1. MEQs Dr. Jamal al Hamad Consultant Family Medicine SFHP

2. Scope of MEQs 1. Problem – Solving skills 2. Behavior of the candidate 3. Handling common problems & conditions. 4. How candidate thinks divergently

3. What does the examiner look at when correcting your answers: 1. Information gathering 2. Hypothesis formation 3. Defining a problem in terms of physical, psychological & social terms (whole person medicine) 4. Use of investigations 5. Preparation of management plans & therapy in terms of sequence. 6. Provision of continuing care & follow-up 7. Anticipation of future problems

4. Examples of typical questions in MEQs: 1. Outline essential steps in managing an episode. 2. What further information would the physician like to gather. 3. What are the alternative ways of dealing in a particular option. 4. What may be the reason for a particular patient’s action. 5. What factors may have motivated a patient’s particular action.

5. Examples of typical questions in MEQs: 6. What factors influence the doctor’s action. 7. What are the doctor’s options. 8. In dealing with a particular problem, what are the advantages or disadvantages of a particular option. 9. Which option would you favor & why. 10. What initiatives could the primary health care team devise in response to a particular problem.

6. Examples of typical questions in MEQs: 11. What would the doctor want to achieve at a later consultation.

7. Instructions 1. Answers should be brief, legible, & concise. 2. Answers should be written in clear hand writing (unclear answers will not be marked). 3. In those questions where a definite number of answers are asked for, do not give more answers than are requested (extra answers will not be marked). 4. Do not look through the whole questions before you start (this may cause you confusion). 5. After completing the whole MEQ, you are advised not to alter your answers.

8. Instructions 6. You are advised to work steadily through the MEQ and not to delay too long on any one question. 7. The MEQ is a test of your practical approach & you could gain more marks for you management of the problem than for your medical knowledge. 8. Each page of the MEQ is marked independently. You should therefore answer each question specifically, even if this answer involves repetition of a part of an earlier answer.

9. SITUATIONAL

10. Sara is a 4 year old girl brought by her mother Samia who is 40 year old. Sara has earache for 2 days. What do you do?

11. One moth later, Samia brings Sara for follow-up appointment How will you conduct this consultation?

12. Samia tells you that her mother, aged 70 years, is refusing to do anything for her self & demanding daily visits during which Samia is criticized for not helping her enough. Samia wonders how long she will be able to cop. Is there anything you can do to help?

13. Just as she gets up to leave, Samia tells you that she has noticed some indigestion over the last 3 weeks & she asked for antacid. How would you respond?

14. Four weeks later, Samia reports that she is no better. The indigestion is particular during hunger without heartburn. Your medicine helped little. She is asking for some investigations. Outline you reply.

15. Samia has positive test for H. pylori & you prescribed triple therapy for 2 weeks but she did not improve. What you will do?

16. Your requested upper GI endoscopy which showed duodenal ulcer. How will you advise Samia in this situation?

17. 6 months passed, Ali the husband of Samia consults you with a complaint of backache. He is 45 years old fitter. Outline you approach.

18. 3 weeks later, despite your management, he is no better. What do you do now?