SURGICAL FINALS Passing the Clinical - PasTest

S E C T I O N 11. InpatientsMost inpatients transferred to the examination will be awaitingoperations such as hernia repairs or removal of breast lumps.Postoperative patients are also available for the clinicals: after all, you willbe expected to manage such patients in your F1 and F2 years. A minorityof patients will be those recovering from acute conditions, with goodhistories and/or physical signs that have not yet resolved.2. Patients coming up from clinicsPatients with good physical signs who attend clinics in the few weeksbefore the clinicals are often asked to come up for the examination. Try toattend clinics in your hospital in the lead-up to finals. (For example, beforesurgical finals, one of the authors walked into the examination centre witha fellow candidate who pointed out two patients who she recognised:‘He has a sebaceous cyst on his forehead. She’s got a left submandibulartumour.’ After revising these two conditions, she was given both patientsas short cases!)3. ‘Professional’ patientsThese are patients with long-standing signs who are listed on a computerdatabase and who have been called up numerous times in the past. Suchpatients are usually excellent historians and may even point out theirphysical signs.4. Simulated patientsSimulated patients are healthy individuals who are trained to simulatea patient’s illness in a standard manner. They are usually actors. Sometraining is usually required to ensure that they are able to bring outthe main points in the history on request and within the time allowed.Simulated patients can become skilled historians and very persuasivepatients, such as when replicating a psychiatric disturbance. They areoften asked to give their own marks on the student encounter.In addition a video of a patient presenting a history can be shown.4