Know the Rules well, so that you can break them effectively

-Dalai Lama XIV

As you know, half of the tasks are rumoured to be structured discussion cases in the coming Part 3 exam. Many candidates get nervous about the SD cases. However, there is really no need to get tensed, you just need to keep a few things in mind, and you can nail it. I have put down a few points to help you get through the structured discussions smoothly.

What Is it?

  • In this task the candidate interacts directly with a clinical examiner.
  • The examiner will have detailed instructions about the task and a list of questions that they can use to prompt the candidate or to move the task on to ensure that the candidate does not run out of time.
  • The examiner may give the candidate further information as the scenario evolves and then ask further questions.

Why is it Important?

In the upcoming exams, it’s rumoured to be half of tasks.

So, this blog is to help you prepare well for the SD.

Tips to handle the structured discussion stations

  1. Keep your knowledge updated – as its complete clinical knowledge, know about common scenarios, how to ask information, diagnosis and management.
  2. Read the question carefully, even if it means taking extra 30 seconds.
  3. To begin with introduce yourself to examiner with
  4. Whenever asked to talk about scenario always talk in SBAR format.
  5. Limit your answer to the question asked- For e.g. if initial assessment is asked, only talk about initial assessment, don’t go to definitive management.
  6. Try to justify as and when required, but not for everything -it wastes your time as well examiner might get offended.
  7. Expect 4-5 questions during the task.
  8. If you didn’t understand the question- Be polite and ask, I’m sorry, could you please rephrase the question for me.
  9. If you didn’t hear properly (sometimes because of overcrowded exam halls), ask I’m sorry, could you please repeat question for me
  10. If Result Interpretation is asked during task –
    1. Take time and answer clearly, if you can’t figure out – For e.g. staging in POP-Q – apologise and say I’m sorry, I cannot make it out, – as staging is important for treatment and it’s about patient safety.
    2. Give your interpretation – For e.g. MEOWS CHART – say she has tachycardia and hypotension rather than telling specific values of pulse and BP.
    3. Laboratory Results – your interpretation like Microcytic hypochromic anaemia instead of rereading the specific value.
  1. Instruments– Don’t bother about names, but you should pick up right instruments. For e.g. right instrument for right pedicle in Hysterectomy, and talk about why you chose it. Talk about serrations, advantages & disadvantages if any.
  2. Procedure related – For e.g.:- operative delivery- Speak in a systematic way (Indications, contraindications, prerequisites, demonstration of procedure with explanation, complications) – most importantly emphasise on patient safety.
  3. Clinical scenario- Always talk about Differential Diagnosis and justify what’s your diagnosis – offering options starting from expectant, medical, conservative, surgical and radical and explain what’s suitable for that particular patient.
  4. Anytime if you are stuck, just think you are dealing with real patient in your clinic -the answer will automatically come to you.
  5. Always remember to Signpost -This is obstetrical or gynaecological, an emergency, Patient safety like MDT, Clinical governance issues (use buzz words-documentation, duty of candour, incident reporting etc.)
  6. The more prompting you need from the examiner, the lesser marks you will score. Try to cover scenario as a whole and minimize prompting.

Finally, remember you have all the required knowledge, you only need to show it to the examiner. Work a little on that front – practice makes you perfect.

Just stay calm, and you can do much better than you imagined.

Hope this helps.

God bless!!

Dr.Sowmya N S
Chief Mentor