I had 5 minutes to read and prepare notes/approach for both encounters in this new station 5. My first question is something like this:
" 50 + year old lady complains of painful joints over the fingers. She also has psoriasis for the past many years.
You have 8 minutes to take brief history and examination and address her concerns. You are not required to take a detailed history of perform a detailed examination in this lady. You have 2 minutes to present your findings and discuss about the case."
I was quite happy when I got this case because I am very familiar about this topic and very well versed in the examination too... My rheumatology posting as a medical officer is really useful here... I was hoping I could do well here.
That was the first time they perform this station in such a way.. In my opinion it was quite chaotic. The examiners were right behind/beside through out the encounters. After taking brief history, I proceeded with the examinations. I started off with joint examination - started from the hands and later the back, scalp, behind the ears, trunk and legs... Then the lead examiner told me... "that is not necessary." they reminded me I was short of time. So I finished it off by asking her occupation and her concerns.. Luckily I managed to ask her this bit! She's an Indian dance teacher and definitely uses a lot of fine motor movements of the hands! 8 minutes up! Time for discussion.
They asked me to present my findings. The lead examiner commented my examination technique. Got to admit. With the examiners around me (the Chief Examiner of MRCP (UK) that is!), I didn't examine her in my usual manner. Wasn't sure how detail the examination/history needed. Guess I didn't use my rheumatology experience well here. Other questions were about diagnosis and its differentials and of course management. Results came out... Didn't do well on the examination part.. Others were okay.
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