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Canadian Imgs Guide to OSCE and Practice

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Canadian Imgs Guide to OSCE and Practice CANADIAN IMGS GUIDE TO OSCE AND Hanan Ahmed PRACTICE A practical guide for International Medical Graduates who wish to pursue Medical Residency Training in Canada 1 2 Author and publisher; Hanan Ahmed, M.B.B.S Internal Medicine resident, PGY3 University of Alberta Canadian IMGs Guide to OSCE and Practice ISBN 978-0-9947342-0-4 © 2015 Hanan Ahmed All rights reserved. This book or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the publisher except for the use of brief quotations for scholarly purposes. 3 Disclaimer This book is designed as a study guide for Immigrant and Canadian International Medical Graduates to give them an idea of the expectation of Canadian OSCE exams. It was not written to provide advice on patient care or management, and is not intended as a comprehensive medical resource. Consultation with appropriate resources is suggested when treating patients. The author and editors are not responsible for any harm, direct or indirect that results from the application of this material to patient care. Patient’s names used in this book are arbitrary. Any similarity to reality is a complete coincidence. 4 Forward To Doctors who move to Canada with a strong will to succeed 5 Acknowledgment My heartfelt gratitude to all people who supported this project. Many thanks to my Program Director Dr. Darryl Rolfson for his encouragement, trust and support throughout the whole process. Thanks also to Dr. Peter Hamilton for his help and guidance. My appreciation to Dr. Liam Rourke for supporting the initial phases of this work. Many thanks to the editors who volunteered their time and effort; Dr. Sara Belga, Dr. David Ross, Dr. Shirley Schipper, Dr. Jay Shavadia, Dr. Subrata Datta, Dr. Stephanie Keeling. Dr. Fraulin Morales, Dr. Anca Tapardel, Dr. Sadik Salman, Dr. Abbeir Hussain, Dr. Erica Paras, Dr. Erin Toor, Dr. James Yeung, Dr. Wasif Hussain, Dr. Abdullah Saleh. My deepest thanks go as well to Cayti Beyer, who extended her passion to help IMGs and volunteered to do the language editing. Finally I would like to express my deepest appreciation to my dear husband, Ayman, for his patience, support and help with website design. 6 Preface When I moved to Canada, I was surprised to learn that there are very little resources for International Medical Graduates (IMGs). There isn’t even a single book to orient IMGs. Witnessing the struggle many IMGs face in preparing for Canadian exams due to the lack of study guides targeting the special needs of this group of physicians, I was motivated to execute this work. This book is an overview of the Canadian Objective Structured Clinical Examinations (OSCEs). The goal of this book is to introduce you to the special aspects and expectations of Canadian exams and provide resources and links that will help you study while preparing for these exams. While the book helps you prepare for exams step by step, it is also a useful resource to understand what is expected from you when you start your training. Chapter one covers the type and content of OSCE exams IMGs commonly write. It details the structure of the exams and pin points high yield scoring points. Chapter two is history taking. History taking is the most common scenario in Canadian OSCEs. This chapter details the various history taking situations based on a general patient population and can be used as a question bank to choose from for focused histories as needed on a case by case basis. Chapter three is physical exam. It details most possible physical exam scenarios and what is expected from examinees. The special aspects, expectations and depth of physical exam pertinent to Canadian OSCEs are presented in this chapter. Chapter four is writing and counselling tips. An overview of counselling is presented in this chapter along with any scenarios in which you may be asked to document Chapter five is clinical cases. Written in interactive format to facilitate practice, this chapter covers 18 common clinical cases designed to reflect the exam format 7 and give you an idea of its flow. The cases presented are common clinical scenarios. Each case has a variation of the case section at the end, to help you practice a wide range of differentials when assessing common presentations. You can use them as a guide as you design a study approach to more clinical cases. Chapter six is ethical and legal principles. It goes over the basic ethical foundations you need to observe during your practice and which could be tested in an OSCE scenario You can use this study guide to prepare for the NAC OSCE and MCCQE2. The content was reviewed for the most recent updates; however, I strongly encourage you to go over MCC website regularly for updates regarding the exams. The best way to use this book is as a study guide along with other resources. The material presented here is meant to give you an idea of how things are done in Canada and what is expected from you in an exam setting. It is not a comprehensive medical resource. Every effort was made to ensure the accuracy in this study guide. However, this book was not designed for direct patient care. Consultation with appropriate resources is strongly encouraged when treating patients. 8 Section Editors Chapter 1 Sara Belga, MD Third Year Internal Medicine resident University of Alberta Chapter 2 Shirley Schipper, MD, CCFP Associate Professor Department of Family Medicine University of Alberta David Ross, MD, CCFP Associate Professor Department of Family Medicine University of Alberta Chapter 3 Anca Tapardel, MD, FRCPC Assistant Clinical Professor Department of Internal Medicine University of Alberta Chapter 4 Cardiovascular Physical exam Jay Shavadia, MD Division of Cardiology, PGY6 University of Alberta Gastrointestinal and Respiratory physical exam Erin Toor, MD, FRCPC Division of General Internal Medicine Department of Medicine University of Alberta 9 Neurology physical exam M. Wasif Hussain, MBBS Adult Neurology resident PGY4 Department of Neurology University of Alberta Musculoskeletal physical exam Stephanie Keeling, MD, FRCPC Associate Professor Division of Rheumatology Department of Medicine University of Alberta Breast physical exam and Fundoscopy Sadik Salman, MD, ABIM, FRCPC General Internist Department of Internal Medicine University of Alberta Chapter 5 Case 1 and 2 Subrata Datta, MD, Division of Internal Medicine, PGY4 University of Alberta Cases 3 and 4 Jay Shavadia, MD Division of Cardiology, PGY6 University of Alberta Cases 5 and 6 James Yeung, MD, FRCPC Rheumatologist Division of Rheumatology Department of Medicine University of Alberta Cases 7, 8, 10 and 15 10 Sadik Salman, MD, ABIM, FRCPC General Internist Department of Internal Medicine University of Alberta Case 9 Erin Toor, MD, FRCPC Division of General Internal Medicine Department of Medicine University of Alberta Cases 11, 12, 13 and 14 Erica Paras, MD Obstetrics and Gynecology Resident, PGY4 University of Alberta Cases 16 and 17 Abbeir Hussein, M.D Pediatrics Resident, PGY3 University of Alberta Case 18 Abdullah Saleh, MD General Surgery Resident. PGY5 University of Alberta Chapter 6 Fraulin Morales, MD, FRCPC Associate Clinical Professor General Internal Medicine University of Alberta English language editor of the whole book; Cayti Beyer IMG Program Developer/Coordinator & Career Coach Directions/Bow Valley College Calgary, Alberta 11 12 TABLE OF CONTENTS ABOUT THE EXAM ..................................................................................................... 17 Overview of OSCE Exams ................................................................................................................................ 18 What Does the Exam Cover? ........................................................................................................................... 18 Interaction with the Standardized Patient (SP) ................................................................................................ 18 Interaction with the examiner ........................................................................................................................ 19 Interaction with the nurse/QE2 ...................................................................................................................... 19 Cases with extra family member ..................................................................................................................... 20 Structure of MCCQE2 ..................................................................................................................................... 20 Structure of NAC ............................................................................................................................................ 21 Scoring .......................................................................................................................................................... 21 HISTORY TAKING ....................................................................................................... 25 Introduction .................................................................................................................................................. 26 Basic Elements of History ............................................................................................................................... 28 Special Populations: History ........................................................................................................................... 36 PHYSICAL EXAMINATION .......................................................................................
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