Website.
Tutorial.
Tonight we had a risk management station about adverse incident analysis and then a viva on the use of the ventouse.
I sent out some papers before the tutorial. If you don't have them and want to listen to the tutorial, it would make sense to send me an e-mail so that I can forward them.
Thursday 27 October 2011
Tuesday 25 October 2011
Tutorial 24th. October 2011
Monday 24 October 2011
Thursday 20 October 2011
Tutorial 20th. October 2011.
Website.
Tutorial.
Tonight we started with a roleplay about androgen insensitivity, but I forgot to press the record button!
Then we had a roleplay about pre-pregnancy counselling for a woman whose father has haemophilia.
Then we had a viva about the non-medical options for the management of a woman of 35 with fibroids and menorrhagia.
Tutorial.
Tonight we started with a roleplay about androgen insensitivity, but I forgot to press the record button!
Then we had a roleplay about pre-pregnancy counselling for a woman whose father has haemophilia.
Then we had a viva about the non-medical options for the management of a woman of 35 with fibroids and menorrhagia.
Tuesday 18 October 2011
Tutorial 16th. October 2011.
Website
We have two podcasts for the 16th.
Tutorial 16 October 2011a and
Tutorial 16 October 2011 b.
This file was so big that I had to split it into 2.
This has taken longer than expected.
I spent Monday driving to Scotland and back to take a handicapped sister-in-law to her brother - she spends some time with us and some with her brothers.
On Tuesday, Sarah, my youngest daughter, who, with her husband, is taking 16 months out to travel the world, returned unexpectedly.
Both my wife and Sarah's mother-in-law have birthdays around now.
They had been in Australia and were heading for South America, but decided to do the trip via Manchester.
As you can imagine, we have had more to do than mess about with podcasts.
We have two podcasts for the 16th.
Tutorial 16 October 2011a and
Tutorial 16 October 2011 b.
This file was so big that I had to split it into 2.
This has taken longer than expected.
I spent Monday driving to Scotland and back to take a handicapped sister-in-law to her brother - she spends some time with us and some with her brothers.
On Tuesday, Sarah, my youngest daughter, who, with her husband, is taking 16 months out to travel the world, returned unexpectedly.
Both my wife and Sarah's mother-in-law have birthdays around now.
They had been in Australia and were heading for South America, but decided to do the trip via Manchester.
As you can imagine, we have had more to do than mess about with podcasts.
Monday 17 October 2011
Sunday 16 October 2011
Tutorial 16th. October 2011.
Thursday 13 October 2011
Tutorial 13th. October 2011.
Website.
Tutorial.
Tonight we had a brief discussion about ERAS: enhanced recovery after surgery.
This is dealt with on the website:
http://www.drcog-mrcog.info/Topics%20not%20in%20the%20textbooks.htm.
We then had vivas on shoulder dystocia and uterine inversion, which are dealt with in the MCQs.
We briefly mentioned, en passant, magnesium sulphate for the prevention of cerebral palsy:
http://www.rcog.org.uk/womens-health/clinical-guidance/magnesium-sulphate-prevent-cerebral-palsy-following-preterm-birth-sa
Finally we had a role-play about a woman requesting sterilisation.
Tutorial.
Tonight we had a brief discussion about ERAS: enhanced recovery after surgery.
This is dealt with on the website:
http://www.drcog-mrcog.info/Topics%20not%20in%20the%20textbooks.htm.
We then had vivas on shoulder dystocia and uterine inversion, which are dealt with in the MCQs.
We briefly mentioned, en passant, magnesium sulphate for the prevention of cerebral palsy:
http://www.rcog.org.uk/womens-health/clinical-guidance/magnesium-sulphate-prevent-cerebral-palsy-following-preterm-birth-sa
Finally we had a role-play about a woman requesting sterilisation.
Monday 10 October 2011
Tutorial 10th. October 2011.
Website.
Podcast.
Tonight we started with a viva in which you had to talk about writing a critical incident report.
The scenario is below.
Then we went on to a critical appraisal of the RCOG's patient information leaflet on herpes in pregnancy.
http://www.rcog.org.uk/genital-herpes-pregnancy-information-for-you.
I have written some thoughts on both.
Spend 15 minutes on each, writing an outline of what you are going to say.
Send them to me and I'll let you have my thoughts on the appropriate techniques.
The critical incident instructions are:
Podcast.
Tonight we started with a viva in which you had to talk about writing a critical incident report.
The scenario is below.
Then we went on to a critical appraisal of the RCOG's patient information leaflet on herpes in pregnancy.
http://www.rcog.org.uk/genital-herpes-pregnancy-information-for-you.
I have written some thoughts on both.
Spend 15 minutes on each, writing an outline of what you are going to say.
Send them to me and I'll let you have my thoughts on the appropriate techniques.
The critical incident instructions are:
Adverse incident report.
Candidate’s instructions.
Mrs Penelope Jane Brown sustained a 4th. degree tear after the delivery of her second baby.
Dr. James Peter White conducted the delivery and was asked to write a statement for the Risk Management Team (RMT), to whom the incident has been reported as an adverse clinical incident.
You have been asked to look at Dr. White’s report to identify issues that the RMT need to explore further. You have 15 minutes to read Dr. White’s report, after which you will have a viva with the examiner. The examiner will not lead the discussion and will simply listen to what you have to say.
Dr. White’s Statement.
I am Dr. J. White. I have been SpR in obstetrics and gynaecology at the Royal Infirmary for over a year.
On the 27th. September I was bleeped by a midwife on the labour ward and asked to see a Mrs. Brown who needed to be delivered as there had been delay in the second stage and she was becoming exhausted.
On arrival on the labour ward I felt that Mrs. Brown was not trying very hard to deliver the baby naturally and that the midwives were not making much effort to encourage her. I advised that they should get her pushing properly and that I would go for a coffee and return in half an hour.
I returned in 50 minutes, having had a phone call from my wife about arrangements for our forthcoming holiday. The situation was unchanged and I was not impressed with either the woman’s endeavours or the midwives’ encouragement of her.
Examination showed the head to be midcavity. I felt that it could get it out using forceps. The midwives told me that her bladder was empty. I applied the forceps with ease. The baby delivered in good condition. I then noted that she had a 4th. degree tear. I repaired this in the usual way.
I went on holiday the next day for two weeks and did not see this woman again.
Thursday 6 October 2011
Tutorial 6th. October 2011.
Website.
Podcast.
We started with a complaint. There is overlap here with the angry patient and you would need to read the roleplay carefully to see what your tasks were. The scenario is you as the SpR. A woman had a normal delivery with an episiotomy, which you repaired. She saw the GP 2 weeks later as she had a foul discarge. The GP revmoved a swab and referred her back to the clinic where you were asked to see her. We concentrated on the processes of adverse incident investigation / complaint procedures rather that dealing with an angry patient or spending too much time on how she was, though you would probably have to do that in an OSCE with questions about possible ascending infection and appropriate investigation, reassurance about fertility / ectopic risk etc.
We then went on to discuss what options remain if the local processes do not satisfy the woman.
We also had a preliminary discussion about diathermy, which is due to make a return as a viva.
Podcast.
We started with a complaint. There is overlap here with the angry patient and you would need to read the roleplay carefully to see what your tasks were. The scenario is you as the SpR. A woman had a normal delivery with an episiotomy, which you repaired. She saw the GP 2 weeks later as she had a foul discarge. The GP revmoved a swab and referred her back to the clinic where you were asked to see her. We concentrated on the processes of adverse incident investigation / complaint procedures rather that dealing with an angry patient or spending too much time on how she was, though you would probably have to do that in an OSCE with questions about possible ascending infection and appropriate investigation, reassurance about fertility / ectopic risk etc.
We then went on to discuss what options remain if the local processes do not satisfy the woman.
We also had a preliminary discussion about diathermy, which is due to make a return as a viva.
Tuesday 4 October 2011
Tutorial 3rd. October 2011.
Tonight we started with a discussion of some laboratory and other results. The usual instruction would be that the consultant is away and the secretary asks you, the SpR, to deal with some results that have come in. You have to decide on the degree of urgency and what action should be taken.
Laboratory results.
+ve MSSU at booking. No symptoms.
GTT at 34 weeks. Peak level 11.5.
FBC with MCV at booking.
Thrombocytopenia at booking. 50,000.
Hydatidiform mole after evacuation of suspected miscarriage.
Histology after ERPC for incomplete miscarriage: no trophoblastic tissue.
Endometrial cancer: hysteroscopy: thickened endometrium. Histology: Anaplastic malignancy.
Endometrial cancer: MR scan: reaching serosa and upper endocervical canal.
Consultant does lap drainage of normal looking ovarian cyst. Malignant cells. Nulliparous. Wants children.
HVS: trichomonas.
Clue cells on smear. 12/52 pregnant.
Antenatal discharge: endocervical swab: chlamydia
Actinomyces on smear.
Herpes in pregnancy
Severe dyskaryosis on cervical smear at booking.
Primary infertility: FSH & LH at 25 on day 3 of cycle.
Primary infertility. FSH 3, LH 12 on day 3 of cycle.
Treated with cabergoline for prolactin and pituitary adenoma. +ve beta HCG.
3 cm. ovarian cyst. Ca 125.
“Miscarriage” → ERPC. Histology report: Decidual reaction. No trophoblastic tissue seen.
We then had a roleplay. You are the Spr in clinic. The consultant is off sick and you have been told to run the clinic.
The scenario is one of breaking bad news.
We then had a roleplay. You are the Spr in clinic. The consultant is off sick and you have been told to run the clinic.
The scenario is one of breaking bad news.
Age 60. Follow-up after hysteroscopy for PMB.
Histology shows poorly differentiated adenocarcinoma.
Unstable diabetes.
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