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400 registered, which is just fantastic. That's so good. And I was looking at the demographics. We've got people from UK Wide Republic of Ireland, wide, world wide, great. Um So folks, hi, everybody. Hopefully we're live now. Um It's great to see everybody. Thanks so much for coming along and this lovely Wednesday evening it is here in Northern Ireland. Anyway, it's absolutely bucket and rain outside. Um But we're hoping that tonight's going to be a good night for revising some S J T stuff. I'm in final year. I know a lot of final years and other years are joining with the looming deadline of S J T come, come December, but hopefully it'll, it'll bring something useful to. You were really grateful for Doctor Olivia Bradley, but giving up our time to put presentation together and, and spend time with us. But before Libya comes on stage, we're absolutely delighted to be joined this evening by Doctor Phil Macal Nay who is Mr Medal Ceo of Medal. Um And it's my absolute pleasure um to let him have a chat with us just about what's going on a medal for a few minutes before we kick off. So I pass over to you, Phil. Perfect. Thank you so much, Tim. And just to say to everyone that I'm really honored to be here. So right, right back at you, we love everything that the D P socks are doing. Uh really love the fact that Olivia is here giving up her time to kind of share her pearls of wisdom about S G T with you. And that's what we are all about. Our mission is how do we make healthcare training accessible to everyone? And I just want to share a little bit about that because we think sometimes people just see what we do and actually why we do what we do is so much more important and why is that much more important? Well, um here is the big problem. We've got to train 18 million more healthcare professionals by 2030. It's a number that comes from the World Health Organization. They explain that that's one third more healthcare professionals than we currently have on planet Earth, but it takes 15 years and $700,000 around the world to train uh fully trained doctor. And the lancet explained that we have severe institutional shortages in our healthcare training capacity. So we've got to train a third more healthcare professionals than we currently have on planet Earth. And we don't have enough resources to train those who we already have. We've got a bit of a toxic accommodation and unfortunately where resources are at their least. The need is at its greatest. There are 11 countries on the continent of Africa which do not have a single medical school there, over 20 which only have one medical school for the entire population. And for us that felt intolerable, but it's not a problem that's confined to somewhere else in inverted commas. These are headlines from high income countries around the world from the last year in BBC news uh in the summer, uh the headline was NHS in England is facing its worst staffing crisis in history. And when you look at the cost of training to the individual trainee, you can see that we face a bit of a problem here to uh this is a slide from the association for surgeons and training, sorry, it's not GPS, but it's surgeons. Uh And when you look at the cost of training to the individual trainee, you can see that it's quite frightening. Uh individual surgical trainees are spending between 20 and 26,000 lbs of their own money over the course of their training or up to 71,000 lbs. If you're a max fax trainee and every year 1300 lbs that is spent on courses and conferences, travel and ticket phase and 41% of those people get absolutely nothing in terms of study budget. So it's coming out of their own pocket. And when you combine that with the reduction in the uh buying part of medical salaries over the last number of years. Again, we have a bit of a problem. So our salaries by us, 10% or 20% in the last 14 years compared to what we did, if you compare it with the retail price index. So we've got reduced buying power in our salaries which paying we're paying for our own training out of our own pockets once we graduate and the cost is astronomical. But yet we need more healthcare professionals and we need to train more healthcare professionals. What does that mean? Well, here's a quote from Maria Prial who heads up the events for the widening participation, Medics network. It's something that she said as a widening participation, doctor money is and always has been tight. Study budget covers one big or two, maybe two or three small courses and to meet she's talking about court surgical training in that context to make CST needs, the wealthy can easily, easily treat the application as a paid tick box exercise with little actual development. And again, that's something that's intolerable for us. Actually, we want doctors who are well trained to care for our patient's and it shouldn't be based on how much money you have or who you know, and that's why we're doing what we're doing at metal. How do we help make healthcare training more accessible, not only make it more accessible but make it more accessible at scale. And if we're really to solve that big problem of training 18 many more healthcare professionals, we can't just do that for the people in front of us. We have to be able to share and collaborate internationally with our colleagues around the world to make healthcare training more accessible. And when we started to look at how organizations were doing accessible, teaching and training, we find that actually it was really tough for them. Many were setting up eventbrite, banking people to a Zoom call or a teams call, sending out uh email with a schedule, picking in a Google forms link for feedback, copying and pasting names from a Google sheet or Microsoft Excel into uh Microsoft word template of certificates, emailing it out individually too as people maybe hundreds at a time. So it's 285 people on this call. Um then downloading the video from Zoomer teams and then because they only got a gigabyte of storage and then adding it to Vimeo or youtube, adding in another Google form description into that video as well. There's no guarantee when that person is giving the feedback on the on demand content that they've ever even watched the video. And it was a mess. I'd actually worked to scale up the amount of training we provide as busy clinicians, that's not what we should be doing. I'm a medic myself. My passion is to see patient's and to provide medical education not to do all of the admin that comes with it. And if we're really to scale up that around the world, we need to think how do we do that uh in a smart way? And if we could solve some of these problems for healthcare organizations, we might be able to bring them with us on a journey of making their education more accessible, welcoming people to their courses, conferences, events, training sessions who might otherwise never be able to attend. This is something that Doctor Tedros said at a tech conference in 2020 ask yourself every day if your technology works to help the poorest in the world and to reduce in equalities and as well as our technology, we actually think, how can we do the same thing with our education? And this is something that, that we're really passionate about. We actually provide your technology free and open access to every organization who's running free and open access events. We've tried to put our money where our mouth is, don't be another barrier. If people are doing amazing education, just make it possible and and don't put another pay wall or barrier in the way. So we provide our technology free and open access to organizations. We're providing free and open access training sessions and we're committed to doing that, but we know that not every organization can. This is another program that, that we've devised metal to try to make it easier for organizations running paid for events to continue to make their events more accessible as well. We know that not every organization can run completely free events, they've got a team member to pay, they've got an office and actually those things are important as well and people need to put bread on the table. And for these organizations, the organization's, you see on your screen, they've all participated in a, in a scheme called Fair Medical Education. When we spoke to healthcare organizations about making healthcare education more accessible, we saw that, that they were still passionate about welcoming people from lower middle income countries to their teaching and training sessions. It's something magical that's happened in the last two years where previously we might have run an event just for the people from our local community. Suddenly we were able to welcome people from around the world and people who benefited from education uh in the last two years should continue to be able to do so. And what the scheme allows them to do is to run a paid for event again, end to end. So you don't need any other tools to do it and actually add free or significantly reduced cost tickets automatically to colleagues in lower middle income countries. So we'll check is that person from a lower middle income country? It automates the admin, it's associated with that. So the person in each of these organizations who does all the admin doesn't get bogged down with checking all of those details and it automatically offers those free tickets. So it really makes their events more accessible. We actually ran a conference for one of the organization's a couple of weekends ago and the only comment in the entire conference was from attendee from Kenya who had said I've only been able to attend this paid for conference, which is in the hundreds of pounds because of this scheme, there was a five or 12th pause from the audience and then they burst out into a round of applause. It's something that we want to do as a community. And we've tried to think, how do we just make this easier for us to do? How do we welcome those who are in the poorest situations and help those who are the least fortunate. We know that live is not a magic bullet. It's great that we can all join 303 of us from around the world at this teaching session this evening. But life is not always great if you live in a low resource setting or actually, if you live in a high resource setting like me, but just in a row, oral part of it, actually, you might not have the best internet connection. So live is great, but it's not always a magic bullet and being able to watch at a time. And much more importantly, an internet connection that suits you is really important from an accessibility perspective. And we've made it easy for the organization with one click to make their event available. There's no downloading, cropping, resizing, re uploading, make it easy for people and they can do that. And that'll, that's the impact when we kind of work together in the last 18 months. We've helped 116 100 healthcare organizations deliver almost 5.5 1000 courses to colleagues in 100 and 71 countries, we are stronger together And when we work together as a community, we can really begin to move the needle. Does it work? Uh Well, this is a really quick paper from uh the Association for Surgeons and training, David, not from the David not foundation who provide training for colleagues in war tour in situations. They actually talk colleagues using metal online and comparative in a study with those who are providing face to face teaching and they actually provided surgical skills, teaching, practical teaching. And they compared the outcomes and they find that there was no significant difference in the competency ratings of delegates receiving online or face to face teaching. We were not involved editorially with this paper whatsoever. And the first time we heard about it was afterwards, but in the discussion, they actually talked about the impact that this could have because in that study, they taught 553 surgeons in a single day across 20 countries. And they said that actually this sort of technology has the ability to scale up the amount of healthcare that we can provide in some of the most challenging circumstances. I'm gonna skip right to this last story and, uh, and then I'm going to leave you to Olivia and Tim, we're gonna smash it out of the park with SGTS. Um You'll see on the right hand side of your screen that we verify people when they're joining the chat. It means that an organization can really make their event accessible without having to worry about who's joining and it keeps it professional. But one or two people per week reach out to us and say for whatever reason, I can't verify myself. And in uh single day in the spring, we had quite 5200 people reach out to say, I can't verify myself. That was a bit unusual for us. And when we reached out to say, why so sue on our support team reached out to say, why can't you verify yourself? Is there anything we can help with? We have a manual process in place to help those people. We got the same response don't have access to my institutionally mail address. And I don't think it's that important for me to get a letter from my dean or my medical school to say that I can access medal before I fled the country. Thanks very much. And what we found was that these were all medical students from Ukraine who had had their entire curriculum flipped online. And it was a wonderful NGO in London who had recruited 250 doctors from around Great Britain and Ireland to provide online education for Ukrainian medical students during the war. And they weren't doing it some sort of UK teach the Ukraine medical students type thing. Uh They were doing it because they were actually trying to free up the clinicians on the ground in Ukraine from instead of providing face to face medical education, to provide face to face patient character, to bolster the entire medical resources that country for a short period of time. And uh the impact of that was pretty huge. So they taught 2000 Ukrainian medical students seven times a day every single day for a number of months. And this is what one of those professors said. Thank you for everything you're doing for knee pro and the people who are trapped in this situation together. We are stronger. We need to train the 80 many more healthcare professionals by 2030. It's only by organizations like Queens University G P Society, uh clinicians like Dr Bradley joining to share their expertise that we can ever begin to imagine that every little helps. So thank you so much for joining this evening. Thank you so much to Queen's University G P Society and to Olivia for this amazing teaching. And I hope you have a really great teaching session. If you want to get involved, you can start hosting your own event, metal door slash host. You can actually find loads of others that metal dot org slash events and you can find some old demand, metal dot org slash on demand. Thank you so so much. Great. That's, that's great. Phil. Thanks. Thanks so much for that. I think everybody could agree that it's inspiring what you guys are doing and what you guys are doing in the midst of current mad issues worldwide to reach out and the work that you're doing to make healthcare, education equitable. Um It's Justin credible. So thank you for sharing that with us. I personally find that absolutely amazing to see what's going on. Thanks for taking time to join us, really appreciate it. Um So folks will move on. Um I hope, I hope you don't mind us sharing that message from Phil and the team at Medal about the work that they are doing. Um It is in credible, but the reason why everyone is here tonight is for some S T A T teaching and it's my absolute pleasure. Um And thanks to doctor Olivia Bradley, who is an F two currently working in orthopedics and outside Glasgow and Scotland. Um who's going to tell us how to ESRs JTS so doctor badly over to you. Okay, thanks Tim. Uh What a great talk from Phil. I didn't realize this is the whole purpose of metal even though I was on it last year during the same talk. So it was great to sort of get that so insight into what's going on, how useful it is. Um So, yes, hello, everyone. Thanks for so many of you joining tonight to listen to this. So I was saying I actually did this talk last year and so two years ago, this time I was preparing to sit the SGOT myself. So I graduated from Queen's last summer. Moved over to Glasgow, started working as an F one and I'm now after you in orthopedics, just outside Glasgow. Uh FDT is always controversial. People don't like it. They don't appreciate that. Half of your scores for going forward is going to be based on one single day. All these arguments are completely valid. You're not wrong and thinking that it's maybe not quite the best way, however, you're still going to do it and you will do it this December or January. So you need to get ready for it because it will have quite an impact on your scores overall. So it's best to just get stuck in rather than not wanted it. I'm afraid, uh I didn't know how well I did, but I was very insistent and clear that I wanted to move to Glasgow whenever I finished at Queen. So I really put a lot of time into SGOT because that was the point at which you can actually change your overall score because at this point now your death I'll is done. It's only up until fourth year, you can't change that score. And if I'm right, you're the first year that don't get scores for additional achievements like previous degrees and publications. So that's a bit of a change to the scoring system for your year. However, it's still, you know, you're still going to come out with 50 marks from your death. 1050 marks from sitting the FDA tea. So I didn't know how competitive things would be. I just knew that I had to put as much effort into FDT as possible because that was the only 50 marks left that I actually had some say over anyone. So people may not agree with my approach at the time because I was putting in more than half my time to sgot that first semester. It was definitely my focus and I pretty much just did what was needed to take over emplacements and doing like your clinical studying. I'm more than half with SCT time because it's a short burst. Just get really stuck into it. And then once it's done, it's done and you move on and the next day you go back to studying for finals. So it's a tough year. It's a top six months sort of from the start to February and March time for PSF these things might have changed since I did it. But once they're all done, they're done and that's it. And you want to just make sure you've given it your all really, and there's lots of ways you can actually prepare quite well for SGOT. That is useful to know. And that's the whole point I want to do that. So I felt that I did quite well in S J T, I was really happy with how I did. So, so almost verifying myself can actually remember the exact score. But I think I got about 40 for an SGOT, which I was really pleased with and, and it was, it is a good score. So it was better than my final score but didn't matter finals, you just sort of have to pass is my take on things and may not agree with that. So we'll get started and go through this. So what I want to focus on mostly is going through the three different sections in it, how the scores work and how they're scored because they're slightly different, working through it. And I think getting to grips with those basics now and understand it, how you can actually go forward and study yourself over the next month 30. It's gonna be more beneficial than me just taking you through a load of questions. And then it's that it's that it's fast. So I want to really help you get on to how you can feel yourself. We will go through questions at the end. Don't worry. But this is mostly about all the tips and tricks and to look for in questions and how to approach the exam. So, let's see, let's get these off. Let's see, Tim, if you can just let me know that that's working okay, because I can't see anything anymore. Perfect. Okay. Right. So we'll throw this out of the water already, I think. But we'll, we'll see how long this takes. Um, I think we're going to be here for a way while I'm afraid, but there's a lot to get to. So you're going to see this slide in particular pop up quite a few times throughout. And if you take anything away from it, I wanted to do this. So every question and every response that you're going to go through as you're studying and as you're sitting the exam for real, I want you to ask yourself. Does this single answer address the question? This will make a little bit more sense the further we go through things, but this is what you need to really differ in mind. Every single response that you read, does this single answer alone just this line I'm written. Does this address the question? Okay. So you've kind of run through this, you know, yourself, you've got 50 points from your death side and then you've got 50 points from doing the F G T queen. Typically score around 40 and I think 40 is generally your average across most of the medical schools in the UK. What you need to know though. However, is that if you have 80% of the marks on the day, you essentially scored 80% from what you've done. That does not get you an 80% score, which would be 40 out of 50. So how it's actually Mark is the person who has the single highest score of everybody sits at, they received 50 points and then it's scaled down from there. So it's not, I got 80% of scores and therefore I'm actually going to come out with 40 cause that's 80%. It's not going to work that way. So you're sort of your raw marks are scaled down based on whoever scored the most. Okay. So S T T is built around these core competencies which are patient focus, commitment to professionalism, coping with pressure, effective communication and team working. So this is really the crux of all the questions in some form. Some may have more than one of those within it. Some might be just that alone, but this is what it's all going to be based on. Okay. So we have three sections. The rating section up at the top is the newest section. I think I'm pretty sure that my year of setting up to two years ago was the first time that this section was introduced. And at that time, there were no answers are rationale for these questions online. So it's really hard to prepare for this section because nobody had done it before. So I've pulled all these numbers from the 2023 I think it's 2023. It says paper online. So if you Google FDT passed papers, it will take you to the foundation program website to the official papers. There's one listed that's separate to this and it does have the rating question. So you're quite lucky that you're the first year I believe that actually has rating questions that you can look out with the answers to them to sort of get your head around it. So what you're going to have is 18 scenario. So that's now the start that you read. And from that scenario, excuse me, there will be from 48 questions that are then based on that scenario alone. So sort of figuring this out that you get a maximum of 100 and 14 questions. If each of the 18 scenarios has yet questions thereafter, for each question that you do, there's four marks available. So roughly this is going to be weight, you've got about 576 marks and it's on near miss marking, which I'll explain a little bit later on the middle section. You then is multiple choice of what you have 42 questions in this section, you select three of the eight responses and from that there's available 240 marks. Now, this is the only section where there is no mere MS marking, it's either correct or incorrect. Then ranking is your last section. And that's really like quite the meaty chunky section of the paper. So you've got 35 questions in it and you rank the five answers at in order of what you think. And this again, it goes back to near missing working. So among the sections throughout you will be asked about considerations, actions and responses. And you'll see that as you go through the past papers, that that's what you're asked to judge for time. Then you've got 100 and 40 minutes for the exam, which works out at one minute and 42 seconds per question. Some, what questions will be pilot questions and what count. But you're never going to know which ones those are. So you don't almost need to worry about that. You just do all the questions, okay? I want to just go back for a second. So I know I've said there's a minute of 42 per question. Okay, particularly when you come to this rating section, you have your scenario at the start which you take a bit of time to read first of all. And then you'll answer either four or eight questions based on that scenario. So you'll get quite quick as you go through, you take a bit of time with the first or second one because you're still getting the scenario into your head then you know it and you're going to three. So you don't need a minute and 42 for each of these. So you'll save a little bit of time here and you can use that elsewhere and that's not rushing through it. That is just the nature of if you answer a question based on the same scenario, you are going to get a little bit quicker each time you do. Okay. So if we look at the rating section in a little bit more detail, which is the newest section that we have your four answers that you have are very appropriate, somewhat appropriate, somewhat inappropriate and inappropriate. So if something is very appropriate, it's a near perfect answer. It's going to address the scenario and it won't have any negative. Somewhat appropriate is also a good answer, usually addresses the scenario but it's going to have some negative project somewhat inappropriate is a response that marginally deals with the scenario, but it's outweighed by negatives inappropriate. However, it does not address the scenario and it's mostly negative however inappropriate does not necessarily mean that something is a bad answer. It is simply an inappropriate response to the scenario. I was trying to come up with even my own. One of these just to sort of make it clear of that inappropriate, doesn't mean bad. So, so for example, you're on a ward and someone becomes unwell, someone's using quite high. So the nurse comes to you. Some patient is my got new score of six. Can you please come in assessing patient and an inappropriate response to that would be I'm going to get my lunch else to see them later. So it's not necessarily that you've done a bad thing, but it's completely inappropriate. It hasn't dealt with the scenario in front of you at all. Okay. So when it comes to just things to think about for this section, you can repeat answers more than once and don't be scared to repeat an answer just because you've already used it. You said something is somewhat appropriate twice in a row. That's fine. Ok. So don't be scared to do that and don't be caught out by that and change your answer just because you've already used it. And what comes with that is that eight response you're answering is a standalone statement that you're rating don't have to fix the whole problem. It is just whether the statement is appropriate or inappropriate. So as I said, take time to read the same at first and then pick up speed as you answer the Ford, your responses that are tied yet, that's really important to remember this throughout the whole exam. You only know the information that is provided to do not fill in any gaps yourself. No matter how obvious it may see. The only information you're working off is the information on the screen in front of you. Okay. So this is how near miss marking works. So it's, for example, over here, if the answer is very appropriate and that's what you put, you get the full four marks if you have instead you can be somewhat appropriate. You're one away from it. So you get three marks and you'll see you're two away. So you get two marks. If you Tuesday, it was inappropriate, it's the furthest away. You're going to get one mark. You can see how it's quite easy to pick up marks throughout the section. So no matter what, you're going to score at least one then to even three or four. And then if we go over to the other side and just sort of see how it works, that's the answer to be and it's chosen be, you get your four. If you're going for A N C, either side, you're going to get three marks and your Tuesday, it's only two months at this time. So if you're stuck, like always try and answer the best you can, if there's ones you're really not sure of. You can see that there is a bit of a safety in choosing B or C because you're never going to be too far away. If the answer is A or D, if you've gone for B or C, don't use that for every question. That is not the way to do it, actually. Think about it and think, you know, is which one of them shouldn't be really if you're getting a bit stuck and you just need to maybe move on and you're not sure if some, it's hard to differentiate between somewhat appropriate and somewhat inappropriate. That's going to be the trickiest part in this section. But at least if you're stuck between the two and it's one or the other, you're actually gonna get three marks. Either way, if not before, if you've got it right. So near Miss Market is quite generous, going to pick up mark as you go through it. And just always think, you know, we're on the best place to do this if I know the answer is go for it. If you're unsure, this is when you can start to use this section unless it's very clearly inappropriate, was very clearly appropriate. If it's in this section, sometimes you just have to go for a lot and between these two, it would usually be there's a slightly more negative attention to the answer if it's somewhat inappropriate or it just seems a little bit better and it's gonna be somewhat appropriate. Okay. So the middle section is multiple choice. Now, I whenever I sort of tried to get my head around, how did it come actually worked? This jumped out to me that this is going to be the section that really differentiates the scores. And what I mean by that is this is the section that doesn't have near miss marking. Okay. So you've got your eight answers and you're going to choose three of them from eight and you get four marks every answer that you get right of the three. So for each question you can get up to 12 points. However, you know, also score zero if you've got none of them right where you get 48 or 12 based on having one to your three, correct. This is the thing, if it's wrong, it's wrong. There's no near Miss Morgan here. You don't pick up one even if you're miles away from the answer. And this is why I think this is the section that is going to differentiate you out of everybody else to get that better score. Because this is where you need to focus on getting the most amount of marks because you're going to pick up and your other three sections with near miss market, you're going to pick up plenty of points, even if you've answered every single one a little bit wrong, you actually get quite a few marks for that. Anyway, this is the one that I really spent time making sure I got my head around because this I felt was why I was going to really ensure I got a good score. So tips for this section is you need to think of just putting and between your three answers because you want to create a combined response between your yet, you've got three. And if you're gonna take the three that you've chosen set and then, and the next one and the final one and those things, those three answers together, does it make a cohesive response? Does it address everything you need to and they all fit quite well. Something that's quite useful as well. Looking through your eight answers on the multiple choice is look for opposite pairs and then you can relax a couple of answers and then you're maybe only choosing the three from five or six things like an opposite pair would be speak to the patient, now speak to the patient tomorrow. You know, it can't be both of those things. And based on the scenario, one is either going to be clearly more appropriate or not. So look for your opposite and rule things out. Okay. So rank and this is a big chunky section. You've got 20 marks per question that you do and you rank your E but we've gone back to nervous marking, which is much more Jenner. So and this is where you really, really, really need to think about those, this single answer address the question and this will become evident why? So you've got your five answers at a and you need to put them in order, read each answer first before ranking any, choose the best answer first, once you've chosen that best answer, your left with your four remaining responses. And what you need to do is go through those again and choose the next best response and do this every single time. Do not go in and choose first and best leaving yourself with three that you're just going to kind of flood into the middle. Every single time you're gonna look at what's their, choose the best rank it, you've got four left, go through them again. Pick your next best one, get your answer down and then you've got three left. So on. So on, don't fall into the trap of doing best and worst and making the rest fit because that's what you'll do. You'll just make them fit because you think that one is the worst and it might not be when you sort of gone through at the stage by stage. So the really tempted to do go 1st and 5th, worst, best and worst, but don't do it to get out of the habit of doing that as you're going through and practicing. Okay. So you need to ask yourself every time when you're looking through your five answers. If this is my only option of something today, is this the best? Then once you've got your order done, you need to compare your order to what's above and below us. And does it seem right? And essentially you're thinking best to worst down your e but don't go best and first with your answers. Okay. So you're going to just reassess every single time. Okay. Roughly, I always find when you're blind soon, excuse me, that you're sort of first effects will roughly going in order to inform, explain and tell and ignore, informing someone is usually the sign of a good answer. If you're going to inform someone of something, you're taking your time to let them know something. Explaining is always a pretty good answer as well. Explain to the patient why they need this side. You explain to the patient what's happening with them? Telling someone is a little bit more forceful, not so pleasant and then ignoring someone altogether. It's clearly not a good answer. So again, does this single answer address, the question told you it's going to pop up a lot because I really need you to think about this every single time you go through those five opposition. Okay. Okay. So this is why I prepared. So I can't, it's hard to remember now. It seems like quite a high little but roughly I said I would have started in October for December sitting. I'm pretty sure I did on the 12th of December. So I used the two official passed papers. There is a third paper on Pearson Vue when you log in no marks or answers available for that. But it's a paper that you can do in practice to time. I've looked today at the website for the official passed papers and that third one is there with the rating section with answers. So you're very lucky you have that. And then it says like pre 2019, something like that papers. So that's essentially without that section. So I know we're on this. Great. That's one that's all that free education I did pay for an E medical SGOT course, which I find really useful and it had a question bank attached to it. Um It's a good question bank, you don't need to spend money. However, on preparing for the S D T I did clausen a bit of a panic and just really wanted to make sure that I was getting a really good score. Uh So I did pay for it. However, if you search for a medical foundation, FDT Essentials on youtube, you'll get almost the same amount of stuff or you'll get a lot of really useful information without having to pay for it. Remember doing a B and are learning module that should be free if your B and I remember I also paid for the M D U S J T preparation course, which game came with the question bank. I'll probably pick the medical of the tooth again. You don't have to pay for anything. But if you're going to, I would pick a medical uh other events like this, which were free, which are great. I quite liked because even if I was here in the same thing again, I find that quite reassuring that so closer to the exam time actually knew what they were talking about. Uh You should not go into this exam without reading GM see good medical practice. Essentially that so it's all based on okay, I read it on a flight from Belfast to Glasgow to like half an hour and that was the whole thing, right? So it's not going to take you very long, just at least do it once and just know that you've done it. So the other thing I did, I made my own answer templates for the past papers and started my progress and flag areas that needed work. Uh might seem like a bit much, but I found it quite useful. So it's not the best photo, but this is the template I need on the past papers that didn't have that new section in it. So you can see question 1 to 47. That was your rank questions of F E and then multiple choice over on the other side. So you can sit up here actually attempt three. So I went through these people constantly okay and scored them all there. And what I would do is I'd have those pages I would write on them like the date I did it. What attempt was it? Did I get timed or untimed? Considered a mix of sort of just what way I would do if, depending on how much less they needed to do. But what I find really useful with this approach was I could then compare how I was doing from going along. I would pick up questions that I would maybe continuously not do very well and, and see what the issue was, I'd know where to focus my attention and then it would be the same on this side, if there was one that, you know, I kept getting maybe a four or any, just like, why is there something about this question that's just not going into my head and right, you can sort of ignore the scores and you know, percentages because that is not how this is more at all. This is purely for me to just have a number in my head and go right. I got whatever percent this time and on this percent, that's purely for my benefits for your benefit if you want to do this as well. But this isn't how it's scored. So don't worry about that, but I quite like this. Um What was frustrating? And I printed a load of days off between the two papers. The amount of questions were slightly different. It was maybe, you know, 45 a few more over here. Now from you had to go make hole and you set a template for the two different papers, but it's a good idea or just track your progress somehow in some form, it'll fly what you need to work on and it'll just give you a bit of reassurance for yourself that you're actually working and making some progress. Okay. What I I have the chest available on my phone, um which I'll keep checking if you want to take away breather for a minute. I actually want to put any questions through and we can do that for a couple of minutes. Like, what I also want to do is we'll get a glass of water. I did not anticipate how much talking I actually have to do. So, I'm going to go get away drink. You can put some questions through and, uh, I'll get back to these in a way minute. Okay. Okay. Uh huh. So, hopefully, um, everybody's enjoying so far, um, pop any questions in the chapter and we'll get down to Doctor Bradley um in um industry and then we'll go walk. Yeah, hello. So do we get a recording? I think we do, Kim. You can tell me if that's right or wrong. Yep. Um So recording will go up over the next few days um on the catch up content page. Okay. Um GNC good practice is the summary or the whole guidance. Uh I'm not quite sure it was a small document. I know that much. It's probably listed somewhere as well online. And uh have we Google a bit later on towards the end and see what comes up? Oh, for ranking questions? Do you drag them into order? I can't quite remember. Logistics of it on the screen. The Pearson Vue um practice paper that you get to do will look exactly how it is for real. Um So you'll get to grips with that. It must have been something along those lines of dragging it into order. Honestly, I can't remember but whatever it was it wasn't an issue or something that, you know, was difficult or added any stress at the time. Did I use any big? No, I didn't use a single bic, just the past papers and the courses that I've talked about. So nothing is endorsed by the U K F P O for SGOT revision that includes myself, but I hopefully have some useful things for you. So the only thing that you can legitimately trust essentially are those official passed papers and the rationale behind them in the, you know, there's your questions you have with other questions only and then a link as well. That'll be the ones with rationale for the answers essentially. So that is your only verified source. But no, I didn't use any books uh tip as well. I'm sure you're all using pass med for your finals. Don't use it for S Jetty. Don't waste your time. It's not any good big question. Um questions that I've kind of maybe come up with as we've chatted three things. I'm kind of made up on the spot for me. Questions later on will be from U K F P O. No, there is no practice paper here isn't from America. There's a question bank on America and there's like many marks and times things that you can do on that website and how many times have I repeat the papers without memorizing the answers? So in order to be able to repeat them quite a lot. You need to basically start now and hopefully you have started by now. If not, you've started tonight, um, you need to give yourself enough space between them. So you don't just remember the answer because you did it two days ago. You need to space it out so that you're actually having to think it through each time. Um I would say I went through the two papers properly about 4 to 5 times each. You can see on the right template that I did. There would be days where I would maybe only do this section and that was it. So I would write up here being, you know, like this is on time, this was a staggered approach and it may be, you know, just for the ease of counting. I stopped every time to add up basically. Um So I never said I want to do half of this section. I'm gonna do just this section today. So that probably added up to a few times more. Doing them. Absolutely. Practice the time. You don't need to practice the time just yet, but get to grips with how everything works now and then at least time yourself doing it about twice. I would advise if not more, as many times as you can, it's going to be your best bet, but at least go through the whole thing to time twice. I would say overall in the exam time wasn't an issue, but I had practiced the time quite a lot. So just go in really well prepared for that. Yeah, so we'll go over some questions after this of eight of the three different types again, um choosing between somewhat appropriate and inappropriate. Um We will go through that again in an example, but I'll go back over how it works. Uh difference between inform and tell. So informing someone is usually quite nice if you imagine, like if someone informed, you have something, you gave them a courtesy to tell them something, you made sure that the patient was making an informed decision. Tell is usually sort of kept for answers that are like tell someone to go and do this for you, tell the patient that they must do this, okay. So you'll get to pick it up as you go through the answers yourself. Question banks that are used the Medica, I think I am the MD. You think they had a question bank as well? That wasn't that big and it was all right, is the whole time for the whole paper or is the time and split per section and you can't go back, you can go back, you can flag questions to go back. So I think it's just a run three amount of time and you can split it whatever way you want. One of my friends in person view with me doing it on occasion will feel less like half an hour, 45 minutes. Before me. So your time is what you want to me about when you're in there, where do you find the correct answers for the papers where you find the papers? Um So Google, you uh Google SCT passed papers and we'll take you to foundation program. How do you, if you repeat them so often, how do you not remember all the answers? Time and space it out quite well? So start now so that you space it long enough that you're actually thinking of the question again. How much time did you dedicate HCT prep per day? Uh Honestly, I probably did something every day for it. From about this is early November and I did it in the middle of December. Definitely from this point, I would have done something every day. Um maybe quite to remember and I was definitely every day that might seem a bit much for some people and I completely appreciate that. Uh at least an hour every day, probably by the Oxford handled estrogen good. I didn't use them so I can't comment. So this is asking is doing the same situation, were repeatedly doing the same papers a good thing or the questions on the day are quite similar to the ones in the paper uh slightly different, obviously to the past papers that you have because they can't just send to those questions again, as nice as that would be. But the scenarios are very recognizable as you go through it. So it will be the same issues, but it will just be a slightly different take on it. So if you get your head around issues and how the SGOT deals with these issues, you'll be okay on the day a lot. I might need to stop and go back to this and then come back to the question. Um Would you advise not using question banks other than the questions on the official website? So official website is the only absolute verified use this resource. I did like the medical question bank if I had to choose, but again, do not use passing out just because you've already paid for and you're already using past medicine, don't use it for sgot. You get a break in between. I don't think so. Um You just have your one big run of time and if you want to stop for a minute or two and not answer a question, you can, I definitely left in the middle of it to go and use the bathroom wasn't an issue for timing, informing and explaining why is why is informing better than explaining and maybe made this away bit too literal being like this is, you know, these are better, these are better. They're usually, they're pretty much the same thing really. Um They're, you're better answers, essentially, they're all better than telling and ignoring someone informing and explaining. Totally Trump's telling someone to do something and ignoring someone altogether would you spend one minute, 42 seconds per question. Nope, absolutely not. Uh So especially in that first section, you're going to get quicker because you've got a scenario and up to eight questions which are related to that scenario. So you're going to get quicker as you go through that. Okay. So don't make, you know, you don't have to say right. I've spent a minute and 42 now I'll move on If you're done, you're done. Go to the next question are the questions stems, answers in the actual exam or are the questions and answers options longer? The actual exam or the marks? A good representation? Yeah, totally the same. However, it is in the mall is completely representative of how it is in the real day. Did something every day. It could be not very much, it could be half of this section if it's all about time for. I just wanted to make sure I was always in that way of thinking of how does SGOT lab work? Festivity world and Real World actually, very different places, unfortunately. And recognize both scenarios. What was your question before? All right. Yes. They are quite recognizable and they'll be same. We'll go onto the sleeve it later. There's like quite common things of the questions. So wait, we'll go through that. There is a timer on the screen, but it won't tell you, you know, you've minute 40 to 1 minute 42. There's just like a countdown. Okay there, counting down or counting up, probably counting down again. All these sort of logistic questions of how things will actually be on the screen on the day will be answered by doing the piercings, view, practice paper. Once you've got your log in and all that sort of stuff, uh, I don't recommend passing because I just know it's no good for it and that was the common thing. It's been um um next all of us and it's sort of, you know, got passed down through the years that passed. That was no good. So I never wasted any time when it. Okay. So these are more based on the questions which will go to not how many multimedia elements further on the day I videos just a couple. Um I want to say two and if it's not too, it's not very, more than that. Uh what are the BNM modules? If you have a B M M membership, you should have access to be in a learning modules and there was uh sgot one there. Um You need to just look into that on the BNE website and think of BNL learning that you need to check, right? I think we're up to date with questions. We'll go back and actually look up real questions but keep and stuff in. That's absolutely fine. Okay. So these are the real questions. So we're back to rating. Okay. So you're working on a pediatric ward and you have prescribed a drug for a patient. After being advised to do so by the consultant, the nurse, looking after the patient has informed you that she will not give the drug to the patient that she has checked your calculation and believe that it is the wrong dose. You were confident that your calculations were correct, the drug was due to be given half an hour ago. And the patient's parents are concerned that it is to let you know that the timing of the dose is not critical. So rate the appropriateness of the following actions in response to this situation. Very appropriate, somewhat appropriate, somewhat inappropriate and inappropriate. So this technically A B C and D that counts as four questions. That would be a minute, 42 can't quite figure out that's sitting around seven minutes. We're not about to spend seven minutes in silence for you to read through all these. Give you a couple okay. And then we'll go through each one. So this is just a direct screen grab from an official paper. I mean, the answer is um is just screen grab, but we'll talk through it. Okay. So what we need you to do is just read each one as a standalone statement and rank it as it is whether it is very appropriate, somewhat appropriate, somewhat inappropriate and inappropriate. Okay. And I'll just see if there's any more questions. OK? Feel like that should be enough time. If there's a mad outpouring of know any more time and says when the chest, but I think we should be good to sort of have a wee look through. That's okay. Remind me, can there's a question I want to go back to about inform and explain what the difference between them. I'm sure I was thinking of a better answer in the head in the silence. Uh So we've got our four responses to this one and you're gonna rank each one individually. So here we go. So reassuring that the reassure the parents that delay in giving the drug will not cause harm to their child, that's very appropriate. There. Absolutely nothing wrong about that answer. If we go back to this, one of the things that flagged here is we now have confound parents that is something that you want to do with and you don't want to spiral and get out of control. So to reassure, reassure the parents, something that, you know, it's, you know, it's not time critical, but they don't know that and they're worried parents, the child in hospital dealing with that. Very appropriate. Okay. So this gives you, you know, which bit of the gm see that it's actually based on and that's a really clear cut, very appropriate answer I think. Okay. So there's no negative in it. It's simply you've reassured parents that's never going to be a bad thing. Tell the parents that the delay is because the nurse thinks that your drug calculations are incorrect. That is inappropriate. Okay, because you don't, you could go and tell the parents that there is a delay and explain to them. It won't cause any harm up here. But what you've done here is you've told the parents there is a delay because the nurse thinks you're wrong. You've just totally blamed the nurse for all the issues. You might be wrong. We don't know in this scenario whether the calculation is correct or not, what you've done is pass the blame on to someone else and not looked into any further, totally inappropriate and unprofessional to them essentially, you know, undermine a colleague in front of patient's on their family. You're blaming the nurse, nurse might not be to blame at all. The nurse might have saved a drug error potentially here. Okay. And it's right for people to raise concerns about drug errors. It's a safety issue. No one should feel that they aren't in a position to reuse concerns on award in Austin environment. So by doing this totally inappropriate, you, it results in a lack of trust and reputation damage and it's also going to damage your working relationship with this nurse. If you've just gone to the parents and gone, well, she thinks I've done it wrong and that's why you're waiting. That's never going to be a good set up on a ward. Ask the consultant to confirm with yourself and the nurse what does to give the patient this is somewhat appropriate rather than fully appropriate. Okay. It's somewhat appropriate because it's your responsibility as the doctor to take advice from a senior colleague when it's appropriate. This is definitely a time when you go and get some advice from your consultant in this scenario to make sure that there isn't a drug error. So this part here ask the consultant too concerned with yourself. Appropriate. Okay to and by doing this, you ensure that the care is being delivered safe and effectively, it could be argued that you don't need to involve the nurse in the discussion list of consultants here. And that's what brings it down from appropriate to somewhat appropriate. You haven't done anything bad in this scenario. Okay. You've, you know, all you've done is also involved the nurse and making sure that we've got the right dose. So overall it's somewhat appropriate, but you maybe don't need to involve the nurse. They have other jobs to do. They're busy with their own work. You know, it's not their job to prescribe. Well, there's independent prescribers will not get bogged down in details of that in this scenario, but it's your job to calculate the dose and prescribe it. And it's the nurses job usually to make it up and administer that. So you've sort of brought her out of brought the nurse out of their work and you don't really need to. Okay, sort of bad thing. Necessarily, you know, everyone's involved then in this process and quite happy that we've got a safe dose, but you may be just, didn't need to do that extra step. But the fact that you've gone to your consultant to check it, great, that's probably what needs to be done in this scenario. Then there's probably doesn't need to be involved. And that's what just steps it down to somewhat appropriate. Avoid having a conversation with the parents until after you've sorted out the issue with the drug dose inappropriate. If you avoid confrontation, avoid and avoid speaking to someone, avoid, explain and avoid reassuring the parents. It's just, it's not an appropriate thing to do. It's totally inappropriate. Haven't addressed or responded to the patient or the family is concerned. You've ignored it. Okay. That's never going to be a good answer. Uh, what else does it say? So, a lot of my gm, see in front and timely fashion us to not cause any distress to the patient or their family. Yeah. So if we go back, we know we've got concerned parents here and with this answer, the, avoid having the conversation until after everything's all sorted, you might think. Well, I'm going to go and sort things out. That's a good thing to do. What you've done is avoid having a conversation. It's not time critical. So you having this conversation isn't going to affect anything either. Okay. So, and this isn't us adding any information into it. We're told quite importantly in this stem that the timing of the dose is not critical. Okay. If it was an emergency situation, you may be then don't have time to speak to patient's family. That is maybe not the best use of your time in that scenario. In this scenario, you're under no time pressure whatsoever. It's been actually told the opposite. So, avoiding having that conversation is inappropriate as it doesn't deal with anything. Okay. Um, we'll just check for any questions afternoon. Can I skip between sections on the actual exam? Er, start with multiple choice in it? No. Well, you sort of can but I wouldn't advise that. Okay. So it should just go through the order that we're doing the meeting. So rate multiple choice rank and you just go through each question. Okay. You can flag a question if you want to come back to it later on, which is quite useful. Remember, flag in a couple and then you go back to it and just sort of check that answer later because you're, you know, you're on an exam, there's always gonna be a couple of questions that you really don't like and you're not getting on with and you need to move on for your own safety. Just keep going through the rest of the question. So you can flag that to come back to. I would just work through it from start to finish. Don't go jumping between sections you're going to miss a question by doing that. Ok. So just go from start to finish. And so when it comes to actually answering a question like this on the day, I think how it will actually look on the day is maybe just answer a will be there. And you've got your four options of very appropriate, somewhat appropriate, somewhat inappropriate, inappropriate you'll have before and I think you click one and move on to them. What would be, be? So it won't look quite like this again. Do that Pearson Vue practice paper and that's all you're sort of screen issues. You'll get used to it through. That is the appropriate and appropriate these inappropriate. Okay. So you've avoided a conversation when this scenario is not time critical. That's totally inappropriate. So both the indeed can be marked inappropriate. Yes. Okay. So be is inappropriate because you have told the parents that it's, this nurse is why there's the delays because of the nurse. Okay. And you've essentially blamed the nurse for all of this when you potentially made a drug error. We never know in this scenario whether a drug error has been made or not. So we never, you know, we don't know there's no blame to be attached to anybody here, but it's certainly not to say, well, the drug calculation was correct in the first place and it's the nurse's fault that this has all been delayed. You know, you need to be able to raise concerns in an environment that you're happy to on a ward. Otherwise patient's safety is at risk. How do you choose which question answer the question the most? Because how do you choose which question answers the question the most? Because talking to the consultant with sob issue but talking to the parents with not okay. So I see what you mean with this. So it doesn't have to answer the whole question. Okay. So just because uh what are the two things here? So talking to the consultant, solve the problem and talking to the parents doesn't solve the problem. Okay. Got you. But they're both appropriate because it's an appropriate thing to speak to the parents in this scenario and to let them know that there is a delay that isn't time critical, that gives them reassurance. So it doesn't get you, the final drug does and like get you the correct answer and all that, but it's still an appropriate part of the response that you need to do. Okay. So you don't just deal with patient's, you do with patients and their families and the next of kin and particularly on a pediatric ward. Not somewhere I've worked actually yet, but it's really important to make sure parents are, you know, kept in the loop at all times. That's a really important part of your job is the question to do with the drug or the parents in this question both. So this answer. I see. Ok, so ask my consultant to confirm the dose is also uh somewhat appropriate thing to do and the reason why it's not appropriate. Okay, in this answer, so see if the answer was just ask the consultant to confirm with yourself what dose to give the patient, it would be a very appropriate answer because you've got the nurse involved, the three of your old going to go and check the dose. That's what makes it somewhat appropriate. It's that step down from appropriate to somewhat appropriate because you've involved the nurse maybe a little bit unnecessarily in this scenario because it is your job and the consultants job essentially to get the dose of the medication and prescribe it. It is not the nurses job to prescribe or to calculate the dose in this scenario, their job is to administer and make up the drug and get it to the patient. Okay. So you need, this is where you're sort of clear on whose job is what you prescribe, you calculate doses. Okay. So the addition of getting the nurse here is what brings this answer down to somewhat appropriate. So you don't really compare the options between them. No, no, no, no. Excellent. Thank you for bringing this up. You treat them with standalone actions. Absolutely. Okay. So each of these four or stand alone statements that you rank individually, they could all be the exact same answer because they're standalone statements. Okay. So if we go way back to tips for this section, okay, you can repeat your answers and more than once and don't be scared to repeat an answer just because you've already used it. Each response is a standalone statement. It doesn't have to fix the whole problem. It is just whether the statement is appropriate or inappropriate or your two years between. So this is the one, this is where the answer of talking to the parents comes in. It doesn't have to fix the whole problem and talking to the parents doesn't fix the whole problem, doesn't get the drug calculation correct. But it's a totally appropriate thing to do in the scenario. Okay. So can you talk through the problems in these scenarios, patient safety, parental there. It's kind of all the three things that you've lifted use and are all the issues in this question? Actually, you've done it yourself. And so, yeah, it's about patient safety. Absolutely. In the drug air or potential drug air parental concerns. Yep, it's quite clearly written here. That that's another thing that we're thinking of and professionalism is how you're dealing with your colleagues who are both the nurse and the consultant and scenario. So, a question is probably going to have more than one focus. Okay. It's going to hit more than one thing usually. And that's okay. And the actual exam for the rating, does the sentence appear one at a time? Yeah. So again, so all these sort of logistical on the screen questions every time, just go to the Pearson Vue one because I can't remember what it looks like. It's nearly two years since I did it and it feels like a long time ago. Okay. So that Pearson Vue go on Google STT passed papers. One of the options is to log into Pearson Vue and do a practice paper that does not have any answers, but it's how the screen is going to look on the day. Okay. So Olivia, um just uh you wanted me to remind you, do you want to go back and just shut up? Oh, yeah. Yeah, I don't see it already forgotten. Uh Let's go back and find it. I've probably forgotten the good answer. I came up. I think it was to do with kind of the four terms that the some of the questions started with, you know, not necessarily but obviously inform and explain as two words pretty much are gonna mean the same thing picking it up from the scenario. It usually means that you have informed the patient Philly you've made, you've helped the patient make an informed decision for themselves. That's pretty much always your best option in these things. If the patient's aren't sure about something, you inform them and give them adequate information to make their own informed decision. Great. Okay, explaining is usually pretty good if you explain how something is done, but it's not quite the same of letting someone have an informed decision. You've just explained how something is done. They're typically both quite good answers. Okay. So informing and explaining, helpful things, approachable things. You are nice to your patient's. You give them all the information. I need you not hiding things from patient's telling someone. Typically not as good an answer than explaining or informing someone because I just told them this thing is happening. I will tell you when it is, I will tell you how to do it sort of thing. Telling someone typically isn't great and then obviously ignoring off the floor is never going to be a good option. Okay. You will pick up on these things as you sort of do your own study going through the papers and just pouring over them quite frankly and you will know the rationale things inside out okay by the end of whenever you're sitting it and you'll get to grips with what seems to be good answers and how things work for it. Ok. So yes, uh multiple choice, but there's no more questions down here either. Uh, inform is educate and explain it. Just a nicer help, kind of pretty much. Yeah. So how to two aside in reading questions, I can't decide whether to choose something is somewhat appropriate or somewhat inappropriate. That's the problem that everyone's going to have. Okay. And that's the trickiest part of it, somewhat appropriate. You need to look at it is if it could nearly be that appropriate answer, but there's gonna be wonderful thing. That's not great or just isn't the optimum response. And that just sort of steps it down to somewhat appropriate, somewhat inappropriate. If you sort of view it as it's not a totally inappropriate answer down at the bottom. Something kind of salvages it slightly and brings it up to somewhat inappropriate. So you can kind of gauge as a roughly in my head. Do I think it's closer to be inappropriate or do I think it's closer to being inappropriate? But something is either sort of picked it up a little bit up to somewhat inappropriate or it was a nearly very appropriate answer, but something is just brought down slightly to somewhat appropriate and typically you're somewhat appropriate will still have a kind of positive approach. So with the example before that you get the nurse to come and check the calculation before it's not anything bad, you know, more people checking something is usually quite good. It's just maybe not really in the nurses job to come and check a drug calculation. So it's not necessarily a bad thing, but it just isn't necessary. So that's what brings it down from appropriate to somewhat appropriate and usually it's an answer that could maybe actually be just inappropriate bottom answer, but something sort of picks it up slightly and takes it into somewhat inappropriate. You're so lucky as a year to have uh questions and answers available for this section because we did not have it. We went into this blind pretty much or we had a couple of examples but no answers. So I was just going through it making up my own things being like, well, I don't know what's right or wrong here. I'm just going to have to sort of go with it. So go through that section quite a few times cause it's going to be the trickier one to get your head around choosing between somewhat appropriate and inappropriate. But if you look at it sort of either too extreme, appropriate and inappropriate and if they're, they're does something bring it down or does something bring it up slightly okay. Every single answer in this entire exam is to be treated a stand alone. So in this section, all of these are standalone okay than in the multiple show where I'm going backwards in multiple choice. It's one question like this. Okay. And you choose three of these ants and you sort of this is where you use and between your three answers to see. Does that make one sort of big cohesive answer? And it comes to ranking? Well, so you'll go through all the stuff when it comes to a ranking question, what you're going to do is read each of these and then rank the one that you think is the best answer first. And that, and that's where the whole does this single answer address? The question really comes into play in this section. So you go through your five, you've probably had a good idea what one you think is going to be your first answer. Your most appropriate answer here. You want to rank it first as best answer essentially. And then you take it away and you have four left and then you go through those four and you think right, these are now my four options. What's the best one of the four remove that got three answers left. Which one is best of the three? Remove that? And so until you're all done. Okay. So these questions are all from the official papers. So I wouldn't get too bogged down with how I marked in percentage things. And then I got 40 for, um, that was more for my benefit just to see to track some progress from the first time I sat up to the last time status. Um, I wonder could I find them? They're probably in a folder beside me. Um And then here's another thing to remind me about in one of these folders beside me. I have a jetty, right? All my final shoulders are back on it because I am studying again for MSRA which conveniently has an F jetty has to, uh, which to be honest, I'm actually quite glad I put all the work in this time around because it's really panel tonight when I come to study for it. So I can hear it. Right. You move all my SJP notes here and here this is the sort of rubbish Arjun. Actually. It's my camera still on. Yeah. All right. Yeah. So, yeah, loads and loads enough, I'm afraid. Uh, but here are my template answers and I can maybe let you see. So I'd clearly done a first copy and then wanted a nice table instead. Uh, so that's attempt to attempt three. Right. This all seems to be sed past everyone. First time I've put on, this is the ninth of November and I didn't do the whole thing that looks like. So I did this section. I did just this section on this one for some reason and didn't fill this in here. So it was in full thing at that point and got 87% by attempt to re on this paper. I got 97% which I did on the second of December. So there was a month between the first and the third and in the middle did attempt to on the 21st. So I did the ninth, the 21st of November and then the second of December. And let's see, between paper to and paper three. I went from 92% overall to 96. Um You didn't do any more that have kept, I think it would have, this is not prepared these folders through sitting beside me. This is sadly, before I sit studying most nights for this exam. Um Oh, yeah. Here super to again. So it looks like I fill them both in sort of three times silly and maybe did a few like scrap ones as well. Attempt 1/10 of November got 83% attempt. Number two, which I also did timed. I wrote that down that was done on the 22nd of November. So 12 days later and got 93% went up 10% in 12 days, which felt like enough time that you were thinking through the questions again. The odd one you're going to just remember because you remember a question you did two weeks ago, but that felt like enough time between things to go through it. Okay. Uh What were the scores attempt to 93% attempt? 3 96% things like the last. So the ones I did were about the fourth and six of December and I sat on the 12th. So what I think I did after that was I was happy with time conditions by that point cause I've done somewhere between six and yes time test. I'm going through all the rationales. I need some notes got looked like that. Just we colored bubbles around scenarios. I think I went through. That's a lot actually in the last few days. Uh There we go. There's the real life stuff. I also need a list of key areas of all those types of things. Uh Last year, I sent out a document which is sort of summaries of all the little bits and pieces I picked up, which I'm sure I still have and we can send out again. So don't worry about all the stuff that's on this. I've kind of summarized it all which I can give to you things that I've written. So these are all the sort of types of areas. So alcohol consent, confidentiality and upset family. Someone's not coping with work, prioritizing tasks, getting discharges done, leaving work on time, having a direct handover, not on whatsapp. So that never happens in real life and things like that. Okay. There are the sort of areas that the question's going to be based on and I've written things here like be direct because you need to be direct in your response. Being direct isn't rude, being directed. Actually dealing with the problem, patient safety duty of candor, confidentiality, ask gather information. So usually ask is always a really good term in a question most of the time never give anyone's fault, too reassurance because don't worry, I'm sure they'll be fine. Terrible answer. In ST T world, you have no idea if someone's going to be fine or not and you've given them the false hope and F one does not monitor others that's quite important. You can't go and tell a colleague you're not doing your work. I've been watching you like you don't know, it's not your job to do that. Okay. Anything else that's useful? It is not an f one job to allocate work or manager would recover, uh, nonaccidental injury in Children. It's a senior that's trained and that's not you. But if it's something that you're worried about, Informa senior, uh, what are there in here? This alone is all I know. So, what is my response? So that's in terms of coming up to questions. Don't feel I don't add sentences to you. Don't add things that you think would likely go on what you read on the screen in front of you. That is all you know, that is all the information you've been provided and based on that and only that, what is your response? Yeah, this is kind of summarize but actually haven't left the disciplinary one, don't blame others. So don't blame that nurse that the medicine is let you potentially made a drug error that the nurses maybe saved you from confidentialities. Massive fall with massive. Uh It's an important one. I haven't included these questions as examples in it. But between paper, one and paper to on the website that has the official passed papers. I'm pretty sure in each of them, there's a question about alcohol. Actually, we deal with one of them later on. But in the other paper, there is another question based on essentially a colleague drinking alcohol, either before or after work, something like that. But that's the crux of the question. However, between those two papers, the answers are slightly different than what you did. I remember people were going through these two questions and being just like perplexed by why they were different. And it was really frustrating and I spent quite a bit of time going through the two questions to pick out the subtle, subtle minute differences between these questions and why the answers were slightly different. What I've summarized from it is, is it time critical? And we're going to look at the time critical question. Okay. And there was another example and the other paper between one and two, I can't have a which one which is from, but you're going to go through papers one and two and the other paper that's available as best sitting 2023 loads and all the time. So you will find it the other one isn't time critical. Okay. And that's why it's a slightly different answer. That's the crux between the two alcohol questions is one is massively time sensitive and the other is not okay. Ultimately, no matter what, uh colleague turning up, either still drunk from the night before or clearly drinking on the wards or something terrible scenario. But the subtle subtle differences between why the answers are slightly different, right? I could stand all night going through this, but we should do questions. But the jest of this stuff is anyway, summer which we can stand by. I'm concert of a flash flash going through if anyone is currently inside Alban. I stayed in a lovely holes there and made all these now. So if anyone's there, I hope you're having a nice time in those holes actually not that bad. Uh So where were we uh we need to do this question, don't we? Yeah. So multiple choice. So what I was saying earlier about multiple choice, this is the section that is the only part that isn't under near miss marking. This is the section where it's going to separate. Okay. So that for this question, there's 12 marks available. There are three answers that you need to choose from the eight. What you need to do is look for opposites and obviously, you can't pick two of the same thing if they're opposite, that's never going to work. So you can rule things out. You need to pick three of these. It's between each of them I want you to put and afterwards and see does that flow into some sort of cohesive answer? So a confused patient has entered, has an intra abdominal infection and acute renal failure. After a procedure, instructions to the nursing staff are clearly written in the notes regarding what actions to take in response to a change in the patient's urine output. On the morning ward round, you find these instructions were not followed by the night nursing team and the patient has deteriorated as a consequence. The patient has now received treatment but follow up actions are required. So this question alone, you got one minute 42 for it. Okay, because this is the one question even though you're picking three answers. So I just find my phone, I'll check the chat but we'll have one minute 42 from now. Okay. Okay. That should be time also. Actually I read the question. So you're one minute 42 would have included you reading through the question first. So our three answers are S E and A. So inform the nurse in charge of the word of the incident, inform a senior member of the medical team of the incident, find out whether the nurses were aware of the instructions regarding change into the patient's urine output. So if you put in and between all those become quite a nice answer. So you're going to inform the nurse in charge and inform a senior member of the medical team and find out whether the nurses were aware, we'll go through the other answers and why they're not appropriate to some of them. It's a bit harder to tell, you know, why you wouldn't have chosen those ones, but we will go through that okay. So explained to the patient that there was an error with the management of her condition. Now that is something that you would do. Definitely, and you should do that, especially if someone's got well, you need to explain this to them. Okay. You can't hide that from a patient. However in this question, the first three words are right there. You have a confused patient isn't really much point at this time to explain, to confuse patient. They won't be able to retain the information and appreciate that. So you're going to do it when they're not confused. Okay. But right now they're confused. You don't need to do it okay. So speak to the nurses involved. Next time, your concerns with the management of the patient offer to write a protocol for formalising team communication. Both of these answers don't do anything at this time. Okay. So yeah, you might speak to the nurse involved at some point, but right now it does absolutely nothing in this scenario. Okay. Offer to write a protocol formalizing team communication. Again, it's not a bad thing, but right now it doesn't add anything for this patient. Okay. So some future protocol that might make this better. Great. That's down the line right now. You have a patient that you're dealing with and writing a protocol doesn't do anything to help them at this time. So what you need to do without answers that we did have the nurse in charge needs to know what happened. Okay. So the nurse in charge now has a sick patient on their wards, the senior member of the medical team. So probably their consultant or a red at the lowest rank needs to know that their patient has become unwell and you need to find out whether the nurses were aware of instructions regarding changes? Because it's in the question here is that instructions to the nursing staff are clearly written in the notes regarding what action to take in response to change in the patient's urine output, which you find out that the instructions were not followed by the night nursing team. And as a result, the patient became unwell, you need to find out whether those nurses were aware of instructions in the notes or not because they might not have been okay. So that's really important to find out. Did they know about what was written in these notes? That was a guide of what to do. So yeah, there's no point in explaining to the patient at this moment because they're confused. But you will later on again, speaking to the nurse involved about concerns, you can do that the further down the line, especially also this is the 19. So this seems like their time you're on a morning ward round the 19 won't be there. So you're not gonna be able to do that as an almost, you know, the next step and writing a protocol might be a good outcome, but it's down the line. Then again, you're going to need to write this in the notes. Yep, absolutely will. But it's not the most priority right now. Okay. Ask the nurses to increase the frequency of obs on the patient unnecessary because you don't need to increase the obs on the patient, the instructions were clearly written in the note for what to do. Okay. So we've got another example here. So Mr Saad is a psychiatric patient who has been brought on to your medical board with the psychiatric nurse. You are aware that he was admitted to the hospital the previous week and was very disruptive and refused all treatment. Your consultant has told you to take an urgent ct scan of his head. When you inform Mr Saad that he is booked for a scan leader that day, he tells you he will refuse to cooperate. So we'll give you like a minute and a half for this one side to read the question, right? All right. I think that's a bit more than time again. So you need to choose your straight and put and in between them to get one good cohesive answer. So what you want to do in this scenario is inform your consultant that Mr Saad is refusing to cooperate with the CT scan, attempt to explore the Mr Sod's reasons for refusing the CT scan and find out from your specialty trainee if it would be appropriate to assess Mr Saad capacity to refuse the CT scan. Okay, so we're going through this again. Your consultant has told you to book the CT scan. So it's going to be a really appropriate to then let the consultant know that he is refusing to cooperate with the scan, consultant, consultants never with the scans. That is your job as fo and have to, the consultant wants you to pick the scan. There's not an issue with it. You go back and tell a consultant of that issue. Okay. Attempt to explore Mr see as reasons, reasons for refusing best thing to do. You can't just go and assume something you need to go and speak to the patient doesn't matter that there's psychiatric patient, you won't speak to all your patient's and you might find a really simple reason why they don't want to go to the scan that you could actually deescalate pretty quickly. Um You can find out from your specialty training if it would be appropriate to assess Mr shots capacity to refuse the scan. Again. In this scenario, this is going to be quite appropriate because you have a psychiatric patient who may have some issues with capacity. And if, well, I don't know if there's capacity issues or not, what you need to find out. Is, are there any capacity issues here? And should we maybe assess the capacity about refusing the scam, who go through the rest and why they're not the answers? Okay. So delay the CT scan for 48 hours and a long time to calm down does absolutely nothing doesn't address any of the issues here. You don't let the consultant know there's an issue you've not thought about a 48 hour delay could be really quite critical. You have been asked to book an urgent ct scan. Urgent is not in 48 hours. Okay. So discuss with your consultant whether it would be appropriate to prescribe solutions for Mr Saad prior to the CT scan and ask. So there's something up with my skin for the boy two. Uh What have I done? Um If you just go back into showing the presentation, if you need to stop sharing screen and go back on, if it's easier to do that. No, that's us. We're back now. We're back now. If you're able to move the slides, just want to check. Oh, so that's not the screen I'm seeing. Uh John just want to go back this way. Yeah, probably best just to re share again. Yeah. Yeah, that's what I need to be. So there's something over answer hit for me at the minute. I can't read it out fully. Um asked my dad if he would something some I think that's what family wants to accompany him during the stay in the hospital. I think it's something like that. Oh, yes, I can move it as much that if he would like a relative to come by and accompany him. Maybe. Okay, but not right now. Okay. So when it's, you're looking for your three appropriate actions, it's like the next three things you're going to do. It's not 48 hours down the line. It's the next three things you're going to do. So you might do quite a lot of these, but they're not the first thing you're going to do. Okay. So, maybe he will need to date it for the scan maybe. But that's a, you're jumping the gun essentially going from, you know, you could talk to him and maybe find out if there's a reason first. Instead you've skipped straight that let's sedate you far, too much down the line. Okay. And again, a relative might help, but again, you just jump the gun away bit. So they're not necessarily things that you won't do. They're just not right now, sort of things. Okay. So we'll have, we'll just sit a question about this as a section because these are the two. Oh, sorry there anymore. Sorry to push some more and politely tell Mr Seah that his disruptive behavior is making it difficult for health workers, healthcare workers to work completely inappropriate. Okay. You might exacerbate the whole thing, even though you said you're going to politely tell him that he's disruptive. There's no need to do this right now or ever. Okay. And asked much sad about why he explained to him why he needs to have the CT scan. So it sort of, I know it's that explain is usually a good answer and why he needs to have a scan is usually not a bad answer. But in this scenario, year, aware that he was in hospital last week where he was very disruptive and refused all treatment. It's a bit patronising here to go and explain to me why he needs to have it rather than asking him why do they have any uh attempt to explore the reasons for refusing is much better than telling him why he needs to have it. It's a much more open conversation. Okay. So between C and you, you're probably going to only ever pick one of those. So attempt to explore his reasons for refusing the scan. It's open. If you tell me what the problems are, explain to him, you need to have this scan. That's the sort of firmer approach here. Got a psychiatric patient who in the last week has been disruptive, that's not going to be the best approach. Okay. Yeah, let's see. So this is why the first one that we did, would you not own up to the error? You do but remember the patient's confused. So you're not going to do it immediately when they're confused cause you'll just need to do it again. If the patient was not confused would inform them about the medical error, be more appropriate than asking nurses if there were aware. So don't get tied down too much and change in the scenario because you'll just confuse, you'll muddy the waters of how you're sort of going through all this. So the question is the question is the question, but I get what you're saying, if the scenario is slightly different, if the patient wasn't confused when you speak to them first. Practically, I think the answers are probably, it's hard to know. Um, it's not gonna be a bad answer. If you're not confused, you probably want to make sure that those things are dealt with first. So you've spoken to the nurse, you've spoken to the medical consultant, you've spoken to the nursing team, you get the full picture of what happened and then you go to the patient with armed with all the information that you need to tell them about what happened. So I would say it would still be speak to everyone's staff wise that you need to first get all your information, then bring it to the patient and explain to them. So no matter what at some point, you're going to explain to the patient, you're not going to do it when they're confused, you'll just repeat yourself and they'll not be able to retain the information or you get all the information first and go to your patient. Okay. Are you provided with a white border blank paper? Yeah, you've got laminated paper and a marker. It's quite useful. I just wrote out luxury things in my head and like bullet points to remind myself of things at the start. So it's not about what the consultant do to make the patient cooperate. You just need to let them know the consultant wants you to book the scan. There's not an issue with that. You need to go to the consultant and let them know. So ultimately, the patient is under the consultants, the consultant is the one whose name is on the patient as the you know, me um consultant for their pair. The they're all the ultimate person responsible for the patient. You need to keep them in the loop. It's not about what they can do differently. It's about making sure that your consultant is informed. So why would you ask a specialty trainee about capacity? So in Scotland, I am working, I cannot sign forms that being someone to be without capacity. So this is where you need to know what an F one can and can't do. And that's up to you to sort of go out and figure those things out. Okay. So you need to ask a specialty training about this because an F one doesn't sign and they're all different things in different places in Scotland, it's called an adult with incapacity form. You don't find that as an F Y one. So you need to get someone else involved here. So you have to strain the answers together as if you could do all of them. Yeah, absolutely. So that's where the, and, and, and so you get three answers. That's sort of become one nice big answer. Oh For your point here, you want to explain to him why he needs. It's kinda before you get them to consent. And so by attempting to explore the reason, isn't you not giving them information as such? It's more important to see why first and then deal with explaining why he needs to have the scan. So it's very specific to this situation because you've got a patient who's been previously disrupted and there's potentially capacity issues. Okay. So it's multiple choice. It's the options that we need to be done immediately. Yeah. So it's what are the sort of the next one of the most appropriate actions to take in this scenario? So yep, you're absolutely gonna go with um putting things in the notes. It's not the most pertinent thing immediately. Okay. You can always write retrospective notes is all you're right. This is a retrospective note. Um This is the time I wrote it. This is the time I saw the patient. So is it in the notes? That's absolutely fine, but it's not the first thing you're going to do here. You want to like find out what happened, right? We will move on. So ranking entity, this is where the whole does this single answer address? The question really comes into play. Okay. So you have your scenario, you've got 80 and you need to rank them in order from most appropriate to least appropriate. You are working on your first rotation in surgery while success in a 65 year old female patient with John. This the consultant surgeon asks you to refer the patient, the gastroenterology department. Regarding further treatment, you are unsure why this referral is required. Again. You've got one minute 42 because this is one question. Okay. Uh Okay, that's your time before we get into the answers for this one. There's still just a few more questions about this answer and, and I can tell there's always going to be a bit of issue between J and see. So attempting to explore the reasons for refusing the scan versus explain to him about why he needs to have the scan. It's really subtle stuff in the language of the answers. Okay. And the more you do this, the more you're going to get used to, this is a really nicely open. Oh The language of this is really open. Okay. Attempt to explore his reasons for refusing. You might find something really small that you can deal with and that's it done. I don't know that, but there's a potential. So attempting to explore someone's reasons for not wanting something typically is a really good answer in SBRT. Okay. Just take appreciate that a really sort of open ended language question is what I'm trying to say compared to explain to him why he needs to have the scan just isn't as open your exploring why he doesn't want to do it versus expansion. Why he needs to have the scan and the subtle table language is probably the needs. Okay, you've gone in and you're sent him, you need to have the scan versus why don't we look about, look into why you maybe don't want the scan versus you need the scan. Okay. There's always going to be questions and answers in this that you will not agree with. Need to accept that. To some extent, you might look at a question with friends and the two of you will never agree on what you think are the correct answers. Okay, the more you go through it, the easier this will become a promise. You just go through it again and again and you will get into the way of thinking of this. So it's hard to pick between these two and I can see why. But attempting to explore, it just seems like a nicer more open approach to the patient rather than explain it. I know I've said explaining is a really good thing to do and almost all questions but not quite here because you've just gone in and it's about why he needs to have the scan versus finding out. Maybe why he doesn't okay is e better because of excessive capacity. And it includes G now that would involve experience, see people. Oh I'm getting too late to understand this way he is better. Yeah, so he is better for your asking the person who can assess capacity because you won't fill out those forms. Doesn't say you can't assess capacity in itself, but you're not going to be the one signing the form to say that someone doesn't have capacity and that includes the gene. Yeah, it probably is better overall. I see what you're coming from now. So you're thinking you're getting the right person involved, you can assess capacity and that's an appropriate thing given the scenario. Okay. And I want to see other half of questions about his capacity to refuse to scan. So that's gonna be a useful thing. Bear in mind this answer doesn't say you have deemed him to not have capacity. You're gathering information for yourself from your reg. Is it may be an appropriate thing to do to assess his capacity. You haven't gone in all guns blazing saying I'm not, I'm telling him you don't have capacity. You're finding out from an appropriate senior to you is this may be the best next step. Okay. So I think we need to move on from this question. Okay. So back to this one, going to rank Ed E, here we go. So it is E D B C A. So in this scenario, if your first job and surgery, you've got a 65 year old patient with jaundice and the consultant surgeon has asked you to refer them to Gastro for further regarding further treatment, you're unsure about why the referral is required. So if you're unsure about something, the consultant surgeon has asked you to make this referral and you're unsure, you speak to the consultant surgeon, the one who asked you to make this referral and to give them for you to gain more information before making the referral of all your thing, of all your options there. That is your single best one. If this is the only thing you did you've done well, it is. Does this single answer address the question? Yes, it does. You've spoken to the consultant, the person who wants the referral made you feel you don't have enough information right now to make this referral spoken to them, you get more information to go on ahead and make your referral. Okay. So a is now out of the question, I got four left and then day and it's really similar answer. So you ask a more experienced colleague, what information the Gastro department will require to make the referral, not just as good because it's a consultant who asked you to make the referral. But if this is your next best answer of what is left, it's pretty good. It's a very similar answer. You've got someone who's more senior than you has the experience and you're asking them the same thing. Basically, what information do I need to make this referral? This is one which I remember I did not get when I was first doing this question, conduct research on the internet into why the referral could be required. Sounds like it's not a great answer because you're going into like, why would I check on the internet? That's not very appropriate. It might not be a reliable source, the rationale behind this being the next best answer. Now, remember E and D are no longer in the picture, your A B and C is what's left. So one is conducting research on why the referral is required. One is asking someone else to make the referral and one is contacting the gastro compulsin explained to them that you need to make a referral and what information they need of the three that are left conducting some research on what could maybe be required for the referral is the next best as compared to what is left. Ok. So just we'll go with this and it might make more sense when we order the next to the next best is see, because you've contacted the gastro consultant to explain, you need to make this referral and you ask them what information they need. So you've asked the person who the referral goes to, what do you need for a referral? It's number four, number four on the list because if that was a standalone answer, that's pretty poor. Okay. You've spoken to a consultant in another team who is a about, hello? What do you need me to do to actually refer to you? You've wasted their time. Okay. It's really frustrating to get a phone call through from someone else to your department's going. Hello? I don't know what you need. Can you tell me? I know it should be approachable and he'd like that, that you can go to someone. But when we compared to everything else, the surgeon can give you that information of what is needed, the more experienced colleagues can give you that information that is needed. You could conduct some research into what is may be needed for this referral. So A D and B for all, you actively doing something to find out an answer to make the referral see is going directly to the source. You've not really tried to do anything before making the referral. You just go on straight to them, annoying them and said hi, what do you need? And the reason why is worse than see, because even though you've essentially wasted someone's time and see asking someone else asking you're more experienced colleagues to make the referral answer is last because you have not learned a single thing from doing that. So remember if a was the only thing you did, was it any good? Yes, the referral got made, but you made zero effort to gain more information from any source about why the referral is made or speak to the team. You've just got someone else to do. You have learned nothing in the process. Your foundation training, you are in a training post, you need to learn by getting someone else to do something. You do not learn, you do not make improvements in yourself. Okay. Typically as well, going through any question, passing off a job to someone else is never good. Okay. Unless there's all the caveat, unless it's an emergency. Okay. Could you do this discharge tomorrow? There's an emergency for a patient who believe in tomorrow. Could you write that? I need to go to the emergency brother that's going off because someone's had a cardiac arrest. That is an appropriate example of giving your work to someone else. This referral, there is no urgency, there is no emergency in this scenario, you're getting someone else to do your work. No good. Okay. You've learned nothing. So that's why there's the last answer compared to see in which you've wasted the consultants time cause at least you've spoken to the right department and you've got the info, you have the information of what information you need to give them in a very roundabout, horrible and efficient way, but you've still done it. You have done something, getting someone else to do it. You did nothing, okay? I'll see if there's just any questions and then probably will be so yeah, it's been not quite unsafe. I was all this thinking when I did this question for the first time, you can see that. Ok. However, when it says internet, you know, there's NHS websites and stuff so you could be on a decent website. I know that's a funny answer in the middle if you doing something and not wasting their time. Okay. And see. So be Trump. See, because you have actively done something. See is you making a frustrating and time wasting phone call to a department asking what do I need to make the referral? Not? Hello. I am making the referral. It's like you need to call them first and say hello. What is all the information that I need to give to you? Okay, I'll bring you back when I get. That's really inefficient. Time wasting so far enough. You can agree that it should be a different answer, but I'm afraid this is the answer and you need, you will not always agree with how the answers are. Like I said, S A T World and Real World are not a perfect fit with each other. OK? So you go through all these answers and you go through all the rationale and get yourself into a way of thinking that fits this exam. If you can't do E and day, then why would you go for c so you go for be next? I'm afraid why is the appropriate? You are still not sure about why the referral is required even if you find out what is needed. So they is appropriate. You're still not sure about why the referral is required even if you find out what is needed for the referral. But it's quite a good answer really. If you look at it compared to everything else that's there, you have someone really senior about what is needed to make the referral. I know this says why the referral is required. But in learning what is needed in the referral, it might become obviously about what's required. Okay. At this rate, I'm going to get J A N C. Don't worry, everyone has these threats. But as long as you're honest and see if you're fine working me check what the areas that, that's why doctors responsibilities and probably in G N C good practice. And it's something that you're also gonna pick up throughout being a clinical placement, okay, and like speak to the team. So there's like a typical F one things that you can't do again, this is very Scotland specific. I was unable to detain someone put in any detention orders, emergency detention orders, unable to complete uh incapacity form. And typically things that F one don't do or you can't consent for something you can't do. You don't consent someone for a surgery, you're an F one you can't do the operation. Okay? Would she be more appropriate if the initial referral? Uh it's even more appropriate if the initial referred me it was rejected. Uh maybe, but it's don't look at a question and start to think if I change this and I change that and I changed this, then what was the question? They, because you'll come up with 100 different scenarios and honestly lose your mind going through this. So take each question as it is, there's enough questions available between all those official practice papers that you will get different versions. So don't take a question and try to tweak it. Um It's not worth your time. You'll get so about time. Okay. So this is how near Miss marking work this. So there's 20 marks available. So down here is the correct answer order. Okay. So if E is in one, you get four be isn't too, you get four and so on. Okay. So it looks a bit funny but you get your head around it to say you did yet. You got the right. And then what we want to be with c was the one about speaking to the gastro consultant. Okay. So let's say for example, but the first you get four marks but then you put see as your second score, you get two marks, okay? And you work from there. So I think instead of conduct research, it would look at guidelines would be better again, don't start making up your own new answers. Think, well, that would be better and then it would change my mind. These are the answers you have in front of you. These are the questions you have in front of you. What you will do on the real day will be very similar. So just get used to how bed do things and just slip your mind into thinking how I think don't start coming up with your own variations of the questions because it's not going to do any favors. Okay. So this is the alcohol question, know some of you are asking about it. So we'll look at this one alone and not the other. The other one is somewhere to be fined in one of the papers. I promise it's there. You will find it as you go through the questions. I don't want to just give you everything because you need to go through these questions yourself and go through them again and again and again and you will find these issues. Okay. So you're working on a surgical ward, your specialty trainee arrives in the ward looking unkempt and you know the study smells of alcohol. He is due to operate in one hour and you believe that his ability to operate maybe impaired. So again, like at a uh most appropriate police to corporate single answer, does it address the question? Remove it, go through your next four, get your next answer. Okay. All right. Let's have a look at this one. Okay. So it's a tricky question cause you got the whole issue of alcohol related to it. Okay. So this is the answer C E B D A. So if you're going to do one single thing about this, inform your consultant of the situation, remember you are an F one right now. Okay. It is not up to the F one to deal with things as big as this. The first thing you go and do is tell your consultant it's up to them to deal with it. Okay, the consultant is above the red, you know, it's the consultant and then the thing again, patient's are ultimately under the responsibility of a consultant. There's an issue here that needs dealt with you, go and tell the consultant and it's up to them to be with it. Okay, if you won't tell your consultant, that is a very dealing that you've passed it to the appropriate senior, senior senior person here and it is up to them to deal with this. Okay. That is not out of the question. And we have four answers left which the next one is a so suggested the specialty training that he should not operate if he is under the influence of alcohol, some of you might have put that first because it's, you know, uh is a good answer. It is direct and you've dealt with the issues here. But again, it's this, you're an f one after a specialty training. It's not up to you to sort of deal with things as big as this. It is a consultant's job to deal with this. However, if this is the only thing you did, it's a pretty good answer. Okay. Ultimately, you've said to him you shouldn't operate. I think you're under the influence of alcohol. You've dealt with it that he shouldn't operate. You don't think you should, you can smell alcohol off him and you think, or well, no, you should not operate if he's under the influence of alcohol, it's not confirmed, but it's very likely he smells of alcohol, but it's not absolute okay. But it's very, very likely it's the only thing you do. And you say to him, I think it, to him, uh, that is an operate, you've done something, those two answers are now way you're left with a B and D. So the next one is the, so as the other team members, whether they think specialty Drainy is fit to operate, you've asked other people, you've involved others, you've made others aware, could be others who are more appropriately in lined deal with this and you've raised concerns. The next thing is contact the theater team and ask them to prevent the trainee from operating. I think in the rationale for this, it describes, it was quite a dramatic response and it is, you don't go off to a theater team, you know, and barge in the theater and said, don't let him do the operation. There were better ways of dealing with this. You spoke to the consultant, you spoke to the person, you spoke to other people in your team, you didn't run off to theater and get them to stop the operation. And A is last because he suggested specialty training, he looks too tired to operate. You don't think he looks too tired to operate. You think he looks unkempt and you think he's been drinking alcohol thinking he looks too tired off with skirts around the actual and doesn't deal with it. Okay? You not addressing the issue here at all, but then he looks too tired. He doesn't look too tired. You think he smelled of alcohol? That is not the issue? The question did not say you think you're special journey looks a little bit tired today says you think that he has been drinking alcohol, you notice the smell of alcohol. So it's a tricky scenario to get your head around. So this is the option in which this is time critical and he's due to operate in one hour. You have one or two D with this. I think in the other scenario, if like someone turns up to award, do you think they were out at a party last night and they still appear drunk, brisk, still smell of alcohol, something like this and that one isn't a time critical. It's like you tell them they should go home. It's sort of the gist of that question because they're not about to operate on someone in the next door, which is like on the wards of not doing anything and you tell them you should go home. It's the gist of that answer. And that's the difference between the two is that there's a real issue of time and patient safety like immediate patient safety in this one. Whereas in the other one, it's not just as immediate, okay. So it took me a while to sort of get my head around this and the other alcohol question in the other paper about why these answers were slightly different. So in this one, I know it might seem better that a you speak to the person that you shouldn't operate issues under the insulin of alcohol is should be the first answer. But you remember you're an F one, it is a consultant. This is under consultant, remits not the new F one on award to go in and do all this. You know, that's not your responsibility. You have a consultant today with this again, the patient is under the consultant and the red, it's actually training is working under the consultant. All of this is going to fall on them ultimately. So you tell the consultant of this immediately and it's up to them today with that. Okay. I'm sure this one has generated questions. Stay all day, this thing, it's really annoying, steady because you can argue which one's right and which one should be first and that should be the next one. That's always going to be the case when you're going through this. But you don't quite agree with what's on the page and you just need to accept that fact because you will not agree with all of these. You just go straight and you get your way of thinking to match how this exam works. Yeah. And just to back that up, Doctor Bradley, just to reiterate all the questions that, that Doctor Bradley has taken here are from the U K F P O passed papers. Um And the answer's also from what their guidance is. So the answers are the way they are. And unfortunately there's nothing that the Doctor Bradley or our team can do about any other. No, I did not say the questions. I'm afraid I'm not that mean. Know. So it is a case of kind of biting, biting the bullet and, and accepting what they believe goes on in real life. Even though as you say, Doctor Bradley, in your experience, it maybe doesn't like it's not, there's loads of things about, you know, unless there's an emergency, you leave, bang on time, that is not really worth at all. But in the land of SGOT, unless there is an emergency, you leave, work on time and created. That is not the case, uh is a, a more nonconfrontational way of achieving a I can see why you think that but it's all in like you needed to take a sentence of the whole and really read the whole thing. You suggest that he looks too tired to operate, he doesn't look too tired to operate. He smells of alcohol. They're two very different things. You have just made up something else because you don't want to like deal with the issue and that's why it's the last right answer because it doesn't deal with the question at all. Okay. You're suggesting maybe he looks a bit too tired operate. It's not. No, I think you're under the influence of alcohol and you should not operate. It's, oh, maybe you need a hand. You look tired, you've not dealt with a question at all. And what situation would you raise a concern with someone directly in comparison to telling the consultant first when it's under such time pressure usually? Okay. So that's the really important detail in this question that this, what is it a and I thought it was being judgmental and the reg is due to operate in one hour time critical deal with a consultant. If it's something less time pressured, you go to the person first usually. Okay. Why is he ahead of me? Because so e is ahead of be because you've gone to the person directly rather than going to a whole team and made this a bigger issue. So speaking to the person directly usually is your higher end of answers. Okay. But the reason that the consultant Trump's e in this one is because of the time sensitivity of it. Okay? And it's a really serious, it's a potentially very, very serious scenario. Consultant needs to know when the consultant will deal with us. That's their job. The next thing next, best thing you're going to do is speak to the trainee specifically been saying you should not operate if you're under the influence of alcohol. Okay, that's why he is head of be good and be it doesn't say you've gone to more consultant for the consultant, you've gone to team members, you've now spread this information out amongst a lot of people when it's better to deal with things directly first. So dealing with one consultant, you can call that direct and appropriate because consultant is above everyone in the team, then you go to the person, then you go to team because you're not quite sure what else to do. Okay would be be considered as gossiping about your senior colleague has the potential to Yeah, although when your chicken see any OAB is going to be your next best because the patient safety is the utmost important thing here. Okay. If you went straight to be, you know, why didn't you speak to a consultant? Why don't you speak to the person? Why did you go straight to a team of however many people and tell loads of people you're more direct in see and the first uh if it's time critical and they are operating within an hour, I wouldn't ask the other team members delayed dealing with the issue, wouldn't they be attempt to do with? At least I can see where you're coming from. And unfortunately, this is the answer that is given for it. Um Again, so if you're going to team members, going to the consultant is no longer an option, you've taken away, going direct, not an option anymore, you've taken it away. Team members are likely going to be more senior than you again because you're the f one remember. So, it's more appropriate for anyone more, you know, the more senior you go is the most appropriate to date with this but others, and it involves others that makes things happen and that's why it sort of lands where it does contact in the theater team isn't the surgical team. Okay. So, theater team is like your theater staff, you work in theater and that's a theater nurses and like porters and all the people who are in theater. I'm never in theater. I don't know exactly who always there, but there's a theater team and there's a surgical team. Okay? They are separate. The surgical team is the consultant surgeon, the red who's training to be a surgeon, the anesthetist. Um were there four grade point of God whether they ask that question because I can't answer it. So there's the surgical medical team. Okay. Your consultants, your training is your foundation. If you're looking up again, the theatre, this foundation doctor, that is the team that this is talking about. The theater team is separate. Okay. Right. We're done with questions and actually going through examples, there's loads of them for you to go for you to go through. Okay. They're all, they're use the official paper. If you don't want to spend any money on doing courses, that really isn't an issue at all. If the only thing you do is go through all the official papers. Perfect. And if you really spend time on them, that genuinely is enough to get you through and get you through. Well, okay, so you have the resources there, you have the papers and you have the answers and then you have the person do one which is separate without answers. But that takes you through the screen and the logistics on the timing. Okay. Everything that is there is enough to get you through if you spend the time on it and you go through the rationale and like really go through it with a fine tooth comb and get your head into thinking how it works. So we kind of talked to this earlier away, but when I was finding all minutes from before. So alcohol as we've just done in this question is usually a big issue. Leaving on time is a big issue. You leave on time unless it's an emergency. Okay. Patient safety, massive issue, confidentiality that will come up time and time again. It'll be questions something along the lines of, oh, like the patient's wife wants to know and in your head you kind of like, oh yeah, this is whatever, like I'll tell you whatever you need to know. You can't, you don't have the patient's consent to share this yet. You always need to protect patient confidentiality. Appropriate handovers are quite an important discussion in this. So there's questions that will be how their hand over appropriately and the best handover is in person to the person you're meant to hand over too. So sometimes there's instances where that person isn't there. You need to hand over to someone else will hand it over to them. You know, you're going through people and it loses its strength as an answer. You never hand over by a message via whatsapp by a, a piece of paper left the lien on the ground with patient details on them because that becomes a confidentiality issue. Okay. Finding out information first typically is a really good way to approach an answer, gather information first before you act on impulse unless it's a really serious time sensitive thing. Okay, encourage others to go to their own supervisor for help. That comes up quite a few times and questions. So that typically presents itself more as a question of your fellow f one, your friend on the ward, blah, blah, blah, struggling and you want to help them. And the best thing you can often do and will be in the answer somewhere is encourage them to go to their own supervisor for help. So you encouraging your friend or colleague to go to their supervisor. Great after is better than you go into their supervisor, which is a really weird thing to do. You go into your supervisor, really weird thing to do. The best way you can approach it is to get the person who has the issue to go to their supervisor and you can offer things like I'll come with you if you want, I can like, help you prepare for that meeting. But as long as you're getting them to go to that meeting by themselves or themselves to their supervisor, that's the best. First thing you can do. Tips and resources start early. So you started, you started tonight. So things like having your day at a time where you're doing it. I'm pretty sure they're all baked now. It was starting to some final years that we have on treatment there. But better. So I'm hoping that was a bit more straightforward than it has been in the past. You know, I know how the exam works because you have listened to me ramble on for two hours. You have three sections, you have different scores, you have different types of questions, different marking. This is where you get, you lay the groundwork. Now you understand how everything works and then you build on that and you do better for it. But if your timing on your exam technique, so things that we've gone through tonight to our exam technique fact is the time you don't have to practice the time every single time. But as long as you've given it a good few goes to time, you will be okay. Time was an issue for me. I left with a little bit of time left, I think um I didn't feel like I rushed through, had time to go to the bathroom and wasn't, you know, like running and running back in a panic. I was quite like, you know, I'm actually gonna have a break in the bathroom for a couple of minutes, take a breather, then go back to it and like time wasn't an issue at all. But practice, don't just go into thinking that's absolutely practice the time and be comfortable going in. Ok. Spaced repetition. So I have the dates on my templates which I can't see anymore of like when I would do them. So you seemed like I was doing them 10 to 12 days apart and that was enough time for things to sort of fall out of my mind, but enough time to, you know, that I was still thinking when I answered the questions. Okay. So no, it is not an exam of clinical knowledge doesn't mean you can't go in quite some preparation. So questions aren't going to ask you about what medication should this person be on? What do you think the diagnosis is? What is the treatment for X? It is. How do you deal with this scenarios around a situational judgment? Okay. Not a clinical exam. All right. So this is the end of my slides. Finally, I'm sure you're all glad to know, but I imagine there might be some questions. So I've sort of said this before about advising courses. I did quite a few. I overdid it to be honest. Um So to recommend one, it would be America but you do pay for it. You don't need to pay for anything to study for this, doing all the official papers. Genuinely. I promise you is enough. Okay, Google youtube E medical sgot. He has like at least a one hour video on SGLT preparation, which is really good and it's just on youtube and a lot of what I've said cause I really took everything he said, of course on board. Uh Tim, I know we had a couple of questions that were sort of pre submitted. Yeah, so there were a few people who had just asked just three short questions that were in the registration form. Um So a few tips on time management for during the test, but I imagine we've kind of covered a lot of that through your, the amount of time to spend in each question and picking up time with, you know, the questions section, you're rating section, you will pick up time. So I imagine you've got your stem your, you know your question, the scenario and you've maybe eight responses related to for those eighth. It says on this, you know, you have a minute and 42 seconds. You don't need a minute and 42 for each of those. That's where you'll probably pick up a lot of your time and you'll spend more time, most of your time going through these ones really okay. Time isn't an issue. Keep an eye on time, practice the time, but overall you do have enough time to do this without panicking. Okay. Brilliant. Um, and also then just about how to tackle escalation questions. So, you know, the order of speaking to your regimen Sulten versus, you know, a member team, a different profession. Yeah, the best thing usually is to your, like, immediate senior. Pretty much is the next best person to go to. Um You would usually go through all of your came before you go to someone from a different team. Largely. I'm sure there's questions on it as you go through them all. I'm trying to think uh sorry in the questions that I had done, it was usually as you say your immediate senior and then depending on the context of the question it was then um after that, either the person above that. So like rage first then make tend to your consultant or someone who's ward based and easily accessible. So with like drug doses and stuff, I've done a few questions where it was like um a patient has been given a dose that you're not familiar with but you know that it can be used to double this dose. What do you do? Um And I think somewhere quite near the top of that question was asking the word based pharmacist. Yeah, that sounds like a really from memory and from trying to apply my own principles that I'm talking about pharmacist is not a bad answer. A lot of the time. Um In real life, the word pharmacists for amusing would all be lost without them. Um But yeah, no one went to involve. The pharmacist is a good one. There are questions on it. Like I said, you just need to go through the rationale and like pick out it does explain why each answer is each answer. You may not agree with it, but the explanation is there and I'm afraid you just have to go with it and get into their way of thinking honestly. As soon as this is done, you don't need to think, I guess JT land anymore, you know. Yeah. Yeah. Um and then uh Doc Bradley's lots of, lots of thank you's coming through. Someone had asked in the middle of that to just repeat the name of the youtube course you mentioned. Yeah, let's see. I wonder if it's worth me sharing my screen. Well, if you let me know if this is working. So can you see me on Google? Uh No, if you just, if you go back in to share your screen and go to window, it'll, it should let you um just do that and just pick whatever. Yep. There we go. That's what okay. Oh, it's taken me to my revisions. I left apologies. This is what I listen to Brian noise to draw night. Like getting an insight, insight into your day to day. There just how do I just get on but it's starting to play. I apologize. I'm not very tech. Okay. We're not, we're not getting it. You're all good. It's just me. That's actually quite nice. I would recommend. Uh sorry, my internet's not fast this here. Yeah, there's a lot of calm mind. Brown noise gently. You can see what I like to go with here. Uh This guy here, superstar, like I have really signed up to his website and course for MSRA practice and questions. And like, so I have to reiterate nothing outside of the U K F P O papers are endorsed by them for SGOT. Like absolutely nothing is if I was to recommend something, I would recommend this guy, if you're going to stand on anything, I would go here. Okay. But this is an hour and yeah, so this guy is gripped. Um This video is over an hour long, honestly watch this before you pay for anything because he sort of talk through a lot of what I have talked to and like what to look for in a question and how to approach it and how it's marked. You might copyright me at some stage, never know. Um get me for it. Uh But the full day you can pay for like a weekend course room like a Saturday, Sunday or something. Um Like one day is all about clinical questions and one day at all or no, was it a two day course, I can't remember, but there was definitely at least a one or a two day of Saturday's on there like all day on a course with him online and it's the same stuff that's in this video here, but with loads of questions and okay, so you're paying for him taking you through the questions. There's a lot of information in this video alone that is probably enough to get you through. Okay if you Google. Um let's see. So that's yet. Okay. Google about 100 times today. Have you giggle out taking a foundation program until these questions? Practice papers. Okay. So this is the new one which has the racing section with answers, which is I cannot express her lucky. This group is to have that I did that section blind without any previous year doing them or having any answers, any practice questions to go off. Okay, then practice paper one and paper to answers and answers. Okay. So and there is a link somewhere around here to a Pearson Vue when I'm pretty sure it'll be somewhere like this paper one there. Yeah, but is there right? Honestly, that's all you need. If you're if you don't want to spend money and you shouldn't have to spend money to do this. If you are, I would recommend the Medica. Nothing is recommended by the foundation program. However, you need to always remember that everything on this page alone is absolutely enough to get you through this, if you put the time and the effort into the resources that are on this website. Perfect. Um So folks, I'm conscious of, of time, but all any, any of the remaining questions that I've had a quick scroll through, answers to them are they're, they've all been answered earlier in the talk and the recording will be available. Um So just if you scroll back through, you'll be able to find that. Um Folks, I think we will wrap it up there. I just want to say a massive thank you to Doctor Bradley for taking us through that session. Again, I found that incredibly useful. Um I have my S A T coming up like many other people on the call. Um And that was beyond useful. I've been making notes, here's have been going on bits and pieces to look up, look out for and ways to approach questions. So thank you so much for taking your time um to do this again. It's really, really appreciate. And I think by all the messages coming into the chart there, you can see how appreciated it actually is. Thank you very much. Do I need to ask if there's a feedback available through metal? That would be very much appreciated just like, but that's important Giulio show some good things by all means grateful. Thank you. It's a two way street. So I'm just going to post feedback form and now folks, what I would ask you to do. I have structured the feedback back form in such a way that there's specific feedback for Doctor Bradley in light of the fact that she's taking her time out to do this for us. Um and it is useful for her portfolio as well. So if you can please give some detailed written feedback in the free answer questions that then we can send across the Doctor Bradley, really appreciate you doing that. Um So the form is in there now, hopefully you can just click that link um and it'll generate uh attendance certificate at the end as well. So with that, I think we're happy enough to end it there. As I say, there will be a recording of this session will go up on the event page and we'll stay there for the foreseeable future. So if you have any unanswered questions or you missed bits and Bobs along the way, you can go back and find out what the answers were from before and for anybody who join. Sorry, go ahead. Uh I just, there's a summary thing I mentioned somewhere in the middle. I'll send that to you that you'll be able to send out to every brilliant imagine as well. Yeah, so that that document that Doctor Bradley's talking about will also be posted on this event page as catch up content. So you'll be able to access that there and both the recording and that document will have their own feedback forms attached so you can give feedback on those bits and bulbs as well. All right. So thanks very much everybody for joining. I know that was a long stint, but I hope you agree with me and that it was more than useful. Um And I'll hopefully stand you in. Good stead to sus JT. So take care and thanks again. Yeah. Good luck, everybody.