10-22-2005, 05:12 PM
Dr. Norwalk,
Please try to understand the concept of this exam.
In no way shape or form are you being asked to come up with a diagnosis! As strange as this may sound, that will mean that you are practising medicine without a license, the same reason that you are not being asked to come up with the treatment plan.
All the examiners want from you is this;
Based on the facts that your SP will give you, and the physical exams that you will
performe, the pt. "could" have any of the following..........list your differentials, and not
"your diagnosis", otherwise they will would have said for you to state your diagnosis, and your differentials.
When you do the closing, after your PE, you are to inform your SP about your findings ( in counselling), and it is always ideal to say;
"Mr Fulano, or XYZ based on the symptoms that you gave me, I will recommend that we
proceed and do the lab work, then we can sit down with the result and discuss your diagnosis. The lab work will confirm my doubt. But your diagnosis will be any of a few illnesses" Or "It sounds like you are experiencing abcd, however we can not be sure until the lab result comes back".
Do not give a diagnosis. Even in real life here in the US, you do not give an outright diagnosis without the backup of the lab. This is to "CYA"- (Cover Your Ass) should in case that you are wrong. This way you do not open yourself to an impending litigation from the emotional distress that your wrong diagnosis "may" cause the pt. The pt's lawyer at that time, God forbid it will ask you "when you gave my client the diagnosis, did you have a the lab result in hand?" A question anyone on this forum will never want to answer.
I am sure that you are quite comfortable with your knowledge of pathology, however your knowledge of political correctness, and along with pathology are what really need to be acertained by these examiners. This also an exam of smartness, and not only of intelligence.
It is no time to show off. After wards ywhen you have passed, you can debate all you want.
Good luck, and keep it simple.
Please try to understand the concept of this exam.
In no way shape or form are you being asked to come up with a diagnosis! As strange as this may sound, that will mean that you are practising medicine without a license, the same reason that you are not being asked to come up with the treatment plan.
All the examiners want from you is this;
Based on the facts that your SP will give you, and the physical exams that you will
performe, the pt. "could" have any of the following..........list your differentials, and not
"your diagnosis", otherwise they will would have said for you to state your diagnosis, and your differentials.
When you do the closing, after your PE, you are to inform your SP about your findings ( in counselling), and it is always ideal to say;
"Mr Fulano, or XYZ based on the symptoms that you gave me, I will recommend that we
proceed and do the lab work, then we can sit down with the result and discuss your diagnosis. The lab work will confirm my doubt. But your diagnosis will be any of a few illnesses" Or "It sounds like you are experiencing abcd, however we can not be sure until the lab result comes back".
Do not give a diagnosis. Even in real life here in the US, you do not give an outright diagnosis without the backup of the lab. This is to "CYA"- (Cover Your Ass) should in case that you are wrong. This way you do not open yourself to an impending litigation from the emotional distress that your wrong diagnosis "may" cause the pt. The pt's lawyer at that time, God forbid it will ask you "when you gave my client the diagnosis, did you have a the lab result in hand?" A question anyone on this forum will never want to answer.
I am sure that you are quite comfortable with your knowledge of pathology, however your knowledge of political correctness, and along with pathology are what really need to be acertained by these examiners. This also an exam of smartness, and not only of intelligence.
It is no time to show off. After wards ywhen you have passed, you can debate all you want.
Good luck, and keep it simple.