patient may have and explain their investigation and/or treatment plan to the patient. The remaining 2 minutes are spent with the examiners, to relate the relevant physical findings and differential diagnosis. Remember, you are not expected to take a complete history or conduct a complete and thorough examination, as you would in the other stations. Candidates should be prepared to encounter scenarios relating to: 1. Old Station 5 cases, i.e. skin, eye, locomotor, and endocrine systems. 2. Other stations of the examination (stations 1 and 3). 3. Medical problems encountered in everyday practice, i.e. chest pain, hypotension, jaundice, and deterioration in renal function. In principle, this station can include any possible inpatient and outpatient medical scenario, and therefore providing a comprehensive selection of cases will never be feasible. Some patients may not display a wealth of clinical signs, and this often occurs in everyday practice. The candidate should understand the key principles, and develop the art of integrative clinical assessment. This will ensure success in any clinical scenario provided. This integrated approach is a test of higher clinical reasoning and professionalism, rather than a simple test of clinical skills— this should be kept in mind when preparing for this station. The compilation of 20 cases in this section is designed to achieve this, and encourages the candidate to adopt a uniform style, and a thoughtful approach and strategy in tackling this station. • Explanatory referrals are provided in the 5 minute interval before the station. • Read these carefully, and identify the clinical problem(s). • Develop a differential diagnosis based on the limited information available, even before seeing the patient. • A preliminary differential diagnosis will initially help guide the focused history. • The history and examination should not be seen as separate components, where the history is followed by the examination. • Instead, both history and examination should be integrated.

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