TEALE FENNING

Nick Raine-Fenning

I moved this from the open forum as I guess more people will look in here for such a thread Wink

It's quiet - I wonder where everyone is!

Can't wait to hear how you all got on Cool

>>>>

I will use this first post to formulate the most accurate breakdown of the March 2007 Exam based on your posts below.

Once I have the formal questions I'll post them in the appropriate Forum.

Short Answer Essay

An interesting batch of essays. Certainly not as straightforward as the Sept 2006 exam.

Obstetric Paper

1 Management of an anterior placenta praevia in a woman with two previous caesarean sections who presents with a light bleed at 37 weeks.

2 Investigation and subsequent management of a term stillbirth after delivery.

3 Management of acute chest pain and collapse on the postnatal ward after a normal delivery. Investigation results were given.

4 Domestic violence - identification and ways to improve detection followed by management.

Gynaecology Paper

5 Assessment of chronic pelvic pain.

6 Assessment of a woman with persistent urinary leakage 12 days after a TAH for fibroids.

7 Principles of palliative care including treatment options for pain and management of related side effects.

8 Emergency contraception - assessment and management.

Extended Matching Questons

Very similar exam to Sept 2006 in both the questions and the lack of time to complete the paper.

Key topics included:

- Management of urinary incontinence
- Diagnosis based on endocrine profiles
- Intrapartum management including delivery
- Management of pre-eclampsia (same question as on RCOG website)
- Types of study
- Antenatal management options for high risk scenarios (e.g. polyhydramnios at 28 weeks with one twin showing reversed end diastiolic flow)

Multiple Choice Questions

An estimated 20-40% repeat from the Past Paper book.

Key topics included:

- Confidential Enquiries
- statistical analysis
_________________
"Teale Fenning Medical Education" delivering evidence-based, exam-orientated learning since 1997

rpwalavalkar · Teale Fenning Administrator Joined: 20 Jul 2006 Posts: 966

hi nick,

i guess everyones is still recouping from yesterday's trauma.

i remembered ur cat at the end of the exam Laughing

.

the essays were straight forward..

don't remember them all at this min, mind gone blank,

1. pr 2 lscs, ant placenta
2. palliative care
3. postpartum acute chest pain Laughing

4. chronic pelvic pain Laughing

will catch up with abi and vangelis and try to remember the rest.

the mcq's were a lot of endo-fetrtility, some onco, 2 statistics,
the dorso ant in oblique lie came up Razz

. about 20% were from the past paper book, 1 from confidential enquiries, 1 on HFEA 1990 act, none on list of diesase for inheritance pattern, there was one but differently worded -- father can't transfer x linked to his child or something.........

the emq's were horrible as usual. 40 in 1 hr is too less time as the Q's are long and it takes about 2 mins to do each, most felt rushed trying to finish them, i think it'll be better if the college does 50 emq's in 1 1/2 hr. there was one on hormone levels and diagnosis, type of study, management options for delayed stage 2.....

more later as and how i remember it. Wink

raj
_________________
Dr Miss. Raj Walavalkar MBBS MRCOG
TealeFenning Administrator
SR O&G Wessex Region

vani s · Century Club Joined: 20 Jan 2007 Posts: 141

What a BOMB BLAST.. Nick, Crying or Very sad

I didnt know Royal college was so cruel..... Shocked

Well, I felt some essays were so vague.... lots to write and nothing really factual and solid, which you are sure would be on the marking scheme..
I liked the EMQ paper, something of standard... and needing brains but as Raj said, "It was race against time... you couldnt read the whole questions and it's all options properly if you want to finish it in time.."

It was better than all palliative care and domestic violence. Mad

Nick.... why did we study so much.... to answer these kind of questions.... Rolling Eyes

OBS were:
as Raj said
1 light vag bleeding at 37 wks with prev 2 CS.
2 Still birth at term , inv and management of pt b4 discharge.
3 PP chect pain n SOB(with the bed side investigations.......)
4 domestic violence

Gyn was
1 CPP
2 Palliative care
3 urinary fistula
4 emergency contraception (god knows what was there to ask so much about her history n what to examine... and what pros n cons for 10 marks... Sad

)
MCQ s were ? some repeat, some ok.. some dont know.. Razz

Anyway it's over and lets just relax...though I would like to know how all others found it? Wink

vani s · Century Club Joined: 20 Jan 2007 Posts: 141

what about the others... Abi, Wolverine, Emak, mridulaben... say something.... Twisted Evil

rpwalavalkar · Teale Fenning Administrator Joined: 20 Jul 2006 Posts: 966

hi vani,

there is no rest for the wicked Laughing

.

i suggest we start OSCE practice by next week, once the result is out there is too little time to get stuff done.

Laughing

_________________
Dr Miss. Raj Walavalkar MBBS MRCOG
TealeFenning Administrator
SR O&G Wessex Region

humera · Joined: 08 Aug 2006 Posts: 27

I agree there was a fast race in the EMQ paper and if u go fast u tend to make wrong decisions and if u take time to make the decision u were worried to miss a few in the end.
Overall nothing horrified in the essay questions.
MCQ's i felt were nearly 40 % from past papers.
Confidential enquiries again dominating in MCQ's and essay.
Thanks to Nick for the chest pain question practiced in essay practice course and for all other techniques and thanks to the forum for helping a lot.
Well time would tell how have v done.
I agree with Raj, should start with OSCE as soon as possible.

Best wishes to c u all in OSCE courses soon.
Humera.

Abik · Posted: Wed Mar 07, 2007 11:35 am Post subject:

hello guys!

What a fun day!!
A big quiz, eh Nick? Wink

Essays were standard but EMQ was a b***t**d!!

Vangelis and I have the questions - were thinking of the teale-fenningers even as we suffered!!

Nick Raine-Fenning · Posted: Wed Mar 07, 2007 11:40 am Post subject:

Very interesting exam to say the least.

My biggest surprise was the type of essays. I expected you to be given very similar topics to those in the Sept 2006 exam and specifically things seen everyday like 'retained placenta', 'superfical dyspareunia' etc. I guess chronic pelvic pain, stillbirth and placenta praevia fit into that but fistula, palliative care Shocked

The EMQ paper was very similar to the Sept one which is what we told you including the repeat question(s) from the RCOG Website. I am surprised the vulva and chicken pox did not make an appearance.

MCQ - I've had reports of 20-40% repeat questions so I'll go for 30% which is what you can usually expect. I guess 40% will be maximum figure for repeats. Again, we did stress the importance of the Confidential Enquiries and this publication will always feature strongly at some stage of the Exam - written or OSCE paper.

I am also surprised that there were no essay questions on delivery / intrapartum care, colposcopy and the BSCCP guidelines, menstrual disorders, or infertility. You can expect these topics to feature in the OSCE.

Listen ... stay positive and fingers crossed you will get good news in the weeks to come. I don't know anyone who knew for 100% that they had passed so it is natural to be somewhat pessimistic and also down-hearted. You have all worked so hard and the aftermath of any exam is bound to leave you feeling a little low.

I agree with Raj that you should think about the OSCE after you've given yourself a wel deserved break. Use the OSCE Forum and related ones in the General Section to make posts. You will still need to pass this bit even if you are unlucky this time so it will be time well spent.

I'd go for key topics and suggest questions and marking schemes based on these such as breech, abnormal smear, menorrhagia, breaking bad news etc.

Overall ... well done to each and everyone of you. It's over now so no point in lamenting. Spend some time to critically think about what you were asked as this may come in useful for the future for you or your colleagues.

I'll try to summarise the questions and exam below so please give me as much info as you can.

The very best of luck guys. Smile

_________________
"Teale Fenning Medical Education" delivering evidence-based, exam-orientated learning since 1997

Nick Raine-Fenning · Posted: Wed Mar 07, 2007 11:41 am Post subject:

wolverine · Century Club Joined: 16 Jan 2007 Posts: 394

Good to see you all so optimistic! I wish you all the best for the results.
For me it was a great experince first of all (although I don't want to live it again...)

For the obstetric essays: The easy ones were unfortunately put first (when you're stressed anyway and your mind can't get into gear and start talking about APH) and last when I didn't have the whole 25 mins and I didn't bubble properly. The stillbirth was expected but not a very welcomed "christmas present" just after the domestic violence one...

The mcqs: I felt that I knew about 60% of those either because of the past paper book or the forum or the guidelines or the cemach report. Therefore if I'm correct for those with a little-bit of good guessing I hope I'll be ok

The EMQs: Adventure! But I agree with vani I enjoyed it most. I'd like a bit more time though as I spent 35-40 mins for the gynae ones but fortunately the obstetric ones looked a bit easier to me! Some of them though were very bad written! What is "station 0-1"? Agent 007? Hawai 5-0?

The gynae essays: The CPP straight from the guidelines which I think they should be everybody's last revision. Then? Emergency contraception straight from the previous essays from the college website (just delete the PC4 bit..) and very much discussed on Teale-Fenning courses (like all of them I think). Then oncology! Paliative care! (what?) A bit harsh when there are so many other oncology topics that if I was the college I would like to make sure that a year 3 registrar knows about.. And then Fistula! "Doesn't matter I thought, this is the last one, go for it!!.." But when I walked out I wondered why a year 3 registrar needs to know about treatment options? Do they ask about management of obstructed labour in the urology exams?

But as I said first it was an experience that I will never forget! Good luck with the results and I hope we'll meet again! I hope I'll be doing the candidate and not just the actor...

Nick Raine-Fenning · Posted: Wed Mar 07, 2007 12:01 pm Post subject:

Nice summary wolverine - thanks

It sounds to me as if you have stuck to the rules and played the game.

I actually think, and Jullien and a few people who have already called me agree, this set of essays lends itself to our advice / system than the Sept 2006 exam. This was truly an exam you needed to bubble and plan properly.

EMQs - I do not think you did the EMQ Solutions course but I stressed the importance of giving yourself 90 seconds for each question. This ensures you maintain a pace that will allow you an equal amount of time and concentration on all 40 questions. It seems you are not alone however and that once again almost everyone feels the time allocated is insufficient. Probably time to make sure the RCOG and Examination Committee are aware of this. Leave this with me.

I'm a little disappointed you did not have 26 minutes for your last essay but if that was your only slip I'll let you off Wink

Well done and good luck.
_________________
"Teale Fenning Medical Education" delivering evidence-based, exam-orientated learning since 1997

Nick Raine-Fenning · Posted: Wed Mar 07, 2007 12:06 pm Post subject:

humera · Joined: 08 Aug 2006 Posts: 27

Hi Nick,
Some more memos from the exam.
Placenta praevia qs was previous 2 ceasarean sections at 37 weeks.
In EMQ's there was one on the types of study and one on antenatal management options for one scenario of gross polyhydramnios at 28 weeks with one twin showing reversed end diastiolic flow.

Nick Raine-Fenning · Posted: Wed Mar 07, 2007 12:55 pm Post subject:

Thanks humera - I've updated my first post to include this.

The gestational age, number of caesarean sections, and position of the placenta are essential details so I hope my summary of .... 2 previous CS, 37 weeks, anterior placenta praevia is correct.
_________________
"Teale Fenning Medical Education" delivering evidence-based, exam-orientated learning since 1997

Polly · Joined: 18 Feb 2007 Posts: 6 Location: Bristol

The essays were quite fair I thought; Confused

Two previous CS at 37/40 with light vaginal bleeding Scan earlier in pregnancy had shown an anterior low lying placenta. Features of Hx and examination suggesting diagnosis 10 Investigations you would do to exclude diagnoses 6 Specific complications you should mention to her before delivery 4
29 yr old just delivered term stillbirth on delivery suite Immediate management 11 Other management issues before discharge home 9
CEMACH report identified 14% domestic violence Strategies to identify this in patient General strategies for detection Management once identified
Para 4 on post natal ward sudden onset chest pain and SOB Immediate management 10 Initial bedside investigations you would do to establish diagnosis 4 Ongoing management 6
32 yr old para 2 with 15 months pelvic pain Discuss differentials 11 Management 9
19 yr old sexually active for past 4 months Recent UPSI concerned re unwanted pregnancy What features on history and examination guide choice of emergency 9 contraception Pros and cons of emergency contraception 11
Palliative care in gynae oncology Discuss main principles of care Management of pain Other symptoms and their control
Woman two weeks after TAH for fibroids presents with urine leaking from vault confirmed on speculum What structures may have been damaged 6 How would you identify which structures damaged 4 How could they have been damaged 4 Further management of damaged structures 6

The emqs were very mixed i thought,,,, hormonal blood results with refernce ranges, urogynae all rather vague and unclear if urodyanamics had been done, three labour ward ones with no mention of contractions or fetal condition except this odd station 0-1 kept coming up Is that minus one to spines or 1 below? very tricky SGA ones esp the TTTs question....... stats wasnt that obvious either In fact have decided I am obviously not a decision maker Crying or Very sad

as cant bring myself to commit to any of them! No nice fetal syndromes or vulvas or varicellas........

MCQs were fair I thought; deafness in Varicella? HFEA guidelines limiting embryo storage to ten years (do they?) only allow communictaion to GP through the patient (do they?) quite a lot of amenorrhoea, delay in anaesthetic room, prolactin, lactation, VTE in blood group O, very few cancer staging unfortunately as i had this coming out of my ears by Tuesday
Smile

Why oh why is it so hard to tell if it was OK or not....
Have to say i was distinctly unimpressed byt the amount of cheating that went on around me; at least 3 individuals writing before the exam had started and carrying on way after we were told to stop......

wolverine · Century Club Joined: 16 Jan 2007 Posts: 394

The first essay was basically like this.
A 37 weeks pregnant lady presents with light vagina bleeding. She has had 2 previous C/s and a sacn earlier in pregnancy showed an anterior low-lying placenta.
1. What are the key issues to arrive to a diagnosis (10 marks)
2. What investigations would be usefull specifically to this woman (7 marks)
3. What specific problems she need to know about before her C/S (3 marks)

Nick Raine-Fenning · Posted: Wed Mar 07, 2007 4:40 pm Post subject: Re: Exam

Hi Polly and thanks for the detailed breakdown.

rpwalavalkar · Teale Fenning Administrator Joined: 20 Jul 2006 Posts: 966

hi nick,

i meant the slide of ur tired cat that u include in ur talks . Wink

.

by the way what is ur cat called?

r
_________________
Dr Miss. Raj Walavalkar MBBS MRCOG
TealeFenning Administrator
SR O&G Wessex Region

Nick Raine-Fenning · Posted: Thu Mar 08, 2007 9:17 am Post subject:

OK - all makes sense now. Silly me!

My cat is "Manuel" - the name reflects the fact that my wife is South American. Laughing

He is almost 16 and does not have too long to go. Good boy though and very loyal. His brother ran off 8 years ago. Crying or Very sad

vani s · Century Club Joined: 20 Jan 2007 Posts: 141

i am missing the regular interaction....feel like something is lacking in the day Sad

It was fun. Wink