GWH Swindon 17/08/2015Phill Burgess MD FRCS

Intercollegiate Specialty Board Examination 17/08/2015Phill Burgess MD FRCS

“ and how long is a piece of string?” 17/08/2015Phill Burgess MD FRCS

Section 1 Paper 1: MCQ 2 Hours (single best answer) Paper 2: MCQ 2 1/2 Hours (extended matching items) 17/08/2015Phill Burgess MD FRCS

Section 1 MCQ Standard Setting Examiners sit and answer the two papers. Assess probability of a candidate answering each question correctly. Pass mark determined by total sum of probability scores divided by number of Examiners (Angoff Technique). 17/08/2015Phill Burgess MD FRCS

SBA Sample 1 A 27 year old woman presents with diarrhoea and weight loss. This is associated with abdominal distension after meals. What would be the best investigation? ABarium enema BBarium enema and follow through CCT scan DGastroscopy and biopsy of small bowel EGastroscopy and biopsy of stomach for helicobacter Sample 2 Laparoscopic donor nephrectomy is generally considered to be superior to open nephrectomy for which one of the following reasons? AReduced incidence of complications in the recipient operation BReduced intra-operative blood loss CReduced postoperative analgesic requirements DReduced warm ischaemia time EShorter operating time 17/08/2015Phill Burgess MD FRCS

SBA Sample 3 A 70 year old man develops hypotension and sweating with associated abdominal pain seven days post sigmoid colectomy. His temperature is 39°C and WCC 18x10 9 /L. What is the most likely diagnosis? AAcute pyelonephritis BAnastomotic leak CLeaking aortic aneurysm DMyocardial infarction EPulmonary embolus Sample 4 A 42 year old woman presents with a two day history of colicky upper abdominal pain radiating to the back. She has previously been well. On examination she is clinically jaundiced. There is no abdominal mass or tenderness. Ultrasound examination of her abdomen shows multiple stones in the gallbladder. Her bile duct is measured at 10 mm and her intra-hepatic ducts were dilated. What is the most likely diagnosis? ABile duct stones BBiliary dyskinesia CCarcinoma of the pancreas DChronic pancreatitis EPrimary sclerosing cholangitis 17/08/2015Phill Burgess MD FRCS

EMI Sample 1 OESOPHAGEAL PATHOLOGY AAchalasia BBarrett’s oesophagus CCandida oesophagitis DCongenital oesophageal stricture EEosinophilic oesophagitis FFibrotic stricture GMallory Weiss tear HOesophageal perforation IOesophageal varices JPlummer Vincent syndrome KPost cricoid web LReflux oesophagitis MSchatski ring NSquamous metaplasia OVascular compression of oesophagus For each of the scenarios below, choose the single most likely diagnosis from the list of options above. Each option may be used once, more than once or not at all. Is a cause of haematemesis following prolonged retching. A 55 year old woman with long standing rheumatic mitral valve regurgitation suddenly develops dysphagia for chicken pieces. An 80 year old spinster who lives alone develops dysphagia for some solids and is found to be anaemic. 17/08/2015Phill Burgess MD FRCS

EMI Sample 2 ABDOMINAL MASS AAppendix abscess BAppendix mass CCaecal tumour DDiverticular disease EEctopic pregnancy FFibroid (uterine) GHypernephroma HOvarian cyst IPancreatic tumour JSigmoid volvulus KTerminal ilial mass In each of the following scenarios, choose the most appropriate option from the list above. Each option may be used once, more than once or not at all. A 17 year old man has a five day history of lower abdominal pain, nausea and a temperature of 37.8°C. He is tender in the RIF and a mass is palpable. A 28 year old woman has a three day history of RIF pain. She is unable to lie flat. There if a vague mass in the RIF and she has a temperature of 37.2°C. A 57 year old woman is lethargic with a two month history of pain in the lower abdomen. She is pale and there is a palpable mass in the right lower abdomen. 17/08/2015Phill Burgess MD FRCS

Section 2 Clinical Component “consisting a series of carefully designed and structured interviews on clinical topics, some being scenario based (structured orals) and some being patient based” 17/08/2015Phill Burgess MD FRCS

Standard Day 1 Consultant 17/08/2015Phill Burgess MD FRCS

Section 2 Held over three days Clinical Examination (subspecialty) General Surgery/ Subspecialty Emergency surgery & Critical care Academic Viva 17/08/2015Phill Burgess MD FRCS

Section 2 Approach the clinical and the oral examinations as if you are a Consultant. You are not sitting the examination as a surgical registrar. The examiners are your “colleagues” with whom you are discussing cases 17/08/2015Phill Burgess MD FRCS

Intercollegiate Academic Viva Phillip Burgess 17/08/2015Phill Burgess MD FRCS

Introduction Two Papers to be discussed 30 minutes reading time per paper 17/08/2015Phill Burgess MD FRCS

Key Points The Journal The Authors/Institution 17/08/2015Phill Burgess MD FRCS

Key Points Aims of the study Type of Study :Observational? Blinded – Single? Double? Multicenter? 17/08/2015Phill Burgess MD FRCS

Key Points Methodology Statistical Analysis Sample size Power Calculation Variables Significance tests parametric non-parametric 17/08/2015Phill Burgess MD FRCS

Key Points Data Collection End points of study Exclusion criteria 17/08/2015Phill Burgess MD FRCS

Key Points Results of the Study Conclusions of the Study 17/08/2015Phill Burgess MD FRCS

Key Points Have the Aims of the study been addressed? Are the authors conclusions justified by the results? 17/08/2015Phill Burgess MD FRCS

Key Points What additional data is required to complete this study? 17/08/2015Phill Burgess MD FRCS

Final Assessment Will this study influence your clinical practice? Has this paper made any contribution to surgical knowledge 17/08/2015Phill Burgess MD FRCS

Final Assessment Give you opinion regarding the merits of the paper. 17/08/2015Phill Burgess MD FRCS

Typical Questions Type 1 or Type 2 errors? Non parametric and parametric tests? What is a consort diagram? What is impact factor? Describe “levels of Evidence” 17/08/2015Phill Burgess MD FRCS

Finally Maximum of 7 years to complete the examination process. Section 1: 2 years from 1 st attempt and maximum of 4 attempts to gain eligibility to proceed to section 2. Section 2: Maximum of 4 attempts 17/08/2015Phill Burgess MD FRCS

Practice!!! 17/08/2015Phill Burgess MD FRCS

Any Questions? 17/08/2015Phill Burgess MD FRCS