PREREQUISITES FOR PRACTICAL EXAMINATION
Clinical skills, such as the physical examination remain an important instrument in the physician's armamentarium and assessment of these skills form the basis of the final clinical examination. Every student appearing for the examination will be under a lot of stress, which even though justifiable becomes detrimental for the performance of the student. Here are some suggestions:
- The first and foremost is preparation. Try to have a timetable and cover all important cases well in advance. You have a set of cases that are usually kept for the examination and most of the questions asked are also predictable. Do not keep any important things pending to read on the day prior to examination.
- Sleep is of utmost importance on the day prior to the exam. You need to sleep for a minimum 4–5 hours on the day prior to the exam. The curriculum being vast, compromising a few hours of sleep would do more harm than good.
- Have a light breakfast. Hypoglycemia hampers your thought process, delays your reaction time and severely impairs the performance. Agreed that the feel of exam maybe like undergoing a surgery, but NIL PER ORAL status is not needed.
- Attire is important. Be neatly groomed and dressed. Wear a clean apron with a number badge.
- Carry all your instruments.
- Write a detailed case sheet. Examine each case thoroughly. Never rely on expert's diagnosis. Make your own diagnosis. Always justify it with your own views.
- Stick to the set time limits. Do not waste time.
- Be gentle to the patient when you examine. The more cooperative the patient is, the better will be your performance. Always take the permission of the patient and explain before examining and do not forget to thank them at the end.
- Never forget to wish the examiner good morning/evening. If you do not know an answer, say sorry! (Most of the examiners will change the question or give you a clue). Always finish with a thank you!
- Confidence is of paramount importance. Practice presenting cases without referring to the case sheet. Be clear in the order of presentation, both history and examination. Stress on relevant important findings. To be expressive is important, but not over expressive. Eye-contact is essential. Answer clearly and to the point. Do not speak about rare causes. When demonstrating signs, do it clearly.
- Most importantly, have faith in yourself and your preparation. You shall succeed.
CHECKLIST FOR PRACTICAL EXAMINATION
- Clean apron with roll number tag
- Hall ticket
- Stationery
- Stethoscope with a bell
- Knee hammer
- Key (to test plantar reflex, stereognosis)
- Wristwatch with seconds needle
- Measuring tape
- Two scales
- Pins
- Glass slides
- Two small boxes for testing smell (soap and coffee)
- Four boxes for testing taste (sugar, salt, bitter and sour)
- Four cards with the words “sweet”, “sour”, “bitter” and “salt” written on them.
- Snellen's chart
- Ishihara's chart
- Cotton
- Tuning forks (128 Hz and 512 Hz)
- Divider
- Ophthalmoscope with full batteries
- Torch with full batteries
- Thermometer
- Cotton wick/throat swab stick—gag reflex
- Two test tubes preferably aluminum for temperature testing (glass test tubes may be used if aluminium test tubes are not available)
- Pulse oximeter (not mandatory)
- Gloves
- Mask
- Hand rub
FORMAT OF CLINICAL EXAMINATION
The general format of cases in the examination is as follows:
Type of case | Time given for examination of patient | Time for clinical viva | Marks |
|---|---|---|---|
Long | 45–60 min Detailed case sheet needed | 15–20 min | 50/40 marks |
Short | 15 min | 7–10 min | 20 marks |
Semilong | 15 min | 7–10 min | 20 marks |
Spotters | 1 min | 2–3 min | 5 marks each |
Charts (laboratory data, clinical) | 1 min | 2–3 min | 5 marks each |
OSCE (any clinical sign) | 5 min | 5 min—observed | 5–10 marks each |
Viva voce | 4 table vivas, each carrying 5 marks, each timed for 5 minutes Topic—X-rays, ECG, instruments, drugs, charts, general viva | ||
COMMON EXAMINATION CASES
Respiratory system | |
Long case | Short case |
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Cardiovascular system | |
Long case | Short case |
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Gastrointestinal system | |
Long case | Short case |
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Nervous system | |
Long case | Short case |
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Semilong cases/therapeutic cases | |
Renal |
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Rheumatology |
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Endocrine |
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Hematology |
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General |
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