khoker

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About khoker

  • Rank
    Gold member

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  • Gender
    Female
  • Location
    sa
  • University
    free state
  • Occupation
    Doctor
  • Status
    Revising CASC

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  1. Gmc

    Thanks for your reply I was going through this guidelines one of the components say u need to have an identity check at Manchester or London office and have to come personally there,I'm currently residing and working in South Africa and to come all the way needing to apply visa ,spending so much money on travelling and accommodation is very difficult is that a compulsory thing or we can do it only when we come there to actually work as I'm not sure when can I actually come to work I just want registration for now appreciate ur reply
  2. Gmc

    Just a general question as an overseas candidate who passed mrcpsych ,is he or she eligible to register with gmc without plab but a valid ielts can somebody please help as on the web site it's not clearly mentioned
  3. I used the spmm video copy by copy and I passed previously , there are three or four scenarios that can come , 1:pt with dementia and memory problems refusing home based care 2:pt with confusion due to upper GI bleed and we have to assess the capacity 3:patient with learning disability and upper GI bleed and we have to assess the capacity , I got this one and passed it too. 4:patient with paranoid schizophrenia who is psychotic not confused and presented with upper GI bleed and we have to assess the capacity 5:then I got in my first exam pt with schizophrenia and he was psychotic and we have to assess the financial capacity 6:there is one case in old oxford case where a female patient with BMD and recent relapse we have to assess financial capacity so these are different scenarios under assessment of capacity then the second part says in most of the cases to explain how you assessed the capacity and what was ur conclusion and what are u going to do
  4. It depends on the scenario there is one case where child took overdose due to being sexually abused by the step father of course in that case father is denied of any access to the pt till the case is investigated if there is mother alive she should be informed after informing the pt ,then there is a case of overdose due to bullying where parents of the child who is a minor needs to be informed and involved in the decision making,then there is overdose due to first episode of psychosis so it depends on the task
  5. It's the same scenario basically I said that we won't be able to discharge her right now and will discuss with the team
  6. I passed this station I just asked about the problem when did it start ,how frequent it is, any specific time day or night,where was she found ,was she ever in any unsafe areas,was she ever involved in any accident bcz of her wandering,was she ever mugged or robbed while wandering ,was she ever sexually abused or exploited while wandering,then about past psych history ,any diagnosis of dementia or other psych illeness any medication that she is on ,any recent change of medication,any other physical health issues I think bloods were done and they were all normal ,any recent stresses,I also asked did u inform the police about her identity,does she wear any bracelet or identity thing so that she can be brought back then in the end I explained that I haven't seen her I would like to see her and discuss with my team and then will discuss with u about the leave plan
  7. Thanks for ur reply one more question I don't have British passport so what visa requirements are needed for eligibility to apply
  8. Hey just want to ask that I have not done plab and u need core training from uk that obviously overseas candidates don't have so I'm not sure as it's required in eligibility criteria
  9. Hello I just passed my mrcpsych I'm currently working in southafrica and have no experience in uk I just want to ask can I get a higher training post in uk even if it's in areas of shortage and how much is the duration of that training and is there an exit examination required afterwards for frcpsych please any body who knw where can I get information I will greatly appreciate plzzzzzz I don't have any psych degree other than mrcpsych and diploma in mental health from South Africa with 8 years psych expereience
  10. I thought this article is useful for paired station 8 on friday.as I prepared night before exams from here u need to take a history from that footballer in detail it was essentially a mental state examination focusing on prodormal phase of schizophrenia ask about all psychotic symptoms,drug abuse,family history stresses ,and symptoms explained in the article below like change in personality,attention concentration problems,anxiety symptoms,social withdrawal,change in personality.in the second part I explained initially to the father that I can understand it's really difficult time for you seeing your son being in the hospital ,i appreciate that you have come to speak to us in this difficult time ,or if he is angry u mention this before explaining any thing ask one or two questions about Last year when the son was seen by doctor and referred for counseling then explain that from the information that I have it seems that he was having some of the symptoms of schizophrenia at that time but they were not sufficient enough to be diagnosed as schizophrenia it looks that it was prodormal phase which means that before getting full symptoms a person will have only few symptoms in milder form ,they can start as early as two years before actual diagnosis ,father will be concerned about that treatment has been delayed and brain damage is done ,U can reassure him at this point that it very common to miss the diagnosis during this stage however we can discuss how we can manage him now,regarding brain damage there is not really any difference ,I passed both these stations. Early detection of schizophrenia is often very difficult before a person starts actively hallucinating or exhibiting bizarre behavior. It can be very stressful for a patient or a loved one to hear the diagnosis of schizophrenia, particularly when it seems to come out of the blue. In this blog, I will discuss the prodromal phase of schizophrenia. This is the period of illness when symptoms first appear but often aren’t recognized. It almost always begins after puberty and is usually followed by a period of increasing symptoms along with a decline in overall functioning. The prodrome phase usually occurs one to two years before the onset of psychotic symptoms (ex: hallucinations, paranoid delusions) in schizophrenia. The symptomspeople usually have during this time aren’t very specific. Usually people report symptoms of anxiety, social isolation, difficulty making choices, and problems with concentration and attention. It is late in the prodromal phase that the positive symptoms of schizophrenia begin to emerge. Three kinds of prodromal subgroups have been described. First, the attenuated positive symptom syndrome (APSS) features problems with communication, perception, and unusual thoughts that don’t rise to the level of psychosis. These symptoms have to occur at least once weekly for at least one month and become progressively worse over the course of a year. Brief intermittent psychotic syndrome (BIPS) is another prodrome subgroup in which, in addition to problems with communication and perception, the person also experiences intermittent psychotic thoughts. The person experiences bizarre beliefs or hallucinations for a few minutes daily for at least one month, and for no more than three months. The last prodromal subgroup is the so called ‘genetic risk plus functional deterioration’ group (G/D). These people are not currently psychotic but have been previously diagnosed with schizotypal personality disorder or they have a parent, sibling, or child that has been diagnosed with a psychotic disorder. They are considered part of this subgroup if in the past year they have had substantial declines in work, school, relationships, or general functionality in daily life. Many times people see a doctor during the prodrome phase because of some of these disturbing symptoms. The problem is that these symptoms exist in many psychiatric and medical conditions. The situation can be confusing for both patients and doctors. Many people with schizophrenia are diagnosed with something else during the prodrome phase. Social withdrawal, unusual behavior, and frequent reprimands or absences from work and school are all red flags that may signify the beginning of schizophrenia. If you have any of the symptoms described here, it’s important to talk to a physician about them, particularly if you have a family member with schizophrenia or another major psychiatric disorder.
  11. For mild cognitive impairment task was history taking and cognitive examination together ,there are two scenarios that come for mci one this one and the other one just history taking so for this one on Friday u start with normal history taking as in spmm course with current problem ,onset,duration ,0progress,any fluctuations,symptoms noted first,then questions about memory like how is ur memory of recent events like in spmm,long term memory,visuotemporal,temporopatietal memory,then speech,reading ,writing,naming problems,attention problems,any behavoural changes like did somebody mentioned that ur behavior has changed,mood symptoms shortly also ask about physical health like hypertension,diabetes,stroke.most of the answers will be negative only few issues like reading or prosopnosia was present I think in this lady then quickly ask about ADLs like how is it affecting ur life ,the way u look after ur self (personnel),are u able to cook or do laundry(domestic),what about doing grocery and paying bill(community)u should be able to finish it in 5 mins,then ask her that u would like to ask few questions to test ur memory is that ok then ask about any problems with hearing or vision and start mmse I comfortably finished it in ten min I was scoring the mmse on the writing pad most of questions will be right in the end thanks for cooperation and ask is it okay if I can speak to ur husband or partner Quote xplanation of MCI is straight farward I started with greeting and introducing my self then said that I just spoke to ur wife as she is having some problems with memory can u just share with me what is ur understanding about it,then listen to him after that explain that she is having MCI,have u heard about it,he will say no than explain that as we grow older we do have some problems with our memory but they are not severe enough to affect our daily life that is normal ageing however in some ppl these memory problems become so much that they start affecting their ability to look after themselves then we call it as dementia ,in your wife case this condition is somewhat in between these two ,these memory problems are more than the normal aging process but yet not severe enough to be diagnosed as dementia.husband will ask question about risk of getting dementia then u can show empathy that I understand ur concerns u worried about her getting dementia ,there is an increased risk of these ppl getting dementia about one in 10 ppl with this condition will go on to have dementia but obviously we not sure as if who is going to get it and there is a possibility that she won't get it ,there are ways where we can actually decrease the risk of getting dementia in these ppl like a physically socially and mentally active life style with regular physical activities like excercise,socializing with family and friends and stimulating and keeping the brain active by reading,crossword,sudoku will further decrease the risk ,he will ask about treatment ,u can say that we usually follow nice guidelines in uk that shows that there is no evidence that anti dementia medication are useful in this condition,we will keep following up every 3 months and at any point if u feel that her condition has changed u can make an appointment with us ,ask do u have any other questions thanks the pt ,offer help .
  12. I think it's very important to start confidently as it helps to build rapport with the pt like asking the patient that I got some information from ur gp that you having problems with ur treatment is it okay if we can talk about it can u share with me what are ur concerns so it's better for ppl who struggle with communication so have already prepared in their mind what to say in different scenarios,like if u see a patient angry I would say that I can see u look upset about what happened ,I'm sorry u have to go through this difficult situation however I will try my best to help u and to answer ur questions and concerns can you share with me about........so in short u acknowledge what ever emotion the patient is showing And regarding your second question can u clarify why will u be asking same question over and over again
  13. I didn't find it noisy really obviously it also depends how loud or low the pt is speaking but if u concentrate it shouldn't be a problem. Maximum u can do is to read the task carefully and organize how u going to start depending on what information u have and from where like from gp or psychiatrist or family,a good start matters a lot and helps u flow through the interview. It's ok to look and smile at the examiner but it really doesn't matter important is to introduce ur self and ur purpose of seeing the patient or relative or whatever is the case. I usually call patient as mr or mrs or miss,if it's paeds u can call directly with the name that helps in rapport
  14. Hi guys for all those who are preparing to give casc in Jan I'm here to discuss different stations as there are small tricky things in each stations that the examiners like after passing the casc I'm definitely going to try my best to help u guys
  15. I m in southafrica i will receive it only in one weeks time