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Exam Composition
Practical Exam Physical Exam History Taking History Presentation Case Write-up
Written Exam
Physical Exam
General Principles
The patients are SPs Grading is performed by SPs and faculty proctors Targeted, but complete physical exam Expectation is NOT to elicit abnormalities No checklists, notes, or aides allowed Required equipment will be posted on CCA website
Musculoskeletal
Split into two components (A & B) During the exam you will perform only either A or B, but are responsible for content of both Musculoskeletal A Hands Wrists Elbows Shoulders Spine (cervical) Musculoskeletal B Hips Knees Ankle/Foot Spine (thoracolumbar)
M2 CCA Website
History Taking
History Taking
General Principles History of Present Illness focusing on key elements that lead to the visit and to address the patients specific concern(s) Assessment of relevant risk factors based on the problem(s) identified Exploration of other relevant history based on understanding of problem(s) Knowing the patients PMH, Meds, Allergies Exploration of relevant family and social history Application of targeted and relevant review of systems to include, exclude other relevant diagnoses
History Taking Station Notes Goal is to elicit a focused, but complete history based on patients chief complaint Patients are standardized Communication skills will be assessed as a component of the history taking sessions Content of interview drawn from CFM curriculum and CEP experiences Time allocation is up to the student
Standard templates and ROS sheets will be provided at each station; no other notes may be used
History Presentation
History presentation will occur as part of the an integrated station lasting 45 minutes during which students perform a history, targeted physical exam, and verbal presentation in sequence During the station block students are expected to: Organize a verbal presentation Present his/her observations to a faculty physician/observer
Notes may be taken during history taking station and you may use these notes to present to the faculty/observer
Exam Format
BLOCK 1: 50 minutes History Taking Abdominal Exam Verbal presentation BLOCK 2: 50 minutes History Taking Cardiac Exam Pulmonary Exam Case Write-Up BLOCK 3: 50 minutes Neurology Exam Musculoskeletal Exam
Groups rotate between sections every 50 minutes. Blocks 1 and 2 are integrated stations following the sequence of History Physical Exam Presentation or Case Write-Up.
Written Exam
Exam Composition
Written examination Closed-book, web-based exam Approximately 120-140 questions covering principles of physical exam and basic pathophysiology Topic areas include: abdominal, cardiac, musculoskeletal, neurologic, pulmonary, ENT, ophthalmology Content from exam covered in CFM lectures, course syllabus, exam checklists Administered during CCA exam weekend
Note: You may take the written examination either before or after the clinical portion of the CCA
Example Question #1
Which of the following is the ideal order in which to perform the abdominal exam? a. b. c. d. Auscultation, inspection, percussion, palpation Inspection, auscultation, percussion, palpation Inspection, palpation, auscultation, percussion Inspection, palpation, percussion, auscultation
Example Question #2
A 17-year-old football player is seen in clinic for his sports physical. Initial blood pressure is 160/90 with a pulse of 68 and repeat blood pressure measurement in the exam room is 170/84 with a pulse of 65. Previous blood pressure measurements have been normal and he is otherwise healthy and asymptomatic. The most likely explanation for this finding is: a. Development of essential hypertension b. He ate a Super size meal at McDonalds just prior to the visit c. He is nervous he may be withdrawn from practice d. Use of a cuff that is too small for the patient
Exam Logistics
Exam Dates
Clinical Exam Friday, February 2, 2013 Saturday, February 2, 2013 Monday, February 4, 2013 Tuesday, February 5, 2013
Make-Up Exam
Wednesday, March 13, 2013 (tentative) Written Exam The M2 CCA Written Exam opens on Thursday, January 31, 2013 at 8:00 a.m. through Wednesday, February 6, 2013 at 12:00 a.m. (24h, midnight). Sign up for the exam will open following the holiday break
Make-Up Exam
Make Up Exam Wednesday, March 13, 2013 Remediation Tentatively scheduled between March 1 through March 8, 2013
Note: Students who are unable to take the exam during February must obtain approval to take the exam on March 13 from the M2 CCA Committee and Director
Contact Information
Michael Lukela, MD Director, M2 CCA E-mail: mlukela@umich.edu Amy Page Lead Administrator, M2 CCA E-mail: amypage@umich.edu