MD3 Peer Tutoring

Medical imaging and pharm undergrads

Surg rotation
 Best exposure to surgery!!
 Wards!!

Junior doctor: Trung

 Good for Long Cases and recalls

Present patients to interns!

Go to ward rounds x3 → knock on doctors office in afternoon******

Pharmacology!! Taught poorly Unimelb

 List drugs and learn (categorise!)

List medical tests!! Come back and sort through later

BMJ Best Practice (esp. DDx)

One examination UniMelb

Rearrange OSCE questions

 Ask relevant qs EARLY!! E.g. hepatitis: ask alcohol early, not at the end
Peer Tute 2 – LONG CASE STRUCTURE

Intro
 Name, age, gender, occupation, location/country (SASPOP)
o Sex, Age, Social, Presenting, On a background of, PHx
 Opening statement – presenting complaint + lead up

HOPC (10min)
 SOCRATES! / numbered points with manilla folder
 Inpatients: why hospitalised?
 Outpatients: major current issue?
 NOTE:
o Time course – draw timeline!
o RF
o Functional assessment
 List relevant negatives

PMHx (and OAHP)

 Draw timeline! Born until presentation
 Mini HOPC for PMHx if relevant

 Active health problems

o DMCC (diagnosis, management, control, complications)
 Inactive health problems (+/- follow up)

 Since admission*
o 1 Admission: tests
o 2 To ward
o 3 surgery

 Cardiac RF for all patients

 Alcohol, smoking, drugs

Rx
 Cross check with HOPC and PMHx
 Current meds
o Name, dose, frequency, indication, other (e.g. side effects)
 QID 4x, BD 2x, OD 1x day, Q6H = every 6 hours
o Highlight problem medications
 Alternative medications
 Vaccinations/allergies

ROS
 Key qs for each body system – screening!
 Safety net qs (e.g. weight loss)
 Health check relevant to demographics

FHx
 Open ended
 Specific conditions/conditions of interest
  N.B age of first MI in first degree relative

Social Hx (relevant for management!)

 Home/living (N.B recovery!!)
 Support
 Occupation
 Finances
 Impact on QOL!

EXAMINATION
 Take BP! Do it quickly (also check OBS!)

 VITALS
o General inspection (ABCDEF)
 Appearance, breathing, colour, diagnostic facies, equipment, fluids
o BP, HR, RR, Temp +/-sats
 Body systems
o Relevant body system exam first!
 CV/Resp/Abdo/neuro (relevant parts of CN exam)
 Talk about what you were looking for
 “subsidiary exams unremarkable”
 N.B diabetes exam for diabetic patients

Summary
 Examination findings
 Interpretation
 Diagnostic/management
 Potential DDx

Issues (1-2 min for issues)

 Short term x2
 Medium term
 Long term x2

 Any unordered investigations

 Issues specific to patient!

 Social issues
 Discharge planning!

Presentation around 12 min

Examination around 15 min (relaxed)