OSCEs for MRCOG Part 2
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OSCEs for MRCOG Part 2
A self-assessment guide
Antony Hollingworth
Consultant in Obstetrics & Gynaecology, Whipps Cross University Hospital Trust; and Honorary Senior Lecturer at Queen Mary and Westfield College, London, UK
Janice Rymer
Professor in Obstetrics & Gynaecology at Guy’s & St Thomas’ NHS
Foundation Trust, London; and Senior Lecturer at Guy’s, King’s and St Thomas’ School of Medicine, London, UK
Hodder Arnold
A M E M B E R O F T H E H O D D E R H E A D L I N E G R O U P
First published in Great Britain in 2005 by
Hodder Education, a member of the Hodder Headline Group, 338 Euston Road, London NW1 3BH
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© 2005 Antony Hollingworth and Janice Rymer
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British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record for this book is available from the Library of Congress ISBN-10
0 340 814950
ISBN-13
978 0 340 814 950
1 2 3 4 5 6 7 8 9 10
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Dedication
This book is dedicated to our support systems: Ann, Roger, Victoria, Chloe and Adam This page intentionally left blank
Contents
Dedication
v
Foreword by Roger Baldwin
ix
Preface
x
Acknowledgements
xi
Abbreviations
xii
Introduction
1
Review Stations
5
1
Gynaecology history
6
2
Early pregnancy problem – management
11
3
Prioritization on delivery suite
16
4
Surgical skills – placenta praevia
21
5
Communication skills – ectopic pregnancy
25
6
Premenstrual syndrome
29
7
Breaking bad news – anencephaly
35
8
Infertility – case notes
40
9
Audit
48
10
Obstetric history
52
Circuit A
58
1
Breaking bad news – cancer
59
2
Preoperative ward round
63
3
Obstetric history and management
67
4
Management problem – gynaecology
71
5
Prenatal counselling
75
6
Obstetric emergency – uterine inversion
79
7
Operating list – prioritization
82
8
Bereavement
87
9
Emergency contraception
91
10
Intermenstrual bleeding
95
Circuit B
99
1
Labour ward prioritization
100
2
Abdominal pain – premature labour
105
3
Urinary incontinence
109
4
Urinary incontinence viva
113
vii
CONTENTS
5
Operative – Caesarean section
117
6
Abnormal smear
121
7
CTG abnormality
125
8
Down’s syndrome
129
9
Ectopic pregnancy – explain laparoscopy
133
10
Breech delivery
137
Circuit C
140
1
Vicar’s daughter – ethics
141
2
Shoulder dystocia
145
3
Breaking bad news – ovarian cancer
149
4
Uterine perforation
153
5
Postpartum haemorrhage – collapse
157
6
Air travel and pregnancy
161
7
Risk management
165
8
Twin pregnancy
169
9
Molar pregnancy – counselling
173
10
Results interpretation
176
Index
185
viii
Foreword
Achieving success in the MRCOG marks the beginning of joining a profession in which there must be continued professional development and learning. It is a hurdle to be conquered. Knowledge is not enough, technique is important.
The authors, Antony Hollingworth and Janice Rymer, are respected and experienced examiners used to setting marking schemes for the OSCE. This work will be an invaluable aid to study and self assessment. The scenarios used are all comparable to those met in the exam, and the properly prepared candidate would be well advised to consider using this book.
Roger Baldwin
ix
Preface
The examination for the membership for the Royal College of Obstetricians and Gynaecologists aims to set a standard of competent, safe practice for anyone pursuing a career in obstetrics and gynaecology. The oral part of the examination now consists of Objective Structured Clinical Examinations (OSCEs). We have both been past or current chairman of the RCOG OSCE Committee, and convenors of the RCOG and Whipps Cross Hospital MRCOG courses. We therefore have extensive experience in teaching and preparing candidates for this examination, and also in examining candidates. In this book we have tried to give comprehensive examples of the type of OSCEs that you may come across and advice on how to approach these stations and the common problems that we have seen candidates encounter.
Remember that the written part of the examination concentrates on your knowledge, and the OSCEs will assess your application of knowledge, and skills. In our specialty, communication skills are especially important and we would hope that by going through this book and practising the OSCEs stations you will be competent in all the skills that the Royal College of Obstetricians and Gynaecologists expect you to have. We hope that you find this book invaluable in your preparation for the examination and we wish you luck.