Fellowship Physical Examination Tips
As the ACEM Fellowship clinical exam looms, we have been discussing tips for making our physical examinations more efficient to fit within the constrains of an OSCE station. One of the tips from Bob Dunn is to focus on "where the money is" given the clinical stem and then go out from there, rather than try to cram in the Talley & O'Connor structured exam in for every patient.
For example, the high yield examination aspects for a CVS exam might be:
- Auscultation for murmur and associated manoeuvres
- Assessment of JVP and carotid pulse
- Assessment of vitals: HR, BP, SaO2
- Signs of heart failure (lung auscultation, peripheral oedema)
- Peripheral stigmata
Or for a respiratory exam:
- Auscultation of the lung fields
- Percussion of the lung fields
- Assessment of vitals: HR, BP, SaO2, temp, RR
- Assessment for cyanosis, work of breathing
- Peripheral stigmata
Bob has previously written some tips for the old style short case, what examiners are looking for and about the cardiovascular and abdominal exams. Most of all, you should tailor the examination to the clinical stem.
For your revision purposes, some kindly person has previously created a series of checklists based on the Talley & O'Connor method, which you can find here:
And in your last few days pre-exam, why not test yourself with a few extra trial OSCE scenarios?
If you have any other resources or similar checklists, feel free to add them in the comments!
