I have sent a verification request to the page which this link led me to .please approve I would request that you don’t share my name with anyone as I would like to remain anonymous. I am a female Dr from Pakistan
Thankyou for the detailed response. I haven’t found any study buddy links yet. I just sent a verification request, maybe after it is approved I ll get the links you are talking about
My question is , how to study before practicing ? Like should I watch the entire videos of mo sobhy, then go through notes? Then try to practice or it okay to not know topics before practicing, how much knowledge is needed ? In online mocks by Dr Ali, he said we have to verbalize even ear exam findings like tympanic membrane and uncut , etc terms I had totally forgotten, are such things necessary?
I have 6 months till exam now, the last two I plan on spending in the academy in boothhall. How would you suggest I prepare.
Hello @Faizan2024 , thankyou for your detailed response. Please see my previous reply as well, and as far as this forum is concerned. @Plabforum asked for my PASSPORT front page as well as plab 2 result. Did you give these details? How to trust. Please advice @Faizan2024
Hello, sorry for late response
Let’s break down the autism station into three domains
IPS (I am placing it first because once you enter the cubicle the chance of scoring high on IPS begins. Be polite, smile introduce)
Keep in mind mother will be worried, make her interact with her. Ask her if she has worried expression what’s going on, tell her she did the right thing by bringing her child and that you will try your best to help her out. Be sensitive as mother is thinking something is wrong with her child. As you go through station at different parts you can use this IPS. in start during history and during management when explaining that this is not a disease. Hope this is clear.
History:
Always starting your history paraphrase from stem. If in stem it’s given that mother is worried start by stating I’ve been informed that you’re really worried can you please tell me what’s going on ? (Don’t start by how can I help you ?)
Whatever is given in stem outside use it.
Your history structure will be same as any pediatric station.
The main things are explore whatever complaint the mother gives you. Like he doesn’t speak , he doesn’t smile. Whatever she says explore it I used DOPA (Duration, onset, progression , associated ). If any time you get stuck in history explore complain using this. Then after exploring in three four questions jump to questions of autism and development
Like his talking ? Does her not hear you when you call for him or does he not respond. Does he get irritated on certain things ? Any repetitive movement? Does he share things with other people?
When did he start walking ?
And two questions specific to development of the age of child .
Rule out NAI in associated symptoms of main complaint. Like who does little Adam live with ? How do they get along ? Anything significant happened after which you noticed these symptoms.
In birth make sure to ask about PREMATURE BIRTHH (might be there and might not be there)
Then MANAGEMENT (Again IPS good will lead to high scores)
Be HONEST
that at this point you can’t give a diagnosis but it seems that Adam has autism. Let her know it is not a disease , not a condition. It’s just some people perceive things and world around them differently then other people. (PAUSE HERE LET HER MOM COMPREHEND)
she might panic, or say is this because of MMR . Make sure to address concerns at this point.
Why my child has this ? Exact cause is not known. If premature birth in history still exact cause is not known however premature birth can be a contributing factor.
AUTISM TEAM WILL SEE PATIENT IN THREE MONTHS OF REFERAL
(ANY REFERAL Involve SENIOR)
ANY QUESTIONS HIT ME UP
GOOD LUCK!
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Hello again, well yes if you are following Mosohby academy. Watch the videos. For example you watch cardiovascular video and read the notes then you can practice that particular branch and move forward. This is how I practiced.
In examination there are TWO CASES ONE WHERE YOU WILL HAVE TO EXAMINE AND ONE WHERE YOU don’t have to.
You will learn how to differentiate as you move down the line and complete videos and attend your academy but if at that time you need help make sure to ask
NOW TALKING ABOUT THE STATIONS WHERE YOU DONOT HAVE TO EXAMINE.
In those stations after history you will verbalize for eg in a case of lung cancer you will say now I would like to check your vitals , do a general physical exam and examine your chest.
Now when you will verbalize this the EXAMINER WILL HAND OVER A PAGE TO YOU WITH examination findings.
Now you have a page with all the findings just take about 20 seconds to tell positive findings to the patient. I would show the cardboard to my patient during my exam and just quickly explain what’s written.
Now as for verification I don’t know even I am verified or not. I don’t know much about these technical stuff. So do so at your own risk.
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Hello again REGARDING YOUR SENIOR INVOLVEMENT QUERY.
so in NHS every patient that is assessed by fy2 is seen either by consultant or reg or immediate senior like trust grade doctors.
Now my advice is if Yu have a very simple case like MOLE it’s fine to not involve seniors
But in most cases be a safe doctor verbalize that I’ll be discussing your case with my senior as well.
Any REFERAL is made after senior input.
Big test like CT biopsy you need senior input.
So better safe than sorry
However, if it’s a councelling case like your consultant has asked you to take blood sample or consultant has asked you to discuss discharge medications or consultant has asked you to discuss life style advice
In these cases verbalize in start that I’m here because my consultant or reg has asked me to inform you on this. And then don’t mention later on
I hope this clears it up. There are some cases where this can be challenged in plab2 so if confused feel free to ask.
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I have to say, you’ve set an example, and the level of detailed explanation and efforts you’re putting in is unmatched! Impressive! Hats off to you!!
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Thankyou very much for the advice, I remember the bit about being handed the examination page with the positive findings but I didn’t handle it well.
In CASES where we do have to examine, how to verbalize the findings? I am asking about eye and ear stations specifically.
Another thing, I am from Karachi, Pakistan 
Is there any other platform to find other study partners? I have nearly 6 months until my exam , how should I proceed with memorization so I don’t forget things?
A good way to find partner is to message in your academy group and usually you will find a lot of people.
It’s different for different examination cases.
Let’s say you examined the ear and you find some wax.
After examining you can say thank you for letting me examine you from my examination I can see you have some wax in your ear and this might be the cause of the symptoms that you are having.
Or in eye like retinal detachment you can say again thank you for letting me examine you it seems that retina which is a structure in your eye has detached from its position
Try to make it simple as possible. Purpose is to avoid medical jarrgon.
Another thing is when in academy try to look at a lot of images of eye and ear to familiarize yourself with different presentations
But mostly you should have a diagnosis in mind through history before proceeding for examination
I had a case of bitemporal hemianopia and by God I have no idea how it looks on FUNDOSCOPY but in history he just said I’m fine but my car keeps getting hit from sides so I crossed fingers and made the diagnosis on that.
But don’t be like me try to have a diagnosis in mind through history and practice by looking at images alot.
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Hi again, I am wondering if you have any leads on the “Simman AFIB+warfarin+bleeding back passage” station. This station is being repeated and I saw many instances in the recalls. Could you please help me with how to approach this? Many thanks and best
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Is ADHD curable without medication?
Hello, this is a tricky station but let me try to break it down. Firstly, I am going to assume that you know the structure of simman stations including universal precautions and general structure for this station.
NOW first let us talk about history : PATIENT PRESENTATIONS either patient will have -SOB, Altered level of conciousness, Palpitations , Feeling light headedness.
As a general rule explore complains briefly don’t forget to ask for chestpain, sob, trauma, heart racing like if anyone of these ask the others after that past medical and MMA.
Try to take a good history as it will help you understand what the station is.
If patient is unconcious or altered level then ask patient name and age announce to examiner that patient is unconcious or altered and proceed to ABCDE assessment.
My tip would be if SOB or PALPITATIONS (Think CCF 2* to Afib or new AFIB-if only palpitations)
HISTORY and ADAPTING to direct assessment if conciousness impaired is the difficult part here.
NOW ASSESSMENT the famous ABCDE approach . GOLDEN POINT: whatever you do in assessment imagine you are really in Emergency department. DONOT move the SIMMAN. APART from that try to do everything oxygen mask put it on, nebulizer med try to put it in mask, IF IV CANNULA is PACKED PLEASE OPEN IT and try to insert in the simman arm, TRUST ME EXAMINER WILL SHOUT DOCTOR ASSUME IT IS DONE. Once the examiner says this only THEN MOVE FORWARD. The examiner will only say it when he knows or sees that you are in the zone and you will INSERT IT and that you MEAN BUSINESS. PLEASE DONOT PUT A PACK IV CANNULA on the simman arm they dont give you score on that.
NOW LET US BREAK IT DOWN
AIRWAY- if patient is speaking we good. - If patient not speaking assess airway using head tilt to rule out obstruction. IF O2 low attach oxygen depending if CCF or Bleeding
BREATHING- Trachea, Chest expansion, Percussion and auscultate (if you find CREPTS) DEAL WITH THE CREPTS ( this is my advice people suggest against this as well but whatever acute issue you find deal with it) you find bilateral crepts and on monitor you can see heart rate as well in CCF case. Verbalize what you found that I can see your heart is beating too fast and I can hear some noisy breathing in your chest so I believe that your heart is not pumping blood properly causing it to pool in your lungs . I will be doing this which inserting cannula and giving water injection. Then you can order CXR ABG and ECG together. Some people do ECG in C . Just follow your approach but if you find CREPTS deal with it immediately.
THEN CIRCULATION
please understand circulation is any INTERNAL OR EXTERNAL HEMORRHAGE
now external hemorrhage you will asses by blood pressure, pulse, Capillary refill time. AS FOR EXTERNAL HEMORRHAGE if PATIENT TELLS YOU DOCTOR I AM BLEEDING FROM BACK PASSAGE or doctor i have black stools in history OR it is given in stem that patient is bleeding OR you BELIEVE DUE TO VITALS that paitent is bleeding. VERBALIZE I WILL EXAMINE MY PATIENT FOR BLEEDING RIGHT NOW DURING C. IF NONE OF THE ABOVE CONDITIONS ARE MET. THen obviously it will be done in E. NOW THIS IS REALLY CONFUSING SO READ IT TWICE.
If bleeding 2* warfarin just verbalize VITAMIN K usually they give minor bleeds.
Apart from that you will send labs
D- in here RBS temperature and pupils
E- if no conditions met in C look for bleeding here in exposure and if CCF insert catheter here
NOW i dont know what exactly is troubling you in this case. My advice is to take a good 2-2.5 minute history that is where your diagnosis will be made.
If patient is unconcious , SOB without dropping saturation, Dizzy most likely it is a bleeding case .
If patient is SEVERELY SOB cant speak, oxygen saturation dropping, palpitations go for Afib CCF.
If you have any questions specific please ask . I would advice watching Faraz ahmed videos on youtube they are really helpful.
FURTHERMORE, if my explanation is confusing skip it completely and stick with what you know simman is a free station so go get it GOOD LUCK!
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Hello, so give this a read it will clear out any doubts.
Usually in any disease like this non pharmacological treatments are offered but mostly the case that is coming their life and daily activities are severely impaired that is why we start them on medication.
Wheter ADHD is treatable without medications is out of my domain. However, in regards to plab 2 any station like this has non pharmacological treatments first. Then proceeding to medication but the case coming so far you have to talk about it. However go through this guideline so that if there is a different case you can ace it.
Also the forum has good notes on ADHD history questions give it a look as well.
GOOD LUCK!
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Thank you so much for your detailed answer! I appreciate it
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Hello Doctor ,
I am wondering if you got a chance to ask about this at the hospital you’re currently? This will be very beneficial to us all. Thanks for your valuable time and effort as always
All of us are grateful for that!
Hello, unfortunately no. Usually they have a teaching session they said. I don’t know what they will actually change. Is there any update on GMC website ?
Congratulations doctor! This is brilliant. I have a query.
Can you please tell, how to summarise the approaches after studying before we practice? Would Dr Mo’s approaches which he explained in the lecture suffice? ( with a little change according to individual station scenario obviously )
My exam is within 2 months, and I am so lost.
Can you please explain your strategy ? Would be really kind of you.
Hello, I’ll try to summarize few approaches but it would be better if you are specific as to which stations we are talking about here.
COUNCELLING STATION
First and foremost the only way to do these right is to practice them with different people. Different people have different approaches. What I did I just copied approaches from literally everyone that I thought was good.
Like in DM station one of the candidates would just build good rapport and then go like Adam I want to help you and you know there are some things that I can do for you and there are somethings that you can do for yourself. So how about we have a conversation where you tell me about what’s bothering you and we brainstorm on different solutions on how we can help you out.
And then he will ask questions and answer simultaneously. Like how is your diet? And then if bad give advice on that. So he would instead of accumulating history would take patient into confidence and provide solutions simultaneously. While continuously taking patients input. Like would you be able to do that ?
What do you think about that ?
Secondly, quesmed and geeky medics councelling videos are a real treasure. So to summarize watch alot of videos on councelling and practice with different people. THERE IS NO RIGHT APPROACH.
IN councelling if you collect data and address patient’s concerns and make patient feel that he/she is part of the conversation and that you the doctor genuinely care about the patient by changes in voice tones , hand gestures, facial expressions.
There is no advice that you can use to narrow approach down. The thing you can do is practice and just knowing how you have to address concerns is really important which you can pick up from the notes. Furthermore, in councelling don’t over do it. Don’t vomit knowledge. Only rotate your conversation around what patient is doing wrong like heart patient eating fast food or obesity patient not cutting down on sweet food. OR what the patient concern is for eg obesity patient wants the pill , so here don’t talk about SURGERY.
TO SUMMARIZE , practice with different people , watch videos , only address concerns and wrongs of patient that are affecting our patients health. This should be your approach to councelling patients.
Smile , tell the patient that you’re glad they came for an appointment or they did the right thing by coming in. And yeah but don’t smile in BBN and sad stations you’ll get a feel of them.
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As for medical stations, now in these stations what I did was I practiced each station at least twice with another person.
What we did we made a list of three DDs for every station and spent more time thinking and brainstorming how to talk to patient regarding concerns. I think that’s what got me the score
Like I have stations where I have 2 in Hx and 2 in management but they gave me 3 or in some 4 in IPS.
The only thing I feel I did different was alot of ICE. And even in end do you have any questions for me ? Any thing else you’d like me to address
And in management after diagnosis , if I knew I had less time. I would use this trick. I’ll just quickly summarize that Adam I’d like to have a detail conversation with you regarding certain tests that I’ll be running certain treatment that we will need to start you on but before that there are some symptoms I would like you to be cognizant about (SAFETY NET) and if it’s not an emergency case I’d say I’ll give you some information leaflets as well.
Also in management first tell diagnosis and ADDRESS YOUR PATIENT CONCERNS FIRST AND FOREMOST. Like if patient was worried it’s cancer ? Address that
If patient wanted pain killer address that.
Anything your patient is worried about address that .
I don’t know how to help you narrow down the approach I’d be honest with you
But in history at least 3DDs
Ice
In management
Give diagnosis
Address patient concerns first
If time go through labs and treatment
If not summarize that you’ll be talking about this and this, safety net and leaflets and then talk about investigate and treatment
My reasoning for this is obviously this won’t be correct approach if you have an emergency case but routine gp consult this will help you cause examiner would know that this guy knows his stuff.
If you have any specific questions feel free to ask .
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Thankyou doctor. It helped pretty much.
I was asking about psychiatry and counselling stations. I really appreciate the way you explained it.
Do you have any handwritten notes for different topics by any chance?