Documente Academic
Documente Profesional
Documente Cultură
Contributions by:
Tan Hwee Leong, Kwek Lee Koon, Liu Xuandao, Vivian Lee, Deborah Khoo, Chue Koy Min, Michael Lim, Sophia Tan, Bryan Buan,
Joel Arun
Note: Format of assessment may be different this year (AY2013/14), please check during your respective postings
Do also take this advice with a pinch of salt experiences and study methods differ greatly :)
General
Time to explore sub-specs that you may be interested in
M4 is a lot more about learning investigations, practical skills and management. The scope is narrower in terms of
approaches, but you are expected to learn certain practical skills in each posting - it would be wise to make learning
them the top priority. It is possible to learn subjects completely in terms of medical student level (unlike IM), so with
the right books things should go well."
Topics covered are real REAL ones that will be encountered with patients next time
No real fixed textbooks for a lot of topics depends on preference
Time for you to revise for final MBBS
Reflect on priorities in life or simply relax
EOPT not as difficult to study for
Doctors treat you like tourists rather than their future HOs
Eat good food and send your friends postcards
In decreasing order of free time: Psych > Anaes > Patho > Eye > ENT > Emed = O&G
Recommended readings: Toronto for all specialties, See individual postings for specific books.
Anaesthesia 2 weeks
What comprises
the posting?
How should I
study for EOPT?
Format of assessment:
1) MCQs & OSSEs combined with EMED
- May be quite factual (eg. interpreting capnographs)
2) OSCEs
- Tend to be repeated
Note: They tend to shuffle the sequence of questions for different test papers so people cant memorise it
How to study:
Department lectures notes
Recommended books
Read broadly (because only comprises MCQs)
Past year EOPTs
It is vital to revise your cardiovascular and respiratory physiology from year 1. I personally like
costanzo, its short and sweet. Most of the mcqs and questions you'll be pimped on have a
physiological basis.
Memorise your ASA scoring, different types of ETTs, and face masks.
What should I
Be consistent
take note of
during the
posting?
Freedom to decide which shift you want to do, fair bit of time to play around with
How should I
study for EOPT?
TTSH posting: Schedule your shifts properly and you may potentially have a few free days in the
second week!
Format of assessment
1) MCQ
- Tend to test esoteric facts
- Another senior said: Almost 100% repeated from past years
2) OSSE
- TTSH had practice slides which were useful
- Theres an OSSE book by Dr Phua Dong Haur (she thinks)
3) OSCE
- Like a condensed internal medicine station
- History, PE, diagnosis, investigations, read ECG
How to study:
Learn the important life threatening causes that must be ruled out (e.g. abdo pain in old man AAA,
6 life threatening causes of hest pain), how to read ABG and CXR/AXR
Black Book
o Not everything there is important though, so it is best to find out on shifts what is
important.
o Although a lot of people take issue with the way they organise chapters (by
alphabetical order) and some of the management algorithms are out of date.
Practice past year EOPT, usually repeated
Study by approaches, questions are quite clinical based
you should find slides resources on your class dropbox or passed down from seniors, cos theres a
very large slides component in the EOPT.
What should I
take note of
during the
posting?
Do your shifts
P1: resuscitation; P2: critical care; P3: everything else
o P1 is usually the most exciting and fast paced setting. You will be expected to help
actively in setting plugs (green, usually), CPR and whatever else there is to do in ATLS /
ACLS.
o P2 is where you can practise your history taking and physical examinations. Take the
initiative to start clerking patients that have just been wheeled in, you can then present
to the MO. You can also start setting the plugs and drawing the bloods, check with your
hospital what are the standard bloods to take, or you just take all 4 tubes to be safe
(+/- blood c/s if theyre febrile).
Follow the cons that let you do stuff (most will but some let you be VERY independent)
Try to clerk cases and present to tutors.
EMed physicians value summarising as a very vital skill
really helpful for overall clinical acumen if you practice the whole process from hx taking to
management, and the more you do it and present to your tutor, the better you'll get.
actually mentally calculate GCS, and ramp up your neuro examinations at twice the speed.
Take the opportunity to do procedures and practice clerking undifferentiated patients
Some opportunities to do some suturing/ help with manipulation and reduction
Serves as revision for GS and IM
No better time to practice blood taking and plug setting, intubation, catheter
Known how to identify what is an emergency and how to handle them
Study from black book, do lots of past year questions
Use your time well
Psychiatry 6 weeks
What comprises
the posting?
Lectures
IMH posting
- Focus: Psychotic disorders and addiction
- Ward rounds were not very useful but eye-opening in terms of severity of disease
- No attendance taking
- Difficult to clerk patients on your own for write up but you can try to experience confusion.
Clarify using case notes.
- Addiction ward rounds are good
- The 2/52 posting at IMH is pretty chill, ward rounds are conducted like interviews, where the
team doctors wait in an interview room as the nurses bring the patients in one by one. The type
of patients youll see depends on the type of ward youre in, though, so you might be limited in
that aspect. After the morning rounds, theres usually not much else to be done. If you want to
clerk patients that your tutor has identified during the rounds, youll have to ask the nurses for
help in taking them out of the ward and into a separate interview room (much like rounds
themselves). If you were thinking of leaving early, though, the school has pre-empted that by
scheduling tutorials in the afternoons, and attendance will be marked.
-
SGH posting: Very exam oriented, get to do a lot of MCQs, sit in a lot of interesting clinics. Dr Ng BY is
a dedicated tutor who will monitor your attendance in a non-threatening manner
Will have to submit writeup and CEX, can do in either hospitals but IMH is relatively more chill, quite
good to get it done there
Recognise psych conditions and their behaviour, develop skills to deal with difficult patients, learn
about the drugs and their side effects as these are important when you are the HO on call
Quite a lot of things scheduled but days dont end too late
Good amount of time to study
Ends by latest 4 pm everyday. There are good days where you end much earlier
How should I
study for EOPT?
What should I
take note of
during the
posting?
Ophthalmology 2 weeks
What comprises
Lectures, Clinics, OT
the posting?
Predominantly in the clinic, take this as an in depth study of the eye component of cranial nerves
examination
Make sure to clarify confusing parts of neuro ophthalmo before you leave
What should I
take note of
during the
posting?
ENT 2 weeks
What comprises
the posting?
Clinics useful to see a variety of cases and to practice fundoscopy (half of the batch will get it in
OSCE practise as much as you can during eye posting)
Fundoscopy!
Get tutors to go through OSSE with plenty of pictures
Lectures, clinics, OT
Clinics most of the time. Specialty spans: ear, nose, throat, oral cavity, upper esophagus, neck
Learn PEs and practice with CG mates early
Top 10 in batch will participate in prestigious ENT quiz at the end of the year!
NUH, CGH: Attachment to hearing test nursing stations, attendance everywhere you go. Try to
rotate around different clinics if you start to see repeat cases of one anatomic region.
Format of assessment:
1) 6 OSSE slides with questions covering important conditions and approaches
What should I
take note of
during the
posting?
Lecture notes and blue book given by department supplemented by Toronto notes to organize
thoughts = sufficient
Other recommended reading: Essential ENT by Corbridge
Clinic is useful to see cases and examine patients
Practice otoscopy well half of batch will get in OSCE + you'll have to do it on own patients next
time
Learn to read hearing test results
Keep practising PEs in videos that NUH uploads for CEXes
A LOT
Lectures end around 4, Forensic patho around 3+
How should I
study for EOPT?
What should I
take note of
during the
posting?
Format of assessment:
1) 3 OSSE slides with questions
- Impossible to predict what will come out
o Each batch rotating through postings will go through histo of different systems so no
real way to prepare for this part of EOPT
How to study:
Pay attention to lectures
Forensic patho will not appear but will feature in 1 MEQ for pros (study CTS notes)
o do double check with your coordinator whether its the same for you guys.
Recommended reading: posting notes
Just try your best with transcripts of the lectures, not just from your own cycle, but previous cycles
How should I
study for
EOPT?
Depending on how intense you are in wards, clinics and labour wards\
I cant really remember, PTSD does that to you.
KKH: Clinics may end around 5, otherwise should have time to study
Format of assessment:
1) MCQ
- Quite factual
2) 6 OSSE slides
How to study
Lecture notes are really useful to complement textbook, so be sure to cover them all
Textbook: Choice between Hacker and Moore and 10 teachers
- Hacker: More content, cheaper than 10 teachers
- 10 Teachers: Need to get 2 separate books
A lot of people use Chin yees notes, useful for introduction and revision, covers main points for
major conditions
Toronto notes are useful
A lot of management questions are asked which are SG-specific so need to know practice in
Singapore also. Most of the lecture notes will mention and Chinyee's will mention some
Practice OSSE very clinical based, focus on management and investigation
Learn important life-threatening differentials
What should I
take note of
during the
posting?
Professional Examinations
General tips:
Be consistent
Learn as much as you can during postings
Stuff that you leave out during EOPT might come back to haunt you during pros
Revise core content (except patho which wont feature except forensic patho)
Do past year papers!
Last years format:
120 MCQs, 9 MEQs, 9 OSCEs
MCQ, MEQ done on a computer
o MEQs: Computerized so you can only spend a certain amount of time on one part of each question and
cannot go back to previous qns to change your answers. Essentially you will find out if your answer is
wrong when you go to the next part of the same question
o MCQs: Heavily features O&G, Emed, Anaesthesia
OSCE: Notes complied by seniors with standard approaches. Pay attention to how clinicians approach their patients
including professional conduct, words and phrases to reassure patients or emphasize a point. These skills are useful
in real life.
Speciality specific OSCE stations
1. Obstetrics &
2 stations
Gynaecology
Require good understanding
Range from history to management
Try quizzing each other before hand
May be given pelvic model so know how to do a proper VE and papsmear
Pros will have a papsmear station and counseling station very important for O&G
A lot of counseling may want to come up with a script
Once again, the pelvic trainer is available during the study period for booking. They may even
ask you to perform an episiotomy repair, thats a separate trainer from the regular pelvic
trainer. So make sure you pay attention during the posting. Or just watch youtube videos to get
up to speed.
2. Psychiatry
2 stations
Usually history to establish diagnosis, counseling to communicate a diagnosis or treatment, or
task station (eg. simple relaxation exercises)
EOPT will help prepare you
Roger Ho OSCEs
Practice lots
Trick Cyclist is pretty useful
3. Emergency
Medicine
2 stations
Can test anything under the sun
Like IM
Usually history and PE and investigation and management
1 ECG usually (so attend Prof Sureshs lecture and learn ECG well)
o make sure your ECG reading skills are up to scratch, they tested ECG for both OSCE
days for our batch.
1 station (Eye on 1 day, ENT on the other day, so you will get either one depending on your luck)
o so if youre on day 2 of the OSCEs, youll know for sure which model youre getting.
Testing fundoscopy or otoscopy
Fundoscopy done on mannequin, this is also done during posting, may request from
department nearer pros to practice
o bad news is that the glass eye reflects light in the temporal retina, so its quite a lot
harder than an actual eye. The good news is that the glass eye doesnt blink.
Find slides of eye pathologies and learn what each thing looks like
Otoscopy mannequin was never revealed until pros which stunned half the batch, so google it
and make sure you know what it looks like
o even for ENT they managed to come up with a model of the ear with an LED display of
the middle ear that can change images
o better news is that the ENT ear canal is so huge you barely have to put an otoscope in
to see the image.
Otoscopy slides unexpected, hence they all died
5. Anaesthesia
6. Pathology
1 station
Usually pre-op assessment (commonly airway assessment) & task (bag and mask, intubation,
larngyneal mask insertion pay attention during simulation in posting, may also request for
practice sessions in simulation room nearing pros)
Bag and mask!
Make sure you know your ABCs very well, as well as NUMBERS. They like to test things like sizing
the various equipment, methods of O2 delivery etc. etc.
The best news is that patho isn't in the OSCEs